Reaching From Mental Illness to Mental Health

Many weeks ago, in commenting back and forth with fellow blogger Dawn Liz Jones, she challenged me with:

I would be interested to know why or in what ways it is hard to reach from mental illness to mental health. I know for me, it was definitely hard work, with God’s help and grace. Only if you’re ever willing to share. Would make a very helpful and insightful post. – dawnlizjones

Be sure to check out her blog – great Bible insights and personal stories – Inspiration with an Attitude!

How can I reach from mental illness to mental health? Why is it hard?

A major part of my struggle in reaching toward mental health is that health feels gradual, and my descent into mental illness – particularly Major Depressive Disorder with some anxiety – felt very sudden. Looking back on it, it wasn’t sudden; it was a slow decline over many months. But it was life changing for me. It’s easy to spot the negative, to see the low points – my hospitalization was a huge “defining moment” – and to focus on the illness part of my diagnosis. In many ways, I’ve allowed depression to define me, to become part of my identity. I have life before depression, the diagnosis and later hospitalization, and then the “ever since.”

My therapist Ted always wanted me to speak of depression as a different entity, not a part of me but separate, and name the friends depression brought with it (ie, anxiety, loneliness, negative self-talk). He wanted me to see that this was not me, not part of who I am, but instead an unwanted outsider who desired to take over my thoughts and emotions.

That’s great to say, and much harder to put into practice. My depressive episodes – for over 8 years now – are part of my lifetime experiences, and they help shape me. Whether I should or not, I define myself by them. I identify myself as a Christ follower who struggles with depression, may have it all of my life, and so am learning to live with it. That means recognizing my symptoms, my markers, and my triggers and responding appropriately to keep depression away as much as possible.

My mental health is not easy to define except as the absence of mental illness. Illness is much easier to name – depression and anxiety. So health must mean something different, or I will never again be mentally healthy, since I see myself as one who struggles with mental illness.

For me, then, mental health is more about learning how to live in the better moments of my illness or when symptoms have subsided and when I’m in remission, like now. Health also means learning to recognize those steps I can take that help with it – eating well, exercising, getting enough sleep, following my treatment plan. Finally, health means recognizing signs that show something might be awry, that depression is fighting for a way in again. Recognizing those markers and triggers can help me take other steps needed to keep it away – giving myself permission to do less and rest more, bumping up my exercise, being more forgiving of myself and more gentle with myself in my own thoughts.

There’s another piece too, and that’s reminding myself to see me the way God sees me. He doesn’t define me as mentally ill. He defines me as His adopted daughter, His precious child, wholly and dearly loved, forgiven. Walking in this world with its troubles, but walking with His Holy Spirit as my Guide. Not alone. Not a mess. But beautiful in His eyes.

The awareness ribbon color for mental health is lime green, for depression it is green, and for mental illness it’s gray. Into the first few years of my depression diagnosis, I had my good friend Carol make a bracelet for me, a mixture of green and lime green stones – it is beautiful. I wore it proudly, as a reminder and hopefully a conversation starter about mental health and depression awareness. But then a few years later I read someone’s comment about the need to bring attention to mental illness, not specifically mental health, because mental illness is the taboo topic. I thought on that a long time, and it makes a lot of sense to me. We can talk about mental health, but that isn’t the issue – mental illness is. So I asked Carol to make another beautiful bracelet – this one is gray for mental illness awareness. I wear it a lot.

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And they look good together, too.

Psych Ward, part 3

(I don’t remember much about my four-day stay in the Inpatient Behavioral Health Unit at the hospital, but I do have some “pictures” in my head to help me recall pieces of it. Even today, lots of it are just fuzzy memories.) 

I checked into the psych ward on Sunday. I know that on Monday, I went to the nurses’ station near the Commons area. This area was enclosed by glass windows, and there was always someone standing outside of it, like a guard. I asked to use the phone and called my church. I think I told the receptionist that I was in the hospital and asked if Pastor Andy could visit me. As clergy, he wasn’t restricted to visiting hours, so he came and met with me later that day, I think. There was a small room off the Commons area where patients could meet “privately” (with as much privacy as is allowed in a psych ward, anyway.) My pastor met me there; I have no idea what I said. I asked him a few weeks later, just to be certain that I hadn’t done or said anything to embarrass myself or him. He assured me that I hadn’t. I had wanted to see him so that he could assure me I would be ok, that Jesus understood and was with me, and I’m sure he prayed for me.

I had two friends who visited one evening. They brought me cozy fleece pants, and confirmed to me that I was doing the right thing by getting help. I remember feeling very comforted by good friends who cared enough to see me in an uncomfortable place.

My husband came for every visiting hour.

And my kids came once, I think one of them came twice. I don’t remember asking my husband to bring them, but it seems that I did. Very quickly, I regretted that I had. I still wish they had never seen me there. The trauma of going through two locked doors was too much – and my flat affect, my lack of energy or any enthusiasm whatsoever – I don’t think they had known how sick I was, but they couldn’t miss it when seeing me on the psych ward. It must have been pretty awful for them. I’m very sorry I put them through that.

At some point, I remember seeing Dr. Larson. It might have been the first or second day – I’m not sure, since time blurred together. He was in my room, and I was looking right at him but couldn’t see his face because he was leaning up against the window and all I could see was his silhouette as the sun shone through from behind him. He was completely in shadow. But I know it was him – I knew his gentle voice. He was telling me about the different medicines we were trying. I remember thinking that I just wanted to go back to sleep. I’m still not sure what I said “Yes” to.

My last night there, I had a roommate. I was in bed when she came in – she laid down and was crying. I tried to say Hi, and she responded, but I ended up leaving the room for a while so she could have some privacy. When I came back in, I packed my things and went to bed.

I slept almost the entire time I was in the hospital. I later learned that’s exactly what has to happen for the brain to heal. The over-saturation of serotonin created a type of brain injury – there is no way to help it get better without sleeping. Dr. Larson gave special permission (Karen told me this later) to sleep all I wanted – no more group attendance requirements. No wonder everything blurs together – I think I slept through it all. But I know I didn’t dream it.

I don’t regret going to the psych ward – I think it was the best thing I could have done for myself. I actually tried to go several years later, when another medication caused a negative brain chemical reaction. Because I had been helped the first time, I knew it was the right thing to do. (I was unable to enter the ward because all of the beds were full – but that’s for another blog post.)

Psych Ward, part 2

(I don’t remember much about my four-day stay in the Inpatient Behavioral Health Unit at the hospital, but I do have some “pictures” in my head to help me recall pieces of it. Even today, most of it is just a fuzzy memory.)

I checked into the hospital on SundayThe rest of the four days are blurry: I slept a lot. 

I had to go to “Group” – twice, I think. The first time, Group was me and a young man, meeting at a low round table with a nurse who read through some pages and a booklet. All I heard was Charlie Brown’s teacher: “Waa waaa wa waaa.” The second time I went to Group, it was just me and the nurse, hardly a “group.” When she asked if I understood, I said, “Yes” so that she would let me leave and go back to bed. It was weeks after getting out of the hospital that I reread all of the materials I was given from my stay. As I was reading, I had a vague recollection of sitting at the table with her. Blurry memory, though.

I recall being awakened once by a nurse who seemed irritated that I was sleeping; she told me I had to get up and go to Recreational Therapy. As I stepped out into the hall, I was completely surprised to see Karen walking by – she was the Rec therapist! I greeted her like the old friend she was, and wondered if it shocked her to see me in the psych ward. We had become friends through our daughters and story time at the library 13 years before! I hadn’t seen her in a very long time – probably 4 years before this. It ended up being ok that I had to go to Rec Therapy, because Karen and I got to talk, filling each other in on our daughters’ lives. The young guy was there, too. I made a small stuffed fleece pillow – the tie kind (I gave it to my dog when I got home). Karen sought me out later in the day and gave me my lip balm (it had my name on it) – she had found my little pouch.

I remember a couple of meal times – my goodness, it was an odd bunch in the Commons. I didn’t see the young man, but I remember an older woman, an older man, a middle-aged lady, maybe another man, perhaps a total of six of us. I think we sat with two or three of us per round table, but I also remember being alone. Or maybe that’s just how we all felt – alone in the group. The TV was on, but no one was really watching – not even the nurses – I think they had their own TV. There was someone yelling, then screaming – down the hall. People rushed in his direction. Maybe it was the young man.

One time that I was out of my room and in the Commons, I tried to do some coloring. I think I worked on a puzzle too, but it was too hard to concentrate, and I couldn’t see well enough for the detail in the pieces. The young man was there, with people who I’m assuming were his parents, and he was crying hard. The man with him looked angry. The boy ended up yelling at them.

On the 6th Floor Behavioral Health Unit: Psych Ward, part 1

I don’t remember much about my four-day stay in the Inpatient Behavioral Health Unit at the hospital, but I do have some “pictures” in my head to help me recall pieces of it. Still, lots of it is just a blur.

It was Sunday, maybe mid-morning. I had packed a bag with some of my things, per Dr. Larson’s suggestion. I had also Googled what to pack to take to the psych ward, so that I knew to label everything with my name. I had some comfy clothes, my slippers, a toothbrush and paste. I had a small pouch with my name written in Sharpie, and my favorite lip balm, some lotion and cuticle cream. I remember that I was always putting on hand lotion and nail cream and lip stuff – my skin was so dry. Looking back, I wonder if it was a side effect of the medication withdrawal.

I was a little nervous as my husband and I drove to the hospital. I recall asking myself over and over if I was doing the right thing, but I honestly couldn’t come up with an alternative. Staying at home, moving from the bed to the couch, in tears and fear and feeling completely out-of-body was too hard to do anymore. I don’t remember talking much on the way. I don’t remember what we had told the kids. I just kept wishing we would get there so I could get started on healing. My reasoning was that if I was with my doctor, he could move my medicine changes along more quickly than what he had us doing at home.

I had to enter from the emergency room, so we parked and walked in together. I told the woman at the front desk that I wanted to be admitted to the psych ward. My husband and I took seats in the waiting area – he held my hand; I might have been shaking. It wasn’t long before I was called back to the triage nurse for assessment – I told her that I wanted to go to the psych floor because I was afraid for myself, and my doctor was there and I needed his help. I said goodbye to my husband, someone took my bag, and I was wheeled through indistinct hallways and an elevator to the 6th floor.

In my room, a nurse told me to put all of my clothes in a bag she gave me. She had two hospital gowns I could wear so that nothing showed out the back, plus a lightweight robe. I was told that I couldn’t have my things until the doctor had seen and approved them, which might not be until the next day. I remember thinking how much warmer my own clothes would have been, even with the hospital robe on top of the gowns.

I don’t really remember much else about that day. I do know I took a nap – I was cold and so tired. And my hubby came to see me for visiting hours that evening.

Calling for Help

TRIGGER WARNING: a statement at the start of a piece of writing, video, etc., alerting the reader or viewer to the fact that it contains potentially distressing material (often used to introduce a description of such content).

TRIGGER WARNING: suicidal ideation

I was recently having breakfast with a wonderful friend whom I’ve known a long time. She is the supervising manager (or some title like that) for a service offered in my old town. People can call with questions for anything – from needing to know which bus line picks up at the mall in the afternoon to whom to call with questions about public housing to someone to talk to when in a personal crisis – an information and referral hotline. I was telling her about the time in 2009 when I called.

I had just been diagnosed with serotonin toxicity, and my new psych doc had taken me off all of my medications to clear out the brain chemicals. He had prescribed mood stabilizers to help me function and my husband was in charge of distributing them. That had happened on Monday, this was now 12 days later – very blurry days. My doctor had told me that he would be on rotation in the psych ward starting Sunday for the next two weeks, and I shouldn’t hesitate to come to the emergency room if I needed help. He made me promise not to hurt myself. The serotonin toxicity had caused some suicidal ideation (thoughts about death and dying but not acting on them).

I remember lying on our bed, wrapped in my blanket which I was hauling around with me like a child. I dialed Great Rivers 2-1-1 and a lovely voice answered. I remember thinking that my voice sounded shaky.

She asked why I had called, and I told her that I wanted to know how to know if I should go to the hospital to admit myself to the psych ward. She asked if I was planning to hurt myself. (TRIGGER WARNING:) I said no, I couldn’t, since my husband had all my medications. I went on to explain that I was under Dr. Larson’s care, and he had said I could come in if I didn’t feel safe. I didn’t have any option but to be safe – my only suicidal thoughts (again, suicidal ideation, not action) were thwarted since my meds were in our safe and the key in Chris’ pocket. But still, I didn’t feel like myself, was very out of sorts. Of course, I was too tired and too weak to hurt myself – that takes energy and planning, and I didn’t have any of those. And like I said, these thoughts were not my own – they were caused by the over-saturation of serotonin on my brain. They sure felt like my thoughts, though – they were in my head.

I cried and told her I was scared, and tired, and didn’t want to fight anymore. She asked where Chris was, and I told her he was working outside in the yard. I recall it was a sunny day, maybe a slight breeze – very nice for late November.

I talked to her for awhile – I don’t remember about what. I probably told her that I had depression and my doctor was doing to be at the hospital on rotation tomorrow, and so maybe I would go in then. She thought that was a good idea. She asked if she could call back in a half hour and talk to my husband, just to tell him that we had talked. I told her, “Sure.” She made me promise to call her back if I needed to, and said she would call in 30 minutes. I hung up and told my husband, so he could wrap up what he was working on (raking leaves?) and come in.

She called back, and talked to him about how to take care of me. Not that he had to sit with me every moment that I was awake. He needed to know what I was doing, but not to hover, and he didn’t have to worry about leaving me unattended. She told him that we had talked, and that if I still wanted to go to the hospital the next day, he should take me in.

I don’t have lots of details of memory from those days – the hours kind of run together – I did a lot of sleeping. And I don’t remember her name. But I remember her kind voice, and her care – enough that she wanted to make sure my hubby was ok, too. I know that when we talked on the phone, I didn’t feel alone. She didn’t sound alarmed at my call, or even worried. She spoke in a soft gentle voice – very calming. I was glad I had called for help. Just hearing the voice of someone who cared got me through the rest of the day. I wish I knew her name so I could thank her.

I went into the hospital the next day.