Disclaimer
I feel the urge to reiterate a few points as more new readers arrive.
Firstly, the blog is not a form of psychological help. If you are in any form of distress, contact a professional. If your situation is in ANY way emergent, call 911. If you need someone to talk to after hours and cannot contact a professional, see the list of 24/7 hotlines in the sidebar.
Secondly, I am not a trained anything, I’ve simply experienced the mental health system from the patient’s side. This blog is meant to share what I have learned with others who have to deal with the system. It is not meant to replace the help of a trained psychological professional.
Process Group or What Happens When You Put Several Crazies in a Room Together
So today I thought I’d talk about being on the inside again, broaching on the subject of group therapy. More specifically one common group known variably as “process group.” Now process group can go one of two ways: it can be helpful and therapeutic or, and I’m using kind language here, it can be a disastrous group bitch session. Basically it’s a free-flowing group where we sit in a circle and one person starts to talk about how they feel and others talk and you basically produce free verse cracked-out poetry. Can you tell how I feel about process groups?
Now ideally, the one person’s problems are addressed and a solution of sorts is reached, then another person goes through the same process, each person processing how they feel about some thing past, present or future. My wife and I had a fight, I’m feeling suicidal today, I don’t know how I’m going to make rent next month etc. Now I can see the benefit of this processing of feelings and events, but process group is like communism…it sounds a lot better than if you do it.
In reality, process group goes a little differently. You begin with one person, and processing happens for a minute or so before someone else is reminded of their problems and has to voice them, then we begin processing them, until some distraction derails the train entirely and you find yourself in a room with 5 people talking over each other, not yelling, and someone’s pissed because so-and-so said he should just suck it up when he didn’t really, he just made a suggestion and the therapist is meanwhile trying to shut everyone up as professionally as possible while trying to continue processing with a patient.
That’s basically process group, one of the most common forms of group therapy, you see forms of it everywhere like AA meetings. There are other forms of group therapy, which I may discuss in another blog, but this is the big one in my experience. Some places have worked it out better, I believe AA and its buddies use timers to limit the time spent on each person, not sure. Sometimes they’re very strict about who’s turn it is to talk etc. all things that keep the peace and allow the group to work. Sometimes process group works but hey, a broken clock is right twice a day.
Cutting Individually-Part 2
Two days before I was to graduate rehab, I managed to procure some razors and I got my first lasting scars. Still no stitches, but it earned me a trip to the ER. It also got me unceremoniously kicked out of the program in a matter of hours. The most important development, though, was now I was a real addict and almost a real cutter.
From there I went back to school. I didn’t advertise my rehab experience, but for those who knew, I acted like it worked. In reality, I was just taking advantage of the cold weather and pushing the limits as best I could by injuring my upper arm. It was fine until my best friend in the world walked in on me doing just that. For me it’s nothing, but if you don’t know injuring intimately, it must be a jarring sight. Soon after my therapist got wise and it wasn’t long before I was off to the next rehab program…I lasted eight days this time. Soon after I entered a cycle. I injured with less frequency but greater intensity until my left arm was a graveyard of lines. One night I decided to try my hand on the right arm and got so far as to get staples. God was that awesome. Staples are like giving a junkie medically sanctioned heroine. I was hooked. Two nights later I was back to get eight more.
The funny thing about this time is I was productive. I had just finished every assignment I had left for the semester and done a little extra work to get ready for the rest of the year. But then I stopped and the overwhelming waves of what I still hadn’t done, what I was trying not to feel beat over me like vicious waves until I was paralyzed and the only apparent way to break it was to stand up and injure. Clearly the ritual and the satisfaction would release me from everything that was suffocating me in the moment. This is how the addict’s brain justifies.
Now I try. Willpower is a part of my vocabulary, but so is slip-up. Only twice have I seen a doctor for my injuries and in 6 months I’ve injured a total of five times, which is pretty impressive for an addict. I get an impulse to injure almost daily. Some days they’re mild and I just turn the music up a little more or play with my cat. Other days I have to actively fight the impulse, washing dishes, using therapy skills. Others still I spend every moment actively not injuring, and that’s all I can do-force myself to stay seated, not walk over to where the sharp or burning object is. That’s how I spend every moment. But sometimes the pain of all the emotions, the anxiety to suffocating I literally struggle to breathe and all I can think of is to injure, to release all that pressure so for one moment I might breathe. Unfortunately bills, blood, emergency rooms and disappointments that far outweigh the high soon follow that breath.
Cutting Individually- Part 1
So I’m in the emergency room again, so I thought I’d finally take a stab at self-injury, pun so not intended. I’m working on a whole separate post trying to talk generally about SI (Self-injury) but it’s a struggle, so to get it out there, I give you my own personal experience.
I started out over 5 years ago, doing SI for relief from pressure normally, sometimes from emotion but most often punishment. It started out small, some “scratches” on my forearm as my shrink of the moment called them. Then it escalated to cutting, not deep but leaving scars for sure. Here it was emotion, not knowing how to express them outside of carving them into my skin, punishing myself for having these emotions. This pattern of occasional SI when under pressure continued well into my first year of college, though the freshman roommate complicated things.
Things escalated in my sophomore year. A combo of increased emotional and occupational stress with general confusion led me to some new discoveries. I could do more, deeper, 10 razors at CVS only cost $1.79 and SI could bring a high. I got addicted. Just a little at first. I remember during the VP debates on CNN, I excused myself to cut about 25 lines into my stomach, then returned to drink every time Palin said “main street.” I thought then that my cutting was extreme…I had no idea, but we’ll greet that later. Now I had learned that when I couldn’t sleep, when my brain wouldn’t stop-a symptom I didn’t know yet to be indicating my Bipolar-I could get up, injure and then fall fast asleep, better that any sleeping pill. I learned that when I couldn’t concentrate on my schoolwork, the ritual and the action cleared my mind so I could sit back down and pound out eight pages of work. But these morbid “tools” became crutches and soon, my superficial injuries did not suffice. I went deeper, I went to hospitals, I went to therapy, and I was encouraged to go to rehab. It wasn’t until I was wondering around campus just about a year ago bleeding from my arm, picked up by cops, then an ambulance that I finally said yes.
Three days later, December 5th, I was on a flight to Denton, TX headed for S.A.F.E. Alternatives, a rehab program for self-injury specifically. We learned things like how to process emotions instead of stuffing them, to analyze the impulse to injure, to have alternatives to the action, to call it injuring instead of cutting. We learned all the skills to not injure, but I learned something else. I observed the other injurers, their scars, their stories, and I learned I was not enough. I had never had stitches, staples, had a cut that wouldn’t stop bleeding; simply I wasn’t enough, I wasn’t a true cutter and I couldn’t stop until I was.
Is it on someone’s mind?
Sorry I’ve been absent recently, it’s been time to get all this school stuff going and all that important life-ness.
Ok real world today. This post is for everyone and anyone. Suicide. It’s serious, it’s scary and too often it gets dismissed. And when it happens, what do we do? Ignore it for fear of copycat instances in the community? Acknowledge it and risk glorifying the act, or conversely risk criticizing the act and thereby insulting the victim? Yes victim. Some people might look at it and think, “They did it to themselves, it’s their own fault. How are they a victim?” In fact I’m currently reading a book on mental hospitalization (a book I truly do not recommend, especially to any emotionally sensitive people like myself) that makes it sound as if mental illness is the fault of the person, laziness, self-centeredness, etc. She makes group therapy sound like a pity party (and no, that wasn’t the first description that came to mind). This attitude honestly makes me sick, for it is the root of so many negative stigmas toward mental illness. Not the point, the point is, someone who takes his or her own life is a victim: a victim of suicide, of mental illness, of neglect, of holes in the mental health care system, take your pick.
Did you know that suicide is the third-leading cause of death among those 18-24 years old. That depression can hit at any age but most often hits people in their mid 20’s, affecting 10-25% of women and 5-12% of men and 40-60% of suicides are by people suffering from a major depressive disorder.
But for all the talk by people like me, are we really there when someone is teetering on that edge? Several months ago a dear friend of mine found herself at that point, this is a poor time for puns, but she was at a do and die instant. Struggling with a multitude of heavy issues, enough to bring most people to this point and faster at that, my friend reached out, or maybe she was just saying good-bye, in a Facebook message. My friends and I were all quick to respond (it was an on-going thread shared among several self injurers who had spent a stint together in rehab). We gave encouraging comments, suggested techniques we learned in rehab, basically everything short of begging her not to do the deed. Today, my friend is alive, but man was that a moment of helplessness. So what do we do? I’m not a professional, nor do I claim to know the correct answer here, so I offer a few things. Like the broken record that I’ve become, contact a professional or at least call a suicide hotline, those are not just for someone in crisis, but also for anyone who knows someone in crisis. We would be remise to assume that we can help someone in crisis more than a professional and frankly it’s irresponsible to try to handle the situation yourself. Outside of professional help the best thing is to be there for them. Don’t turn your back or criticize them, offer a shoulder and an ear and simply be there for them. Anything beyond this depends so entirely on the individual and their distress, which is why I reiterate seek out a professional. I realize I said little in this post, forgive me. For more information look at the links on my sidebar or look at http://www.facebook.com/#/itsonmymind. I promise to get back to regular posting soon, my life is a little spastic these days.
A Day In The Life
Sorry, no awesome Beatles song here, just some late night ramblings.
So recently I’ve wanted to express what a day in the life is like with my Bipolar Disorder. Not for the oh-woe-to-me pity aspect or because it hasn’t been done before, but because I think it’s something important to express and maybe more iterations of similar stories will better spread awareness.
My day starts with my alarm at 5:45. This is three hours before I need to do anything, but I have to because of how unregulated my sleep cycle is. Some days, I need no sleep at all, sleeping 3 hours in as many days, some days I end up sleeping over 12 hours, it depends on whether I’m in a Manic or Depressive episode. I take my morning meds and get ready like a normal person. That’s the key here, my day is like a normal person’s, just with a little different flavor.
I start my day next, for me it’s classes. Often in class, I have to fight to keep my brain on track. It’s not your normal distraction, nor is it ADHD mind you. Two things can happen: I’ll have racing thoughts, trains jumping tracks and circling like their riding a track drawn out by a toddler doodling or thoughts of anxiety that can get so overwhelming I lapse into a panic attack in the middle of class. I realize as I write I very much view my brain as a web, in both the structure but more so the purpose, catching me by surprise and holding me hostage with thought, so if my words seem to hint to catching, stuck, that’s why. It doesn’t always happen, nor is it always so severe, some days I just fight a little to focus and win, some days I don’t.
After class is lunch, an incredible litmus test of my mood most days. This varies with mood, but I’m almost always one or the other. That is extroverted or not. Some days I may just sit; observing or stuck in my own thoughts, not saying a word to anyone around me or I may just find a quiet building and eat alone. Other days, I seek out people and can’t seem to keep my mouth shut, overwhelmed by pressured speech, inevitably annoying the crap out of everyone around me.
I feel I should take a second to try to describe pressured speech, a common symptom associated with manic episodes. It is what it sounds like and more. An urge to speak that is painful to suppress, you may have nothing to say, it doesn’t matter. Every thought that crosses your mind has to be verbalized immediately. Someone else may be talking, you may even be alone, but you MUST tell this to someone. (When I’m alone I don’t explode in speech, but I may call someone, write like I am now, like that comment about my brain as a web, or bottle it up until I’m not alone again) It can be stopped but it’s hard and normally it’s not until well after you’ve spoken that you realize what’s happened in your brain, and it’s to late or you bottle it up and get caught in the thoughts you’ve held in.
After lunch more of the same with classes and activities. At any point during the day something may trigger my anxiety or worse my impulse to injure, which may just pass over me or stick for a while. If the anxiety gets bad I use coping techniques I learned in the brig like breathing or distraction, but if it gets to bad I may have to take an anti-anxiety pill which throws off the rest of the day, so I try to avoid it. With the injuring I use the same techniques, plus find people, even when I don’t want to, making it harder to injure. When I get home it’s the goal to stay focused as long as possible to get work done and stay safe. Injury is a whole other topic that I’m trying to write about else where so no climax here. The only struggle at night is the sleeping. Some nights I go to sleep at 9, others I’m up ‘til 4 or don’t sleep at all. Some nights the anxiety or racing thoughts get me and instead, I lie in bed wide awake thinking myself crazy so to speak until my body finally takes over as I’m hoping it will now, as I’ve stayed up an extra two hours to write this.
There you have it…a brief-ish day in the life of one girl with a bipolar diagnosis. Look for more posts in the next month after school lets up. Cheers!
On Medication
So for the first time in a while I don’t have a paper or test to be working on, so I thought I’d write about something that’s been on my mind this weekend. I know I normally just talk about the experience of living with psychiatic disorders, but I thought I’d make some words on medicine. Forgive me because I’m going to break a rule of mine, to not write about myself personally, but just view it as a short case study written by the subject.
Now I’ve come across a lot of people against psychopharmacology (mental meds), in fact I was among them until this year. Over the last ten years, it was suggested on a few occasions that I be on some sort of meds, which I always fought. The idea of medicine working on my brain made me think of some sort of medical possession, a pharmaceutical masking of the real me, which needless to say I wasn’t to psyched about, not pun intended. In the year before I finally conceeded, I was experiencing severe and very real symptoms of Bipolar, which I hid for a myriad of reasons. Even once they became a problem and many medical professionals suggested some sort of drug therapy, i refused. Finally, I ended up in the hospital and had no choice, I either had to take the meds or stay in until I did. Over the course of a year my meds were changed and adjusted until they found a “cocktail” that at least mostly worked. Even know I know several people (not medical professionals) who would urge me not to take meds, but I’ve learned to take it with a giant block of salt. Here ends the majority of the personal, and comes the advice if you will. These people who diss drug therapy because of whatever reason-”You’d be fine without it, you’d learn to deal”, “It’s messing with you and your brain”, “All those chemicals, there’s got to be a more natural way to deal”, “It’s all money, the psychiatrist doesn’t care, he’s just trying to make bank, the pharmaceutical companies too”-they aren’t medical professionals. It’s hard when a family member or good friend says these things, especially if you respect their opinions. You may want to listen to them, especially if you, like me, aren’t a huge fan of the current medical system and the intrinsic corruption that comes in any corporation, especially those that spend much money lobbying on the Hill, but these people did spend all those years in school for something, and I can’t believe they didn’t manage to learn at least a little more about medicine and the brain than the laymen. So to those who are on the fence about medication, I’m not saying yes take whatever, it should be an informed decision. Disclose ANYthing even medically relevant to your doctor, let them formulate a plan, they may not even feel medication is necessary. And if you begin taking anything educate yourself, know the side effects and be vigilant about taking the correct dosage, be aware of what you should do while on the medications and monitor any changes you notice. Be aware of yourself, your mood and your physical state. It is a responsibility to be taken seriously.
On a side note, I know people who choose to treat it with more “natural” methods…they tend to spend most of their days in their apartments smoking copious amounts of pot, not necessarily the best seeing as pot has been associated with increased rates of anxiety, depression, suicidal ideation, and schizophrenia just by the way.(this isn’t meant to spark a debate about those who smoke pot, do what you do. I know it serves its purposes for some)
Now for those already taking meds. It’s a very common problem in the psychiatric world for a patient to be on meds for a while, feel better and then cease use, without the knowledge of their supervising physician, thinking themselves cured and soon relapse. This is so very unsafe, and so hard to monitor. If you stop you may feel different, thinking it’s the side effects wearing off or something. But with psychiatric meds its so easy to relapse an not even notice. You may start having depressive thoughts or even suicidal ideation, and it’s so easy to assume that it’s just a change in mood because of some other change in meds. It can be subtle. Not to go on a suicide bender, but one of the reasons it’s around the 8th biggest killer in America is because it’s so hard to tell. These thoughts can creep in as you cease medications and you may not even realize how dangerous or irrational they are, and if you don’t notice, chances are those around you won’t either, because you won’t display outwardly what you don’t even notice internally. And so I urge you. Communitcate with your doctor, follow their treatment plan, and take care of yourself.
And if you are having any suicidal thoughts for whatever reason I urge you to reach out to a friend, a hotline, a professional, anyone who can help you. Even if you think the thoughts are harmless, one drink too many or one stressful event may pull you out of what we call your wise mind, into your emotional mind, where reason has no role and that one harmless thought may be enough. Take it seriously!
Stereotyping the Patients
I’d like to share with you another social topography in reference to the patients. You have the new babies and the new ones who have been inpatient before, and the old ones, who either control the group, hover on the side or stay in their rooms. The newbies come in normally overwhelmed, even the most talkative person in the real world clams up when the first come in. Its overwhelming to walk into a ward; the other patients and all the employees know what’s going on, how things go, the code if you will, the newbie knows nothing but what Jack Nicholson and Green Day taught them. Inevitably someone comes along, shows them the ropes and they transition into the general population of the ward. There’s also the newbie that’s been through the mill a few times already. They integrate or isolate pretty quickly, not much exciting there.
Now as I mentioned, there are the people who’ve been in for a few days. I think I’ve mentioned in previous entries that the average stay can be anywhere between 3 to 30 days, it really depends on the place, and if you’re curious, this information is readily offered at most facilities if you give them a call, but not the point. It takes a few days to get used to the place, even if you’ve been there before; every visit is different due to the changes in patients or staff and what not. Inevitably a few stereotypes will work their way out giving a pretty clear social topography for the ward. There’s the mothering patient, who take newbie’s under their wings and protect the weaker patients. This species is very kind and loving, but a bad person to cross because they will probably hold onto that for a while, it’s catty in there. There’s the snotty “I-don’t-belong-here” patients; most people go through this phase at some point, but repeaters are normally more resigned to their lot after the second admission. Normally this patient complains a lot, compares their problems to other in the opposite manner of the one-upper. If one stays in this phase too long, they normally start to cause problems with the staff, begging the doctors, pestering the nurses and aids. Sometimes there comes a mutation from this breed in which they may partially accept their situation, but they seem under the impression that they’re at the Ritz, not a hospital, and that they are better than other patients and clearly have a better grasp on reality.
The one-upper I mentioned is normally an outgoing patient that constantly has one better on everyone else. Their life is harder, they used more drugs, they hurt themselves more, they had the most hardXcore suicide attempt etc. Basically the same as your one-upper in the outside world, but with a sprinkling of TMI and generally inappropriate comments.
On to the next variety, there are two types of recluses, neither of them concern the other patients much unless they want to be awakened for food or smokes. The first breed in the medical recluse; these people normally have a valid medical reason to stay in bed all day and some of them even try to emerge, but inevitably tire to soon. The second is the psychological recluse. For a variety for reasons, they don’t like being in the milieu of the ward and confine themselves to their room. They may be dragged out occasionally by a desperate tech, but they will almost never do so voluntarily.
There’s also the grandpa/ma. This group is normally saddening to see. For the most part, before they came in they were struggling and now they can’t leave because they have nowhere to discharge to, but they are normally very kind, if discouraged, creatures. If you find yourself in the general milieu at a not super expensive hospital, you will probably encounter this sexagenarian and find yourself growing attached. And yes, this person is normally only in their 60’s, but so worn down hey appear 85. The last group is the general population, which is on a whole open and amiable, but still carrying the weight of whatever brought them into the system. This group will be sociable, attending most groups and meals, but not all, and at least mildly polite to the staff, if not genial. In this group there are a few subsets like the person who knows the ropes and just came in for an 8 day break; the patient so desperate to discharge that they do everything the staff says and try to say what they think sounds most sane; the pot head who engages the one-upper in drug-based story trades, etc.
Now the melding. You know those war films where macho and macho clash, but once they hit the big fight everyone bonds and you’ve got each other’s backs? It’s similar in the ward. At first there may be cliques, but as time goes one, you begin to realize, everyone is working toward the same goal, the staff included, and you bond. When the staff is getting the shaft, you add an extra dash of patience and let them handle the melee they’ve found, same with the nurses. Inevitably the patients break down into the above groups, but the newbies join in with the oldies as some leave and new ones come back; even the recluses with pop out once in a while. And those ringleaders can sometimes be asses, but in my experience, kinder leaders take over fast and soon the whole group, smoking or non, is gathered in the patio sharing stories, the staff included. Someday I’ll tell you of the crazy canuck tech, but that’s later.
The PC Balance
I actually prefer Mac’s, but how ’bout that annoyance of political correctness? There is much to be said about PC in the psych world, but this is less controversial…
Psychology is difficult, especially when touching on the dissemination of related info. I’ve encountered this, advertisers have encountered this and surely everyone in the psychology world has encountered this in some manner. You can’t make something sound too good, too easy or too fun, because then people who may not necessarily need something will seek it out. Two examples, first, if I or someone else speaking on staying in a mental hospital makes it sound enjoyable, someone who doesn’t need to be there may work their way in for an easy break. The second example actually exists. Meds like adderall clonopin, valium, and other psychotropic meds are validly needed by some patients but are often prescribed or illegally sold to people who don’t need them and use them recreationally.
On the other hand, if psychotropic drugs or psychological help in general are cast in a deterrent light people will avoid it. Personally, I avoided therapy for nearly 4 years, and medication for even longer when I genuinely needed it because I felt being in therapy made me weak and medications would mess with my mind. Even today, some people who know I’m on medication take issue with it, feeling it might hurt more than it helps. Who am I to say yay or nay, I’m not in the least medically trained. There are some doctors out there who over prescribe and some who under prescribe, but they are all far more trained than me, so I’ll take their word for it in most cases. But not the point. My point is that the depiction of psychopharmacology and therapy has had a negative affect, discouraging people from getting the help they may need. In my position I’m hoping more to encourage the misinformed to take their mental health seriously. It’s a very difficult balancing act at that, complicated by the really bad version of Major Tom by Sarah McLachlan playing in the background…my mind is easily distracted.
I recently started a new semester including a class on abnormal psychology. The teacher had to start off with a speech on medical student syndrome, a problem that causes many med students to turn into hypochondriacs of a sort, thinking they have every disorder described or diagnosing friends and family with disorders. It’s also a problem with psychology students, almost more so as the disorders are easier to manipulate and harder to disprove. Basically my prof was in the same situation, discouraging hypochondria but encouraging people with real problems to go to our university counseling center. So basically, if whatever I say sounds strange, I’m probably trying to maintain a balance. If you need help, seek it out. If you just need to talk, call a hotline or contact me. I ask that you contact a hotline or 911 if you find your situation dire, because I can’t guarantee a prompt reply, but you will get one.
I apologize for the filler post, another one is on it’s way.
Cool Facebook Page
I just wanted to share this page with everyone called It’s On My Mind. It’s got some really great stuff, especially aimed toward the 16-23 age group. Their quick blurb states
It’s On My Mind is a movement of people like you who:
* Make emotional health a priority
* Want to raise awareness of the warnings signs of distress or suicide so we can improve and save lives.
It has a page for discussions, including asking an expert (what my blog sorely lacks), as well as a page for the warning signs you might see in friends. Now personally, warning signs bug me, but that might be buried disdain for the horrid PSA I had to watch in high school (bad act, “hiding under a rock” “just wanting to sleep forever”) but that doesn’t mean they shouldn’t be acknowledged.
There was a postsecret (ya I’ll reference them a bit) posted once of a girl who was brave enough to ask for help, but her mom called her a drama queen. My point of this is if more people know warning signs and take mental health seriously, people who need it won’t be left floundering. That’s part of the reason I have my site, the other being to give insight to those lucky enough to get help, and that seems to be the goal of this page. So become a fan and invite your friends, spreas this blog while you’re at it. I know there are a lot of big causes out their today, fights for freedom in Iran, fighting censorship, going green, cancer research, and I’m not saying those aren’t important, the kick my cause out of the water…i think I’m mixing adages. My point stands, this is something you can get out to your friends and family, they don’t have to be struggling, because the more people know the less likely a hurting girl will be belittled to a drama queen.
Soapbox over, have a great weekend. New post a-coming on monday
Ward Politics: The Employees
So just like high school, the ward has politics, however now we’re adults so things like MD and PhD factor in and the line between patient and employee can be blurred. Now I know one girl who blurred that line into oblivion with a tall, dark and handsome tech, but if you heard the circumstances you’d cheer too. So let me break down the group before I tell you how they interact. On the employee side, from bottom to top you have the mental health technicians (techs), the nurses, the nursing supervisor, the psychologists/therapists, the medical MD and the psychiatrist MD. Those in between techs and MD’s might have interns. The interns will either be just as involved in the work or just kind of hover in group therapy and the common area, observing and asking the occasional question.
Now on the employee end I don’t know much of the interaction. The order I listed them is the reverse of the food chain, techs being at the bottom. Techs interact the most with the patients throughout the day. Techs control smoke breaks, meal time, doling out of contraband bins, taking vitals. They also will talk to you if you find yourself struggling. You want to stay on the good side of the techs, they aren’t “the man” you’re fighting, and they’re just trying to make their way. Many techs are there because they love helping, some are budding psychologists saving money for grad school, or just someone who found a slightly above minimum wage job. The point is don’t give them tons of grief; they do as much as they can. Techs also keep tabs on the patients. Depending on the facility and your level (there are numerous names and acronyms but basically what level they’ve been ordered to watch you) they have to mark down what you’re doing every 15-30 minutes. Known as “checks” in Girl, Interrupted, they really aren’t that invasive, it’s just keeping up on your behaviors, if you’re eating, sleeping, socializing, etc. They have this full page with all these grids and code to mark stuff down. I have to say it’s always fun to sneak a peak over their shoulder just to see the classifications: laying down, sleeping, sitting, standing, walking, smoking, eating, talking, the list goes on. But anyway, don’t be freaked, it’s just protocol.
The nurses are your main connection to the medicine. They dole out the meds and the prn’s (as needed meds), or at least that’s all you see. Behind the scenes they are taking the doctor’s impossible to decipher orders and turning them into orders to the pharmacy to get those very meds, then sorting everything out for the six or so times a day they have mass-med-distribution. They also have to chart EVERYthing. Every vital taken, what you ate, how you sleep, how much you participate and socialize; anything that would indicate medications working or not, and all in legibleish handwriting for the pillshrink. There will be a nursing supervisor on during the waking hours, normally one in the 7-5 and 5-11. They do the same as the nurse plus they just oversee all in the ward. As one notably cranky NS RN told me, “I don’t just have eyes in the back of my head, I have 360º vision and I know everything that occurs in my ward”. As things go, the ward is under them and what they say goes. The others listed above the nursing supervisor are above by technicality, but they’re in charge.
So what of those others. The therapist will normally only be there 9-5, maybe less. They run the group therapy and depending on the place, they may do individual therapy with you. The individual can be tricky, because they don’t want to interfere with any outside therapist, or just repeat what you’ve already done, so if you have it, be forewarned it won’t be like therapy on the outside. The therapist also charts on how you’re doing, all of which helps the psychiatrist decide on whether to discharge you.
The medical doctor you will probably only see once, unless you have some medical issue like diabetes or high blood pressure, whatever is purely medical, non of the shrink stuff. They’ll normally meet with you early on, do a quick once over, check for possible problems, make sure you have a pulse and any open wounds are tended to. Also a heads up, if you are a person who often takes Advil or the like for headaches, he has to write and order for it so be sure to preemptively strike and ask that it finds it’s way to your chart; no biggie to ask, and when you need it and you actually get it you’ll thank me.
Lastly and most respected is the psychiatrist. Now don’t be fooled, just cause he’s up there doesn’t mean anyone likes him. In fact I’ve had many a conversation with nurses bitching about a need shrink they have to deal with (always entertaining). The shrink decides when you get to go, first and foremost. You will meet with them every day, they’ll mess with your meds trying to get a good balance and then, once they hit it, you get e two day waiting period before you’re out, just to make sure everything’s in order. Some are faster, some are slower. Some will take time getting to know you, and they tend to take longer on the discharge. The other end will focus mainly on the meds, and once you’re stable, you’ll be outtie. I can’t tell you which is better, but I’ve had both and they each have their pro’s and con’s. Treat them with respect, do as they ask, and you’re stay may not be to long.
The interacting is pretty simple. You know the 1-10 scale for dating, how an 8 can only date a 7-9? It’s the same in the ward, techs associate with nurses, nurses with techs and the therapists and docs and the docs just with the nurses. Now obviously they all interact with the patients, but the patients are a whole ‘nother story for another time.
Jude
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