Alice In Wonderland By Lewis Carroll   

Image obtained by Google Images  Location:
Mad Hatter's Tea Party in the National AIDS Memorial

^{The Hospital}

I have been hospitalized more times then I want to remember. Each hospitalization is different. It varies because most of the time there are different doctors and other staff  members and very different approaches. Each facility is different as well. Sometimes the programs change. I can tell you that the best place I have ever been hospitalized is Johns Hopkins Hospital in Baltimore, Maryland. It's located about 3 hours from my home. They have an excellent medical team and approach. I have been a "guest" there more times then I'd like to remember. Prior to going to Hopkins, I have been in and out of my small local area hospitals on numerous occasions. It wasn't until I went to Johns Hopkins that I started on my journey to some stability.

In my experience, it's a strange occurrence to be on a locked psychiatric ward. They tell you that the locked aspect of the ward is for safety purposes. It's odd not to be able to come and go but when one is in a critical state, I suppose it is safe to be "locked in." Each hospital has its own set of rules and expectations of the patient. They are some what similar in my experience. When you arrive you are evaluated by a nurse and then the doctor. They ask a series of questions regarding your affect. At Johns Hopkins they give you what's called a "mini mental" exam. It's a series of questions designed to see how you function and what your memory capacity is at the time. The psychiatrist will evaluate you and then give you a physical examination. When I was at Johns Hopkins last July, the exam with the doctors was about 90 minutes. They have a "team" approach at the hospital.

The team is made up of an attending doc who is the primary on the case, and an resident doc who does most of the work and sometimes a medical student. They do rounds in the morning to assess how you are doing. The rooms are comfortable and the baths are shared by two rooms. They have private and semi-private rooms. Fortunately, I was able to get a private room. I was glad of that.  The daily routine consists of educational groups, support groups, occupational therapy, relaxation therapy and gym. Not all hospitals offer these programs. Twice a day you meet with your assigned nurse to discuss how you're feeling. This gives the staff an opportunity to write down your progress so that the team can review your status each day. The majority of the nurses at Johns Hopkins were excellent and very comforting. Meals are served three times a day. One is allowed to select meals from a provided menu. The food was pretty decent and the selections were adequate.

I usually end up in the hospital because I am suffering from very severe depression or mixed states. I had an excellent and very skilled set of doctors thankfully. After my assessment, the team put together a proposal for me that I was not comfortable with however. They suggested ECT for me which threw me completely. Because of the nature and duration of my depression, they felt that ECT would help break the cycle. I had been in bed for months on end with no hope in site and finally I developed a plan to take my life. I was a wreck when I went into Johns Hopkins. After four days of careful consideration, I decided to ask what plan "B" was. My doctors had examined my lengthy records and decided that I had not had a long enough trial of Lithium. Thus they decided to put my back on that drug. They felt I needed two mood stabilizers and I was already taking Depakote. I went through days getting my blood drawn to check my levels and suffered some side effects to boot. However, I decided I wanted to give this a fair chance. So I went through the daily routine each day in the hopes I would start to feel better soon. Just a note about ECT. I did see some improvements in some of the patients who were undergoing ECT. It just wasn't for me at the time. (Update: I no longer take Depakote. I'm on Lamictal and Lithium now).

The first few days being hospitalized are the hardest. I cried and cried after my husband had to leave. It was very difficult on me. I felt totally isolated and all alone. My depression seemed to get a bit worse because of these intense feelings. You feel like you're under a microscope with all the docs and nurses watching you, not to mention the other patients. Eventually, you make friends, however. It's easy to relate to someone who shares a similar illness. At first you're very quiet at the groups and don't want to talk or look at anyone. Then in due time you warm up a bit. It becomes easier to look people in the eye instead of away. It also becomes easier to speak if you choose to. The main thing to remember is that your there to get stabilized. That should be your main goal. It takes a lot of work to get there, however.

Each day I awoke around 7 AM and literally forced myself to shower at least every other day. That was really hard because I was not showering properly at home. I would try eat breakfast like a good camper even though I didn't have much of an appetite. I went to most of the groups as it was expected of me. I tried my best to do what was asked of me, but sometimes I skipped going to the gym and relaxation group because I just wasn't up to it. I would take naps on occasion even though they request that you stay out of your room for the day. Occupational therapy allows you to work on arts and crafts and other things. That group seemed the most enjoyable. They requested that I do an extra task and cook a meal because I was not going to the grocery store or cooking at home. They took me to the grocery store, well actually we walked, and I purchased what was needed for me to cook lunch. Making the lunch seemed rather foreign to me since I hadn't cooked anything in such a long time. I stared at the stove for what seemed like and eternity. It took me a while to get going, but once I did everything turned out fine. I worked the program as best as I could even though it was tremendously difficult. When your so depressed you can't see straight, it's really hard to participate. I fought my feelings to surrender to my gloom on a daily basis.

While I was in the hospital, my mood was not stable. My doctors gave me a scale to measure my moods on from 1-10, 1 being the lowest, 10 being the highest. My moods would fluctuate several times a day. I was never hypo manic, however. For example, my mood would climb in very small increments usually between a 1 and 3. I was very hopeful when my mood would get to a 3 thinking the drugs were working. Then I get slammed back down again. It was very upsetting to say the least. I was in tears a lot of the time. The whole experience was very difficult. I also suffered agitated depression which is very uncomfortable.

Being hospitalized is not glamorous. They expect a lot out of you in an attempt to help you I suppose. You are exposed to all walks of people with varying degrees of illnesses. You are expected to follow the schedule, eat, and participate even if you don't feel like it. On Meyer 4 where I was, there are two groups of illnesses which are affective disorders and eating disorders. The unit has 22 beds and it's very difficult to get on this unit. They always have a waiting list. I had to wait a day or two before they would take me. This was really hard on my family because of the degree of my suicidal state. They watched over me very carefully until I was able to be admitted. Once there, I felt extremely sad, especially when my husband had to leave. He was facing a 3 hour drive home. He visited me during visiting hours as much as possible. The staff was very nice and allowed him to come a bit early and stay a bit late sometimes as long as it didn't interfere with the groups. They do this for people who live far away.

Gradually after more then a month, they discharged me. They had put my on lithium again and it was not an instant success. My doctors explained that it could take several months for the lithium to reach optimum benefits. When I left the hospital, I was still depressed however it wasn't as seriously pronounced and my death wish had gone. I look back on this experience and am thankful for the excellent and knowledgeable doctors that I had. The staff treated me very well for the most part. I fired my old psychiatrist and went with another Hopkins trained doctor. He's awesome and has written four books to boot. I feel very fortunate to have him. Today, I'm doing much better and I feel the Lithium and other drugs I'm taking are starting to improve my state. It was very hard to be hospitalized for that long of a period of time, but I managed and got through it!

Now if you will go back the hospital page, you can see what hand outs and things they give you when you arrive. It will give you good insight as to what it's like to be in the hospital. Thank you.