Ten things I love after coming out the mental hospital

I wanted to write a more lighthearted blog, I feel my last one was a bit too serious (not many people wanted to read it!) I thought I’d write something a bit more personal – something not just about mental health but about me as a person and about where my life is now and where it might head. Also I wanted to discuss other aspects of my life, like polyamory (I’ve been polyamorous for 14 years!) So I’ll list ten things that are better since leaving hospital.

1. My depression has gone!

I have been depressed off and on since my late teens. However this particular bout of depression was particularly severe. I sometimes could put a face on and carry on like I was okay even if on the inside I basically felt dead, but the longer that went on, the harder and harder it became to “fake it till I make it”, and I started spending days in bed, feeling so disgusting inside that I genuinely felt the only way to free myself was to die. I seriously wanted to die: I planned it. I took an overdose (it didn’t work) so I planned to hang myself. I was prepared to go through the gruesomeness of hanging to achieve death, as I believed that nothing could feel worse than the depression. When I died I hoped I just wouldn’t exist anymore because existing felt too painful. The only reason that didn’t happen was because Howard stopped me, got me help and I was sectioned.

Now six months on I feel free. I am so very glad that he helped me. I was furious to be sectioned but it literally saved my life. That’s what sectioning is meant to do. There is not a moment that goes by that I don’t remember that I’m not depressed. I feel it’s important to fully comprehend that people who have serious mental illness are at risk of dying when their illness is at its most severe. When anyone with that kind of life-threatening illness recovers, they appreciate life in a new way. You never forget that you’ve been so unwell and you never take for granted the feeling of good health. Also you live in fear of it returning. If I feel even a little bit sad for a few moments I think “shit, it’s coming back” and it really panics me. It’s been 44 days that my mood has been stable; I fill in a mood chart so I can see how things are day to day. I don’t know how long it will last; in the past ten years I really haven’t ever felt this well. I hope it will last a long time but I’m making the most of every moment. I’m honestly not sure I could survive another bout of depression as severe and as long-lasting as that.

2. I’m seeing my partner (Howard) more

Without going into too much detail about Howard’s private situation, there were lots of changes for him when I was in hospital. It’s worked out that he now has more time for me. I adore Howard. I think that anyone who knows us will see that clearly. I have never in my life met a person that is so kind to me. He’s done things for me that I never imagined another human would ever do. For example when I was in hospital he visited me almost every day for the full five months. When he was tired and needed a break, he would only take one when he was able to arrange another visitor, making sure that I was never without a visitor even though I never asked this of him. As a result there was not a single day that I went without a visitor. I remember one time he told me that seeing me there was the highlight of his day, which kind of got through the depression and made me feel loved. Now I get way more overnight visits with him and see him a lot more than I used to.

The extra overnight stays are the best. I love going to bed with him and waking up with him in the morning. I love visiting him and being around him. Everything about him makes me happy. When he’s with me, I get a sense of calm in his presence that I’ve never had before. It feels like I’m home. I don’t want this to change back; I want to continue seeing him as often as I do now. I have never felt so happy and in love and I’ve never fully trusted someone to always have my best interests at heart. In the past my trust has always been broken.

3. Less anxiety

One of the things that I suffered from terribly over the past ten years is pretty extreme anxiety. I chart my anxiety out of ten, with zero being none at all and ten being that I’m so anxious I am at the point of vomiting. I regularly (once or twice a week) vomited from anxiety. Before I went into hospital it was daily. I never imagined my anxiety would ever be under control. However, on my new meds regime where I’m able to take a high dose of amitriptyline, my anxiety is under control for the first time in years. It’s so good to just relax! I have days where I get a bit anxious but usually it’s on the lower end of the scale and I now get times when I’m not anxious at all. So my anxiety is a zero on my chart. In the past this just never happened. It’s a very freeing feeling to not have that gut-churning anxiety all time time. I can be more social without freaking out beforehand that everyone hates me, and I’m not constantly worrying like I used to any more. In fact even though I do care what people think, it’s nowhere near as much as I used to!

4. Not sleeping all the time

This is huge for me, because for the past ten years I have slept so much. In my old routine I would go to bed by 10pm, sometimes much earlier, and regardless of how early I went to bed I would regularly not wake up until 11am or 12pm or even later. It wasn’t unheard of for me to sleep until 2pm. I was taking a drug called chlorpromazine and it was making me very, very drowsy. The sleepiness I felt invaded every part of my life. Mornings were lost because even when I did get up earlier I was thinking through a thick fog. I often woke up depressed, likely due to oversleeping and the drug itself. I could never plan a morning activity because I was always unconscious in the morning and it was so unpleasant to wake up early that I just refused to do anything before 12pm, and even 12pm was early.

So why did I continue to take chlorpromazine despite that horrible side effect? The answer is, I cannot sleep without night-time sedation. If I go even a couple of nights without sleep I get manic. My mania is severe and life threatening, therefore I had to take something to make me sleep. The only thing offered to me was chlorpromazine. I tried to take the smallest dose I could but I regularly needed doses of up to 200mgs per night. Chlorpromazine also dulls down all of your emotions so for me everything was muted, especially early in the day. I’d been on it so long that I’d forgotten what life was like without it. In hospital they started giving me amitriptyline which is sedating itself. That meant that once I got up to a higher dose I was able to drop the chlorpromazine, which was such a huge relief; amitriptyline makes me very sleepy a couple of hours after I take it in the evening, and it guarantees me a good sleep, but by morning I feel refreshed and awake and don’t have that horrible hangover effect. I now set an alarm for 8 every morning and aim to be up by 8.30 to start my routine. At the weekend I let myself have until about 9.30. It’s so lovely to get my mornings back, to have a proper length of day, to just feel refreshed after sleep and alive instead of constantly sluggish. I love it when my partners Isaac or Howard stay over and I can wake up with them in the morning, have breakfast and say goodbye to them if they are leaving for work. I’m being very careful not to get into a bad habit of sleeping late everyday now.

5. Isaac

I think people might believe I don’t really love Isaac; I admit that I tend to talk about Howard more just because he’s my longest-standing partner and I have more commitments with him, but Isaac is adorable and funny and kind, and I love him in a very unique way. The days I spend with him and the adventures we go on are always fun and carefree. He is like a tonic to the other serious things I have going on. It’s no secret that after 14 years I don’t want to be polyamorous anymore. The only reason I continue to do polyamory at all is Isaac. I cannot give him up. I love him too much and I enjoy being around him. He was also a huge support when I was in hospital, often taking me out for a few hours and frequently in the car going to see the dogs and hanging out with them in the field near the kennels. We had lots of fun there even though I was often desperately unwell. Isaac can get through my sadness and depression and make me laugh in a way that nobody else can. I need that in my life. Because I don’t have as many commitments with Isaac, it means I’m with him just for the sheer joy of being with him. He has two beautiful children and I feel honoured to be a part of their lives too. I have no idea what will happen in the future in a romantic/sexual way but I do hope that even if one day we break up again we can still stay close friends. What’s even nicer is the rivalry that existed between Howard and Isaac seems to be over. They seem more content with my being with the other and less afraid. I think they both know that they bring different things to my life and that that’s okay. Now I just need to convince them to hang out more so I get to enjoy being with them both in the same place!

6. Being productive

I have been so unproductive the last few years. Even when I thought I wasn’t clinically depressed my mood was often still very low. I remember when people would ask me if my mood was normal I’d say yes, but really it was only a 3 or 4 (5 is normal). 3 or 4 was literally the best it ever got and as it wasn’t as bad as 1 or 2 I just thought that was acceptable and normal, and even I had forgotten what normal was. I never got a long run at being okay; my mood was always on the way up or on the way down. I spent so much time in bed that nothing got done. I remember wanting to go to the outpatient pottery class at the hospital and being unable to because it was in the morning and mornings were something I just couldn’t do. Now I am regularly going to the Monday morning class which starts at 10.30, I’m out the door by 9.15! Seeing friends was a struggle, taking the dogs on a longer walk was a huge effort, I just had no energy. Housework never got done, washing was left until it overwhelmed me. Dishes would pile up, everything was cluttered and stressful. I had really let things get on top of me. Now I’m up early I can do a morning dog walk and be home before lunch. My personal hygiene is better. I put nice clothes on, I wear my makeup and other things that make me feel good about myself! I’m making more effort around the flat and I’m interested in making it a nicer environment for myself. I just feel like I have motivation for the first time in years. I’m enjoying being productive, I want to be productive. I’m not just sleeping my life away or lying in bed staring at the wall for hours. This is probably one of the most important things that has improved and I didn’t even realise that my lack of motivation was part of my mental illness. I genuinely thought I was just lazy and useless.

7. I can feel feelings again!

When other people talk to me about depression they often say they feel sad, or they feel empty or hurt or unhappy. When I feel depressed I feel dead. It’s hard for me to feel anything. The only words I can use to describe how I feel is ‘disgusting’, ‘sluggish’ and ‘muted’. My emotions are very dulled down. This might have been partly down to my medication regime too (chlorpromazine). I did feel love, or at least I knew I loved Howard and I loved Isaac but I couldn’t fully feel it, not in my bones, the way love should feel. Nothing made me happy, nothing made me sad, it was just this dreadful nothingness. I think the only time I could feel anything at all was when I was in physical pain. I could feel that, and it was real and sometimes I would enjoy it when my endometriosis would flare up because then at least I felt something. This is also why in the past I have self harmed though I haven’t done that for years.

Now I feel everything and it’s with such powerful intensity. It’s like the shell has crumbled and underneath everything is red raw. The love I feel for Howard is overpowering. It’s frightening, to actually feel like that about another human being who could possibly hurt me. I care what happens to me. I don’t want to die. Let me say that again. I. Don’t. Want. To. Die …

I’ve spent so many years wishing for death because I couldn’t stand the disgusting, sluggish, dead feeling I constantly felt. It was literally torture. People don’t understand. How can someone commit suicide? Don’t they care about their loved ones and responsibilities they leave behind? I believed everyone would be better off without me. Towards April when I was sectioned, even my dogs. I thought life was absolutely 100 percent not worth living. That I’d rather go through the gruesome process of hanging myself than go on another day. I actually wanted to die in a horrible way because I wanted to feel something/anything before I went. How I never came to any harm is partially down to luck, and partially down to Howard taking me in when he did. I am 100 percent in love with life just now. Everytime I feel an emotion I haven’t felt in a long time it’s like feeling it for the first time again. I feel like I’ve woken up from a nightmare and reclaimed myself.

8. My flat is a lot nicer

My flat has been in a terrible state for literally years, in fact ten-plus years! I was in the horrible situation of owning the flat with my ex and being unable to get his name off my mortgage because I live on benefits, and therefore they wouldn’t give me a mortgage on my own, even though I was clearly making the repayments! As a result of this I was never able to raise the money through remortgaging, and I wasn’t able to get Chris removed from the mortgage despite the fact that he abandoned the flat many years ago and had hardly paid a penny towards it. Howard sorted this out by taking on half ownership himself. I want to stress this is an extremely kind thing for him to do. I’m overwhelmed with gratitude and I have a feeling of security that I now have a co-owner that I can trust. Not only did he do that but he sorted out all the paperwork and worked very hard to make it happen. It took a year! Chris (my ex) was made it really hard by refusing to sign the paperwork. Now finally for the first time ever I am in a position to actually sort my flat out.

Since going into hospital Howard arranged for all the work that needed to be done. This was a lot of work for him. In my depressed state I wasn’t even able to give him any input. I didn’t even care that much what happened or how it looked. Howard encouraged me to pick colours and other such things which I did but I never really believed it would happen.

Now I have a new boiler, new radiators, new flooring in the living room and hallway, new windows and a new bathroom, and now I am out of hospital the kitchen is in the process of being done! Eventually we will decorate the rooms and I’ll have a nice home to be in that I love and that’s not a nightmare. I can wake up in the morning and take a shower in my nice new clean bathroom. My old bathroom didn’t have a shower and I had to take baths that took ages to fill because of the failing boiler. Now I wake up in the morning and hop straight into my nice hot shower and feel clean. I haven’t had a working oven for nine years and my hob barely works. Once the kitchen is finished I’ll have a really decent oven and cooker. I’ll even have a dishwasher (luxury)! It’s going to be amazing. I’m eternally grateful to Howard for his help with all of this. I think it has such an impact on my state of mind to have a nice environment to relax in. It also makes me confident that he is as in love with me as I am with him because it’s such a huge thing that he’s done!

9. Personal hygiene

I feel ashamed to admit this but my personal hygiene hasn’t been good. Depression sucked away any motivation to keep myself clean and tidy. I would regularly go an entire week without washing. If I was staying in bed or not leaving the flat I wouldn’t bother and even if I was going out I wouldn’t bother. I’d even lie to Howard when he’d asked me when was the last time you washed. I’d never say a week ago or more because I knew he’d be appalled. The more depressed I became the worse I got. It was particularly bad when I was in hospital. I remember at the start of my admission in IPCU (intensive psychiatric care unit), I was wearing leggings, a soft dress, a cardigan and socks, basically the clothes I was in when I got sectioned. No bra, no pants. This is disgusting but I was sleeping in my clothes and going about my day on the ward in those clothes. To make matters worse I started my period and I just didn’t bother to sort myself out. I was just bleeding onto my clothes and because they were black nobody noticed. Howard eventually noticed I smelled rotten and I finally showered and changed. The nurses would come into my room and coax me into the shower, remind me to put my pyjamas on at night and day clothes on during the day. I did the bare minimum. I also didn’t brush my teeth for months and now my teeth look a bit more stained than they used to.

Now I shower every day. It’s part of my morning routine. I think having the new shower makes it far more likely that even when down I’ll still wash, because it’s so much easier than running a bath and waiting for it to fill and having to sit in it. Usually I’d sit in it, perhaps wash my hair but then just get out without properly cleaning myself. In the shower it’s far easier to keep clean and I generally like feeling clean now. The idea of going for days without washing seems really yuck! Also I’m brushing my teeth in the morning and night and using mouthwash. Soon I need to finally see a dentist for the first time in over a decade! I’m working myself up to that one.

Lots of things have gotten a lot better since leaving hospital. The biggest change is just how I feel. Depression is crippling. I wouldn’t wish it on anyone. Nobody really knows how it feels to be that depressed unless they have experienced it themselves. Many people who read this blog will understand. Things can get better though. I genuinely thought that it would just never end. I really believed my only option was to end my life. If Howard hadn’t got me to that appointment with my psychiatrist I could very likely be dead or badly hurt. I am in love with life at the moment. With each passing moment I’m aware that I’m alive and that horrible disgusting, sluggish feeling is finally gone. The only negative is that I am very afraid of it coming back.

10. Reclaiming my sex drive

Some of you might think this is too much information but it’s actually very important. Depression and mental illness can and do frequently have a profound effect on a person’s sex drive. I was still having sex (though not as often) when I was ill because it brought me some comfort but I wasn’t reaching my full potential. It was hard to connect with my partners because I felt so numb. My orgasms weren’t as strong. I hadn’t even noticed that they were weaker than usual because it happened so gradually but since I got well I can see a big difference. I believe the chlorpromazine was dulling down those urges for me and sometimes I would need to push myself to have sex because I knew I’d get some enjoyment out of it once I started, but I just never felt properly in the mood. I’ve known people with depression who have lost their sex drive completely and just stop having sex. This has an impact on relationships. Partners can feel rejected you aren’t getting the bonding that comes with being intimate, this is especially hard-hitting if, like me, you usually have a very active sex life.

Now my sex drive is very high again (which is my normal). I’m enjoying reconnecting with my partners in that way and having very good, intense orgasms that I haven’t felt so powerfully in years. I’ve stopped feeling like I have to force it and when I initiate intimacy I genuinely feel in the mood! As a result I feel more bonded with my partners. It’s not just about the physical pleasure that sex brings (though this is good). It’s also, for me, a way to show and express love.

Some medications can affect sex drive and ability to orgasm. I’ve heard this from many people, especially those on SSRI antidepressants and heavy-duty antipsychotics. I have been in the system long enough to know now that there are solutions to this problem. There are many alternative drugs that can be taken that are just as or more effective in treating depression or psychosis that do not have this effect. They are not routinely prescribed because they are more expensive, but I pushed for my meds to be changed so I didn’t have this side effect, and eventually my doctor and psychiatrist listened.

Feedback

If you like this blog feel free to send me a friend request on Facebook as Jools Christie (but send me a note saying who you are). Also you can follow me on Instagram. I plan to post more photos there under the name little_miss_black_sheep. I feel like I owe it to everyone who is struggling with mental health to spread awareness and knowledge. I know one of the things I really valued when I was unwell was reading other people’s stories of mental illness and recovery. Do I think I have recovered from schizoaffective disorder? No. I will get unwell again in the future. I’m aware of that, and denying it won’t protect me from it happening. At some point I’ll either get manic or depressed. Either way it will mess things up. What I’m hoping for is a long run of stability. I’m aiming for six months to start with, then build on that. I have lots of blogging ideas but suggestions are very welcome. Comments are appreciated either here or on Facebook. Thank you for taking the time to read this.

The diagnosis and treatment of schizoaffective disorder

I want to talk about diagnosis and treatment of schizoaffective disorder. I believe it isn’t talked about enough and many people don’t appreciate what a struggle it is to get diagnosed and then get effective treatment. Unlike bipolar and schizophrenia where most people know what they are, at least vaguely. This isn’t the case with schizoaffective disorder and obviously because I have it, I want to make people more aware of what it entails to live with it. Perhaps I’m hoping that if people understand what it’s like to struggle with something like this, then they might find more warmth and compassion when they come across someone who is fighting that battle. I hope my blog inspires empathy for any mental illness to be honest. So I’m going to go through some key facts about the diagnosis and treatment of this disorder, and I’ll try my best to explain each one. Please feel free to ask questions in the comments or message me directly.

Diagnosis

One thing I’ve found with people who have schizoaffective disorder is that almost all of them were misdiagnosed at first.

When I first started becoming unwell in my late teens I presented with depression. I was therefore unsurprisingly diagnosed with unipolar depression. (unipolar depression is just depression that a person has who does not have a bipolar aspect to their illness.) I was given antidepressants and sent away. Those antidepressants didn’t work so I tried a few until I found something that worked for my depression; finally I did and all was good (for a while).

I have always since my late teens had periods where I felt elated. I now recognise that as hypomania but because I felt so good during those periods I never presented to my doctor in this state. I never even thought to mention the fact that I might be “too happy”! That changed when I turned 26, whereupon I had my first full-blown manic episode. At first I was just elated and doing quite well – spending a lot of money, which isn’t good, but doing well at work and feeling really good about myself and life. My elation started to creep up and up. I started to hallucinate that there was a pony in the garden. I spoke about this a lot. I started to believe I had a very important spiritual mission to unite all the world's religions into one. I believed my partner (Rick at the time) was a Buddha and so was I, that we had phenomenal cosmic power. Trust me, there is only so long you can go on with these beliefs and talking about them before people start to notice! Finally it was work that gave me the final push. They said I didn’t seem well (which I thought was ridiculous) and sent me home to rest advising me to see a doctor.

A week later I needed a sick line and so reluctantly I went to see my GP. When I arrived for my appointment I remember I just kept talking and talking about religion and all sorts of things. The GP explained to me what mania was but I didn’t listen and she got an urgent referral to see a psychiatrist. I waited one more week with my GP phoning every day to see how I was and her trying to hurry the referral. Fortunately, even though I had some odd beliefs I wasn’t a danger to myself or anyone else. Eventually I saw the psychiatrist. A friend came with me to make sure I’d go and at this point nobody wanted to leave me alone. I sat down and started talking and within two minutes I was diagnosed with mania and told I had bipolar, I later found out type 1. It’s not that I didn’t believe this at the time, I just didn’t care. I had too many other ugent things to do than worry about that. Rather than go into hospital which I really didn’t want to do, I was given the intensive home treatment team, and my partner took some time off work to look after me. We started the task of finding the right medication(s) to fix me. During the time I was manic I was also hearing voices. This is not unusual for mania and it was assumed that when my mania went away that I would stop hearing the voices.

It took a good couple of months but eventually my mania did go away, in fact it crashed into depression. During the time I was depressed I was hearing voices and I assumed (without telling anyone) that it would go away when my depression lifted. My depression lifted and I was still hearing voices. I decided to tell someone. I had a psychiatrist, I had a CPN, but at this point I didn’t know either of them that well so I went to my GP (a different one this time). When I told him he seemed to panic. He asked me what the voices were saying, so I explained that mostly they were just talking about me and not to me but that it was still destressing, and that sometimes they asked me to do things that I didn’t want to do. He contacted my psychiatrist and I got an urgent appointment. Then in that appointment I was diagnosed with schizoaffective disorder (bipolar type) and psychosis. It is also possible to have schizoaffective disorder (depressive type) which is just without the manic symptoms.

I believe some people are misdiagnosed with schizophrenia if they present with the voices as their primary symptom and the mood disorder part is not noticed until later. This has happened to at least one other person I know. Either way once schizoaffective disorder is diagnosed the next stage is finding the right medication.

Medication

Many (if not most) people with schizoaffective disorder use medication. I simply wouldn’t have a quality of life at all without my medication and I am very pro using psychiatric medication if it helps. I will never shame someone for taking meds, no matter how much or little they take.
It’s often really hard to get the combination right. In my last hospital stay I was told that it’s not uncommon for it to take 10 years for the psychiatrist and the patient to get the right balance of meds. I’m coming up 10 years past my diagnosis so I’m hoping we have finally got it right! I’m going to go through each type of medication that a person with schizoaffective disorder might need to take and say a little about each type…

Mood stabilisers

https://www.mind.org.uk/information-support/drugs-and-treatments/lithium-and-other-mood-stabilisers/#.XaSbhIFKjnE

If your schizoaffective disorder is bipolar type like mine then likely you will need a mood stabiliser. My psychiatrist says that “Lithium is the best mood stabiliser by a country mile” I have no reason to disagree with her. The evidence is there to say that it’s the best. I’ve been on lithium for 10 years and I have never had a problem with it. Some people say it dulls their emotions but past the first couple of months this has never been a problem for me. Side effects for me are feeling thirsty a lot and peeing a lot, this is annoying but a sacrifice worth taking to stay grounded. You must get a blood test to check your lithium level every 3 months, and every 6 months you need kidneys, liver, and thyroid checked. They use smaller doses of lithium than they used to so complications are less likely. However everyone’s dose is different depending on their blood levels. I went to a talk about 10 months ago about lithium and found out that even though it is by far the most effective treatment for bipolar and bipolar type schizoaffective disorder; commonly it is not being prescribed which means some patients may be missing out on treatment that could really help them.

https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/changes-in-prescribing-for-bipolar-disorder-between-2009-and-2016-nationallevel-data-linkage-study-in-scotland/AD94F0E7B0274C639ECDA60C75B630AD

Other mood stabilisers that are often used are the drugs that are more commonly used for epilepsy. I am also on lamotrigine which I needed because even though lithium did level out my moods I was still getting unwell. There is also sodium valproate which nowadays is rarely given to women of child bearing age and carbamazepine. I’m sure there are others but those are the main ones that I know.

Quetiapine which is an antipsychotic is also frequently tried as this has mood stabilising properties and also antidepressant qualities and I believe other antipsychotics have mood stabilising properties. Also I believe that lithium is more effective in type one bipolar (which means that you get full blown mania) and not as effective in type 2 (which means you get hypomania but not mania). Another important note about lithium that I found out the hard way is that if you stop it suddenly you can get rebound mania that can be quite severe, so if you are on lithium and you want to stop then please talk to your doctor first.

Anti-Psychotics

These are probably the type of drugs that people hate the most. The side effects of these drugs are the worst! I have tried SO many until I found the right one. chlorpromazine was the one I was on for ages but the sedation was crippling me and it dulled down EVERY emotion I had plus apart from make me sleep at night (which is important when you have a bipolar type illness and why I kept taking it so long) it didn’t actually do much for my psychosis. olanzapine is another popular choice. This worked relatively well to suppress my psychosis, however it made me put on lots of weight very fast. I know not everyone who takes olanzapine will have this problem but it is very extreme and very common. It makes you so hungry you cannot resist eating, you don’t know when you are full, and your metabolism slows down! I went up from a size 16 to a size 24 in a matter of months and in the end I had to stop it. I’ve tried risperidone, amisulpride, aripiprazole, quetiapine and then finally I tried haloperidol! I really didn’t expect haloperidol to work, it was a last ditch attempt but it actually worked! When I say worked I don’t mean things are perfect but they are a LOT better. Anyone who knows me well can tell that. Now I get an injection in the bum once every 3 weeks and my psychosis only really comes back a few days before my injection is due. That is heaps better than struggling everyday.

Side effects for me are restless legs, and stiffness of my joints. I take a drug called procyclidine three times a day which basically suppresses the side effects of haloperidol. It sounds complicated but it works well.

The thing about psychosis is that everyone is different. Everyone responds to meds differently and it’s trial and error. There is only one antipsychotic that statistically works better than all the rest and that is clozapine. Had my haloperidol not worked that was the next step for me. I don’t have enough experience or time to write about clozapine in depth but I will share some links in case anyone is interested. Anyone on clozapine has to be monitored very carefully because there are serious risks but I have seen it change lives.

https://en.wikipedia.org/wiki/Clozapine

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4169186/

The main problem I’ve had with antipsychotics is that they have a tendency to dull emotions down. I’m very lucky that for me haloperidol only really does this for two or three days after my injection and not extreme. For me it’s worth it. Everyone else has to decide for themselves if it’s worth it for them but if you are in the mental health system and have been under section or a community treatment order it can be decided for you. Even in 2019 forced injections do happen. I myself am on a CTO and have been told that if I refuse my injection I will be taken to hospital and given the injection against my will. That for me is a scary thought.

Antidepressants

The next kind of drug that’s given to people with schizoaffective disorder is antidepressants. It’s important to note here that psychiatrists are wary of giving anyone with a bipolar type illness an antidepressant because they can and in my case frequently do cause mania. That being said sometimes antidepressants are still prescribed.

There are several different types of antidepressants but for the sake of stopping this blog becoming an entire book! I am going to just give a brief overview and focus on my own personal experience because at the end of the day, that's what I know best.

SSRI type antidepressants are the most common. I’ve tried a few of those, mostly when I was only diagnosed with depression. I tried fluoxetine (prozac), sertraline and citalopram. These helped my depression in a very mild way. They took the edge off, they didn’t take it away and I still struggled. For me the main side effect of this drug was intolerable and that is sexual dysfunction. To put it bluntly, I was unable to have an orgasm. For some this doesn’t happen but for many it does. For other people it is a side effect they can live with and that’s ok, but for me it was not tolerable and I went to my doctor asking for an alternative. I was then prescribed amitriptyline.

Amitriptyline is an older antidepressant, it’s a tricyclic rather than the more commonly used SSRI types. The main side effects I get are constipation, some difficulty peeing (I need to totally relax) and sedation. There are other side effects that I don’t get that others do. I’ll provide a link so that people can read up for themselves…

https://www.nhs.uk/medicines/amitriptyline-for-depression/

Amitriptyline is guaranteed to raise my mood. I’ve never been on it and had no effect. It’s amazing. Even more amazing is that it gives me the best quality sleep possible. I won’t hold back, it’s my favorite drug! So what’s the problem? Why have I, up until now, still been having severe periods of depression? The answer is mania. Amitriptyline up until now has always pushed me into mania; this has made my psychiatrist very reluctant to give it to me even though when depressed, I frequently ask for it because I know that it will bring me out of depression. For me (in a depressed state) mania seems like a better alternative! What’s changed for me now is that since my hospital admission, I am now on a second mood stabiliser “lamotrigine”. Since then I have been able to tolerate a very high dose of amitriptyline without being pushed into mania (so far). It’s early days but I am feeling hopeful and so are my psychiatrists. This is what I mean about getting the combination of medication right. Everything has an effect on everything else, every person is unique so everyone will get optimal effect from different meds.

Another thing worth noting about amitriptyline is that there is a huge risk for overdosing that the person will die. This is obviously a concern when giving it to someone with such a serious mental illness. I was warned when I first got prescribed amitriptyline that it was very dangerous to overdose on. When suicidal I did overdose on it, twice. First time a smallish amount, the second time a larger amount and I very nearly died. I now only get a weeks worth in an NHS dossete box and if I am seeming low enough to be a suicide risk someone (usually Howard, my partner) will look after my medication for me and only give me a day or two at a time.

There is some evidence that amitriptyline is one of the most effective antidepressants. This does not surprise me.

https://www.ncbi.nlm.nih.gov/pubmed/11157426

Anti-anxiety medication

Most patients with schizoaffective disorder will experience anxiety at some points in their illness. I have often felt anxious, especially when depressed. I haven’t had a lot of anti-anxiety medication mainly I’ve had it when I’ve been in hospital. The most common type of medication I’ve had for anxiety are benzodiazepines. Such as diazepam, lorazepam, temazepam. All of these drugs work well for me but really people should only take them short term. Tolerance happens very quickly and they are addictive and habit forming. I have abused them in the past because I know they are going to take away my anxiety and I’ll feel relaxed and calm, so of course there is a constant urge to take more and the more you take the more you need for that same effect.

When in hospital I use these a lot and rarely when things have been bad in the community. When in hospital the last time I used a new drug (to me) called promethazine which I took in a fairly high dose (50mgs). I’m not going to say that it works as well as the benzodiazepines but it did help take the edge off when I was in hospital. It’s mainly used as an antihistamine but can also be given for insomnia and anxiety.


The other drugs I’ve known to treat anxiety are drugs like gabapentin. I have no experience of those so can’t give much of an opinion but if you are really struggling with anxiety and it’s everyday for a prolonged period they could be offered to you. Anxiety is horrible and can ruin a person's quality of life.

Being compliant with medication regime

If you know someone with any mental illness you might be aware that sometimes people are not compliant with their medication regime. This can be extremely frustrating for loved ones because it seems like the person is deliberately sabotaging their mental health. I have at times deliberately missed meds or taken too many meds. Why would someone with a serious mental illness like schizoaffective disorder do this? The answer is for several reasons.

Side effects

The side effects of some of these medications can be severe. Especially antipsychotics. Until I found haloperidol and started getting it injected I often skipped or quit my antipsychotics. Dulled down emotions are horrible, especially when you are already depressed. It can ruin the feelings of love, warmth, happiness, excitement, passion, sexual arousal… Sometimes it feels like it’s better to be psychotic and feel rather than be free of psychosis and feel nothing (or very little).

Trying to affect mood

This happens particularly with lithium. As I’ve already said if you stop lithium you have a high chance of getting rebound mania. Once I figured this out, when severely depressed it was very tempting, in fact I did, stop lithium to induce mania. It often worked but then my bloods would be taken and it be very obvious that I hadn’t been sticking to my lithium regime. My loved ones would get angry with me. Why would I do this? I’ve effectively created chaos and upset for the people around me. I feel bad for this but imagine being so severely depressed you can’t feel any emotions, you are constantly thinking about suicide, everything feels sluggish and hellish and that goes on for months and months. Now all you have to do to feel happy is to stop taking a particular pill every night and you are going to not only feel happy but feel on top of the world. Often I try and do it in a subtle way. Taken less of my dose, missing a dose here and there. In the hope that I can just induce hypomania. Usually though it’s resulted in severe mania and a stay in hospital. My admission for 6 weeks back in January was a result of this.

Missing the psychosis

Yes you read that right. It is possible to miss the psychosis. Especially if you are not depressed and your psychosis was not all negative. Hearing voices can be mixed. I often hear Howard’s voice telling me he loves me, he sings to me, he keeps me company when I’m alone. I miss that part of psychosis. If you are lonely sometimes hearing voices can be a comfort. You get used to hearing voices and you can miss them when they go away. Also sometimes you feel like they are giving you important messages or information. To cut them off feels wrong. It took me some getting used to after 10 years of hearing them every day to suddenly not have them at all (most of the time).

Being too unwell

When you are very unwell taking medication can be difficult. Voices might tell you not to take medication. You may be so depressed you just lay in bed and don’t get up. Taking your meds is the last thing on your mind. When depressed, a person might not care if they live or die. So taking medication to make you feel better seems pointless.

There are lots of reasons and I urge you not to judge. Help the person understand that the medication is important. If their side effects are unbearable help them explain this to their psychiatrist and when they and their psychiatrist are trying to figure out what medication works for them be supportive, be kind, don’t judge. Keep in mind it can take up to 10 years, with an illness as serious and complicated as schizoaffective disorder, to get the medication right. I can promise you if you had to take so much heavy medication then you would struggle too. If you feel a person is in danger then get them help. In Edinburgh you can call MHAS (Mental Health Assessment Services) which are based at the Royal Edinburgh Hospital , https://services.nhslothian.scot/MentalHealthAssessmentService/Pages/default.aspx the police are also an option, talk to the people close to them, also talk to the person. You might not get through to them depending on how ill they are but you just might. I have in the past been convinced to go to MHAS of my own accord. It can happen. Remember for people like me MHAS and places like it have often be a one way ticket to the psych hospital. Be understanding about why people might be reluctant to go.

Some people choose not to take medication and sometimes that’s okay. There are some people who can manage without it. Just because this isn’t the case for me doesn’t mean I would invalidate someone else’s choice. There is other support available that is not simply to medicate. Which leads me on to my next and last point.

Talking therapy

Ironically talking therapy is harder to get on the NHS than pills. I have had psychotherapy for three months in my recent hospital stay.

In my experience talking therapy has been good alongside medication. I don’t think it can cure schizoaffective disorder but I do think that it can help manage it especially (but not always) alongside medication. There are various things that can lead to a person developing an illness like schizoaffective disorder. It is thought to have some genetic basis however other things can bring it on such as trauma. I have had psychotherapy for sexual assault/rapes in my past. Going through therapy is extremely tough. Like me, a person might get worse before they get better. It can be rocky. I have finished therapy for now but I’m still having the effects, mainly flashbacks at night. I hope on the whole it’s helped though.

I hope this blog has been informative. Please leave comments if you have any questions. I’m very open and I will try and answer you. If you know me in person feel free to drop me a PM. I hope that this blog has been informative. Feel free to share it far and wide; if I help one person then for me it was a blog worth writing. I am willing to take suggestions for any future blogs. If it’s something I have experience of then I will happily write honestly about it.

Thank you for taking the time to read.

7 facts about being a patient in a mental hospital

Those of you who know me will know that I have been a patient in a psychiatric hospital many times over the past decade due to my Schizoaffective disorder.  For those who don't know Schizoaffective disorder is like having the mood swings of Bipolar and the psychosis of Schizoprenia I’ve been admitted to hospital for this so many times that I’ve lost count.  Recently I spent 5 months in a psychiatric hospital with a  severe depressive episode and it was one of the worst periods of depression I’ve ever had.


To give some background back in January I ended up in hospital for mania.  After I crashed from this I had a slow depression that crept up on me and eventually left me at the point where I was about to commit suicide.  I had several ideas about how to go about this and I was very serious that I wanted to end my life.  My major plan was that I would hang myself from a ligature point in my flat.  Thankfully (for me) I was open with my partner (Howard) about what I wanted to do and he made sure I was not left alone until he could take me to see my psychiatrist where he basically begged her to take me into hospital.  My psychiatrist agreed with him and since I wouldn’t go willingly she sectioned me under the mental health act.  I was then brought to hospital and put on a locked ward.  At the time this felt like the worst thing ever but looking back I am eternally grateful because it literally saved my life.

I’m going to go through 7 facts on what it’s like being admitted and staying in a psychiatric hospital.  Please note I can only give you my point of view of what I’ve seen and experienced. Everyone’s experience is different but there are some similarities.

1 Being admitted

Everybody gets admitted for different reasons but there is usually a few things that they have in common.  Mainly to be admitted you need to be a danger to yourself, or others.  People can and do go to hospital voluntarily however a bed is really only given when there is a clear danger.  There is a very serious shortage of beds in the NHS for things like mental health.  The hospital I was staying in this time recently built a whole new section for their acute wards.  They lost 20 beds in the process so that has put a massive strain on an already strained hospital!

It’s not always just being suicidal that makes a person a danger to themselves,mania (when a person may well be presenting as happy) can also be dangerous.  For example when manic I had the idea that I could climb onto North Bridge and lean back and be supported by angels to float to the ground.  I was elated and appeared incredibly happy; not suicidal in the traditional way at all but I was a very real, serious danger to myself and possibly for anyone who tried to help me or intervene with my plans.

To get admitted usually someone has to come into contact with a medical professional such as a GP, nurse or psychiatrist.  Sometimes if the person’s behaviour attracts the attention of the police they will bring the person into a hospital to be assessed.  In Edinburgh we have MHAS - Mental Health Assessment Services.  I’ve been sent to MHAS before by my GP, sometimes family have brought me into MHAS to be assessed and other times my CPN - Community Psychiatric Nurse has sent me.  When I was admitted this time I just so happened to be at a routine appointment with my psychiatrist and because my mental health officer was also there it was easy for them to section me on the spot without involving the police or MHAS. To be sectioned you need to have both a psychiatrist and a mental health officer agree that you need to be detained.  Had I refused to come in to hospital though then the police would have gotten involved.  This is not because I’d done anything wrong it would just be to get me as quickly to hospital as possible where I’d be safe. Initially I was detained for 28 days but then that changed to a 6 months detention.

It’s also important to note that even if you go voluntary that doesn’t mean you can choose to leave at anytime.  In my experience if you are unwell enough to be there at all you are not well enough to simply leave.  If you do ask, or try to leave (remember that the door is locked) they will send a doctor first to assess you and most of the time you will then just be sectioned.  Once you come into the locked ward and the door closes behind you it’s not easy to leave at all regardless if you are voluntary or detained.

I’ll be honest those first few days after being admitted are the hardest.  When you’re used to doing whatever you please to suddenly be confined to a psychiatric ward is terrifying.  Over the years I’ve gotten used to it but the anxiety still creeps up on me every time.  The feelings of panic that you can’t just leave and you are at the mercy of the doctors and nurses.  It is somewhat frightening and it gets to me.  Those first few days are the worst.

2 Passes

Passes are just the term that in the psychiatric wards I’ve been in means ‘time out the ward’.  The more unwell you are the more restricted your passes.  Also they assess how likely it is that you will abscond or self harm or do any other risky things on your pass.  Usually (for me) it takes 3 or 4 weeks and then I’m given nurse escort passes.  This means I am allowed to leave the ward if I have a nurse with me (often they extend this to occupational therapists as well).  So to give an example when I wanted to go to hearing voices group which is still in the hospital but not on the ward a nurse would take me and wait until the group had finished then take me back.  If you run away they will simply phone the police.  Before you leave the ward they write down a description of what you are wearing etc…  I have never absconded but I’ve known other patients who have and it does seem to be the case that they are found very quickly and brought back to the ward and then of course any passes they did have are lost and they have to build up trust again from scratch.

The next stage with passes is family (then friends) escorted passes.  This means that the hospital will allow you to go out with visitors.  Depending on how unwell you are depends on who is allowed to take you out and for how long.  When I first started getting these passes it was only Howard (my partner) who was allowed to take me out and only for an hour.  Gradually this built up to having friends and other family take me out and for longer periods.  It was several months until I was allowed to leave the hospital site itself.

If this goes well you are then given limited passes on your own.   It starts off just 5 minutes and then 15, 30, 1 hour.  When this finally happened for me I found that I was extremely anxious to go anywhere alone and despite wanting my freedom I just didn’t use the passes because I was too afraid.  The nurses noticed this and we did graded exposure which means a nurse takes you on a walk, leaves you there and then you have to walk back by yourself.  This might seem silly but I was really and genuinely very frightened when doing this.  I realise it was important though because if I ever wanted to leave hospital I needed to learn to walk about outside on my own!  Eventually I got more used to being outwith the ward and walking around on my own.  Patients at the start of their stay are often more restricted to the ward and not doing very much outwith it.  Towards the end of a stay (especially if it’s been a long one) a patient starts to spend more and more time away.  The last couple of weeks I was spending entire days outside and only coming back in the evening to sleep.

3 Named Person

If you have a mental illness and there is even a small chance that you will be hospitalised at some point then it is well worth having a named person.  Who you choose as your named person is up to you but ideally it will be someone close to you and it must be someone that you trust knowing all the details about your mental illness and circumstances.  Howard (my partner) is my named person.  This means he receives copies of any important documents such as notice that I’ve been sectioned or the outcome of any mental health tribunal.  He is also invited to attend any important meetings and tribunals.  During the time I was in hospital and beyond my mental health officer was able to phone him directly and keep him up to date and more importantly Howard’s input was given consideration when it came to how I was treated.  He also at one point had a meeting with my psychiatrist about me without me being there just so he could give his point of view.  I felt that they take what he says very seriously and he is a good advocate for me.  He is also invited to my discharge planning meeting and when I’m out of hospital he has the contact number for the CMHT Community Mental Health Team and he can call at any point if he is concerned with anything to do with my mental health.  Some people might think that this means he can get me sectioned again easily if he wants to.  This is not the case, although his view will be taken into consideration a psychiatrist and a mental health officer still have to agree to me being sectioned.

4 Other Patients

One of the things that’s unavoidable when you are in a mental hospital is the fact that there are other patients.  Every mental hospital is different.  I am very lucky that at least in the newly built hospital (The Royal Edinburgh) each person has their own room, toilet and shower.  In the past though I was in a dorm with 7 other women and this was extremely difficult.  It can be hard to unwind and relax when you’re in a dorm and everyone has different mental illness and is at different stages of recovery.  I often found in these situations that I wasn’t getting enough sleep which was making my mental health much worse.

Meal times tend to be in a communal area and if like me you need some kind of human contact then some time spent in the communal areas is likely.  I’ve been in single sexed and mixed sexed wards.  When I was in IPCU Intensive Psychiatric Care Unit it was mixed.  The sleeping areas/rooms tend to be separate but the communal areas are not.  If I’m honest I don’t like mixed sex wards.  I usually feel anxious and vulnerable.  I have been sexually assaulted in the past and when I’m unwell enough to need hospital I’m usually in a very vulnerable position.  I do not feel comfortable being around men in this situation.  Because I have been raped in the past and men are threatening to me in general I am extremely anxious in mixed sex wards.  I have a hard enough time with male staff let alone male patients who are unwell themselves and often acting in an inappropriate way.  I spent most of my time in the mixed ward on flight or fight mode or hiding in my room and a male patient did barge into my room at least once despite it being against the rules.  After I moved from IPCU into the normal acute ward it was all woman and I was able to relax a bit more and feel safer.

Some people make friends when on the ward.  I have made friends and there have been people that I have genuinely warmed to and liked.  I’ve found though that it’s hard to stay in touch once you are out because at least in my case I’m a very different person when I am unwell and once I’m out I want to leave that part of myself behind.  If I bump into people I’ve met in hospital I’ll often say hello (I wish everyone well) but it’s rare for me to stay in touch.  I’ve learned a lot about people through being in the wards.  I remember some of the roughest looking people on the ward turned out to be the most gentle and kind hearted woman I’ve ever met.  I’ve also met some very interesting people and learned a huge amount about mental illness.  I would recommend if you are on the ward, do interact with the other patients.  In my experience isolating myself only made my mental health worse.  I have even picked up some techniques from other patients about how to manage my illness or how to deal with the side effects of my medication.

5 Restrictions

So apart from not being allowed to leave the ward unless you have a ‘pass’  what other restrictions are there?  The answer it that it’s different for each individual.  One restriction that almost happened to me a couple of times but fortunately I avoided was to restrict access to my phone.  This can be for many reasons.  For me it almost happened because I was manic and was posting lots on Facebook and calling and messaging people in the middle of the night.  I was also at one point during my manic stay in January inviting random men I’d met on Tinder to come to the hospital for sex.  There were actually men who knowing my situation and obviously realising I was seriously mentally ill (I was after all in detained in a mental hospital) who still thought that was an acceptable thing to do! When I’ve seen other people with a phone restriction usually they get some time on their phone but with staff watching.  The amount of time you might get on your phone does also depend on how free nurses and nursing assistants are you supervise.

Another restriction that people have that I’ve seen is very difficult is not being allowed to smoke.  I don’t smoke thankfully but for people that do they are often really struggling.  The ward is completely smoke-free now.  In order to smoke you need passes to go out.  Usually smokers are given 10 minute passes quite quickly.  Obviously if they run away during that time they lose those passes.  In the Royal Edinburgh each acute ward has a little garden.  Smoking is NOT allowed in this garden but vaping is.  If you are a smoker and you think that you might end up on the ward then having a vape on you might be a good idea rather than have to go cold turkey.  They do offer smoking alternatives such as gum, patches, inhalators.  I am very anti-smoking but even I can understand that when you are seriously mentally ill and living in a mental hospital, it's not the best time to quit! (Saying that I’ve known people who’ve done it).  To prevent people smoking on the ward or in their rooms everyone is searched when they first arrive and cigarettes and lighters are confiscated.  They search everyone who comes in regardless just to make sure that they don’t have anything on them that can be used to hurt themselves or others so things like razors, over the counter medications, sharp objects, or glass are all taken away.  It’s also worth noting that IPCU is a lot stricter.  In there, there are a lot of things that you can’t have.  I wasn’t even allowed my spare clothes during my weeks in there or my phone charger, or toiletries.  IPCU is very restrictive but fortunately most people don’t end up in there or if they do it’s only when their illness is at its most severe.

The other main restriction is visiting times.  There are set times that friends and family can visit.  For my ward it was 2pm till 4pm and 6.30pm till 8pm.  Outwith those times it has to be agreed by the nurses on the ward.  Some are stricter than others especially in IPCU because in IPCU all visits are supervised.  The bonus of getting friends and family passes is that you are less restricted because you are allowed with visitors off the ward.  It took me months to get to that stage though so I was very limited in how much time I could spend with people I care about.  An extra note for people with kids.  There is a family room separate from the ward that’s quite nice and if you have children usually it’s possible to book that room making it a little easier for children to visit.  Obviously I can only talk about the Royal Edinburgh hospital here.

6 Staff

During your time in a psychiatric hospital/ward you will come into contact with different members of staff.  The most important one will be your consultant psychiatrist because they make all the basic decisions such as when you are ready to go home, what passes you get and what medication you take.  These decisions are mostly based on what the nurses are reporting back about you.  I saw my psychiatrist on average about once a week.  Sometimes I’d go two weeks but one of her juniors would check how I’m doing and feed back to her.  If you are detained and refusing meds it’s not uncommon to be forcibly injected.  That doesn’t mean that the doctors won’t listen to your opinion about drugs and which drugs work for you and what doesn’t.  My own consultant was very good at listening to me and Howard.  I’ve been going through the system for a decade, I’m educated about many of the drugs and have first hand experience on how many of them affect me.  The plan they came up with that got me better this time I really felt that I had a say in it.  My consultant listened to my views and also Howard's views.  In return I was open minded and listened to my doctor and I was willing to try a new medication that I’ve never been on before and that I didn’t know much about.  I put my trust in her and it paid off because it seems that this new drug (Lamotrigine) has actually allowed me to recover.  I have a very good relationship with my hospital psychiatrist she even gave me a hug after my discharge meeting.  Like most consultants she has an air about her of being in charge and 10 years ago I was actually afraid of her!  Now that I’m older and had many admissions under her care I have nothing but respect and trust in her.  She is very good at doing her job and she has brought me back from the brink so many times.

You will also come into contact with nurses.  Usually everyone has a key worker and that person will guide your recovery, catch up with you regularly and be the person you go to if there are any problems.  It’s important that you gel with your key worker and if you don’t it’s perfectly acceptable to ask for a swap.  I’ve done this in the past with no real issue.  I had two key workers this time and they were so important in my recovery.  One word of warning though everything you say to nurses is very likely to go on your notes.  Nowadays health professionals have access to a software note taking system called Track so what you say to one nurse will likely get passed on to other professionals involved in your care.  Along with talking to you nurses are also responsible for giving out medication.  Another thing worth noting is that nurses are often doing 12 hour plus long shifts.  They are not immune from making mistakes so if you are with it enough it’s good to be checking what medication they are giving you.  In my 5 month stay I was given the wrong medication twice, both times I noticed and it was sorted out.

Along with nurses there are nursing assistants who are there to make sure the ward is running smoothly and be on the floor most of the time which nurses can’t do because they have to write and read notes.  I got on well with most of the nursing assistants and I often opened up to them in moments I was really struggling and there weren’t any formal nurses about.  They do also feedback anything you say to the nurses so again be mindful that what you are saying is likely being put on your notes.

7 Discharge

Each time I’ve been discharged it’s happened a little differently.  When I’ve been there on a voluntary basis and it’s been a relatively short admission then I usually get a couple of over-night passes then discharged.  It’s worth noting that because of the shortage of beds in mental health wards if you do go on overnight pass they frequently give your bed away which makes it hard if your pass didn’t go well!  When it’s been a longer admission and I’ve been detained then usually there is a discharge planning meeting were all the people who have been involved in your care have a meeting to discuss how the admission has gone and what (if any) support you might have in the community.  This can be daunting having so many people in one room talking about you.  It’s often helpful to bring someone you trust to be there with you.  Isaac (one of my partners) attended my most recent discharge meeting and that was helpful because he was able to help me remember what was said and just give me a bit of moral support.  Ideally your named person should be there but on this particular occasion Howard couldn’t make it.  At my last discharge meeting my Psychiatrist, Psychologist, CPN, Mental Health Officer, a nurse from the ward and myself and Isaac attended.

Everyone feels very different about discharge.  When my psychiatrist first told me we were working towards discharge (about 3 weeks before it happened) I was really apprehensive and worried that I wasn’t ready and that I wouldn’t cope at home.  I trust my Dr though and she was confident that now was a good time.  It’s rare that someone is completely 100 percent well before discharge.  There is too much of a shortage of beds for that to be the case but I was definitely no longer a danger to myself anymore.  As it stands within the 3 weeks that I waited for my discharge planning meeting my mental health improved even more so that I was as well as possible when I finally was discharged.

Going home after such a long stay is scary.  I had become somewhat institutionalised.  The hospital routine was really familiar and safe for me.  I was used to meals coming at certain times and now even 3 weeks after discharge I’m not really cooking for myself.  I was used to having someone about 24/7 and never really being alone.  I still haven’t spent a night alone in the flat yet and that’s a bit daunting.  The truth is that as much as it’s great to be discharged after so long it’s also scary and it takes time to adapt back into real life.  For me after such a severe depression that lasted a long time, I still have anxiety about it coming back.  Now I am well and I can see just how close I was to ending my life I am terrified of ever getting that unwell again.  My life is literally at risk which I think many people fail to understand with serious mental illness.

I’m doing much better now.  I have as close to a normal life as I can get.  I hope that the medication combination I’m on now will keep me sane for a long time.  Realistically I will get unwell again at some point but I hope I at least get a decent run with my new found stability.  I am grateful to the hospital for helping me get better; for basically saving my life.  I needed to be there to be safe and get better.  I was angry at the time that I was being detained but without that happening I would possibly not have survived.  It meant that the people who love me (Howard) weren’t under so much pressure because before I was admitted I couldn’t be left on my own for even 5 minutes!  I had a very good and positive experience this hospital stay.  On the whole I think I was very lucky.  If you are ever in the situation were you need to stay in a psychiatric ward, all I can say is that the hospital is there to help you get better.  It’s not prison!  It can be scary but it can also be a relief to finally be in a place that is going to let you heal.  The stigma around mental illness and mental hospitals/wards needs to be broken.  Like physical illness, it can happen to anybody at anytime.  Nobody is immune.  The experiences I’ve had through being mentally ill, in hospital and coming into contact with other mentally ill people has been profound.  It has been life changing in both a positive and negative way.  It’s horrible getting so unwell but I really believe that it’s made me a better more empathic person.  I hope writing this blog has helped in some way to demystify mental illness and mental hospitals.