Last week my wife and I collaborated on my blog post, ‘Prison Changed Me’. We are doing the same thing for the next two posts. Our goal is to address the failures of our healthcare system and our criminal justice system, as they relate to mental health.
The concerns we’re addressing are based on our experience in the last year and a half. Please note that everyone has their own experiences and opinions to share. We are fairly confident however, that our experience is like millions of others around the world. We need to change this and make it better for everyone.
There are four main ways that we feel the healthcare system was less than adequate when addressing my mental health needs:
1. Access to Mental Health Treatment Options
Most people are not aware of the federal law (The Paul Wellstone and Pete Domenici Health Parity and Addiction Equity Act of 2008) that helps to prevent disparities between mental health and physical health insurance practices. AKA, if your insurance policy states that you can have unlimited visits to a doctor for physical wellness then they must also provide you insurance for unlimited visits for mental wellness. Sounds like this would make things easy for people seeking treatment for mental illness. Unfortunately, the statistics on people who have health insurance are unfavorable. And even if you do have health insurance, it’s still not as easy as you think.
When I first realized I needed professional help my only option was to make an appointment with my general practitioner. I couldn’t just go to a psychiatrist of my choosing and start there. When I met with my GP we discussed what I was experiencing. He first suggested depression and I shared my medical history with him. I also made a point to express my concerns with medications and being open to alternative medicine. His only answer to my needs was medication. So, as someone in desperate need of help, having just started a new job, I took the meds and went home. I felt hopeless. I tried the meds for a couple months and things only got worse. I was then referred to a psychotherapist by my GP. That didn’t work either. Finally, after visiting the ER twice, I was handed a stack of papers with a daunting list of psychiatrists to choose from. Maybe I was finally on my way to proper treatment. How long do people suffering with a mental illness have to wait for proper care?
2. Lack of emergency mental health providers
If we think about mental health as being completely differentiated from physical health (sarah absolutely hates this approach and thinks that it is the fundamental flaw in treatment of brain disorders) then why is it we do not have the same emergency care for mental health? Specific to our location, we have one Level 1 Trauma Center nearby, and if you have read my previous posts then you know they are not equipped to handle mental health emergencies. In fact, they do not even have a psychiatrist on staff.
3. Lack of training in emergency room staff
There is an incredible shortage of acute mental healthcare facilities right now. A recent report shows a 14 percent decline in available psychiatric beds. At this point in time, there are approximately 14 beds available per 100,000 people. At the same time, the number of adults who present with mental illness has increased. This results in people flooding emergency rooms for treatment, or worse, not seeking treatment. Nationwide, hospitals are reporting significant increases in patients seeking treatment for mental health crisis. Unfortunately, hospitals are not providing the appropriate staff trained to handle these situations.
4. General Stigma
One in four adults is diagnosed with a mental illness. One half of Americans live with a diagnosable mental illness at some point in their life. To put this in perspective, you are 11 times more likely to know someone with a mental illness than to know someone who identifies as LGBTQ, 1.3 times more likely than someone who has had cancer in their lifetime, and 6 times more likely than someone with blue eyes.
Our healthcare system influences the way society views mental health. If the healthcare professionals we trust are placing less of an emphasis on mental health, than we fail to believe that BRAIN HEALTH IS PHYSICAL HEALTH! MENTAL HEALTH IS MEDICAL HEALTH. Currently, we cannot replace or transplant a brain. Therefore, our healthcare system needs to put this at the top of the list.
If this is just my story, one story, than imagine what others are going through, who don’t have support, or insurance, or the financial means. In addition, how would being wronged by our criminal justice system affect their access to mental health resources and treatment? This is the second failure that we will address next week.
After seeing the Magistrate and being released from the Wake County Prison, I could finally go home. Sarah came to pick me up and met me inside. We exchanged a few words with the women working there, including how ridiculous it was that I was even arrested. Then we walked out and drove home. This was our first time seeing each other since she watched me get handcuffed and put into the back of a police car. Here’s a bit of our conversation:
(Getting into car)
Sarah: Hey Andy from Shawshank. Or would you rather be Piper from Orange is the New Black?
Stephanie: Hey, you could just say ‘Hey Shawshank, or Hey Orange is the New Black.’ You don’t have to reference the specific actor.
Sarah: Damn. Prison changed you. (I should add that Sarah was so happy to be able to reenact this scene from pitch perfect.)
Stephanie: (Sighs. Hangs her head). Speaking of Orange is the New Black...
Sarah: You met someone on the inside didn't you?
Stephanie: That's funny, but no. They wouldn’t let me keep the cool orange sandals as a souvenir.
Sarah: Oh that's gross, they made you wear communal shoes? You were only there for like 45 minutes.
Stephanie: What am I going to do with my life? I’m ruined.
Sarah: Don’t be silly. We can get you some athletes foot spray or something.
Stephanie: But seriously....
Sarah: This whole thing is ridiculous. You should’ve never been arrested. On a side note, I am pretty sure your mom and sisters are ready to yell profanities at this guy. I kind of want to know what your sisters would do right now. I imagine Katie stalking him on social media and then sending him an email telling him what a jerk he is and why he made a mistake. Samantha on the other hand, would most likely tag him in her status on Facebook telling him to 'Suck a D'.
Stephanie: Bahaha, that's about right. Their hearts are in the right place.
Sarah: They always stick up for you. You Gaal sisters are scary. I wouldn't mess with you.
Stephanie: Will you be my lawyer?
Sarah: Hells yeah. Especially if it means I get a new Brooks Brothers outfit.
Stephanie: Oh man, I don't know, you might be a little too pricey for me.
Sarah: I’m glad we can laugh at this. I was worried you’d be super angry and, well, emotional. I wasn’t sure what was happening while you were in there, so naturally I was so worried. And of course I had no clue that when they arrest someone they don't actually take them to the police station so I went to like 5 different places before I was finally told to go to the Wake County Detention Center, which can I just say makes 'jail' sound like an after school special.
Stephanie: Honestly, I surprised myself. It certainly could’ve been worse, but I was so clueless as to why someone I didn't know was pressing charges against me for something that I didn’t remember, and certainly would never intentionally do. I’m a nice lady. I’m going through a hard time. The emergency room was where I needed to be. And now my mugshot is out there. They didn’t even let me look at the picture to make sure I was happy with it.
Sarah: I'm just glad you weren't wearing something ridiculous when they took your picture.
Stephanie: Like a UNC shirt?
Sarah: EXACTLY! If only people could hear our conversation.
Stephanie: They can. I’ll write about it.
Sarah: Ok, but first I think we are supposed to go to a crappy diner and your supposed to scarf down a bunch of food really quickly like you haven't eaten in days.
Stephanie: Soooooo we go to a crappy diner and all I have to do is eat exactly how I always eat?
Sarah: (nods her head emphatically).
So, that’s kind of how our conversation went. Why? Because Sarah handles everything with humor and it was exactly what was needed at the time. I know it’s hard to imagine when you’re not actually there, but we laugh A LOT, about everything! It’s one of our strengths as a couple, among many. What we’ve both learned from this, however, is very serious. Our views on mental health and the criminal justice system have changed. Individually and collectively.
You have to really imagine this situation. While we joke and laugh, it was very much a serious one. For several months I was struggling. I had no clue what was happening with me. I had experienced depression before, but this was different. More severe. The anxiety was new. Sarah had no clue what I was going through and she wasn’t sure how to help. I go to the emergency room twice, within two weeks. I hoped with all my might, that the sadness I felt, the worthlessness, and the guilt, would all just disappear. I didn’t want to die, but i certainly didn’t want to wake up another day and feel the way I was feeling. And that my friends is not okay. So Sarah did what every caretaker in this situation should do--she sought emergency medical attention for me.
We rely on healthcare professionals to care for us and expect emergency healthcare professionals to be trained to handle anything. This is where I feel our healthcare and criminal justice systems fail. Not all policies and laws make sense. North Carolina, for example, passed a law a couple years ago that makes it a felony to assault any provider on hospital property. This is one of those laws that Sarah has become so frustrated with. Admittedly, it sounds like something that would be good, right? Hospital workers deserve to be safe at work, but their jobs do have risks. And punishing people who are not able to control their actions because of behaviors resulting from brain disorders is not going to deter them or others from acting out in the future. It is only going to punish them more severely for something they can’t control. In situations where people are clearly hurting, these policies and laws only make things worse. People who need emergency medical attention for mental health emergencies (or those seeking treatment on their behalf ) should not have to worry that seeking the necessary medical attention could result in felony charges. In my situation, Sarah took me in for emergency help. My treatment consisted solely of Haldol and Ketamine. Less than 12 hours after pleading with a police officer to take my life, I was released from the emergency room without them even notifying my psychiatrist. This is the first failure...the failure of our Healthcare System.
After my 2nd emergency room visit things were calm...er. I can say with certainty however, that we were both on edge. I still wasn’t sure what I would feel like in the long run with the meds I was on. I was even more afraid of feeling so sad and hopeless again. Unfortunately that has happened several times, but it hasn’t been as scary, more manageable. No more ER visits since. I credit this mostly to adjustments with my meds and how they’ve been treating my unique little brain. I want to touch more on this specific topic, but I’ll save it for a future post because I think it’s important to note the role meds have played in my situation.
This leads me to drugs, sex, and prison. Have you seen Orange is The New Black? You can also add the show Wentworth to your list which is 100X better. Sorry Piper! You can find Wentworth on Netflix. The sex (if you’re into that sort of thing) is not raunchy like it is in OITNB. And there are certainly drugs involved, which will likely piss you off and make you cry in one episode. Lastly, both shows take place in prisons, which brings me to my audition. No, I didn’t really audition for OITNB, but I felt like I did.
So I’m feeling pretty good right? It had been a month since my last ER visit. Sarah and I went out to walk our dogs and came back to discover two police vehicles in front of our house. Yes, we shit our pants. We thought maybe our neighbors had something going on because we live in a cul-de-sac, so the police parking in front of our house wasn’t really a definite sign that we were in trouble. Nope, that wasn’t it.
Then we immediately thought about the pot--the wicked neighbor lady behind us must’ve reported us for smoking. I was shittin’ bricks people! I didn’t want to be known as a druggie. Poor little me from Kansasville, Wisconsin, never touched pot in her life, swore she never would. Then had to cave because her anxiety was so bad and nothing else was working. Dude, I was so scared. How would I ever survive prison? Would pot lead me other drugs? I was doomed.
I had it all planned out in a matter of seconds. I mean, I had to act fast. I’d write Sarah a letter every day. I’d read tons of books and go back to school. I’d offer to clean the inmates’ prison cells so I wouldn’t have to smuggle drugs into the prison via butt. Would that work? Maybe I could sell cigarettes. Turns out the cops weren’t there for the pot either. Phew.
Sarah instructed me to stay on the sidewalk with the dogs. I observed from a distance of about 25 yards. I couldn’t hear a single thing, but she later told me what was said. She walked up to the house and asked the officers why they were attempting to open our front door and looking through our windows without our permission. Apparently they can do what they want.
They greeted her with, “Is this the residence of Stephanie Ryckman?” Sarah replies, “What can I do for you and what does this concern?” Sarah totally gave them a hard time and played sassy wife. I love her for that. She wasn’t about to give them any information without getting more from them first. Smart lady. They asked her again, knowing full well her intentions. She eventually said that I was in fact, a resident of the household and again asked what they wanted.
“We have a warrant out for her arrest and need to speak with her.” Sarah’s jaw dropped and her heart sank. Not good, not good at all. This is hysterical right, because here we have some cops about to arrest me, after I just broke my house, my car, and hassled eight EMTs while they attempted to strap me to a gurney.
Sarah replies, “Okay. So um, yeah that’s not gonna work. She was having a bad day earlier and she’s on meds. Let me be the one to tell her.” So Sarah walks toward me thinking they were just going to hang back, but nope! They followed her.
She got to me a bit quicker then they did. In the calmest way ever, she said, “Hun, the police are here to arrest you. It’s going to be okay.” So it’s me, Sarah, and two police officers standing in a circle, fairly close to one another. I think they were preparing for a potential chase. As if little oI' me, who has never been in trouble, would run...from cops..with guns...and cars.
We had a small discussion and they told me charges were being pressed against me by one of the ER nurses that I apparently kicked in the face. I almost passed out. I had no clue what they were talking about. I was clueless. I had no memory of arriving at the ER, let alone kicking someone. I was in a mental health crisis for crying out loud! Who the hell presses charges against a patient in a crisis, especially hospital personnel trained in such scenarios?!
I remained calm though. Sarah still tells me she’s not sure how I managed to just casually walk over to the squad car and hold out my wrists for them. Truth is, I thought maybe prison would be good for me. If I really had kicked someone, then what else was I capable of?
I am handcuffed. Put in the police car. And taken away. I had no phone. No jacket. No money. And no pot. SML
The inside of a police car is so uncomfortable. I felt like my arms were going to fall off. They were so numb by the time we arrived at the jailhouse. We pulled into an underground parking garage and I was taken inside. I was searched. I was fingerprinted. My picture was taken, which they would not allow me to smile for, trust me I tried. My shoes were taken away. And though I didn’t get to wear an orange jumpsuit, I did get a nice pair of orange sandals.
All I wanted to do was call Sarah. It’s amazing how lost one can feel without a cell phone. Sad really. I looked around the room and saw a payphone. What the hell am I supposed to do with a payphone? I didn’t have any quarters. Furthermore, why was there a payphone? This all felt too real.
They finally told me how to call out. I hear this prompt and I’m supposed to state my name. This way, Sarah would know that it was her wife calling from prison. She could choose to answer and hear my plea, or never speak with me again. I immediately thought of an idea for a podcast: K-Town, the life of a Midwestern woman from podunk Kansasville, Wisconsin, who sold DIY pottery barn clocks, falsely accused of a crime she didn’t commit. A girl can dream.
I sat in a waiting area for a long time until I was finally able to speak to the Wizard of Oz. Actually she was the Magistrate, but whatever. She asked me what I was doing there. I told her I didn’t know. She asked me if I knew the person who filed charges against me and I told her I had never met him in my life. I had no memory of it so I was telling the truth. She noted I had no criminal record (DUH) and was very empathetic toward my personal situation. She understood why I ended up in the ER in the first place. She literally told me that I shouldn’t have been charged and that the case would be dropped. Could it be that easy? Would they really just drop the charges?
Before I leave you, let me just make sure that you understand that I have never been to prison. I have no idea what it’s like or how it changes a person. I know what the Wake County Jail taught me in less than two hours but I am in no way saying it compares. I hope you recognize my sense of humor. I have a very serious opinion about our justice system. I’ll share that later.
What’s in store for next week? The hilarious dialogue between me and Sarah as we drive home from the jail. You do not want to miss it. Subscribe to my blog and you’ll get an email every Wednesday with a link to my most recent post.
Until then, do your best to stay out of trouble.
Last week I told you about the worst experience of my 36 years on this Earth. That was only half of the night. There's more.
I'm not sure I can even say which half was worse because each tops my list for different reasons. They were both horrible. The first half of the night (my violent, yet inadvertent actions) was the worst because of what I subjected Sarah to. It was the ugliest version of me. She saw it and I knew she saw it. I can't come back from that.
The second half was also the worst because of the unknown potential and loneliness of my actions. I know I've said this before, but Sarah had to help me remember this ER visit just as she did the first. I remember the latter parts as the drugs started wearing off.
After being turned away by Holly Hill, a psychiatric hospital, we returned to the same ER I was at a couple weeks prior. We pulled up to the doors and Sarah asked the hospital personnel to help her. I was refusing to get out of the car and didn’t want anyone touching me. I was extremely combative at this point. There was a police officer and approximately eight hospital personnel that ended up being called to the scene.
“Just shoot me, just shoot me. Take your fucking gun and shoot me in the head and this will all be over.”
Those are not words that I ever imagined would come out of my mouth. In my other years of battling depression and anxiety, not once did I request that someone shoot me.
I was in and out, but recall snippets of my combativeness. I know it was scary for Sarah and others including the police officer who had the gun. Sarah said he was crying as he watched me desperately calling out for help. That’s what it was; desperation.
As I replay this in my head, I feel out of sorts knowing those words came from my mouth. But it is possible for that to happen to anyone who suffers. I am so grateful that my wife had the courage, and the physical and mental strength, to get me to the right place at the right time. There are no words that could ever express how much she means to me and how she has helped me through the worst of times. I need you, I need everyone, to know that.
I was later told that 8 grown men, hospital personnel, had to restrain me and hold me down on a gurney in order for them to administer meds to subdue me. This is not a joke. I am 5'3" tall and I weigh 125 lbs. Now you can imagine the level of my combativeness.
After reviewing my medical records, I was admitted to the hospital around 6pm. At least this is when all the test results were completed. My last vitals were taken around 6am the next day. I was administered 5 mg of Haldol (haloperidol) which is an anti-psychotic drug that decreases excitement in the brain. I was then given 50 mg of ketamine in my left anterior thigh. Ketamine is an anesthetic medication. Ketamine is used to put you to sleep for surgery and to prevent pain and discomfort during certain medical tests or procedures.
When I started coming to, it was the strangest, loneliest feeling I’ve ever experienced. I was still very out of it. At one point throughout the night, I remember having to pee. The nurses had to move me to a toilet. I couldn’t even resist if I wanted to. I had to pee and there was nothing I could do but pee. Throughout the night I was transferred to and from the bedside toilet. They took care of me so that I wouldn't piss myself. I feel embarrassed right now, but it's OK. As I've said before, it's a part of my story. It's true and it's real. That's what matters.
After a while I was able to fully open my eyes. I could barely lift my arms and felt glued to the bed. I immediately began looking for Sarah. I kept looking around the room to make sure that what I was seeing was not a dream. It felt so real, but so unreal at the same time. No matter how hard I tried to see her, Sarah wasn't there. It was in that moment when I realized I never wanted to feel like that again. My call for help was answered.
Sarah didn't choose to leave. She wanted to stay and would've stayed as long as she needed to. The nurse told her to go home and that there was no need to stare at me while I was drugged out and recovering. We had dogs to take care of. She had to take care of herself. I was in good hands. I understand this.
When I was finally able to form a sentence, I met a nurse. He was super cheery and such a wonderful nurse. He joked with me and said I was apparently stronger than eight grown men. We both laughed, though I knew that meant I was the talk of the ER as some super drunk lady beating up hospital personnel. Yikes. Not necessarily what I want to be remembered for.
When I was finally able to stand and walk on my own I made it to the bathroom. I examined myself. I felt so sore. I had bruises on my wrists and upper arms from the personnel needing to hold me down. I don’t remember acquiring them, but I understood why I had them.
I was so happy when Sarah arrived to take me home. For a few days after that things were a blur. I couldn’t tell you what I was feeling or doing. I do know that Sarah and her parents were there to support and comfort me.
If I had gotten a gun in my hands during this night, it could've turned out very differently. There was no chance of me grabbing the gun from the police officer in the emergency room. We did however have one in our bedroom closet. The laundry basket I fell on was approximately three feet from our gun. I later learned that Sarah had locked me in another room that night, so that she could go back into our closet and disassemble the gun.
I dislike guns. All kinds. I've never actually shot a gun. I have no desire to. They are scary. To me, guns mean harm. I hate the thought of doing harm to anyone or any thing. Here again, is another example of what the struggle with mental illness can do to someone. No one wants to suffer.
With all my might, and the fight I have within, I always want to live. I've always wanted to live.
I can't wait until next week when I tell you about my audition for Orange is the New Black.
At this point it had been a few months since my struggle began at NC State. The depression hit me like a semi and the anxiety railroaded my entire being. I was constantly telling myself I needed to just suck it up. I’d feel good about that thought for a few minutes and then I’d find myself on the verge of tears. It went back and forth like that all day, every day.
One day, after feeling so defeated and unsure of how long I’d be going through this, I just said fuck it. I started drinking.
I started early in the day. I don't remember when exactly. My wife stopped me as I was chugging a bottle of whiskey in the kitchen. She had to grab it from me and yell at me, asking me what the hell I was doing.
I don't remember much of that night. I was out of it. I was so tired of it all. I make mistakes like everyone else, but this was different. I wasn't thinking clearly prior to the alcohol. Yes, I was depressed, utterly anxious, but I felt something else. For a split second I felt like drinking was the answer. In that moment I thought a drink or two would dull the anxiety, that feeling in my chest, and the million negative thoughts in my head." Another second later I was happy. It felt good to toss the fight aside. The mistake was trading it for alcohol. I knew this, but two drinks turned into a lot more.
This particular day I thought about everyone I loved. I kept thinking, "them or me". I'm a failure. I let them down. How would I ever fix this? How could I put Sarah through this? My heart ached because as much as I wanted to live, I wanted it all to be over.
At this point I was on a couple of medications. I wasn't yet at the point where I found "the one". My psychiatrist and I were still experimenting. I never even considered what drinking while on meds would do to me. It wasn't good.
What happens next is an experience that Sarah and I have had to heal from. I wish I could go back in time and delete it from our history. We've talked about it a lot. I couldn't remember what happened. Sarah had to fill me in. She had to explain to me how I acted, what I did, and what I said. Per her recollection here are some details:
At some point in the evening I became violent. I kicked two holes in the wall, damaged the linen closet door, fell on my laundry basket, and hurt my wife. As Sarah tells it, I inadvertently punched and or kicked her as she attempted to restrain me. I said hurtful things to her. My wife, the love of my life. I did those things.
My wife made the call to my psychiatrist. Being a Saturday, she had to leave a message on the emergency line...my psychiatrist called back within two minutes! He told her to take me to Holly Hill Hospital. Holly Hill provides treatment for psychiatric conditions and substance abuse for children, adolescents, adults, and older adults.
Sarah had to restrain me, get me into the car, and manage to drive half an hour on the freeway to the ER, hoping that I wouldn’t steer us off the road. Before she could even leave the driveway I had already torn off the visors and rear-view mirror, and cracked my windshield.
This experience has been the worst of my 36 years. This is only half of it.
My call for help, in next week's post.
Dear Friends & Family,
If you know me, you know me not for this ugly side. You know the best of me, the positive stuff. I'm sorry if you're reading this and you're not sure what to think. It's OK. I'm still me I'm doing fine. I'm here, lucky enough to have your support.
Sometimes it's easier to feel like I'm admitting something about myself that may not necessarily be true, instead of not being so hard on myself. I am hard work. I am more than 40 hours a week AND I'm a volunteer position. Sounds exhausting doesn't it? Who would want that?
This week's entry is unplanned. I wrote it on Feb 4th, 2019. I felt it was important to write in the moment, especially in lieu of the last few days. It is a part of understanding mental illness and many things that may come along with it.
**Side Note: I spent one night writing my entire story. I get these manic moments where I have so much energy that I can get a lot of shit done. Feels great at the time. I had an idea to start this blog soon after my down-spiral here in North Carolina. It was weighing on my mind heavily. One night I couldn't sleep and I spent the next several hours writing out my timeline and most of the posts. I am not joking. So each week, I go to my Google Docs and I find the next post in my story. I look it over. I make sure I wasn't too drunk when I wrote it (KIDDING) and I post it. So yeah, this post was not written ahead of time like the others.**
I try my best not to transfer negativity to others, but this is just another part of my story that I know other people experience. I would be doing you a disservice if I wasn't honest with you. So, despite the mostly happy days that I've been having, I get some pretty shitty ones. Like the last few days. And they suck. I'm not myself. It just hits me. It's as if I have no control over the steering wheel. No matter how hard I try to veer off in a different direction it just doesn't work.
Have you heard of Premenstrual dysphoric disorder (PMDD)? Well, I emailed my psychiatrist this past week because it's important I tell him when I have these shitty times. He mentioned the possibility of PMDD in his email. It's not something we've discussed yet, but we will at my next appointment. Anyways, there's a good chance I fit into that category. No, I'm not diagnosing myself or adding something else onto my plate and wanting people to feel sorry for me. It's reality and it's important that I'm real about my health. My goal is to learn how to manage it after all. Eventually I will have control. See, that's positive?!
So what is PMDD? Hopkins Medicine says, Premenstrual dysphoric disorder (PMDD) is a much more severe form of premenstrual syndrome (PMS). It may affect women of childbearing age. It’s a severe and chronic medical condition that needs attention and treatment. Lifestyle changes and sometimes medicines can help manage symptoms.
The exact cause of PMDD is not known. It may be an abnormal reaction to normal hormone changes that happen with each menstrual cycle. The hormone changes can cause a serotonin deficiency. Serotonin is a substance found naturally in the brain and intestines that narrows blood vessels and can affect mood and cause physical symptoms.
While any woman can develop PMDD, the following may be at an increased risk:
Symptoms of PMDD appear during the week before menstruation and end within a few days after your period starts. These symptoms disrupt daily living tasks. Symptoms of PMDD are so severe that women have trouble functioning at home, at work, and in relationships during this time. This is markedly different than other times during the month.
The following are the most common symptoms of PMDD:
**Actually, I'm only going to list a few because there are a shit-ton**
Psychological: irritability, nervousness, lack of control, agitation, anger, insomnia, difficulty in concentrating, depression, severe fatigue, anxiety, confusion, crying spells, poor self-image, paranoia and more. There are also others such as gastrointestinal, skin problems, neurological and vascular, fluid retention, respiratory, vision issues, and other complaints.
HOLY SHIT IS RIGHT! I told you, I'm a full-time job. I know what you're thinking; her poor wife. (I do have a sense of humor believe it or not). And if you're one of those people who thinks PMDD just means women become raging bitches, than you're mostly right. If my sister were here defending me she would tell you to "SUCK A D". Then I'd apologize.
It's easier to just tell myself that I'm friends with depression, anxiety, and PMDD. I guess I need to walk alongside them and find a way to cooperate. Maybe I could bribe them. Like a bunch of moms watching a bunch of toddlers bite each other as they steal each other's sippy cups. Another full time job, but a less negative and ridiculously funny way to look at it. In times like these humor can be the best medicine.
Can I put in my 2 weeks now?
Stay tuned next week for that phone call my wife had to make to my psychiatrist.
Meds take several weeks to make their way into your body chemistry. It’s like trying to fit in, in middle school--super weird and scary.
Call 'em shrinks, crazy doctors, whatever. I have never, nor will I ever, regret seeing a mental health professional. In my opinion, it could benefit everyone to talk to someone about your life, someone who doesn't already have a biased opinion of you. They are neutral. They don't pick sides. They listen and simply help you navigate difficult times in your life.
After saying sayonara to the dazed and confused psychotherapist, I needed more help. My depression and anxiety were only getting worse. I needed to find someone else that could provide more than just a question-asking type of counseling. Enter mental health professional #3. (Since 2009 that is.)
That packet from my first ER visit actually came in handy. Sarah helped me research and together we found this dude who has turned out to be a very good match for me. He’s a psychiatrist. He has a degree from Harvard and he is really great at his job. His beliefs in health align with mine and he doesn't push anything on me. He doesn't just prescribe meds. He does a lot more. We work through breathing techniques, meditation (it's not all weird), and other ways to manage panic attacks. Seeing him has been one of the best decisions I've ever made. Marrying Sarah is up there too. ;-)
Because they are physicians, psychiatrists can order or perform a full range of medical laboratory and psychological tests which, combined with discussions with patients, help provide a picture of a patient's physical and mental state. Their education and clinical training equip them to understand the complex relationship between emotional and other medical illnesses and the relationships with genetics and family history, to evaluate medical and psychological data, to make a diagnosis, and to work with patients to develop treatment plans. These treatment plans sometimes include trying certain medications to see if they can help in managing mental disorders.
Yes, I decided to try meds after many discussions with my psychiatrist. At this point in my life I had exhausted every other means. For me, my medication has been a saving grace, in addition to the ongoing support I receive from friends and family.
Meds of these kind take several weeks to make their way into your body chemistry. It’s like fitting in in middle school--super weird and scary. Deciding to see a mental health professional can be scary too. People are judged. That's the truth. I could tell you I hired a personal trainer and you'd probably be like, "Awesome, good for you. Can't wait to see your progress." But I'm willing to bet that not many people react the same way when you tell them you are seeing a psychiatrist. You simply have to do what's best for YOU and let go of any negative opinions people may have. It's not worth your time and energy and certainly doesn't help with anxiety. Toss it aside! Focus on you.
When you find your match, you'll know. It doesn't always happen on the first go. You have to be willing to be open with your psychiatrist. If it's not working, no hard feelings. You move onto another one. Not the most enjoyable thing, but it's VERY important to find someone you feel comfortable with. In my experience, they understand this and will likely help you to find someone else.
I got a two-fer. We spend half the time discussing meds and how I'm feeling and reacting to them, and the other half we talk about life. I started seeing Doc Harvard 1-2 times a week at first. It's a year later and I see him ONCE EVERY THREE MONTHS. This is good. It means that I've learned to manage my depression and anxiety better AND that my medication is working. It means a lot more than that, but you get the point. OH, and I save a lot of money by going less frequently. Ha. I'm not held to once every three months. My psychiatrist gives his personal number, email, and I'm allowed to reach out to him at any time. My wife also has his contact info and is free to use it for emergencies.
She does end up calling him for an emergency...
Hi you. Thanks for being here. Last week we went to the ER together. You already know that I end up back in the ER 11 days later. Before that however, I have more to tell you. If you're just joining me for the first time, I encourage you to start from the very beginning so that you can truly embrace my story.
After that visit to the emergency room I wasn't sure what was going to happen. I've said this before, but I have a hard time remembering all of the details during these distressed moments. Sarah has helped me through everything. I'm just not myself. I fear I may sound "crazy" here, but the super difficult times are like out of body experiences. It's so hard to imagine myself being in them, but then I am. After the fact I just feel so sad and disappointed. How could I be like that?
I finally realized that I needed to put everything else aside and get to a happier place. It's hard to put yourself first. We're all guilty of not doing it. We like helping others and we lose sight of our own needs. It's easy to do. This wasn't just about me though. I wanted to take care of myself so that Sarah and I could healthily navigate this through our marriage. We knew it wasn't going anywhere so our goal was to learn how to manage it together. No more thinking it would pass or that it was only temporary. This was not good and something needed to be done.
And, in order to take care of myself like I needed to, I had to make a very difficult decision. I had to quit my job at NC State, that I had just started in August of 2017. I didn't even make it a full semester there. Talk about feeling like a failure. BUT, I've learned to stop being so hard on myself. I am not a failure. I did what I had to do.
I felt that all of my colleagues at NC State knew something wasn’t right. I interpreted every look and lack of interaction as a sign that they were afraid to get to know me. It’s probably mostly false, but that’s one shitty part of mental illness--it makes you feel as if everything is your fault and you misinterpret a lot! I do not truly know how everyone felt. We barely knew each other. Aside from my interview, which went very well back in May of 2017, only a couple of them saw me teach. I received good feedback. Those that weren’t involved in the interview or my peer review knew very little. There was no time to get to know me or to see the good in me.
I was on a down-spiral at work. I tried so hard to do the job right. My confidence disappeared. I withdrew from social interactions. I couldn’t teach. I wasn’t getting out of bed. I wasn’t responding to student emails. The department chair at the time kept up email communications with me and even sent me student feedback from course evaluations. He was trying to tell me that I was doing a great job. My students said incredible things about me. It just wasn’t enough. I couldn’t function even if I wanted to.
No one ever said anything negative to me at work. I was supported in many ways. For that I thank the department in its entirety. I did try to seek accommodations through the Office of Institutional Equity and Diversity, but I was denied. They didn’t feel they could accommodate what I was asking for. At that point I had to make a decision. It was a very difficult one, but I said goodbye to NC State. I contemplated the decision constantly. I lost sleep. I cried a lot. I told myself to "Get Over It" and "Suck It Up". There are plenty of people out there who believe that's an effective method in overcoming mental illness. Sorry to break it to you, but it doesn't work.
In the end it was the right thing to do. What kind of wellness professional would I be if I didn’t choose to take care of myself first? I just couldn’t let the students down anymore. They deserved the best and I wasn’t the best at the time.
I knew I’d never get that job back, but I was going to fight to get my life back. If you’re reading this, YOUR HEALTH ALWAYS COMES FIRST. It’s like being on an airplane--you put your oxygen mask on first before assisting others.
For a while after that I kept reliving the moment I found out I got the job. How the hell did I mess this up? How did I get back to this awful place? How could I put my wife through this?
Things would get worst before they got better...
Last week we were in the shower.
But really, you should go and read last week's post so my opener makes sense. ;-)
That moment in the shower was like standing in mud, not being able move. I felt like I couldn't see anything. No matter where I looked, what direction I turned in, I saw white space. Not walls, just white space that went on for miles. I saw nothing and that nothing was endless.
Welcome to my first emergency room visit.
I don’t know how emergency rooms work. I’m not a specialist on the logistics: who comes first, why is the wait so long, why can’t you get anything for the pain, and the list goes on. I can come up with a few ideas like the lack of ER staff, the severity of an injury, and the amount of people waiting. Having said all that, arriving to the ER in my condition was not given enough attention. It simply was not viewed as an emergency. Only when there is physical, VISIBLE harm, do we get the attention we need. Is there blood? No. Is she breathing? Yes. Then she can wait.
Definition of emergency
1 : an unforeseen combination of circumstances or the resulting state that calls for immediate action
2 : an urgent need for assistance or relief
So then we ask, “Is it life-threatening?” You tell me. What questions do we ask? Are we asking the right ones? My life felt threatened. I was afraid for my life.
When I was admitted to the hospital due to a mental health crisis, it was difficult for me to understand why it took so long for someone to help me. I didn’t feel like anyone cared about me or what I was experiencing at that time. Maybe it was because my wife was with me and she seemed to have things under control. It’s hard to feel justified trying to explain it to you because you had to be there. I was crying, uncontrollably. I’m pretty sure I was staring off into some place. I don’t know where. I can’t even remember arriving, talking to any sort of secretary, or even getting into a room. I know I did those things because Sarah was there and we talked about it.
The fact of the matter is, my wife brought me to the hospital because I needed urgent assistance. We were desperate for help. I didn’t know how to help myself and she didn’t know how to help me.
I think that’s one reason why mental illness can be so scary. One day you feel really great, happy, and on top of the world. And the next day you’re in the deepest, darkest hole imaginable. You do not want to wake up and repeat another day like that. That is not normal. Not all people make it to the ER in those situations.
I believe that not all hospital staff are trained to treat mental health crises as actual emergencies. I may be biased, but I’m not alone. Yes, I am fully aware of the wonderful staff out there that recognize and understand a mental health crisis. I will tell you this though. Society has misunderstood mental health for quite some time and that includes hospitals.
After waiting for two hours during this particular ER visit, I was taken to a room where a woman asked me a bunch of questions. I couldn’t even tell you what she said. I mean seriously, I was not in any shape to answer her questions at that moment. My visit resulted in her handing me a packet of information on depression and anxiety. I was sent home. It was like a one-size-fits-all brochure. The lady was probably just doing what she was trained to do, but it wasn’t good enough. I’m not sure what is. I just know there’s a better way. How do you give a brochure to a severely depressed person and expect them to do something with it? Luckily I have Sarah, who assisted me in moving forward.
My poor wife. She felt helpless. I couldn’t console her. We were a hot mess together, but she was determined to help me. She didn’t waste any time. She started doing research on psychotherapists and psychiatrists and psych, psych, psych. I may not have said it then, but Sarah, I love you so much for your strength and determination.
I saw a psychotherapist for a bit, but it wasn’t helping. This lady sat cross-legged in her chair and constantly asked me, “Well, why do you think you feel that way?” I DON’T KNOW LADY THAT’S WHY I’M HERE! I fired her needless to say. Just wasn’t for me. That’s OK. We don’t always find the right shrink on the first go. I’m sure she was a great fit for others.
Between those visits and taking time off of work, things just got worse. I would return to the ER eleven days later. Maybe this time it'll be an actual emergency...???!!!
See you next week. Thanks for being here.
It was so hard to leave South Bend, Indiana. So hard. It was scary. It was scary to just pick up our lives and feel as if we were letting something good get away.
We ended up buying a house in Knightdale, NC. We looked at the house thanks to FaceTime and Sarah’s parents. They were instrumental in this process. When they found the one we wanted we said yes and on went the purchase.
We shuffled around a bit until we could actually move into our house, but we got there. Sarah’s parents looked after the dogs for us, which was a huge blessing. A co-worker of mine at the time from NC State was very generous to us and allowed us to stay with her for a few weeks until we could move into our house. We both were starting new jobs the same week. Everything was falling into place: we had a house and we had jobs.
In the middle of my first semester at NC State I began to curl into a ball. The world around me felt like it was crumbling down on top of me. I had feelings of doubt. I started to feel like I wasn’t capable of doing my job. I couldn’t get out of bed. I wasn’t eating or sleeping. WHAT IN THE HELL WAS HAPPENING TO ME?!!!!!!!!!!!
I knew that depression could come back into my life. I just never thought it would come back like it did in 2009. Nor did I think it would bring a friend (anxiety). I try to be positive about things and move forward. You accept the past and move on from it. I've learned now that my mental health is a priority. I mean, it should always be (for everyone I think), but for me it's a different priority. It is a part of me, and my job is to learn how to manage it. That's what I believe at this point in my life.
During the first year in North Carolina, I believe I was frequently misunderstood. Sarah could not fathom why I would ever want to miss work. Here we were starting a new journey and I was screwing it all up. We’ve talked about this in length and part of our understanding of mental illness as a couple has been her realization that she had no clue. She does now and has been the most supportive wife I could ever ask for. And it's not just about me--Sarah has a place in her heart for those who suffer. Mental illness was just a new addition. I love her for taking the time to learn about my mental health and for adapting to my needs. I know it's not easy. I have also tried my best at understanding her feelings and challenges through all of this.
Her parents gave me similar feelings about how they viewed my "situation". I don't necessarily like to speak for others, so I will say that I am not 100% sure this is how they felt, but I am 100% sure of how I felt. I believe that they still are unsure about what to think. And I want to make sure that I make a point of saying that, THAT'S OKAY! It has not been the best of times with them because of misunderstandings. I believe I've been misunderstood and that I've not understood them. Does that make sense? I'm re-reading this and my brain feels wacky. Ha.
I love them of course, with all my heart, but it saddens me that I wasn't able to reach them. I have felt like a complete failure to them. They were so excited when I got the job at NC State. I was even credited for bringing Sarah back home to them. I was happy. Really happy that Sarah would be back in North Carolina and that her family wouldn't be 800 miles away. I'm not sure I'll ever be able to convey to them what I was going through or what depression and anxiety truly feel like. I just know that I don't want others to have that same feeling.
My anxiety only worsened. I drove it into my head that I was worthless. It happened so quickly. I've wanted to be a teacher my entire life, and it took less than a month to make me believe otherwise. Nothing I had accomplished in my life mattered. I didn't care about our house, my job, this place, this state. I just wanted it all to go away. I wished to be back in South Bend. I wish for this, for that...
I was laying in bed for hours, for days. I wasn't sleeping. The scarier part is that it felt like I didn’t even need to--like I was born without a need to sleep. I couldn’t escape feeling that way. I couldn’t force myself to feel better.
Then one day I just broke down. I was in the shower. I remember staring at the wall and crying. Sarah heard me and came to check on me. She asked me if I was okay and I just shook my head and said, “I’m not okay. I’m not okay.” I was repeating myself, crying hysterically, and feeling hopeless. I remember how I felt, not how I was acting. I know that I felt like not breathing. I didn't want to see anything. I didn't want tomorrow to come. I wanted that feeling to go away. At the same time I was so scared of what I thought I might do. I didn't want to leave Sarah. The dogs. My family and friends. In that moment I just struggled with what mattered most. I know what matters most: LIFE MATTERS. But this is what I'm trying to tell you. Depression and Anxiety take over and life doesn't matter sometimes.
Sarah knew, in that moment, that I needed help. Professionally, it was beyond her control, but she did the right thing by taking me to the emergency room.
Back to that “falling into place” feeling. It's awesome! I can honestly say that I've always said everything happens for a reason. Things just fall into place, ya know?! This is one of those times however, where Falling Into Place walked in the door with a mask on. I wouldn't really believe that until later on.
Stay tuned next week for my first emergency room visit in North Carolina.
I just want all people to learn and grow together.