Like a Refuge and Like a Prison

Laura López-Aybar: How would you describe your psychiatric hospitalizations?

Francisco: Well, it’s supposed to be a process of improvement, and in some ways, I can now see it as a process of growth within the same trauma. You arrive with some issues and leave with others. That’s the deal, looking for help, but at times you can feel like a prisoner, a criminal, a person who is a problem, a person who is a burden. Sometimes, they can childishly treat you or treat you as if you were part of the herd, so to speak. Like one of the sheep that has to be herded or something like that. 

Laura: What do you mean?

Francisco: The disciplinary measures, and I understand the protocols in part, what I don’t understand are the methods. Well, there are specific hours and one cannot question it and one cannot refuse. There are expectations for the behavior of participants within the programs. If you don’t comply with them, they either yell at you, scold you, intimidate you, or threaten to put you in another area, or inject you or give you medication to calm you down, or take other measures.

Laura: Did that happen to you or did you see that at some point?

Francisco: Yes, and I have my blackouts too, from the events. I was overmedicated. One of the things that shocks me about my hospitalizations is how much of my consciousness disappears. Since I’m so delicate, I forget a lot of things. I lose track of time, space, and days. One of the days I was overmedicated, I remember going to bed early and couldn’t get up the next day. My body held back the urge to go to the bathroom so much that when I went, I was in pain. I reported to the infirmary that I felt too “druggy,” and they told me I had to wait for the psychiatrist to come in for an appointment. They basically underestimated the dosage. They lowered it and kept changing me, but I still had intrusive thoughts, and after leaving, I reported that I couldn’t walk. I haven’t been under psychiatric supervision for two years and I’m still taking medication. My primary care doctor prescribes them, who understands they’ve done me good, and he continues to give me the prescription automatically. During my most recent hospitalization, at one point I thought I was going to die. I had a hard time getting out of bed due to the effects of the medications. I don’t know what my vitals were like, but I felt incredibly weak, incredibly dizzy, I could even feel my heartbeat, and I was completely out of it and dysfunctional. I was like, “Wow, I’ve lost my mind.” 

Once, I was cold because they didn’t give me my things. My relative had brought them to me, and it wasn’t until the next day or two days later that they gave me the things to keep me warm. I was hospitalized as a young adult and as an adult, but I’d been receiving treatment since I was a teenager, almost a psychiatric child. I had sleep problems, anxiety, and they kept changing my diagnoses. And they were never that assertive, I’d say. What the psychiatrists saw, what the teachers perceived, and what my family perceived was quite another. I didn’t have any autonomy; I had no way of expressing things, or I didn’t have the vocabulary, I didn’t have the tools. 

Once, after a phone call that triggered anger on my part, I got frustrated, went to the bathroom, screamed, kicked against the bathroom door and the plastic trash can in the bathroom, and was crying my eyes out. When they intervened, they gave me an injection of medication, a tranquilizer, locked me in the nurses’ supervision area, tied me up, and gave me electroshock therapy without my consent. They also proposed this to me in the most recent one because I had mentioned that it had happened, and they told me, “Oh, but that’s not so bad,” and told me not to see it as something bad, negative, or traumatic.

(Francisco reports that he was not told about the side effects of electroshock therapy before receiving it and that he was already calm when it happened.)

Laura: What triggers of anger or frustration did you observe in other patients?

Francisco: Many times it was due to the lack of freedom regarding sleeping hours, food, people who wanted to smoke, the volume of the television, or what they were watching, or if they wanted something different. The television was controlled by patients or the administration. The impositions of having to do this or that, and the way they told you to do it. 

Laura: What was the process of admission to the psychiatric hospital like?

Francisco: On those occasions, employers have been great. When they move you to another room deeper in the hospital where the psychiatrist intervenes, things change so much, the whole atmosphere of light, space, stratum, and form are transformed. It’s much more serious, much more somber, I would say. It’s an almost formal interview, like a job interview, but at the same time, it’s like you’re going to be admitted to a prison.

I’ve noticed with other people that there are some questions that, if you answer them a certain way, mean you’ll be hospitalized longer. There are many patients who learn to say, “I’m not going to answer, I’m going to answer what they want me to say, so I can have the freedom I need.” Also, the “you can’t wear this, you can’t do this, you can’t do that, you have to have no shoe cabinets, you can’t use electronic devices, you have to disconnect from the outside world.” I wanted to bring a notebook, but they didn’t let me. In the first ones, yes, but not in this one.

The response I got from one of the staff members was that I needed to take a break from the world. They wanted to make sure that whatever I was writing or reading didn’t trigger other kinds of emotions. “We can’t supervise every reading; we don’t know if something might make you cry or make you angry. For example, a newspaper or the news or things happening outside, like a murder or corruption, well, why should we find out about things happening outside?” I assimilated that, I accepted it, but on the other hand, there were times when all I did was stare at the walls, walk down the hallway, be completely silent, spend time with other colleagues, talk to other colleagues.

Laura: Going back, what made you feel like a prisoner while you were in the hospital?

Francisco: In addition to the fact that all the doors and windows are security-equipped, and all sections have to go through a security check, with specific codes, specific security keys, they’re always watching you, and you’re kind of afraid of, “Where are you going?” “Stay here,” or “Don’t go over there,” the supervised calls, the restrictions. I remember there were some specific rooms that we were warned had closer surveillance than others, and that if we behaved in a certain way, they’d move us to another room, depending on how we behaved. 

Laura: Changing the subject a bit, you told me about medication you were prescribed. Can you tell me a little about the medications you’ve been prescribed?

Francisco: I’ve been taking medication since I was a teenager or pre-teen. Paxil, 
Prozac, Wellbutrin, Lamictal, Zoloft, Effexor, Ambien, Klonopin, Abilify, and Lithium. Abilify started giving me manias and that’s when I started questioning my sanity and I was like, “What is this? I’m imagining violent scenes in my mind.” I was talking to you and suddenly I was imagining myself pulling your hair or some things that I was like, “What are these possessions that I have inside? Where do these intrusive thoughts come from?” I became afraid of it and also of Klonopin because they left me dysfunctional. 

Laura: Did they tell you about the side effects of the medications?

Francisco: Never. They always give you the literature and all that. Also, when you read them, I said, “Look, this could cause such and such a thing,” and they told me, “Dude, if you’re going to be paying attention to everything the papers say, you’re going to be scared all the time and you won’t want to resort to treatment. All medications have side effects; it depends on the dosage, your body, how you take it; it depends on many things, and like everything in life, it has some.” They give you the pamphlets when you go to the pharmacy to buy the medication. It’s not the psychiatrist. In less than a month, or two weeks, or three weeks, I was already seeing effects. I remember one day I almost crashed and couldn’t drive. That frustrated me because I had to depend on a family member, and it was the family member I felt most uncomfortable with, and this made me feel like I couldn’t make progress. Seeing myself dependent on that person. 

I wanted my freedom, independence, and autonomy, but the medications didn’t allow me to have those because I wasn’t functioning properly, I could cause an accident, or hurt someone else. I was between feeling sleepy, trembling, imagining things, persistent memory problems, having intrusive thoughts, etc. I’m someone who has an almost photographic memory of things and childhood traumas. I’ll tell you, but now as an adult, I forget a lot of things.

There are times when I try to justify it and figure out if it’s ADD that’s not being treated, or if I need some other medication, or if it’s because of the various traumas or the amount of medications I was given or the treatments I was given. So, many times, I question both my current mental health and it makes me anxious about how the future might develop. Sometimes, I see people who also have depression and they end up homeless, and I’ve seen myself there, like that could happen to me, and let’s hope it doesn’t.

Laura: How horrible, really. What did they tell you about the medications and how they will affect your life?

Francisco: Most people have told me I’ll be taking them for life; others have told me no. Some say I can take them for more or lower the dose. I’ve found myself in situations where I want to lower the dose, raise it, or lower it. The medications, rather than treating the trauma, rather than the problem I have, treat the physical manifestation of my emotions and what I haven’t been able to work on. And my appetite, sleep, and libido improve or worsen, depending on the medication. They take me off them, and for now, I’m experiencing these side effects: tremors, pain in my hands, and restless leg syndrome. 

Laura: And finally, would you resort to psychiatric hospitalization again?

Francisco: I don’t rule it out because finding a psychiatrist, finding a psychologist, has been so difficult and uphill that it leads to resorting to hospitalization because it’s my last resort. It doesn’t address the problem that was around me, but there comes a time when one sees it as a refuge, but also a prison; it’s constant. I would have liked to spend more time outside, working with the plants, listening to the animals, the birds, in the fresh air, reading, painting, or sculpting, learning something new, struggling with cooking, struggling with practical and useful things, having more therapy.