[Question] Inpatient Psych

[Dirona]

All the Trigger Warnings.



So, after kinda deliberately getting in a car accident in early March (nothing really happened, I didn't get hurt, and the car only lost the lower half of the front bumper), and having a history of cutting, and having increasing symptoms of both bi-polar and chronic pain - which means needing to take more and more pain killers/narcotics on a regular basis, my family doc has suggested the I consider going to the hospital for inpatient psychiatric care for a bit. While my first response was an emphatic 'NO!' since I truly don't believe that I am a risk to myself or others, there has been a part of me that's been seriously considering it since it was mentioned.

That said, if I wasn't a good candidate for hospitalization when I was cutting, and having massive panic attacks and wandering to the local hospital at 3 in the morning because I was so freaked out and manic and wanting to do something permanent, I fail to see how I am a candidate now. But no matter.

The hospital I'd be going to is not in town though, it's a couple of hours away, and that concerns me, since I'd be away from my support and usual coping sources (spouse, pets, friends, computer). But at the same time there are no psychiatrists in town, just a social worker who I've been seeing off and on for a few months. So the help available at home is rather limited.

The question is, for those of you who have had any interactions with inpatient mental health care, what was your experience like? Did it help? What was good, what sucked? How long were you (or a loved one) in for? What could you take with you? What did you do all day?

There's part of me that very very much wants to collapse publicly. Mainly so I don't have to keep faking all the damn time. (I was at a meeting last month, and one of the other people mentioned that I clearly wasn't *illness I have* because I don't show *symptom I totally have*. It was a thing, and rather hilarious from my perspective.) At the same time, I am utterly and completely terrified of what this will do to my job/career, my family, my personal and professional relationships, and all that. But a goodly chunk of that fear comes from not knowing what to expect. Even though I've worked with inpatient psych units before, I never really got to see how they worked/what the patient care looked like.

I was going to post this anonymously but fuck it, screw stigma.

TL;DR - my doc wants me to go into the looney bin for a bit, what can I expect if I say 'yes'?

 

[Bubble181]

Hmm. I don't know how useful my input in this could be, given that different countries have different rules and all that.
@figmentPez, @Chad Sexington, and others here who have been inpatients before in the Americas may have more useful info to share.

Anyway, short replies from my end: yes, it can definitely help; simply (well, no) by giving you time and space to really work at it, rather than having to balance it and squeeze it in in between ten thousand other responsibilities and issues and problems. It may seem impossible (and, of course, it is, in some ways) but putting a pin in everything else to let you get yourself sorted out a bit (or a lot) can be a major help. Figuring out your issues, learning how to deal/cope, adjusting in some ways, looking at things fro ma new perspective, all that jazz, can help in coping/dealing with all the other stressors/triggers/issues in life afterwards much better.
As for taking things with you and such, I've seen different approaches - depending on different philosophies behind those treating you, and also the type of problems you (and others) deal with there. Giving a gambling addict internet access and a credit card makes the whole thing sort of pointless. Some places I've worked (as security) didn't even allow outside books because of the ideas they might contain - only their own library allowed. Granted, their library was pretty diverse and large, and you could order practically anything out of the city library as well, it wasn't a sect-like brainwashing set-up. Other places allow you to bring pretty much anything except drugs/alcohol/etc...
In your family life - well, your partner has to be on board. They may or may not allow conjugal visits, and they will be coping with the household pretty much on their own for a while, which can get tough, and push them into depression/burn out/whatever if it's too hard - that isn't exactly the point. Other family members and friends....Those who insist such help is only for the "weak" or the "permanently broken" can be safely cut from your life, frankly. Depending on your relationship with people, you can give more or less information - you do not need to share everything with everyone, after all. I'd hope those closest to you would be supportive and help you through a difficult time, support you in trying to improve the quality of your life, and so on.
As for professional life...Yeah, that's one of the major sucking bits, I'm afraid. There's still a stigma about psychiatric help, certainly in-patient care. IIRC you're a minister? If so, I'd imagine some might lose faith in you as the solid rock to lean on, some people might see you as less reliable in the "wise" department. Others might see it as proof that you're wise/smart enough to ask for help when it's needed - the idea you need to go it alone no matter what is horribly flawed (and deeply entrenched in American/Western male thinking). Again, however, you're usually not obligated to share everything with everyone. As far as most people need to know, you can be taking a sabbatical for health reasons (which is technically true) and you can leave it at that.

 

[WasabiPoptart]

I haven't been admitted to or worked in a mental health care facility. Depending on the philosophy of the place it could be easier to get multi-disciplinary care. That can be helpful, particularly in a situation like yours where you're having a mental health issue plus chronic pain. You could have a pain management specialist and physicians on your team as well as psychiatric help.

Unfortunately that's about all I can add to what Bubble has already posted.

However, if there is anything Aussie and I can do for you or @Eriol we are glad to help.

 

[Dave]

It's always the cleric that ends up needing help. I have never been, nor do I have any insight to anything. I'm just posting to let you know we're here for you and if there's anything you need, all you have to do is ask.

 

[Chad Sexington]

I imagine this is too different from my experience for me to be helpful. I was there involuntarily and was actively antagonistic to the psychiatrists and psychologists, and refused to participate in group therapies and such. I did as little as I could, and gave perfunctory answers to get out as soon as possible.

I suspect if you want help, it will benefit you.

 

[Bubble181]

It's always the cleric that ends up needing help.

That's why you always try to have a secondary healer in your group

 

[strawman]

I have no direct experience, but I suppose I'd think of it like a training seminar or educational summit. The thing is that you need to step out of your life for a time, look at things objectively while not being pestered by those things, gather and learn to use tools to help you deal with the major issues, then step back in and see how it all fits back in.

If you are willing to put in some serious effort then I'm sure you'll gain more from the experience than you might lose having to step away from work or other aspects of your life.

Good luck, whatever you choose, you'll be in my thoughts and prayers.

 

[blotsfan]

I have a friend who ended up in the psych ward, and he was there unwillingly. He was pretty miserable most of his time in there, but he started to buy in eventually and it really seems to have helped him a lot in the long term. I'd imagine like Chad said, being there willingly from the start will be even more helpful.

 

[ThatNickGuy]

If they believe you should go on, then I would strongly suggest taking that advice. I've been in the hospital a few times for similar reasons (depression, suicide attempts or threats). Honestly, it not only helped me recharge my batteries, but I was constantly talking to different doctors who were trying their best to help me.

Just remember this: you're not going in there forever. It's just for now, where you likely need help. Maybe it's only for a week. Maybe two. But I guarantee, you'll come out of it at the very least with a better plan on dealing with all of your issues.

 

[Dirona]

Thanks all. It's been both reassuring and helpful to hear what others have to say. It's really easy to get all wrapped up in my own head, especially about this kind of thing (I agonize/over analyze the folks that come to talk to me too), so hearing others helps a whole lot.
I'm on new meds (so I'm hallucinating a lot less, yay!) and I've got another (longer) appointment with my GP tomorrow, so we'll see what happens.
And then I'll have to face HR. Regardless of what happens. Ug.

 

[PatrThom]

I want to write more, but the last couple of weeks have quite literally not afforded me with the hour-plus time I would need to put together the sermon I want to give. Instead, please accept the following 30-50 millisermons:
-Thinking != doing, thinking != Evil, thinking != Sin. Think anything you want, but only do what you believe is Right.
-Discussing your thoughts with others should be beneficial, if those people genuinely wish to help you AND you have some idea of where you want to be. If you don't, then perhaps that should be the first thing you ask for help with.
-We like you a lot and don't want you to leave...unless you have to, in which case (barring some catastrophe) we should be here when you are ready to return.

--Patrick

 

[Squidleybits]

Thanks all. It's been both reassuring and helpful to hear what others have to say. It's really easy to get all wrapped up in my own head, especially about this kind of thing (I agonize/over analyze the folks that come to talk to me too), so hearing others helps a whole lot.
I'm on new meds (so I'm hallucinating a lot less, yay!) and I've got another (longer) appointment with my GP tomorrow, so we'll see what happens.
And then I'll have to face HR. Regardless of what happens. Ug.

I really hope that you get the help you need and I'm glad to hear that your new medication is helping.

Why would you need to talk to HR though? They only need a medical note right?

Good luck tomorrow!

 

[Dirona]

I really hope that you get the help you need and I'm glad to hear that your new medication is helping.

Why would you need to talk to HR though? They only need a medical note right?

Good luck tomorrow!

Re: HR.
Short version - church is special.
Long version - Because church is special, HR is a volunteer committee of regular folks to whom I report whenever I am sick, on vacation, on study leave, or generally going to be out of the office. The group here is good, but if I am going to be looking at an extended period of time away, I need to get them to approve it under the denomination's/head office's correct policy (medical leave, stress leave, etc), and help them fill out the forms, which means that I would be required to disclose the details of all that's wrong with me to that group of un-trained, not-bound-by-any-sort-of-policy-or-ethical-guidelines-let-alone-confidentiality-agreement people. Thus - Ug.

All that said... I'm on another new med, so two new meds in total. One for pain, and one for mental health stuffs. And while it will take a bit for the 2nd one to really kick in, the new pain med is fan-fucking-tastic. Like, I now regularly have moments throughout the day where I am genuinely not in pain. It's glorious. I have energy. I can concentrate. I don't just want to curl up and sleep. Don't get me wrong, I still hurt damn close to all the time. But not as severely overall.

And all that is good news, because this week - which I think I mentioned before, I have off for cont ed/reading, I have two funerals. Which makes the week look like this: Friday - meet with family A, Saturday - meet with family B, Sunday - family service at funeral home for family A, Monday - funeral for family A, Tuesday - family service at funeral home for family B, Wednesday - funeral for family B.
Each service requires at least 10 hours to prep. Each meeting with a family lasts 2-5 hours. So I'm now asking HR peeps for a good chunk of next week off, because damnit I need to get this reading done!

So... things are going better? Meh, it's a mixed bag.

 

[Squidleybits]

Re: HR.
Short version - church is special.
Long version - Because church is special, HR is a volunteer committee of regular folks to whom I report whenever I am sick, on vacation, on study leave, or generally going to be out of the office. The group here is good, but if I am going to be looking at an extended period of time away, I need to get them to approve it under the denomination's/head office's correct policy (medical leave, stress leave, etc), and help them fill out the forms, which means that I would be required to disclose the details of all that's wrong with me to that group of un-trained, not-bound-by-any-sort-of-policy-or-ethical-guidelines-let-alone-confidentiality-agreement people. Thus - Ug.

All that said... I'm on another new med, so two new meds in total. One for pain, and one for mental health stuffs. And while it will take a bit for the 2nd one to really kick in, the new pain med is fan-fucking-tastic. Like, I now regularly have moments throughout the day where I am genuinely not in pain. It's glorious. I have energy. I can concentrate. I don't just want to curl up and sleep. Don't get me wrong, I still hurt damn close to all the time. But not as severely overall.

And all that is good news, because this week - which I think I mentioned before, I have off for cont ed/reading, I have two funerals. Which makes the week look like this: Friday - meet with family A, Saturday - meet with family B, Sunday - family service at funeral home for family A, Monday - funeral for family A, Tuesday - family service at funeral home for family B, Wednesday - funeral for family B.
Each service requires at least 10 hours to prep. Each meeting with a family lasts 2-5 hours. So I'm now asking HR peeps for a good chunk of next week off, because damnit I need to get this reading done!

So... things are going better? Meh, it's a mixed bag.

I'm so sorry to hear about your HR committee. I don't even know what to say

I am glad to hear about your new pain meds though. That's awesome!

 

[Dirona]

I'm so sorry to hear about your HR committee. I don't even know what to say

I am glad to hear about your new pain meds though. That's awesome!

The thing is, my HR peeps are good, I'm just worried about small town and boundaries.
You should hear the horror stories some of my friends and colleagues have! For example (all of these are things that have actually happened to people I personally know in the last 5 years):
- Running after tractors in order to get their pay cheque (a colleague in Manitoba or Sask (I can't remember which), about 4 years ago)
- Having the treasurer garnish your wages to pay your pension, which they are keeping in a bank account that you don't know about (this is currently happening, and has been going on for over 2 years)
- Being denied vacation because "you really only work Sunday's so why would you need time off, (even though we are contractually obligated to give you time)" (a friend, last year)
- Being denied sick leave because "back in my day, we didn't have things like that" (someone I was working with, 2 years ago)
- Folks demanding to see a detailed time sheet of exactly how much time is spent on what every week for years (a la a lawyers billing system). (a colleague, last week)
Seriously, it runs the gamut from horrendous to just plain idiotic. But my peeps have been good. Really good. When Eriol had surgery last year, they gave me leave w/full pay for a week to get him to and from surgery on the other side of the province, and when it went longer because he was bumped (so I was away for a second Sunday), they said "no problem" and have never held it against me/raised it since.
But.
I'm still not comfortable telling them I'm bipolar, and being hospitalized because of a (probable) suicide attempt. It just screams "bad idea!"

 

[jwhouk]

Hon: clergy are sometimes the worst when it comes to mental health issues.

An example can be found here.

 

[strawman]

A doctors note that provides the needed details (time off, change in work schedule, whatever) without specifying the illness should be sufficient. If you don't want to disclose your health specifics you should be able to find ways to operate within their requirements that don't require specific health disclosures.

It's not perfect, because sometimes the secrecy leads to assumptions that are worse than your actual illness, but that's better than not being treated properly.

It may also be possible to discuss your illness with one person who then knows what's going on and, without disclosing specifics, is able to verify to HR your status. This might be useful in the case where certain positions are not open to individuals with certain illnesses, and the HR needs specifics or a trusted third party to verify that you don't fall in those categories.

All that said, my experience with decent religious organizations is that they want to see you helped and well, and will bend over backwards if they can do something to help, so while it will affect how people act and react to you, chances are good any changes will be positive for you, rather than negative.

The negative stereotypes around mental illness are falling away.

 

[Squidleybits]

I agree with Steinman, less is more. I am currently off work for stress and my arthritis pain. I gave my direct supervisor (cause of said stress) a minimal description and I will get her the note. I called her boss before I went and gave him a bit more. My Union rep got the full story.

 

[Dirona]

Hon: clergy are sometimes the worst when it comes to mental health issues.

An example can be found here.

Yes to all of the above. It would be super super easy to end up on the bottom end of an addiction. I've seen it, and I can see it from where I am now.

A doctors note that provides the needed details (time off, change in work schedule, whatever) without specifying the illness should be sufficient. If you don't want to disclose your health specifics you should be able to find ways to operate within their requirements that don't require specific health disclosures.

It's not perfect, because sometimes the secrecy leads to assumptions that are worse than your actual illness, but that's better than not being treated properly.

It may also be possible to discuss your illness with one person who then knows what's going on and, without disclosing specifics, is able to verify to HR your status. This might be useful in the case where certain positions are not open to individuals with certain illnesses, and the HR needs specifics or a trusted third party to verify that you don't fall in those categories.

All that said, my experience with decent religious organizations is that they want to see you helped and well, and will bend over backwards if they can do something to help, so while it will affect how people act and react to you, chances are good any changes will be positive for you, rather than negative.

The negative stereotypes around mental illness are falling away.

I'm going to chat with my family doc about a note of some sort, but again, details need to be relatively sparse, because while I agree that on the whole the negative stereotypes around mental illness are falling away, I'm still living in a small rural town where that is soooooo not the case. That said, there is one person who is trusted by both me and committees who can act as a go-between.

Something to think about for sure.

 

[Squidleybits]

Yes to all of the above. It would be super super easy to end up on the bottom end of an addiction. I've seen it, and I can see it from where I am now.




I'm going to chat with my family doc about a note of some sort, but again, details need to be relatively sparse, because while I agree that on the whole the negative stereotypes around mental illness are falling away, I'm still living in a small rural town where that is soooooo not the case. That said, there is one person who is trusted by both me and committees who can act as a go-between.

Something to think about for sure.

It frustrates me on your behalf that this is the case!!

How are you doing? Have you taken any time off?

 

[Dirona]

It frustrates me on your behalf that this is the case!!

How are you doing? Have you taken any time off?

Thanks Squids! I appreciate your frustration on my behalf!
I think I mentioned before that last week was a week of continuing ed (reading week)... but there were 2 funerals, so not so much with the reading. So I asked and got this week assigned as a replacement cont ed week... and I have a funeral, and a committal, and a pastoral counseling session with a congregant pre-booked (that we've already rescheduled like, 4 times at least), and a 5 hour policy meeting, and a retirement/moving supper for 2 of the other clergy in town who are changing roles... so I should be able to chill and read tomorrow? HR peeps have asked if I want to take a chunk of next week and I have declined. Strategically, it's a better move. And I can take some afternoons off next week without ruffling feathers this way.

The new meds are helping, but aren't perfect.
For example, instead of my moods going up and down all the time, they just don't really exist at all. Which is handy around all this death. It means that where I would usually crack at least a bit (there's a reason all my eye make-up is waterproof!), I don't at all. And given that this week's family is super weepy, this is a good thing. (I got to bodily haul someone off the corpse at visitation on Monday evening and practically drag her over to the other side of the room, then sit with her for 45 mins to get her through what was basically a fit of grief. It was a thing.)
That said, having no moods rather sucks when you're trying to be compassionate and empathetic.
And dry mouth is a shitty side effect when speaking a lot in public.

So... things are stable, but I do need to check in with my GP. And I'll have an excuse to this week, because I'm having some sort of test done on Monday in the big city (read: 2.5hr drive one way) about the nerve issues/chronic pain thing, so we'll see what comes of that.

On the whole: brains?

 

[Bubble181]

For example, instead of my moods going up and down all the time, they just don't really exist at all.

Oh, I remember that side effect. Great fun. My grandmother's funeral, my niece's birth, all with about as much feelings as doing the dishes. Yup. It mellowed me out a bit, sure, and made me easier to be around for some people, but really wasn't a sustainable solution....Best of luck playing around with dosages and stuff!

On the whole: brains?

I'm sorry, you've had quite a bit of education. Neuroglial cells.

 

[WasabiPoptart]

Even though I'm on a low dose of Zoloft I feel like I can't cry. It's not that I have no moods, but actually crying itself rarely happens. That irks me because sometimes I'd really like to have a good one, but I simply can't.


Sometimes I wonder if people get so used to their emotional level being at a 15 on a 10-scale that once they take medication to help with their depression/anxiety/mood that "normal" feels like they are emotionless. Like, you're so used to being in pain that you don't remember what it feels like to not have pain. I believe it's very much a real side effect. I know many people who have experienced it. It does make me curious about why the side effect occurs (I mean I know how most of the medications work on the brain, but is that all there is to it). Which is why if I was 20 years younger I would be pursuing a degree in neuropsychology or psychopharmacology.

Also: Neurotransmitters. Amirite?

 

[Bubble181]

I dunno. Depression and its ilk) tend to make all kinds of emotions translate into one - "sad" being the most cliché one, though I can't say whether it's really the most common one. Before medication, I got angry when I should've been happy, angry when I should've been sad, angry when I should've been disappointed. On medication, I got nothing when I should've been happy, nothing when I should've been angry, nothing pretty much no matter what. Nowadays I get frustrated or irritated, mostly, but....well, still better than nothing. The very occasional moments I do manage to feel sad (or...ummm...content?) are amazing and show me that there really is a whole wide world of emotions out there I generally just don't have access to. So, hey, therapy, not working much yet but I'm keeping up hope.

 

[WasabiPoptart]

I dunno. Depression and its ilk) tend to make all kinds of emotions translate into one - "sad" being the most cliché one, though I can't say whether it's really the most common one. Before medication, I got angry when I should've been happy, angry when I should've been sad, angry when I should've been disappointed. On medication, I got nothing when I should've been happy, nothing when I should've been angry, nothing pretty much no matter what. Nowadays I get frustrated or irritated, mostly, but....well, still better than nothing. The very occasional moments I do manage to feel sad (or...ummm...content?) are amazing and show me that there really is a whole wide world of emotions out there I generally just don't have access to. So, hey, therapy, not working much yet but I'm keeping up hope.

Like I said, I know it's real. If I'm giving the impression that I think the lack of emotion or feeling when on medications is something made up, I'm sorry. It isn't the case at all because I do know so many people who have experienced this including my problem of not being able to cry as easily. My depression and anxiety has made me angry rather than sad, too. My idea was that I'd like to understand if it's the medication by itself, the autonomic nervous system or parts of the brain are so used to high levels of stress that it's now a normal state in memory (or something to this effect), or if it's a combination of that some how. Would it be beneficial to teach emotional regulation skills some how to people who are having this kind of side effect so they can recognize their emotions again? I don't even know if that can be studied. It would be interesting though.