There are so many resources out there! Seek and you will find!
And my best wishes and luck to you while you do that.
It's not an easy journey, but it's worth it.
You will come out the other side.
I promise.
~ Emery
Thursday, April 30, 2020
A Final Note -- And the future of this blog
Well, this is it, my last day writing this blog. What next? I want to turn this information into a book or a guide of some kind, hopefully with some professional influence. I want all of you out there to know that you're not alone. And that it's hard when you feel like you're losing your mind, but you can get better, that you can get help.
There are so many resources out there! Seek and you will find!
It's not an easy journey, but it's worth it.
You will come out the other side.
I promise.
There are so many resources out there! Seek and you will find!
It's not an easy journey, but it's worth it.
You will come out the other side.
I promise.
How to create a crisis plan
Crisis plans -- Easy to make, hard to follow. There are many versions of this that I am currently working with.
There's the official crisis plan (for an extended look at this I suggest Susan Rose Blauner's book), there's what I call a crisis journal, and there's a crisis, or happiness box.
For the happiness box, I can't speak much on that, but I love the idea. Here is a sample https://youmatter.suicidepreventionlifeline.org/self-care-box/ of what that could look like.
I have actually used my crisis journal a few times. It's a non linear thing that reminds me of ways I can support myself, or ways in which the world sucks.
A crisis plan is the most official of these, and it's hard to use in the moment to my experience. What I have found helps is keeping it simple. If it's too elaborate, it simply doesn't work.
What your crisis plan absolutely needs to have: a progression of events -- if you're mildly suicidal, you don't need to jump right to calling 911. See if you can calm yourself down first. The best way I've found for this is distractions. If you want to add meditation or music to this, go right ahead.
You can journal, play a game, take some deep breaths, and take stock of what's going on. Try writing down your feelings, sleeping if you need to sleep, eating if you need to eat, etc. You can do these things for as long as they feel helpful.
If you're still feeling awful the next step is to call someone. Call your mom, call your therapist, call a friend. Repeat if you want.
Then, you need to call a crisis hotline or text line. This step is crucial for me, and if I feel VERY suicidal, I'll often go straight to this step.
If you still don't feel better, that's where you want to call 911 or have someone take you to the hospital. Don't be alone if you are actively suicidal during any of these steps, but especially the last one. Call over a neighbor or a friend. Your dad.
The last step of any suicidal crisis plan is this -- put down any weapons, get to a safe place, and keep both hands on your phone.
On a crisis plan you can also write what it's for -- mine says for when I feel: Worthless, depressed, afraid, sad, numb, and hopeless.
It has a list of activities, such as reading, candy crush, video games, knitting, drawing, etc.
It also has a remember list, such as: You are a fighter, you will get better, all feelings change, etc.
I also have a call list, of people I need in emergencies. It's good to have this where you can see it.
My crisis journal (I also call it a lighthouse book), has the following sections, all illustrated.
*Reasons to Live
*People to Call
*Beautiful Things in Life
*Things I want to do
*Things to Distract
*Things that might help that you haven't tried yet
*Compliments
*Rules e.g No Suicide for 48 hours.
*Happy Memories
*Acts of Self Care
*Things to Remember e.g Your mood drops at night so be gentle with yourself.
*Coping Tools
*What to do when depressed
It helps a lot in a bind and I can slip it in a bag pretty easily.
In future, I would like to do a whole, more detailed post on both subjects, but I think that is all for now. Coping and getting better is all about developing a tool kit for the bad times. It is yours, and yours alone, and you have to experiment and find out what works for you. It's a process, but you will get there, I promise.
~ Emery
There's the official crisis plan (for an extended look at this I suggest Susan Rose Blauner's book), there's what I call a crisis journal, and there's a crisis, or happiness box.
For the happiness box, I can't speak much on that, but I love the idea. Here is a sample https://youmatter.suicidepreventionlifeline.org/self-care-box/ of what that could look like.
I have actually used my crisis journal a few times. It's a non linear thing that reminds me of ways I can support myself, or ways in which the world sucks.
A crisis plan is the most official of these, and it's hard to use in the moment to my experience. What I have found helps is keeping it simple. If it's too elaborate, it simply doesn't work.
What your crisis plan absolutely needs to have: a progression of events -- if you're mildly suicidal, you don't need to jump right to calling 911. See if you can calm yourself down first. The best way I've found for this is distractions. If you want to add meditation or music to this, go right ahead.
You can journal, play a game, take some deep breaths, and take stock of what's going on. Try writing down your feelings, sleeping if you need to sleep, eating if you need to eat, etc. You can do these things for as long as they feel helpful.
If you're still feeling awful the next step is to call someone. Call your mom, call your therapist, call a friend. Repeat if you want.
Then, you need to call a crisis hotline or text line. This step is crucial for me, and if I feel VERY suicidal, I'll often go straight to this step.
If you still don't feel better, that's where you want to call 911 or have someone take you to the hospital. Don't be alone if you are actively suicidal during any of these steps, but especially the last one. Call over a neighbor or a friend. Your dad.
The last step of any suicidal crisis plan is this -- put down any weapons, get to a safe place, and keep both hands on your phone.
On a crisis plan you can also write what it's for -- mine says for when I feel: Worthless, depressed, afraid, sad, numb, and hopeless.
It has a list of activities, such as reading, candy crush, video games, knitting, drawing, etc.
It also has a remember list, such as: You are a fighter, you will get better, all feelings change, etc.
I also have a call list, of people I need in emergencies. It's good to have this where you can see it.
My crisis journal (I also call it a lighthouse book), has the following sections, all illustrated.
*Reasons to Live
*People to Call
*Beautiful Things in Life
*Things I want to do
*Things to Distract
*Things that might help that you haven't tried yet
*Compliments
*Rules e.g No Suicide for 48 hours.
*Happy Memories
*Acts of Self Care
*Things to Remember e.g Your mood drops at night so be gentle with yourself.
*Coping Tools
*What to do when depressed
It helps a lot in a bind and I can slip it in a bag pretty easily.
In future, I would like to do a whole, more detailed post on both subjects, but I think that is all for now. Coping and getting better is all about developing a tool kit for the bad times. It is yours, and yours alone, and you have to experiment and find out what works for you. It's a process, but you will get there, I promise.
~ Emery
Psychiatry and what it entails
First off, you should know that the line, "psychiatry kills," is false. There is nothing more infuriating to me than people who insist you don't need meds when you clearly do. The truth is psychiatry saves countless lives and it certainly saved mine.
But it is also a dangerous game and you need to find the right person. I have worked with three psychiatrists. Two were good, one I am still angry at.
The first psychiatrist I met with was highly recommended, because she didn't overdose people. This is important, but in the end, I found her to be highly uninformed and she gave me some drugs that were awful, though to be fair, as I've mentioned before, each person and each drug will interact differently.
Things I was put on that did not work for ME.
Valium
Wellbutrin
Abilify
Hydroxyzine.
This combination of drugs was what landed me in the hospital.
Let's take a look shall we - Valium is in an addictive class of drugs. It should not have been used as a first choice. What would happen for me with valium, was I would use it (as needed) when I was suicidal, it would take me up a few notches . . . and then I would crash, and wind up worse than before. It was incredibly dangerous for me and those crashes could have killed me.
Wellbutrin -- I have never felt so drugged out as I did on this one. I felt like half of my brain was missing. I couldn't think, I was sluggish and slow, and when I came off the drug, the room spun and I couldn't stand up.
Abilify -- I felt as if everything had sped up. It made me jittery and inpatient.
Hydroxyzine -- was given to be in too high a dose, so instead of slowing down my anxiety, it made me fall asleep, a very quick, very drugged sleep.
In addition, despite after talking to me and giving me an extensive questionaire, I was diagnosed, incorrectly with bipolar two disorder, which took me 3 months to rectify.
Finally, she never bothered to tell me that meds take a long time to work. I was expecting an overnight success. That I would take these meds and two days later, the suicidal thoughts would be gone. That's not how meds work. At all. But they do work. But they're not miracles.
So, enough about this woman. This is to show you that meds can be dangerous, and harmful in the wrong hands. This is not to frighten you, but so you know what to look for. If a med feels "wrong" it probably is. You should just feel like a better version of yourself, and the side effects should be mild, not strong.
The second woman I worked with is also my current psychiatrist. We'll call her K. There are also nurse practitioners, like the woman above, and my other psychiatrist, C, who we'll talk about in a moment, but this woman is an official one.
Either way, they all know their stuff. They have med school backgrounds, and are doctors first.
K worked in the locked facility, That is where I first met her. She is kind and compassionate, but not to be crossed. She knows her stuff inside and out.
She put me on Latuda and Lamictal, which both help bring any suicidal thoughts down from a 10 to a 3, and help to keep them off overall.
These are bipolar drugs, and she agreed with the other woman that I had bipolar. Still, they didn't hurt, and I have no adverse effects to them to this day.
I did however, have to mess greatly with the dose. It turns out that too high of a med dose makes the suicidal thoughts worse for me, so they had to make sure the dose was correctly adjusted.
I was then given someone more permanently, as K was very, very, busy.
That's where C came in. She had me take the genesight test, and in the end, suggested Lithium for me, as I continued to struggle daily. She also finally listened and took the bipolar label off, replacing it with MDD, with mixed episodes. Lithium is still a bipolar drug, but it worked very well for me, though it took a long time to really make a difference.
She helped me through this transition saying how the drug worked was like a puppy transforming into a dog. It would be bit by bit and I'd barely notice it, but before I knew it, I'd have a full grown dog.
She was right.
She also did, at my absolute pleading, try me on an antidepressant, and that went as well as she thought it would. Which, was terribly. It had an adverse effect that took me months to notice.
But the Lithium saved me, even though like before when she tried to up the dose, it nearly landed me back in the hospital, and we had to reduce it again.
She also suggested I add Deplin in, a high vitamin B complex. That helped.
Finally though, I felt like I was stuck and like she was out of ideas.
I switched back to K, to get a new look at things. K suggested Fish Oil (UGH) but it helped. I've been pretty stable since then.
A standard psychiatry appointment isn't especially scary either. It's like a less personal version of therapy. You're asked how you are, what's been going on, what's going well, what's not, and of course, how the meds are doing. They should get a sense of you, but it's not therapy. They care, but they are also trying to make sure you're stable.
My appointments have lasted 20 minutes to 60 minutes, though initial appointments for me have been up to 90 minutes.
You should look for in a psychiatrist what you look for in a therapist. Someone kind, knowledgeable, who is a good listener, and likes you and wants to and can help.
Psychiatry appointments are typically once a month, though when you begin they may be every 2 weeks, and once you are established, they may be farther apart, like every 2 months, or 3 months.
Finally, take all this advice with a grain of salt. I am not a doctor, I just speak from personal experience and your experience may differ vastly from mine.
And of course, the takeaway:
Everyone is different. All meds work differently, even on different people, in the same or different doses. Meds are all about trial and error. Trust your doctor, but if you feel worse for an extended period of time or something seems wrong, don't hesitate to switch doctors.
All on this subject for now.
~ Emery
But it is also a dangerous game and you need to find the right person. I have worked with three psychiatrists. Two were good, one I am still angry at.
The first psychiatrist I met with was highly recommended, because she didn't overdose people. This is important, but in the end, I found her to be highly uninformed and she gave me some drugs that were awful, though to be fair, as I've mentioned before, each person and each drug will interact differently.
Things I was put on that did not work for ME.
Valium
Wellbutrin
Abilify
Hydroxyzine.
This combination of drugs was what landed me in the hospital.
Let's take a look shall we - Valium is in an addictive class of drugs. It should not have been used as a first choice. What would happen for me with valium, was I would use it (as needed) when I was suicidal, it would take me up a few notches . . . and then I would crash, and wind up worse than before. It was incredibly dangerous for me and those crashes could have killed me.
Wellbutrin -- I have never felt so drugged out as I did on this one. I felt like half of my brain was missing. I couldn't think, I was sluggish and slow, and when I came off the drug, the room spun and I couldn't stand up.
Abilify -- I felt as if everything had sped up. It made me jittery and inpatient.
Hydroxyzine -- was given to be in too high a dose, so instead of slowing down my anxiety, it made me fall asleep, a very quick, very drugged sleep.
In addition, despite after talking to me and giving me an extensive questionaire, I was diagnosed, incorrectly with bipolar two disorder, which took me 3 months to rectify.
Finally, she never bothered to tell me that meds take a long time to work. I was expecting an overnight success. That I would take these meds and two days later, the suicidal thoughts would be gone. That's not how meds work. At all. But they do work. But they're not miracles.
So, enough about this woman. This is to show you that meds can be dangerous, and harmful in the wrong hands. This is not to frighten you, but so you know what to look for. If a med feels "wrong" it probably is. You should just feel like a better version of yourself, and the side effects should be mild, not strong.
The second woman I worked with is also my current psychiatrist. We'll call her K. There are also nurse practitioners, like the woman above, and my other psychiatrist, C, who we'll talk about in a moment, but this woman is an official one.
Either way, they all know their stuff. They have med school backgrounds, and are doctors first.
K worked in the locked facility, That is where I first met her. She is kind and compassionate, but not to be crossed. She knows her stuff inside and out.
She put me on Latuda and Lamictal, which both help bring any suicidal thoughts down from a 10 to a 3, and help to keep them off overall.
These are bipolar drugs, and she agreed with the other woman that I had bipolar. Still, they didn't hurt, and I have no adverse effects to them to this day.
I did however, have to mess greatly with the dose. It turns out that too high of a med dose makes the suicidal thoughts worse for me, so they had to make sure the dose was correctly adjusted.
I was then given someone more permanently, as K was very, very, busy.
That's where C came in. She had me take the genesight test, and in the end, suggested Lithium for me, as I continued to struggle daily. She also finally listened and took the bipolar label off, replacing it with MDD, with mixed episodes. Lithium is still a bipolar drug, but it worked very well for me, though it took a long time to really make a difference.
She helped me through this transition saying how the drug worked was like a puppy transforming into a dog. It would be bit by bit and I'd barely notice it, but before I knew it, I'd have a full grown dog.
She was right.
She also did, at my absolute pleading, try me on an antidepressant, and that went as well as she thought it would. Which, was terribly. It had an adverse effect that took me months to notice.
But the Lithium saved me, even though like before when she tried to up the dose, it nearly landed me back in the hospital, and we had to reduce it again.
She also suggested I add Deplin in, a high vitamin B complex. That helped.
Finally though, I felt like I was stuck and like she was out of ideas.
I switched back to K, to get a new look at things. K suggested Fish Oil (UGH) but it helped. I've been pretty stable since then.
A standard psychiatry appointment isn't especially scary either. It's like a less personal version of therapy. You're asked how you are, what's been going on, what's going well, what's not, and of course, how the meds are doing. They should get a sense of you, but it's not therapy. They care, but they are also trying to make sure you're stable.
My appointments have lasted 20 minutes to 60 minutes, though initial appointments for me have been up to 90 minutes.
You should look for in a psychiatrist what you look for in a therapist. Someone kind, knowledgeable, who is a good listener, and likes you and wants to and can help.
Psychiatry appointments are typically once a month, though when you begin they may be every 2 weeks, and once you are established, they may be farther apart, like every 2 months, or 3 months.
Finally, take all this advice with a grain of salt. I am not a doctor, I just speak from personal experience and your experience may differ vastly from mine.
And of course, the takeaway:
Everyone is different. All meds work differently, even on different people, in the same or different doses. Meds are all about trial and error. Trust your doctor, but if you feel worse for an extended period of time or something seems wrong, don't hesitate to switch doctors.
All on this subject for now.
~ Emery
Monday, April 27, 2020
Option two -- unlocked facilities
So, there is apparently an option for voluntary hospitalization, but I have never encountered that, so I will not be speaking on it, but know that it does exist.
An unlocked facility is one that is a step down from a locked facility. I just have experience with mine, but I will explain how it worked.
It was considered a crisis residential, which meant you could stay up to two weeks (sometimes longer with exceptions) and it was similar to the PUFF in that all your needs were met and you had a roommate.
The difference in these two facilities couldn't have been more different, however.
Instead of being staffed by nurses, it was staffed by students. You could leave the building for outings either with staff or with permission. Dinners were homemade. There was mandatory meetings twice a day that ranged from art sessions to discussions of boundaries.
Like before, I had a roommate. Like before they didn't allow us to take our own meds and did "Mouth checks" to make sure we swallowed.
You met with a psychiatrist (nurse practitioner in my case) twice weekly.
There was still no therapy, but you could talk to staff at any time, and they tried to make some of the groups therapeutic.
Overall, it was a nice place with a homey atmosphere and (mostly) caring staff.
The biggest difference for me though was that the space was not psychically safe. They came and did hourly checks, but the space itself was dangerous. I, again, refuse to mention how as per rule one, but there were plenty of ways for someone to get ideas and to harm themselves. And even though I later found out there were cameras (duh, but I wish someone would have told me) I didn't know at the time and I felt like it would be very easy to carry out a plan.
For that reason, I did not feel as if it were doing the one thing a facility ought to do -- keep me safe.
Now, for many people, this could be a very valid option, but for me, I would not do it again. If I wanted to be hospitalized, no matter how traumatic, I'd take the locked hospital option.
BUT I don't suspect that would be true for most people.
If you are on the edge and you don't want to be put on a 5150, but you consider yourself to be in a psychiatric emergency (the criteria for entering such a place) this may be a great option for you. Talk with your team of people to discuss unlocked options. They are less severe than a 5150 and may really help.
However, in the case of my facility, they made an exception by taking a suicidal patient, because they had assessed me and felt I would be ok. The rules may vary wildly for each place. Check. If you are very suicidal, my first choice is still a locked facility, but that is my two cents. You need to figure out what works best for you.
~ Emery
An unlocked facility is one that is a step down from a locked facility. I just have experience with mine, but I will explain how it worked.
It was considered a crisis residential, which meant you could stay up to two weeks (sometimes longer with exceptions) and it was similar to the PUFF in that all your needs were met and you had a roommate.
The difference in these two facilities couldn't have been more different, however.
Instead of being staffed by nurses, it was staffed by students. You could leave the building for outings either with staff or with permission. Dinners were homemade. There was mandatory meetings twice a day that ranged from art sessions to discussions of boundaries.
Like before, I had a roommate. Like before they didn't allow us to take our own meds and did "Mouth checks" to make sure we swallowed.
You met with a psychiatrist (nurse practitioner in my case) twice weekly.
There was still no therapy, but you could talk to staff at any time, and they tried to make some of the groups therapeutic.
Overall, it was a nice place with a homey atmosphere and (mostly) caring staff.
The biggest difference for me though was that the space was not psychically safe. They came and did hourly checks, but the space itself was dangerous. I, again, refuse to mention how as per rule one, but there were plenty of ways for someone to get ideas and to harm themselves. And even though I later found out there were cameras (duh, but I wish someone would have told me) I didn't know at the time and I felt like it would be very easy to carry out a plan.
For that reason, I did not feel as if it were doing the one thing a facility ought to do -- keep me safe.
Now, for many people, this could be a very valid option, but for me, I would not do it again. If I wanted to be hospitalized, no matter how traumatic, I'd take the locked hospital option.
BUT I don't suspect that would be true for most people.
If you are on the edge and you don't want to be put on a 5150, but you consider yourself to be in a psychiatric emergency (the criteria for entering such a place) this may be a great option for you. Talk with your team of people to discuss unlocked options. They are less severe than a 5150 and may really help.
However, in the case of my facility, they made an exception by taking a suicidal patient, because they had assessed me and felt I would be ok. The rules may vary wildly for each place. Check. If you are very suicidal, my first choice is still a locked facility, but that is my two cents. You need to figure out what works best for you.
~ Emery
Energy and the human condition
With depression, you only have so much energy. The more the depression lifts, the more energy you'll have. But until then, know that you have a select amount of energy, and it's probably less than you need to get through your day. On a good day, I have about 6 hours of energy. But on a bad day, I have maybe 1-2 hours. What you decide to do with that energy is up to you (see other posts for ideas). But the important to realize is that sometimes you don't have the energy or will power and that's ok. When we are depressed, we are drawn to low focus things, like our phones or tv shows. This is okay. It's a part of the process of depression.
I was really hard on myself about being on my phone. I tried very hard to control it. And if that's what you need to do, then that's what you need to do. But I found that being gentle with myself helped a lot. This period in your life is going to suck a lot. But you'll get through it. You have to just keep moving. Easier said than done, of course.
If it bothers you, try to replace the things you hate with something you like -- if you're always playing candy crush and you hate it, find another game you feel less guilty for. Watch videos on your hobbies instead of random fails. Or embrace it and find other things that make you laugh. Make your media consumption that helps you - not makes you feel guilty. Your phone or other device will seem less interesting once you're better.
So be easy on yourself. It's okay. You're ok. It's going to be ok.
~ Emery
I was really hard on myself about being on my phone. I tried very hard to control it. And if that's what you need to do, then that's what you need to do. But I found that being gentle with myself helped a lot. This period in your life is going to suck a lot. But you'll get through it. You have to just keep moving. Easier said than done, of course.
If it bothers you, try to replace the things you hate with something you like -- if you're always playing candy crush and you hate it, find another game you feel less guilty for. Watch videos on your hobbies instead of random fails. Or embrace it and find other things that make you laugh. Make your media consumption that helps you - not makes you feel guilty. Your phone or other device will seem less interesting once you're better.
So be easy on yourself. It's okay. You're ok. It's going to be ok.
~ Emery
Saturday, April 25, 2020
When it all hits the fan -- on hospitalization and what your options are -- part one, locked facilities and 5150s
There are two types of hospitals -- ones where you can leave any time you well please, and ones where you very much can't. This about the ones where you can't leave.
I think anyone who's ever felt horribly depressed and knew it has had the terrible fear that they're going to be locked up, and their life will be forever ruined.
I want to look at the hospital process and tell you my experience about it. It may differ depending on where you live and what insurance you have.
The first thing I know is that I was afraid to be hospitalized and didn't always tell the full truth because I was so scared of this. As a result, I didn't get the treatment I needed as soon as I needed. Always tell the truth. Your life is the most important thing. Don't gamble with your life.
Second, not everyone you tell that you are suicidal has the power to lock you up, nor do they want to. Hospitalization is absolutely a last resort. Even my psychiatrist who WORKS IN A MENTAL HOSPITAL admits that it is traumatic and will only use it as a last resort. But she will use it.
Your risk of being hospitalized is highest in the ER, or in a county building. Most therapists do not have that power, nor is that your go to.
You are likely to be hospitalized if
YOU HAVE NO SUPPORT SYSTEM
YOU ARE ACTIVELY SUICIDAL
YOU HAVE A PLAN
YOU HAVE A WAY TO CARRY OUT THE PLAN
You probably SHOULD be hospitalized if you are several of the above.
You should know however, they can't just be hospitalized like THAT. You have to be assessed.
The thing that they will put you on if they assess you to be a danger to yourself is a 5150. It is a three day hold by which they will assess you within the context of the ER and/or a mental hospital. They do not make this decision lightly.
After this three day hold, they will decide if you need to be continued to put on a hold. If they renew the hold, which will last for 14 days at maximum, this is called a 5250 and you will continue to be assessed. If after this you are still not judged to be stable, you will be put on a final 14 day hold, a 5260.
You cannot legally be held longer than that.
The team will reassess you daily. If they feel you are stable, they will release you. There is a team of people making this decision, and they do not make it lightly.
After a three day hold, if they decide to put you on a 5250, they will hold a trial where you will work with a patient's right advocate, the hospital, and a judge to make sure that you are not being held without good cause. The patient's rights activist is on your side. They are there to represent your expressed wishes. The hospital is there to defend their decision. The judge is there . . . well, you can guess it.
They have your files and everything can and will be used against you. I was judged for being unkept -- because I didn't brush my hair. Luckily on that day, I had chosen to take extra care with my appearance, so the judge looked at me and brushed it off.
I won't lie and say the experience can't be scary, difficult, and even traumatic. It can be. But there's also something to be said for it. It will keep you alive. And that's a pretty good reason to be hospitalized.
But keep your eyes and ears open. Every facility is different.
You will not have access to your phone, your wallet, or anything valuable. They will lock them up and give them back to you at the end of your stay. They will allow you to use their phone, however.
There are LEGAL rights that you have as a patient. I will make another post on that soon. These rights are yours and cannot be taken away without reasonable cause.
You should be hospitalized if: YOU CANNOT KEEP YOURSELF SAFE.
When I was admitted, I was having suicidal thoughts 24/7 and they were a 10/10. Mental hospitals (or psychiatric hospitals, or PHF (Puff) unit) are physically safe places, where your primary responsibility is to get through the day. The nurses are there to help you. It's a good place to get on the right meds, to meet with a psychiatrist daily, and have all your needs met.
Sometimes you'll get more out of it -- there are programs, but how good or helpful depends on the people and what you need. Where I went, there was no therapy.
Things to consider:
Pros:
You'll be physically safe
You'll be constantly monitored
Your meds will be adjusted
You can be as unstable as you want and people will understand.
You will have all your physical needs met
You will have food prepared for you.
You will be alive
It will give you time and space to process safely
Cons:
The people around you are as crazy as you are
The people who work there vary widely
You may not always feel emotionally safe
You may be bored
You will probably have a roommate
You will be constantly watched
You will lose your freedom
You will only be allowed limited visitors.
I might write more on this, but for now, that is all I have.
~ Emery
I think anyone who's ever felt horribly depressed and knew it has had the terrible fear that they're going to be locked up, and their life will be forever ruined.
I want to look at the hospital process and tell you my experience about it. It may differ depending on where you live and what insurance you have.
The first thing I know is that I was afraid to be hospitalized and didn't always tell the full truth because I was so scared of this. As a result, I didn't get the treatment I needed as soon as I needed. Always tell the truth. Your life is the most important thing. Don't gamble with your life.
Second, not everyone you tell that you are suicidal has the power to lock you up, nor do they want to. Hospitalization is absolutely a last resort. Even my psychiatrist who WORKS IN A MENTAL HOSPITAL admits that it is traumatic and will only use it as a last resort. But she will use it.
Your risk of being hospitalized is highest in the ER, or in a county building. Most therapists do not have that power, nor is that your go to.
You are likely to be hospitalized if
YOU HAVE NO SUPPORT SYSTEM
YOU ARE ACTIVELY SUICIDAL
YOU HAVE A PLAN
YOU HAVE A WAY TO CARRY OUT THE PLAN
You probably SHOULD be hospitalized if you are several of the above.
You should know however, they can't just be hospitalized like THAT. You have to be assessed.
The thing that they will put you on if they assess you to be a danger to yourself is a 5150. It is a three day hold by which they will assess you within the context of the ER and/or a mental hospital. They do not make this decision lightly.
After this three day hold, they will decide if you need to be continued to put on a hold. If they renew the hold, which will last for 14 days at maximum, this is called a 5250 and you will continue to be assessed. If after this you are still not judged to be stable, you will be put on a final 14 day hold, a 5260.
You cannot legally be held longer than that.
The team will reassess you daily. If they feel you are stable, they will release you. There is a team of people making this decision, and they do not make it lightly.
After a three day hold, if they decide to put you on a 5250, they will hold a trial where you will work with a patient's right advocate, the hospital, and a judge to make sure that you are not being held without good cause. The patient's rights activist is on your side. They are there to represent your expressed wishes. The hospital is there to defend their decision. The judge is there . . . well, you can guess it.
They have your files and everything can and will be used against you. I was judged for being unkept -- because I didn't brush my hair. Luckily on that day, I had chosen to take extra care with my appearance, so the judge looked at me and brushed it off.
I won't lie and say the experience can't be scary, difficult, and even traumatic. It can be. But there's also something to be said for it. It will keep you alive. And that's a pretty good reason to be hospitalized.
But keep your eyes and ears open. Every facility is different.
You will not have access to your phone, your wallet, or anything valuable. They will lock them up and give them back to you at the end of your stay. They will allow you to use their phone, however.
There are LEGAL rights that you have as a patient. I will make another post on that soon. These rights are yours and cannot be taken away without reasonable cause.
You should be hospitalized if: YOU CANNOT KEEP YOURSELF SAFE.
When I was admitted, I was having suicidal thoughts 24/7 and they were a 10/10. Mental hospitals (or psychiatric hospitals, or PHF (Puff) unit) are physically safe places, where your primary responsibility is to get through the day. The nurses are there to help you. It's a good place to get on the right meds, to meet with a psychiatrist daily, and have all your needs met.
Sometimes you'll get more out of it -- there are programs, but how good or helpful depends on the people and what you need. Where I went, there was no therapy.
Things to consider:
Pros:
You'll be physically safe
You'll be constantly monitored
Your meds will be adjusted
You can be as unstable as you want and people will understand.
You will have all your physical needs met
You will have food prepared for you.
You will be alive
It will give you time and space to process safely
Cons:
The people around you are as crazy as you are
The people who work there vary widely
You may not always feel emotionally safe
You may be bored
You will probably have a roommate
You will be constantly watched
You will lose your freedom
You will only be allowed limited visitors.
I might write more on this, but for now, that is all I have.
~ Emery
Thursday, April 23, 2020
What a sample crisis line talk looks like
This will not be a word for word example, because I worry that that will be triggering for both myself and others. Instead, I'll use some of my conversations as an example, but I won't be going into anything that might be triggering.
First off, all you have to do to text a crisis line (at least the 741741) is text hello. That's it. From there you'll get a message that says "Resources and coping skills while we connect you:" with a link. "STOP to cancel convo"
"What's your crisis?"
They then go on to say they can't accept messages of over 160 characters.
From there, you describe your crisis. You don't have to be suicidal to text the hotline. You can just be in a bad place, depressed, or have something to talk about that you feel you can't talk about with anyone else. They don't judge.
There is a minute as they assign you someone.
The person will then reach out and introduce themselves. My person wrote, "Hi there, I'm Ashley, and I'm here to listen and support you through your crisis. I see you're in immense pain. It's courageous of your to reach out. Can you share more about what's going on?"
I explained more of what was going on. I explained a certain health care provider had made me feel like my depression was a personality thing and that I would not get better. This had spiraled me.
I got an immediate response. "That is not okay for her to tell you that. That would be devastating for sure."
Then, "If you feel comfortable sharing, what is your name," they will often ask this, but you don't have to tell them. If you say no, they will say something like "that's ok," and then go on.
In my case, I didn't care, so I told her.
She continued. "Thank you for sharing this with me Emery, it's great that you're reaching out for help when you notice that things are getting worse. That's really hurtful that your (redacted health care provider) is saying that your personality is what is causing you to struggle. I highly doubt this is the case."
We go on with more sympathy on her end.
She continues by asking if I have suicidal thoughts. I tell her no, but the night is still young. I have told them yes before. They are compassionate either way.
I tell her no but she asks if I have a plan for ending my life.
I tell her no again. She says she understands and just wants to make sure I'm safe.
We talk about my situation some more, then she asks what has worked for me in the past, and I tell her that distractions are very effective.
She asks me to specify.
I tell her that texting and games are most helpful.
She also suggests mindfulness and links me with a website.
I tell her thank you and we close the chat.
I feel a bit better.
Something to keep in mind -- each counselor is different. Some are more helpful for you than others. The goal of crisis lines are to take a client from a "hot place" to a "cool place" they do this by asking questions, listening, being kind, and offering resources.
If you are suffering, I highly recommend reaching out.
I may do a second post on this, but I am not sure. I think it's nice to know it's a resource that is good in a pinch and that it can really help calm you down.
It has saved my life many times, and I think it will likely do the same for you.
~ Emery
First off, all you have to do to text a crisis line (at least the 741741) is text hello. That's it. From there you'll get a message that says "Resources and coping skills while we connect you:" with a link. "STOP to cancel convo"
"What's your crisis?"
They then go on to say they can't accept messages of over 160 characters.
From there, you describe your crisis. You don't have to be suicidal to text the hotline. You can just be in a bad place, depressed, or have something to talk about that you feel you can't talk about with anyone else. They don't judge.
There is a minute as they assign you someone.
The person will then reach out and introduce themselves. My person wrote, "Hi there, I'm Ashley, and I'm here to listen and support you through your crisis. I see you're in immense pain. It's courageous of your to reach out. Can you share more about what's going on?"
I explained more of what was going on. I explained a certain health care provider had made me feel like my depression was a personality thing and that I would not get better. This had spiraled me.
I got an immediate response. "That is not okay for her to tell you that. That would be devastating for sure."
Then, "If you feel comfortable sharing, what is your name," they will often ask this, but you don't have to tell them. If you say no, they will say something like "that's ok," and then go on.
In my case, I didn't care, so I told her.
She continued. "Thank you for sharing this with me Emery, it's great that you're reaching out for help when you notice that things are getting worse. That's really hurtful that your (redacted health care provider) is saying that your personality is what is causing you to struggle. I highly doubt this is the case."
We go on with more sympathy on her end.
She continues by asking if I have suicidal thoughts. I tell her no, but the night is still young. I have told them yes before. They are compassionate either way.
I tell her no but she asks if I have a plan for ending my life.
I tell her no again. She says she understands and just wants to make sure I'm safe.
We talk about my situation some more, then she asks what has worked for me in the past, and I tell her that distractions are very effective.
She asks me to specify.
I tell her that texting and games are most helpful.
She also suggests mindfulness and links me with a website.
I tell her thank you and we close the chat.
I feel a bit better.
Something to keep in mind -- each counselor is different. Some are more helpful for you than others. The goal of crisis lines are to take a client from a "hot place" to a "cool place" they do this by asking questions, listening, being kind, and offering resources.
If you are suffering, I highly recommend reaching out.
I may do a second post on this, but I am not sure. I think it's nice to know it's a resource that is good in a pinch and that it can really help calm you down.
It has saved my life many times, and I think it will likely do the same for you.
~ Emery
Subscribe to:
Comments (Atom)