Chapter Twenty-Four: Off the Meds and Out of My Mind

During my first few days on the locked psychiatric unit of the hospital on the hill in early December 2008, I counted the passing minutes mostly from my hospital bed, incapable of eating or drinking.  Because of my suicide attempt a week prior, my medication regimen of Lamictal, Lexapro, and Klonopin had been abruptly terminated to prevent further organ damage from the overdose.  My body was experiencing intense withdrawal and my mind had accelerated into overdrive without the medications it had adjusted to over the prior seven years.  On my second night on the unit, after shuffling to the nurses’ station with my walker to get my nightly Ativan— the benzodiazepene they’d told me would help with the withdrawal— I was asked how I was feeling by my nurse.

“I f-f-f-feel like my mind is in fast-forward m-m-motion right now, like I c-c-c-can’t speak fast enough to k-k-keep up with my thoughts,” I spluttered to the nurse as I watched her hands get a small plastic cup of water and push the pill out of its sheet and into my hand.  I realized that it wasn’t just my thoughts that were moving in fast-forward, but the visual stimuli my eyes perceived as well, as her hands had flashed around and left trails of color behind them.  I wondered if I was beginning to hallucinate.  I could feel my arms twitching uncontrollably, and wondered if I’d done something permanent to myself.

“Well, without your medications, which you can’t take right now because of what you did to your organs, your bipolar disorder is really active, Laura.  Clearly the med regimen you were on before your attempt was not working, so your new psychiatrist here will find a better combination to treat your condition.”  Attempt.  I noticed how the word ‘suicide’ had been gently removed, leaving behind the general ‘attempt’.  “She attempted to traverse the mountain.”  “She attempted to break the high-jump record”.  “She attempted to kill herself.”  I contemplated why she had said it in such a generic way.  I furrowed my brow as I wondered if she thought I’d half-assed it for attention, that I really never wanted to kill myself, and, in a panic, realized that I wasn’t sure whether I’d said this thought out loud or simply thought it.  “Time for your vitals, Laura,” she said, and walked away from the window.

As I shuffled along the glass windows of the nurses’ station and around the corner to the pleather armchairs where patients had their nightly vital signs taken, I was struck with a renewed sense of defeat.  I remembered when I’d once had a swipe card to the locked psych unit in the Boston hospital I’d done research in for those few months back in 2006, when I’d stand on the inside of the nurses’ station, placed right in the center of the Panopticon, and look out through the glass for potential patient recruits for the study I was working on.  With the snap of a finger, my mind ripped itself out of that memory and plopped me back in the present.  I knew I’d never be on the other side of that glass again, that I’d always be the one observed and monitored.

How did I get here— to this very chair I am now sitting in, to this locked psych ward, to this identity as a person who has a case of bipolar disorder so severe that simply a week without psych meds has made me this manic?

I had never experienced thoughts ping around my mind as quickly or as intensely as this before; I had never found myself stuttering because I felt so much physical energy shooting through my body, just below my skin.  It was so intense that I worried I might blurt out incoherent words or even uncontrollably fling my arm out and hit something.

“You’re still really orthostatic, Laura,” the staff told me after I had my vitals taken sitting and standing and I felt an intense a wave of lightheadedness swoop over me.  I sat back down, looked at my feet, and then up at the whiteboard on the wall next to me, where my name was listed along with those of the other patients, a ‘1- no sharps’ and ‘15’ next to my name— I was still a level 1, not allowed off the unit and not allowed access to anything sharp, and I was still on 15-minute checks.  I was in no place to be given increased privileges.  In fact, I didn’t even want them.  I wanted people to look at me and see just how crazy I was.  I’d wear it like a badge of honor.  It’d be the one thing I could have pride in.  Look at me as much as you want.  Stare at the bruises on my face, document my manic symptoms, and eye the old scars on my arm and hand.  I am as crazy as you think I am.

I was bipolar.  It was all I would ever be.

As those first days passed, the sheets I woke up under in the morning ceased to be soaked with sweat.  The headaches decreased slightly, as well as my dizziness.  I gained enough strength in my legs to be able to shuffle the halls without falling over, and left the walker in my room.  I began to eat saltines and basic foods, and started to spend more time in the dining room with the other patients, despite the fact that I had nothing to talk about other than my failed ‘attempt’.  The more people asked me about my bruised face, the more anger I felt.  When other patients tried to tell me that they knew what I was going through and that they’d thought about it or attempted it themselves, I wanted to scream, ‘NO!  You don’t understand!  You only thought about doing it.  Or, if you did try it, you called someone right afterwards to tell that person what you’d done.  I actually wanted to kill myself!  I did everything humanly possible not to be found!  I wasn’t doing it for attention or dramatic effect!’

I still carried no regret in my heart for what I’d done, for I had yet to cease believing that I was destined to go through the motions of living a life that would never know happiness or inner peace, a life that would only disappoint family and make everyone around me miserable.  I wanted to scream at the top of my lungs, ‘I didn’t want to be saved!  I didn’t want to wake up!  It is a big mistake that I am here!  I don’t understand how the hell I didn’t die!  I don’t want a second chance!”  All of these thoughts, however, remained in my mind, tucked quietly away from my fellow patients, and I focused only on making sure that anything I said to others remained thoughtful, considerate, and calm.  I believed, in my heart of hearts, that I was sicker than everyone else and that there was no sense in trying to explain this, as they couldn’t understand.

Around this time, the psychiatrist who’d been assigned to me on the unit and whom I saw for ten minutes a day, Dr. L., determined that I was ready to be put on my new medication regimen.  The brief time that my body had spent free from psychotropic medications, save the small dosage of Ativan, was ending.  I was glad to know that the intense mania I’d been experiencing during these days off my meds would be stopped once and for all; I felt like a rabid animal that needed to be put out of its misery.

I fantasized about the idea of feeling comfortably numb, of muzzling the neuroses that raged ferociously in my mind, and without death as an option during my time there, numbness was the second best escape.  What happened once I was discharged, however, was a whole different story.  I held onto faith that I’d have my freedom back to do what I wanted with my life— to my life— when the hospital deemed me well enough to leave its locked doors.  However, despite making the firm resolution upon my arrival that I needed to get out of the hospital as soon as possible in order to make my failed ‘attempt’ a success, I soon slipped into a comfortable routine on the unit and within a matter of days found myself thinking there was no real sense in leaving any time soon.

I discovered what life was like in a time warp.  The minutes dragged themselves past like legs in quicksand, and I quickly stopped distinguishing between hours or even days, mostly because there was no real need to.  I knew it was morning because I’d be awoken by staff for my medications; noontime because the door to the dining room would be unlocked; and the evening, not because it was dark outside, which I wouldn’t have even noticed because I rarely looked out of the windows, but because patients started to congregate by the nurses’ station for nighttime meds.  There was always a subtle excitement in the air during that time, as though we knew it was finally considered normal and not symptomatic of depression to go pass out in bed in deep, oblivion-inducing sleep for a chunk of many hours.  ‘Normal’ people slept at night, and it was my chance to feel like I was doing the same thing as everyone else outside the confines of the hospital.

With the new medications in my system, my crisp, sharp, intense thoughts and feelings quickly dulled, my body and mind felt less tense, and I began to sleep through the night.  I felt detached from myself, insulated from the intensity of what I’d been feeling and thinking while off the meds, and I realized that maybe living with my fiery mind wasn’t as intolerable as I thought it was.  I grew to find comfort in my emotional discomfort— it wasn’t as though I was feeling happier, healthier, or more motivated; rather, I just stopped engaging with myself and became a passive, paralyzed observer of what I was feeling and thinking.  I glided through my days like a car on autopilot, unsure of who or what, exactly, was behind the wheel.  To be honest, I couldn’t have cared less about figuring out the answer.

The unit ceased to feel like a hospital and started to feel like a home that had everything I needed, from its own dining room with endless sugar-free hot chocolate packages, granola bars, and instant oatmeal, to its art room stocked with markers, non-toxic clay, and colored construction paper, and to the little gazebo just outside the doors where patients with level 2 or 3 privileges could get fresh air every few hours if they so desired.  As my days on the inside accumulated, the distance between me and the world beyond the hospital’s gates grew longer and longer, and the life I’d had on the outside felt more and more unfamiliar to me— from the job I’d been working and would need to quit, to the boyfriend I’d been dating and would need to break up with, and to the aftermath of watching my family begin to heal the psychological wounds I knew my suicide attempt had inflicted upon them.  Here, I only had to concern myself with whether there was maple sugar oatmeal in the pantry and enough mandalas in the art room to color in with markers.  Here, I was too mentally ill to be considered responsible for anything or anyone, including myself.

In a brief matter of time, I had settled myself right into the rhythm of the unit.  I stayed on as most of the patients around me came and went— we were on an acute, short-term unit, after all, and its purpose was to quickly stabilize patients and send them on their way.  A perverse pride slowly crept into my sense of self as I realized I was now an old-timer on the floor.  When I was moved to a two-person room on a different hall that was further away from the nurses’ station, a part of me felt insulted.  More than that, if the staff thought I was stable enough to not need constant supervision, this meant I was stabilizing and ‘getting well’.

I wasn’t sure what ‘getting well’ meant, but clearly my treaters thought it was something I was accomplishing.  If I got well, that meant I’d have to leave.  If I left, I’d have to enter the real world, and this was an environment that now felt foreign to me.  I’d gotten good at living on the locked unit, and had no idea how to leave it behind.  Other than drawing pictures, painting heart-shaped boxes, and molding small animals out of non-toxic clay in the art room to put on display at the nurses’ station, I had no expectations of myself on any given day.  I could sleep when I wanted to check out from my reality and not feel guilty for missing commitments, eat microwaveable oatmeal when I was hungry, and go straight to the lavender-colored room with the rocking chair when I needed to check in with my assigned mental health worker about how I was feeling.  That was my day, and I’d grown quite accustomed to it.  The real world beyond the gates of the hospital now loomed ominous in my mind.  Facing family, facing work, and facing my old reality now felt out of the question.

I was sent to the locked psychiatric unit in the beginning of December determined to get myself out as quickly as possible in order to complete the task of ending my life.  By Christmastime, I had emotionally disconnected from the fact that just one month earlier I’d made a near-lethal attempt on my life, and I was ready to move home to Connecticut with my parents, begin a partial hospital program at the same psychiatric hospital in Westchester County, New York in which I’d stayed in 2004, and leave my life in Boston behind.  I wasn’t even sure what I was looking for anymore, as though I’d once known and still had a faint glimmer of it on the tip of my memory that I just couldn’t retrieve.  My parents picked me up on my date of discharge, the fresh air abrasive on my lungs as we walked to the car, and we headed home to the house I’d grown up in.  Looking out the window, I was sure that somewhere inside of me I was feeling something about all of this.  I felt relieved that I was now safe from the anger, the sadness, the confusion, the guilt, and the desperation, and it was thanks to my new med regimen that I’d been assured was the right one.  Luckily, the rabid animal I’d become during my time off meds had been put out of its misery.