My Psychotic Break

I pretty much have to write about this.

A month or so ago, I found myself in a spiral of irritation. My sleep pattern slipped from not much to none at all. I was unsettled by something in my relationship and let it fill my mind. I spent the entire day of Sunday yelling at Janice. That’s what I remember.

In a lull of my mania, I asked for something to relax, Janice handed me a few of her pills. After that it gets hazy. The next thing I remember is the phone waking me. It was the police, they were outside my door and would like me to come out with my hands in the air. In my mind, I thought it was Sunday evening. It was Monday evening.

What I have been able to put together is that I was increasingly irrational, and threatened to kill myself quite convincingly. Janice was able to show me texts I had sent; I was horrible. But at this point in time all I knew was that I had fallen asleep and she had left.

I threw on some clothes, and slowly opened the door, revealing myself hands first. There was a nice little barricade set up down the hall, and the glint of laser sights from the rifles pointed at me. I invited them in, they placed handcuff on my wrists, and we took a ride to the hospital. My memory is still shaky at this point, I remember moments but not entire scenes. I know I was well mannered entering the hospital, and I know I lost all contact with reality shortly after arriving. I remember trying to bite one of the nurses, and seeing Janice through the glass door of my room. Later, they took me to a mental hospital, I had been involuntarily committed.

I arrived at the hospital Tuesday about noon, and suddenly realized I was missing an entire day. In my mind I was angry at Janice, thinking she had drugged and abandoned me. The conditions were as one might expect, a few steps up from Ken Kesey’s Oregon State Hospital, but the vibe remained. “Long Distance” calls had to be dialed from a special room, and for some reason anything out of the area code was considered long distance. It took another two days to get in touch with Janice. I think that was a good thing, I hadn’t quite figured out what had happened yet. She had been the person who had signed the order for involuntary commitment.

After release I was able to read the notes from my intake interview. I was described as having a flat affect. I remember slowly waking into reality, realizing the time lost, feeling shock.

It became rapidly apparent that the way out was to comply with treatment. I attended all the groups I could, making friends with the other mental patients. It was a fascinating microcosm of society, we had all, in effect, been equalized, stripped of our individuality. The depth of our mental illnesses determined our ability to recover. Some folks would obviously wait their time out and be released, some folks I seriously hope are never released, but I did not meet anyone who did not belong there. When I was able to realize that, I was able to realize that I belonged there, opening my mind to correcting my mistakes.

The groups were educational, not always about the subjects for which they were designed. One group about red flags put a bright light on one person’s attitudes about relationships, and also showed the folks paying attention that everything goes both ways. Had it not been such a hetero-normative group the message might have sunk in better.

I was (of course) open about my sexuality, I figured it would confuse the staff and spare me a room mate. It did, I was the only male without a room mate. A couple of women opened up about their sexuality, as far as I could see no one was uncomfortable in our group. We quickly became known as “The cool kids,” sitting at our own table at meals; then we slowly became “The old folks” as we dispensed our wisdom to the younger folks. The camaraderie helped us all.

As the week passed, new people arrived, most of them faceless, keeping to themselves, a few more aggressive, pointing out to us how we had felt during the early hours of our incarceration. I could see how I had been and was glad I had not been able to talk to Janice until after I calmed down. One person was particularly intimidating, and knew how to play the staff. He was what they called a “frequent flyer,” someone who had been there repeatedly. The staff knew he wouldn’t follow through on his threats, but we the patients did not. The tension was palpable, and I would like to think that my explanation to staff was a part of my release. I could see it from both sides and explained the difference between physical safety and emotional safety to a couple of nurses, people trained in the field who had just turned a blind eye to the purpose of the facility.

My medications were interesting. I received prompt attention because I take Truvada, an anti HIV drug. They wanted to know if I was HIV positive, so I was processed through medical quickly. Because I had drugs in my system (the ones Janice gave me) when I was admitted, they diagnosed me as a drug addict, and gave me anti-withdrawal meds all week. I received my anti-depressants as usual, but because Truvada and Fosamax are expensive they asked me to have them brought in. Remember the Long Distance issue? Knowing they would have to put out thousands for my meds helped me get permission to make phone calls.

That first phone call with Janice, on Thursday, was overwhelming. I was disgusted by the things she told me I had done as she gave me the timeline of my missing day. I thanked her for having me admitted. I was astounded that she cared for me, and missed me so much. I gave her the number to call in, so I could hear from her, and returned to my group. They could tell I had spoken to Janice, I was glowing. She called every evening, and for that time I was free, not incarcerated. She came to visit and time stood still.

I was released on Monday, and the morning was pure stress. I was told my regular psychiatrist had not been contacted, and I couldn’t be released without appointments with her in the next week. It was less than an hour before my scheduled release when I finally got my post hospitalization therapy schedule. We drove home and spent the rest of the day talking. I had the epiphany that the psychotic break was related to having never fully grieved Emma, and was up all night organizing her shrine, telling stories about each item.

As a result of my commitment, I am no longer eligible to own firearms. I agree. I had no idea what I was doing for over twenty four hours, had I chosen to resort to violence I had a solid arsenal and a couple thousand rounds of ammunition. The possibility I could have another break is higher after having one, so I have no issue with surrendering my weapons. The police were exceptionally nice, assisting with selling the firearms and returning items that were borderline inappropriate, like a set of rolling papers in packages designed by Olivia De Berardinas. I did like the expression on the detective’s face when he said how nice my rifles were, and don’t want to imagine the look when he entered the bedroom with the swing.

My doctors have been interesting, the “What happened?” opening was almost funny. Because what happened was not funny. My brain broke. You can call it a nervous breakdown or psychotic break or whatever makes you comfortable, but I did a hard reboot. I did things I do not remember any part of. I had conversations and wrote texts of which I have no memory. I am better, but the experience was moving. I am fortunate that Janice, against her normal intuition, called 911 and followed through in committing me. I needed the rest. I still need rest, but have spent the intervening month helping Janice move her mother in law (her husband passed away) into my home. I have watched my friend’s final performances before “retiring” to Arizona after fifty years in the music business and spent late nights hanging with musicians several times. I know I am slowing down relative to what I was before, but when I look at it I can not call it “slow.”

I know the path to illness and can avoid it, I am building my resources to be prepared.

 

Depression

I’ve heard it said that all great writers are depressed. Watch out Hemingway, here I come.

I have always been a “look on the bright side” kind of person, but my ability to see all sides of an issue always had me aware of the dark side as well. I just ignored it. I told myself that was part of the life drive, to remain positive at all times.

I know my brain isn’t always honest with me. I don’t carry many unhappy memories. I can remember things that were bad, they just don’t inhabit my daily experience. If I don’t think about them, on some level they did not happen. At least the pain they caused did not happen. For instance, there was a period of my life that I remember rather vividly. It was filled with exciting events and good friends. If I really focus on it, I can remember the hell I was living in and how very close to death I came a number of times, how those good memories comprised a very small percentage of the actual tour. As long as I don’t focus on it, it was a really good time, but if those memories were in my mind all the time I would not be much fun to be around. Maybe I’m not, and everyone is just patronizing me.

When I was diagnosed with Multiple Sclerosis my neurologist mentioned that depression could be a symptom, and that fifty percent of people with MS get divorced. It occurred to me that fifty percent of people who get married get divorced, so I didn’t let it bother me.

When my second wife and I were later considering divorce, I went to a psychiatrist. My wife had told me I was crazy and I was looking for a second opinion. The psychiatrist asked me about my childhood and such, and then told me that I was very depressed, because I had had such a traumatic childhood. Really? I just couldn’t believe it. I had never thought of my childhood as anything other than good. My parents rarely beat me, we did happy family things, we were moderately well off financially, what was traumatic? He said it was because my family had moved so often and my parents divorced when I was thirteen. Lots of kids move about, hadn’t he ever come in contact with an upwardly mobile family? Or a military family? This was in 1994, wasn’t divorce rather common by then? It just didn’t make sense, but I’m not a doctor so I took his word for it.

My mother told me that depression ran on her side of the family. My grandmother had been bedridden for the last ten years of her life, and my grandfather took care of her twenty four hours a day. They never appeared outwardly to be depressed, but yes, I could see being depressed under those circumstances. She said she was “clinically depressed”, which I later discovered was a way of saying a doctor had confirmed that she was depressed. Well, so was I then.

A few years later I had a really bad incident, and started taking an anti-depressant, and it worked rather nicely. The only problem was that it interfered with my ability to enjoy alcohol, and working at a winery I needed to be able to drink on a regular basis, so I left the winery. That was more depressing. No win there.

I’ve gone back to the anti-depressants, having learned how to adjust the dosage when needed, and my daily depression has largely subsided. I still have days when I just cry for no apparent reason, and depressing events can get to me more than they “should”, and I tend to be much more emotional than I used to be, but I can tell that the pills do have a positive effect. My current psychiatrist is either a really good actor or he believes I’m handling the ups and downs rather well. He doesn’t tell me I’m depressed, he asks if I feel depressed. I usually don’t. On the other hand, I know that if I allow myself to laugh out loud at disasters he’ll want to give me something a little stronger. So maybe I’m the good actor.

All in all, I know I’ve weathered storms that have sunk others, I know I can make it to tomorrow. I also know that I have depression. I just try not to suffer from it.