Adjusting and Recovering: How a Psychiatric Ward Can Mess You Up

Changing How Mental Illness is Treated. Did Kennedy Have the Solution? Watch For Five Minutes and Read

So, imagine you have schizophrenia or schizoaffective disorder and your mental state is going off the rails. Schizophrenia, especially when either untreated or not properly treated, is a literal personal hell. For starters, you can’t even trust that inner voice, that still, small voice most people have that is often called a conscience, or even the gentle guidance of a higher power. These are delusions which are fixed beliefs that can take the form of a running dialog of negative and positive thoughts that just sort of force themselves into your head. You can think that you are psychic, and can hear the voice of your ex-girlfriend in a very similar way to a vivid memory of her voice, telling you to walk out in the middle of winter without a jacket and she will send the Limo her dad bought you as a wedding present. You haven’t seen this ex-girlfriend in years. When you did, she called police on you and you know her dad hates you for some unspecified reason.

But none of that matters in psychosis. Quite often you will also have hallucinations which are false sensory inputs, most often taking the form of auditory hallucinations. One time I was out in a field walking through the snow and I heard the crunch of footsteps from behind me. I was a mile from anything. It kind of seemed that somehow I was hearing myself walk, but hallucinating that the sound was coming from someone who was following me. Another time I was watching a clock tick and as the second hand moved, it made a clear sound of tick, tick, tick. But my hallucinating mind turned those tick sounds into repeated swear words. Then you have paranoia. This makes you not trust even your closest family members. Once, I had left the hospital and went to a mall to watch a movie. The staff on my psychiatric ward called the police who were staking out my house (and as if that isn’t enough of a reason to feel paranoid) before the police came into the house, my mom came out of the master bedroom and I ran my fingers over her face thinking she wasn’t really my mom and that somehow she was wearing a rubber mask or something. In my head she wasn’t my mom, but an Australian woman I was close friends with.

There are of course many more symptoms, like wanting to isolate, not keeping up with hygeine, losing all ambition, and experiencing severe depression. These are known as negative symptoms because they take things away. The delusions, hallucinations and paranoia are known as positive symptoms because they add to your mental makeup.

I have explained all this before, but I want to emphasize here that frequently, and especially if a person has a psychotic illness, these symptoms can only really be dealt with by forced hospitalization. This is often because of anosognosia, which is when a person is very ill but lacks insight. It is literally a symptom of schizophrenia to not even believe psychosis is real.

One of the most troubling parts of needing forced hospitalization is that, as well as a person’s natural desire not to be restricted and told what to do, which is what happens on a psychiatric ward, you are also often given all kinds of medications as the doctors and other staff members try to fix you if they can. (I don’t say nurses here because there are many different staff members on a psychiatric ward from unit clerk to psychiatric aide to occupational therapist and social worker, along with psychiatric and registered nurses who all try to work together for the good of the patient).

All I can think of when I was in a psychiatric hospital or psychiatric ward was how and when I was going to leave, and to feel extremely resentful at the family members who I felt caused me to be hospitalized, never mind that I was ranting and raving and in dire need of the help. Right now I am so lucky to have a sister who remembers when I was very ill and how I lashed out at her but has forgiven all that and seems to only act in my best interests (thank you for the $$ to take a vacation by the way!) What I also have to realize is that she was acting in my best interests almost the whole time, but needed her own time away from our family to sort out her own life. The funny thing is, my dad resented her for moving out of the house when he needed her the most, at which time I would visit her all the time, but then she moved across the country and I resented her for not being a friend in a world where people with mental illness don’t have many friends. Our parents are gone now, but myself and my brother and sister are still very close.

I never much liked my time in the psychiatric hospital. There was one day when we were told we would be taken to play badminton. I love the sport and once tried (and failed) to join my high school badminton team. Then I got to the gym they had set up for us and there were no nets. Everyone just had to improvise with rackets and birdies and watching it brought back a flood of memories of how I first experienced psychosis during the time I was playing badminton in high school. Despite the urgings of the recreation therapists, I left and went back to the ward. I couldn’t help myself, I felt like I was floating off into eternity, kind of like I had eaten poison or something or been exposed to life ending radiation.

So, experiences like this go on while in the hospital. When I was in Alberta Hospital, the only real way to pass the time was to smoke, watch TV and occasionally eat a snack plus of course meal times. It made me lazy, fat, short of breath and out of shape but my head was all over the place. Even though I had never been in an official adult military (I was in Air Cadets for three years and was obsessed with the military) my delusions told me I was some great hero or saviour of the world. A delusional thought would come to me saying the president of the US was down the hall waiting to give me the congressional medal of honour. I had done nothing to deserve one, I wasn’t even in the US at the time, but I would have hallucinations that the air conditioning fan was the sound of a snare drum playing a slow, somber rat-at-tat-tat saying it was time for me to get my medal. I would never even get up and look, somehow I knew this was all false, but it was tearing me up. As I watched TV sometimes, a commercial would come on and I would have a hallucination that someone had bought me the company that was being advertised or the product, but if I stayed seated they would send it away. It is hard to explain but while I was ill, I had so many moments of profound disappointment thinking I was being paged to receive all these visitors and gifts. I summed it up well when I said that I knew I was ill, and I knew the thoughts were false, but I started to wonder if there weren’t at least a few million around to make up all these billions I supposedly was worth.

So, you go to a hospital. You are very ill. You work with the doctors, read when you can, quit smoking because the nicotine patch is free in the hospital. You get back in shape and soon improve physically because you are getting three reasonably healthy meals a day. Then medications begin to work and the delusions, hallucinations, paranoia, lack of proper hygiene and lack of ambition go away. Soon it is time for you to go home so that everything can fall to pieces again.

I was glad to go home after getting help I needed for my psychosis, or for the times I was hospitalized for depression. I could smoke, watch movies, drink coffee, stay up all night reading, and sleep all I wanted then wake up and use my computer flight simulators or go into chat rooms. I was isolated, I was out of synch with the rest of the world, but I was at least thinking clearly enough to not run out of coffee or cigarettes. Things like this went on for a long time and now I have health effects which include breathing issues (I quit smoking for good 20 years ago), need for high blood pressure medication, cholesterol medication, meds for type two diabetes along with a cocktail of psychiatric meds. But the first few weeks out of the hospital were often the worst.

I don’t know why this happens, but I have found that over the course of a number of hospital visits, I tend to lose my social skills rapidly on psychiatric wards. There was one time where it was a warm summer day and I took my laptop outside to sit in the grass and type, and some 10-year-old kid could see me from his apartment window (I wonder now looking back if it was a delusion but I didn’t seem to have any others) and he was insulting me and seemed to know I had recently been hospitalized for mental health issues. I shrunk in fear from what might happen even if I just insulted the kid back, and went inside and didn’t go to sit in the grass anymore that year.

Basically, when you go into a hospital stay you feel strong and confident, even powerful. You imagine you can insult anyone and you seem totally positive that you are some wealthy, well respected person who is the very furthest from crazy. But you’re not. It seems sometimes that the hospital wants to break you. Strong on confident? We will beat on you, wrestle you to the ground, inject you with medication to tranquilize you out of your mind, then toss you into an isolation room for however long we feel like. Imagine not just weeks of this, but months. Then imagine losing all the positive benefits of being in a hospital from meals to recreation to mental health support, and you might have an idea as to what it is like to go home from a hospital.

I do want to emphasize though that I couldn’t come up with any better ways myself to take someone who is that far off the rails and get them to take the needed medication that will take away their psychosis. The total shock of being locked in a violent ward of patients and muscle bound male nurses ready to modify your behaviour to suit their wishes was horrible. But in just two months they took what is the most complicated and baffling organ in our body, the very seat of our soul and basis of all human experience, a human brain—and a very flawed one at that. They took this brain and brought it from insanity to recovery. But it wasn’t done in the community. I had to be taken from my home, my friends, my school, my car, my job, my beautiful neighbourhood with forests and parks and fields and playgrounds and basketball courts, into a filth, locked down hundred year-old building seemingly built to punish people who think differently. I had to be put there until medications were found that would help, and because of the remote location, I lost all those things. Perhaps the worst part of it all was that I was never educated on the importance of my medications or how to get along better with people, or counselled so I could return to living in my parents home until I could just finish high school. I really feel mental health treatment should be forcibly taken from where it exists now and be in a community that supports and continues to care for a person after they get past the initial phase of treatment. John F. Kennedy tried to do it, he tried to close down hospitals and set up block grants for communities to treat the mentally ill like human beings, but it all fell apart, I am not sure but his assassination didn’t help. Most of that money went to other purposes and the mentally ill who were no longer in hospitals ended up in jail or died homeless.

So really, what is the solution? Maybe we all just have to be a little tougher, or perhaps a little better educated. Rules should be in place to limit certain practices in hospitals, and perhaps more transitional housing should be provided. I was lucky. Eventually, I went into a group home. It wasn’t funded by the government, but basically we stayed there and they took as much of our support payments as they legally could. They encouraged me to take treatment, monitored my appointments and made sure I ate and got proper medication. It did a world of good for me and for many others, but we need hundreds if not thousands of places like these. We need to build awareness, and not just of insomnia or depression, but of serious mental illnesses where people need support or will end up like the people Kennedy was trying to help—homeless, addicted, in jail or the grave.