Quite a few readers have been writing with questions regarding my hospitalization. For awhile, I was writing private email to those who wrote, telling you the highlights (or perhaps I should refer to them as “lowlights”?) of those events that have transpired over the previous 100 days. I will tell you a little bit about what i’ve been experiencing, and answer any questions that you might have in comments or in email, depending upon the nature of the question. This particular issue is a topic that I will be exploring more on this blog, so it seems fitting that I say something about it publically (I have written approximately 80,000 words about it in the past 100 days on my private blog, so there’s plenty of available material for me to draw from).
In early August, on the anniversary of the beginning of the fourth year of my ongoing fruitless job search, I attempted suicide via overdose on vicodin mixed with vodka. As with everything else I had tried, I failed at suicide, too — obviously, or I wouldn’t be writing this missive to you now. However, after staying in the ER for four days, I did end up in a state psychiatric institute against my will and was diagnosed with a very rapidly cycling bipolar I disorder — it was cycling on average three times per day. It was so bad that I typically had no idea how I felt or what I thought about anything, and it was incredibly difficult to concentrate on even the simplest of things.
For those of you who don’t know, bipolar disorder, or “manic-depression”, is a mood disorder where one’s emotions are not congruent with a particular situation. For example, a person with bipolar disorder often overreacts with depression or, as I refer to it, with despair, at the slightest provocation, or sometimes with no trigger at all. The same can be said for happiness and exuberance. Basically, a person with bipolar disorder can and often will roller-coaster wildly from one extreme emotion to another, and these moods can also be entirely inappropriate to the situation.
The main goals of the state psychiatric institute where I am staying are to get the patient stabilized using drug therapy, individual and group therapy, good nutrition and a rigid sleep schedule. For example, when I came in, I had only gotten 2-4 hours of sleep per night since sometime in November 2005, and I had not been eating much. Further, I had never received any sort of psychiatric care or medications in my life. Needless to say, this last factor represented quite an enigma to the psychiatrists here, who typically see patients who are “veterans” of the mental health system, some of whom probably know nearly as much about human psychology as the shrinks do. How did I manage to get so far without coming to the attention of the mental health system? They asked again and again. Was I aware that I had something wrong with me?
Even though I am (fortunately) receiving free medical care at the state psychiatric institute, I agreed to help “pay my way” by volunteering to be a guinea pig in several suicide research projects, the most terrifying of which required having spinal fluid collected from my spinal column via a lumbar puncture (a “spinal tap”).This spinal fluid is being analyzed for metabolites from a variety of neurotransmitters, such as serotonin, dopamine and GABA.
Neurotransmitters are biochemical messengers in the brain and elsewhere in the body that help to perpetuate (or muffle) electrical transmissions in the nervous system. When the body breaks down these neurotransmitter molecules, the smaller pieces are known as “metabolites”. Monitoring specific metabolites provides a fuzzy snapshot as to how the brain is (or is not) functioning, and thus, it is a good beginning for further research.
In addition to the lumbar puncture, I also underwent a lot of psychological testing that was stressful beyond words, and I was also a guinea pig for medical students, residents and psychiatrists who were practicing their interviewing techniques on real patients.
During my time here, I continued to pay all my personal bills and rent for my apartment, which of course, drained my bank account and added considerably to my stress levels. I also found someone to care for my birds, someone whom I thought was qualified because she is a veterinary technician. However, while I was incarcerated here, she came in to my apartment one morning and found one of my beloved parrots, dead.
Not only is one required to possess a USDA permit to hold this species of parrot, but I had owned these birds’ parents when I lived in Seattle and I had raised these particular parrots from the day they hatched. In captivity, these birds live to be approximately 30-35 years of age, but this individual was only 6 years old. To say the least, this loss nearly killed me. The institute would not release me, and did not show much sympathy in my situation, and so I fell into a deep and paralyzing despair where I was so distraught that I was catatonic at times and I couldn’t eat or drink for many days. I was almost sent back to the ER due to medical health concerns.
After that setback, I suffered several more setbacks in the form of a wide variety of debilitating side effects from the medications. The most alarming side effects were both physically painful and terribly disappointing — they were mostly seriously exaggerated side effects to the therapeutic medications that they gave me, starting with lithium — which gave me a five-day-long vomit-inspiring migraine that no pain medications could relieve. This was followed with depakote, which made me acutely, desperately, eagerly, irrationally, suicidal after I had only reached half of a therapeutic dose.
I guess that the third time is a charm because finally, I am using a group of drugs that might be helping me. I am now using citalopram (celexa), olanzapine (zyprexa) and clonazepam (klonopin) — which appear to be working at least somewhat well, although the dosage must be adjusted for maximal effectiveness (for example, I am currently coming down off a 4-day rapidly-cycling mania, which required large doses of haloperidol and lorazepam to bring under control) — to say the least, that entire experience was most, most unpleasant.
But my medications are not affordable, especially for people in my situation. I am trying to arrange to get some medications for free, but so far that has not been successful. If I have to pay for my drugs out of my own pocket, they will cost in excess $600 per month! This, when I have other, much more pressing money problems, such as rent, to deal with.
Currently, things are getting messy regarding my discharge date. Some people on the treatment team believe that I am not strong enough to be released, especially because I lack a social support system here in NYC, while others on the team think that I don’t want to be released at all because, as they say, “I know a good thing when I see it” (three meals per day, for example). Of course, those team members are conveniently ignoring the fact that I am still paying all my personal bills on deadline and without anyone’s help, even though I haven’t set foot in my apartment nor seen my parrots for 96 consecutive days as of this date. Nonetheless, at this point in time, some of the team want to transfer me to a long-term facility where I could stay for many many months, years, or even for the remainder of my life.
I know this situation sounds preposterous, that I am not really “crazy” at all, and I treated these threats as preposterous until recently when a crisis caused reality to set in like a dark thunderhead, so I delivered my “72 hour letter” to the staff. This “72 hour letter” petitions the courts to either release me or to schedule a court date within 72 hours so I can argue my case. For reasons I don’t understand, my letter was not delivered until today — 72 hours after I’d written it, so my court date is scheduled for next Wednesday. I am presently seeking a lawyer, preferably pro bono who knows how to handle such things.
So I will keep you updated on this ongoing saga, if you are curious.
An original poem inspired by this situation.