Psych Hospital Redux:

The Safety and the Apprehension

Although unknowns are mercifully fewer, past experiences weave in new fears as I seek depression treatment at a second psychiatric hospital

I stood in the bath, waiting for the water to fill enough to settle in for some self care when my husband knocked on the door, “Honey? I hope you’re not submerged yet. Four Winds called back and they would like to speak to you.”

We had called the certainly out-of-town, yet relatively nearby, psychiatric hospital over the weekend when it had become abundantly clear that we could not keep me safe from incessantly unwelcome desires to end my life. I stepped out of the bath, and wrapped my still-dripping self in my husband’s more absorbant robe to take the call. I spoke to an admitting consultant, where I successfully walked the fine line between sharing enough frightening details to convince them I was truly in need of a safe, healing environment, while concurrently downplaying the strength and immediacy of the self harm urges, lest I be ordered to immediately go to our local emergency room. You see, this will not be my first hospitalization.

Earlier this year I voluntarily admitted myself to our local hospital to manage my self-harm and severe suicidal ideation resulting from Major Depressive Disorder. I recognize my hospital stay was entirely necessary for my survival, however there are many shortcomings of my local facility. As a well-educated, middle class individual with access to quality outpatient care and a strong support network, I felt peerless among the other patients. Learning from and sharing strategies with your peers is supposed to be a key part of the inpatient experience, but in that environment I felt very much on my own. In addition to other patient’s mental health afflictions, many also struggled with substance use, financial insecurity, and previous episodes of abuse. I fully recognize and am grateful for all of the pieces in my life that work, but this disparity in life experiences and my high-functioning state made multiple people question why I was there, as though wanting to end your life is not adequate justification. The querying parties included hospital staff, as though they forgot the biochemical misfunctioning that is depression has causes other than violent trauma. There are certainly genetic components to such conditions, and my family has a history of mental illness in spades. I also have my own share of psychological issues stemming from emotionally disorienting, though not physically violent childhood experiences. Despite those fact, after failing to cry while detailing my entirely executable suicide plan to the admitting ER psychiatric doctor, he seemed confused and commented that I did not present like a standard depressed patient.

The facility itself had all the necessary pieces to keep the patients safe — a locked outer door, a generally kind nursing staff that worked around the clock, a few wonderful therapists, and the confiscation of any items that could be used to harm oneself or others. Well, most objects that could be used to harm others. In the case of one sporadically violent patient who restrained a woman on the ward and threatened her with sexual violence, his voice and strength were not confiscated. In the case of another patient who lasciviously looked up and down women’s bodies and would park himself outside my room to sing and chatter in Spanish, his gaze and intimidation could likewise not be confiscated. Programing was limited, which left long hours between morning occupational therapy, fairly useless afternoon group psychotherapy, and the day’s highlight of visiting hours. Having time to journal and process my experiences and medical condition was surely helpful, but I found I lacked the stamina to fill all open hours with the emotionally exhausting work of looking at your injurious thought patterns and past wounds. My physical safety was assured, and I did some beautiful work for a few hours of my week long stay with one therapist, one psychiatric doctor, and a book of Dialectical Behavioral Skills that I tried to teach myself, but for this second hospitalization I’d sure like more care. More therapy. More emotional safety and inclusion.

The rest of my day will now be dedicated to deciding what to pack for a roughly one week stay at Four Winds in what their virtual tour suggests is in a beautifully wooded area of Saratoga Springs. There are obvious items to omit: belts, razors, any toiletries in glass bottles or with alcohol. Depending on the facility, forbidden items may also include tank tops with spaghetti straps or yoga pants. I’m not sure if the former is to discourage provocative dress or if it shares the mission of the latter — to prevent hanging attempts. But the decision between other items is less straight forward.

Previous skepticism about the severity or veracity of my illness suggests I bring nothing but sweats and sad sack shirts to non-verbally communicate that all is not well. Fear of being judged by other patients — ah, the deep marks left by middle school interactions — makes me lean towards something still comfortable, but hipper and more put together to prevent ostracism. Based on the intimidation I’ve felt from male patients during my previous hospitalization, large, unflattering, and concealing garments also sound appropriate to limit the areas accessibly by unwanted wandering eyes. Ultimately, I’d like to dress myself in clothing that makes me feel comfortable and positive about myself: maxi skirts, which with the rest of America’s women I’ve developed a penchant for, or shirts that were gifted to me by loved ones, or biologically oriented necklaces that feel like a talisman on my chest, or beautifully eccentric tops, that while they don’t cure depression, give me something interesting to look at and physically be a part of while I wear them.

Much like the treatment of my depression, I have difficulty recognizing the through line of me that exists in these various sartorial options. As I seek the mythical magic bullet to cure my illness, I agonize over choices, from clothing, to self care activities, wondering which will bring solace, and fearing that if it doesn’t I will have one less tool to turn to in the future. With a place in the hospital confirmed for tomorrow afternoon, it seems none of my choices will compromise my ability to be here tomorrow, but I still search for one that will make me want to be here tomorrow.

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