Just Another Manic Mommy

In my greatest fantasies I have solved world peace, written a best selling book and am a good mom. In my grandest delusions I have already accomplished these things. My daughter is now 2 months and when she was born the doctors diagnosed her as “perfect”. Worry enveloped me throughout my whole pregnancy. During pregnancy I had to stay on a medication for bipolar disorder that had not been studied in pregnancy and the added toll on my body exacerbated the physical disabilities I have from a previous medication’s side effects. So my daughter’s perfection was the greatest news I’ve ever heard. Yet, my psychiatrist and I both know the added limits sleep deprivation places on my mental health. My adjustment to motherhood also included buying our first house and learning that whole complicated game. We closed a few days after she was born and the nightly news kept being terrible.

Disclosing my bipolar diagnosis is a delicate dance I do, as people often seem surprised I have a limp and that my right hand is compromised. These physical disabilities render my invisible illness visible and people ask me about them more than I’d like. I already have physical limitations that are a constant reminder. Why are people so curious to know why these physical limits are there? I don’t want to talk about it all the time. I’m trying to “pass’. I want to “pass” as normal, with maybe the exception of passing as an artistic weirdo. Yet, when I must disclose I sometimes just say I have a sleep disorder. At the crux of any manic episode I’ve ever had is the total elimination of my need for sleep. When I met my husband that is what I told him and when he told me he was a type 1 diabetic I was actually relieved. When you have a chronic illness, only someone else with one can understand.

Our plan when the baby came home was to ensure I got enough sleep and in a few months my mother in law was coming to help with childcare. Taking care of a newborn is harder then anyone can tell you. I thought I knew what I was facing, as I had worked with a lot of new and expecting moms in shelters. I had a vaginal tear and keeping up with my own healing was a mighty task. After 6 weeks of taking care of my daughter I received some added stress and my mind broke. I am still so scared of dropping my baby, yet in the beginning I often just held her on my chest between feedings instead of sleeping, like I was making up for not breastfeeding. When people asked me about why I do not breastfeeding it pained me to say my medication wasn’t approved for it. So the whole experience of becoming a mother was difficult, but our daughter will always be our greatest accomplishment.

When you are in a manic state you often can’t remember everything. I don’t want to ask my husband, family and friends what happened, but I’m so privileged they were there for me. I just know that I disintegrated over a weekend and my husband took over care for the baby and myself. He took time off work and convinced me to get mental health help. Unfortunately, I didn’t have an advanced directive and couldn’t even remember my local psychiatrist’s name… and so began the odyssey of accessing mental health services in the most powerful country in the world.

We went directly to an in-patient clinic and they denied me entry because they said I was on drugs. We then went to our first ER and they had me change into a gown, but then couldn’t find a placement for me. I screamed for my clothes back because one of my scarier delusions is that I’m the reincarnation of Ann Frank and I’m being persecuted. Yet, for some reason I was yelling at them in Spanish? No se por que. We went to a second ER and I could have slept it off, but I tried to make a run for it. Big men surrounded me and in a panic I pulled the fire alarm. Yet, my behavior was truly alarming. The worst thing is that by delaying my access to care it had exponentially increased my symptoms. Finally, I got a placement for in-patient treatment.

Now the reason I should have had an advanced directive is that I would have scouted potential placements prior to going crazy. Facilities greatly vary and I ended up at one that served primarily Medicaid recipients and the indigent. This is not a comment on the patients, but the quality of the medical services and facilities. They made me get naked squat and cough when I checked in, like I might cough out my affliction. The experience of giving birth doesn’t prepare you for that kind of humiliation. I was mad being there and do recall calling everyone there “fucking retards”. It is interesting that the insults you used as a teenager just come flooding back. And a psych ward is never PC.

It seems like most patients there are on PRN tranquilizers at night to make everyone’s job easier. Even then the first night I still had mild insomnia. By the next day I had the wherewithal to ask for an overview of the meds they put me on. The nurse acted inconvenienced by my request, probably because it used too much printer paper. Yet, side effects have already inconvenienced me more than the cost of printer paper. I quickly deduced that most of the young people there were there as a stepping-stone to drug treatment and older people had a host of conditions, including chronic homelessness. The evidence is there that access to early intervention is fundamental to improving long-term outcomes and it is hard to know some young people now are on the way to preventable long term instability.

By the second day, I was able to apologize for insulting staff and realize I should be taking copious notes with the provided fat magic markers. I then learned that my baby couldn’t even visit me. I paced the halls for exercise and sometimes her new baby smell would envelope my olfactory. I hadn’t been in-patient for a decade and even then I only had a 72-hour hold. Therefore, I was sure I’d be getting out soon. Yet, I was informed that the average length of stay there was 10 days so I started doing my discharge planning. I read the manual and clearly attending groups was considered imperative for release. The first group I recall was karaoke and I sang a duet with the sweetest girl with a baby voice that lived in a group home. She shared later that her rap sheet was multiple pages because she liked to pick fights with the cops that get called on her. Relatable. My other new friend at karaoke was someone who had blown through 40k inheritance money and had been in detox for heroin 5 times in the past year. Although, he did have bad taste in music and sang an acapella tribute to the Linkin Park singer that killed himself. We later debated about whether suicide is courageous. I think not.

It was on the third day that my new best friend arrived. She was a young twenty-something in the midst of her transition. We were insta-besties. She’d walk the halls with me and we’d gossip and laugh. Some patients called her a faggot and other names to her face. Some staff appeared uncomfortable around her and she was the coolest one there. Haters. The next time we each individually met with the psychiatrist we were both accused of being “hyper-verbal” and having “inappropriate conversations”. This is probably because we talked about stuff relating to gender, sex, and politics. We attended our first group together and got to paint our nails, which was great for the guy who ended up spiriting away some nail polish remover to huff in his room. After group, I ran into the medical doctor in the hallway and asked him if he knew when I could be discharged, as I had missed my postpartum check-up and had residual pain from my stitches. He was kind and said that only the psychiatrist has that power.

It became Saturday and I still had no idea when I could officially leave. Every morning you have to line up for meds and I have them tell me what they are giving me to avoid mistakes. Well this nurse said I had to take Paxil now. I lamented to her: “No one has even talked to me about modifying my meds so I shouldn’t take it”. “If you don’t take it you’ll be non-compliant and have to stay here longer”, she scolded. I needed to be compliant so I swallowed the pill with so many questions. I had a flight to catch early Wednesday morning and they liked to discharge people by 11am. So I needed out by Tuesday. My bestie and I wait all day to see the psychiatrist. We shot the breeze with staff and they shared that the psychiatrist comes and goes without a set schedule. It is funny that it was easier for the staff to violate HIPPA and tell us a certain celebrity’s kid had been a patient there, then to tell us when the psychiatrist will be in.

By 8pm the same night the staff told us there was no way the psychiatrist was coming that night. That’s the straw. My bestie told everyone about the grievance forms on the wall and led the revolt, despite people’s earlier misgivings about her gender. Everyone had a grievance and wrote them in fat magic markers. I called to her “Bring me the manual!” and right there it says “On the days your psychiatrist is not available, another psychiatrist will be available to respond to your concerns”. (Behavioral Health Center of Michigan Patient’s Welcome Packet, p.10) My bestie told everyone there was also a grievance hotline. The Patient Rights Advocate was called by many of us. The nurse that forced me to take that Paxil acted very worried telling patients “Oh why can’t you just talk it out with us?” No, I had a flight to catch to see the totality in Oregon.

The Patient Rights Advocate was there the next morning and met with us individually. I had the Linkin Park guy corroborate my Paxil incident, as he was getting discharged that day. I got my stitches looked at and the doctor reassured me that my pain was to be expected. I met with the psychiatrist who barely talked to me and relayed I could “probably” get out Wednesday morning. I cried to him that I needed it to be Tuesday because I’d miss my flight and I had to run to the university in person to verify my I-9, as I am a Research Assistant and PhD student and I need it to get paid.

“Oh you have a job!? That is not a concern of mine.” he says…

Switching tactics, I drop in the info to the Indian psychiatrist…

“Don’t worry my mother-in-law is coming from India to help me with the baby” I say.

“Why is she in India?” he says.

“Well my husband is Indian sir,” I say.

“Oh, he is?! What part?” he says.

“Maharashtra” I say.

“Well I will talk to your husband and see if you can be released” he says.

I thank him and run to the phone to have my husband call the psychiatrist right away. And soon thereafter I was told I was going home. The rest of my stay was a breeze. I went to my last group and made a necklace as a memento. I talked to an older woman and asked her about the Detroit Rebellion. She said “I was at home with a one month old baby, while my family was out lootn’.” I have a beautiful perfect baby and when it feels like chaos reins supreme then home is where I want to be.

I did get out by Tuesday and had just enough time to pack for my vacation. I’m so fortunate, but these systems I’ve encounter are not dutifully serving those in need. I’m lucky I have regular quality health care. Today I finally had my postpartum check-up. My OB teared up when I told her I had a manic episode. She looks at my baby and said, “Look at her. She is real life”.