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Being a Public Psychiatric Patient

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As I said in my last post, I have stayed in two different types of hospital situation when I have been hospitalised for mental health issues. In the local public hospital and in a private psychiatric hospital. I have never had the dubious pleasure of being admitted to a public psych ward. 

My stays in the public hospital were in the general ward and the ICU. Obviously when I was in the ICU I wasn’t at all well as the result of an overdose. As soon as I was a bit more with it, I was moved to the general ward. I have been in the Emergency Department of two public hospitals with mental health issues and in the general ward of two public hospitals for the same reason. One was a quite large regional hospital, one was a large regional hospital and the other was a very small hospital in a country town (so small it didn’t even have its own Emergency Dept).

The response of staff in the ED to patients with mental health issues has improved over time. The first time I was at the ED was in 1990, the last time was in 2011. In 21 years things had changed for the better. They still aren’t perfect of course but generally much much better. The same goes for the general ward. I found the nurses much more empathetic in recent years than they were back in the 90s and early 2000s. I found the residents (doctors) much more able and willing to deal with a patient with mental health issues. In 1990 when I overdosed as a 16 year old, psych services wasn’t even called. Now I can rock up to the ED and ask them to call psych services and they will. And psych services will come. Eventually. The times I went to the ED in 2011 (several times) I had the most incredible psych services worker come to see me. He was great. Everything you could want in a psych nurse/worker. Brilliant in fact. I will never forget him and how much he helped me when I needed it. 

Being an inpatient on a general ward means you see more people. There are staff in and out all day long and there are usually visitors, if not for me then for the other people in the ward (generally a two patient ward). There isn’t a lot of privacy and there isn’t much chance of sleep. Basically a psych patient is kept in a general ward if they are a suicide risk (but not at risk of harming anyone else other than themselves) or if they are changing medications/withdrawing from medication/starting a new medication. And, in my experience, a psych patient is only put on the general ward if they are a client of Community Mental Health Services and there is no designated psych ward at their local hospital. A patient with a private psychiatrist is not likely to be admitted to a public hospital unless maybe they are recovering from an overdose or the like.

As I live in the country, there have never been many (if any) private practicing psychiatrists in this area. If you wanted private you had to travel at least 2 hours. If you needed a shrink you had to take your chances with Community Mental Health/Psych Services. When I was a client of theirs I saw a different shrink nearly every appointment I had. And I can’t say I would sing the praises of any of those shrinks. CMHS went through psychiatrists like normal people go through underwear. And you had to be in crisis to remain on the books. A Community Mental Health patient would get a case worker for 6 weeks. If you were stable (even remotely) at the end of 6 weeks, your case was closed. If things went to shit again after that, you had to be assigned a new case worker and start all over again. It was hell. 

Unfortunately last year when I was having a rough time, I didn’t have an after hours contact for my private psychiatrist so when things got bad, I had to be taken to the local hospital’s ED and they would called CMHS. As I said earlier, I was lucky that I got an amazing worker who knew exactly what he was doing and how to help me. Other patients aren’t so lucky. CMHS workers in my area are on call after hours and it is generally a wait of at least an hour usually more before they arrive (they are usually based in a town about 45 minutes away). So a patient with mental health issues has to either sit in the public waiting room with everyone else or if they are lucky, be put in a cubicle in the ED and tell their story to every nurse and resident that wanders in (and they do so on a regular basis). Not to say any of them treated me badly, they just all wanted to know what was wrong, how I was feeling etc etc. I didn’t want to talk to anyone. Thankfully my partner did some of the talking for me when I just could not (or would not) talk myself. 

Living in the country there is always the issue of already knowing the nurses or other staff members at the hospital. This has happened to me a few times. Once I asked to see someone else for my triage assessment. Another time it didn’t bother me that it was someone I knew. Back in the 90s and early 2000s the ward nurses would often just stay away from me as a psych patient. I felt a distinct disapproval from some of them. Not so much in later years. Maybe the stigma of mental illness is changing slowly over time. Maybe. 

 

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Visiting the Psych Ward

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I haven’t posted in a  while… I haven’t been unwell (thank goodness!) but I have been busy. With other stuff. Like a post graduate degree. Kids. Family. All that life stuff.

But Madam Bipolar’s post today got me thinking so here I am.

I have been hospitalised for psych related issues many times. Probably about eight to ten times. 5 that I clearly remember. I am pretty sure there have been more though. So let’s say 8 to 10 times. 9 of those times have been in my local public hospital in a general ward. One time has been in a private psychiatric hospital.

The first time I was hospitalised I was 16 and I had taken an overdose of assorted over the counter drugs that I found in my family home. I was in hospital for 2 nights. I recall being visited by my mother and my youth pastor and his wife (at least twice). The second overdose I took was when I was 28. This time it was prescription meds and alcohol. I was in hospital for about 10 days. I was visited by my father, my son, my then boyfriend and my then best friend. Other times I was in my local hospital I was visited by my husband, kids and father. I have assumed I didn’t have other visitors mainly because no one knew I was even in hospital let alone why. I was ashamed to tell anyone why I had been admitted. I didn’t want people to know I had mental health issues. Particularly people from work. Particularly my line manager who I had a fraught relationship with at the best of times.

Then there is the time I was in the psych hospital for 3 weeks. I was visited by my immediate family (Husband, kids and Dad) and a close friend. A few other people knew I was in hospital and why. One person I wanted to come and visit me but they didn’t end up coming. Another couple wanted to come and see me but I put them off. I was hurt at the time that the one person I wanted to come didn’t. I knew this person would understand what I was going through. I have never gotten into it with than friend as to why they didn’t come. I have chosen to take them at their word as to what the reasons were for them not being there in person. They did keep in touch via text message. The other couple that wanted to come I put off because I was ashamed. I had never really talked to them about my mental health issues and so I was embarrassed and ashamed for them to see me like that (distressed, drugged up and in a psych ward). They wouldn’t have judged me, they aren’t like that. It was about my own feelings about being in the state I was in.

What hurt me most was that prior to that hospitalisation I had been extremely active online. Then I dropped off the face of the earth (Net wise) for about 3 months. Only 1 person got in touch with me to find out how I was or what was happening. No one else emailed me or text me or anything. That stung. It made me question the friendships I thought I had (particularly the real life friendships that were maintained online due to distance). It also made me more aware of getting people’s phone numbers and staying in touch if they suddenly weren’t active online, just to check in and make sure they were ok and let them know I was thinking of them. I haven’t held any grudges towards those people who didn’t chase me up to find out where the hell I had disappeared to. But it stung and I will admit it still does to a degree.

 

*edit to add*

There were some people who did keep in touch with me via text message and email and that meant a lot to me. I wasn’t very open about where I was or what I was going through so I don’t blame people for not realising there was something really wrong. And I understand that a lot of my friends simply live too far away to have come and visited me at that time. It was probably more about my own sense of shame than it was about people not caring. I have some of the most caring, amazing friends and I love every one of them. I know who they are and I hope they do too.

Drugs

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I have been on a lot of different kinds of antidepressants, antipsychotics and mood stabilisers. Not surprising when you consider I have been medicated since I was in my early 20s and I am now in my late 30s. 

I have also experienced many, many different kinds of side effects. And withdrawals. 

The worst side effects have been weight gain (significant weight gain) over a short period of time and restless legs. This was on Avanza and Zyprexa. I carry about an extra 60kg thanks to these two drugs. And I have found it impossible to lose even after making considerably extreme efforts to do so. 

The worst withdrawals were from Efexor. Nothing has ever come close to the horror that was withdrawal from Efexor. 

The problem is that often after a prolonged period of time on a particular drug, the patient become ‘immune’ to the effects of the drug and the therapeutic effect is nullified. In other words, in my case, I become depressed and ultimately suicidal fairly quickly. 

Another problem is that often when changing from one drug to another, you have to wean yourself off the first drug and have a period of time drug free before you can start on a new regime. This can be a very difficult and very dangerous period. In not so many words, it sucks. 

I am on some good drugs at the moment (a mood stabiliser and an antidepressant. And a benzo for when the anxiety gets out of control, which isn’t often thank goodness). If I was a praying person I would pray that these drugs at this dosage keep working for all eternity. I know this probably won’t happen but I can hope. 

What is your experiences with antidepressants, antipsychotics etc?  

 

 

 

When they know you and you know them

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I have never had the ‘pleasure’ of being a patient in a public mental health ward. I have however been a mental health inpatient on several occasions. Once I was in a private psychiatric facility for 3 weeks. The other times (about 6 times if I recall correctly) date from over 22 years ago until approximately 7 years ago and at those times I was a psych patient admitted to a general ward in a public hospital. This happened mainly because the hospital in my town doesn’t have a psych ward. The nearest hospital with a designated psych ward is 45 minutes away and, by all accounts, it is a place that is better avoided if you can so I was admitted to my local hospital under the care of either Community Mental Health Services or my General Practitioner. 

My experiences were, in general, reasonably positive. There were however, some exceptions to that generalisation. Not to mention the awkward moments when I encountered nursing staff that I knew from outside the hospital (this is where the ‘in the country’ part of my experience comes into play). 

Have you ever encountered professionals that you knew from outside the professional realm? How did you deal with that? Did it affect your experience in a negative or positive manner? 

 

 

 

The Original Diagnosis and the Dead Shrink

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So I took myself to a town some way down the highway to see a private psychiatrist. There were no such services in my town and my GP at the time didn’t even mention Community Mental Health Services (I now know why!). 

The psychiatrist was an older man. Slight in stature and build, greying. Reasonable bedside manner. After hearing my story he diagnosed Bipolar Disorder and gave me my inaugural seat on the medication merry-go-round by prescribing lithium. 

A week or so later I saw a death notice in the local paper for a man by the same name as the Shrink. It wasn’t a particularly common name so I rang the clinic to see if my Shrink had departed this mortal coil. The receptionist laughed and assured me he was alive and well. Two weeks after that I recieved a phone call from that same receptionist. My Shrink had decided to die after all. 

I was left somewhat paranoid and without a psychiatrist. 

Not Staying Long

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I am in the process of setting up my own domain etc so Bipolar in the Country will become

hoothoot.com.au in due time. I have registered the domain name but have to wait for my chosen blog designer to have time to fit me in! The idea behind hoot hoot is the idea of not giving two hoots about those who make erroneous assumptions about or who negatively judge those of us with mental health issues. Plus I really like owls. But I think I already mentioned that…

I have a Twitter account under the name hoot2hoot so you can follow me there if you feel so inclined! 

It will be business as usual here until the launch of the new domain and design so I hope you will continue reading and spreading the word (it’s nice to see the hit counter increase each day!)

 

 

How I came to see a Shrink

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My first psychiatrist’s appointment was when I was about 21 or 22. It had been a long time coming. By my record I have been dealing with depression and anxiety since I was about 7 years of age. The older I became, the worse my mental health issues got. But I put my depression down to a wide variety of other sources such as being bullied at school, feeling that I was an outcast in my own family, my feelings about my biological father abandoning me, being fat, being in an unhappy relationship which then became an unhappy marriage, my mother dying when I was in my late teens, being attacked by Satan and not having a close enough relationship with God. I figured I had plenty of reasons to feel like crap and at that stage I knew very little about mental illness. When the topic of my low mood came up I was told by those I surrounded myself with to ‘pray harder’. Yeah, my church wasn’t any great help at that point*.

Breaking point came when I was speaking to my aunt on the phone and she told me about some of the things my cousin had been doing: my ‘crazy’ cousin. The cousin I had always been terrified of because I never knew how she was going to act or what she was going to say. She was seriously unstable and (rightly or wrongly) she scared me. I became increasingly uncomfortable as my aunt related my cousin’s behaviours to me as they sounded awfully like things I had either done, or had considered doing. Without saying anything to my auntie about my own issues, I made an appointment to see my GP about what was happening my own head.

 

 

* This is not a religious blog. I haven’t been part of the church for 15 years and I haven’t identified as a Christian since then. If church is your thing, that’s cool and you are welcome here as long as you don’t preach at me.