Documenting my journey through the mental health system

Last fall, almost a year ago exactly, I started hearing voices again. Started to decompensate again. A female voice was telling me to do things, in particular, kill myself. Showed me the 10 dimensions and told me at length about them, where I would go, that only death would free me. I posted previously some conversations I had with her. I had been dealing with so many life stressors – the difficulty in living with my mom was top of that list., overwhelming demands at work, very low motivation, a sense of futility and hopelessness and despair. Normally obsessed with Halloween (it’s the closest thing I have to a religion) I could barely put up even some of my decorations and simply didn’t care about any of the events or parties in which I might normally be interested. I never bothered with a costume, wasn’t talking to friends, and isolated at home, trying to hide the voices invading my mind and trying to hide the despair creeping into my life, overwhelming me.

I stopped caring about anything, especially myself. I stopped doing any of the things that used to interest me like movies, books, dance, and singing. My brother was looking at me funny. I was fighting to hide my conversations with voices in my head. I heard the screaming again, sometimes so loud I was reduced to tears in my bed, my hands over my ears. At work, someone asked me if I was planning on killing myself. I was shocked it was so obvious to them. I refused to answer.

I first called the veterans crisis hotline sometime around September, crying, and already making plans for suicide. I described some of the existential hopelessness I felt so strongly – for years, had been fighting mental illness and just couldn’t seem to win. I was Sisyphus with his rock, pushing up a hill, only to roll back down again. Over and over, a hamster wheel I could not get off, insurmountable pain and anguish. I wanted to give up. I had no fight anymore. I endorsed feelings of suicide and the operator made a safety plan with me and referred me to the VA for follow up.

A day later the suicide prevention coordinator called me. I sobbed quietly into the phone, curled up in my bed. I told her I’ve been hospitalized three times in the last 12 years and I can’t do it anymore, I can’t fight anymore, roll the rock up the hill…only for it – me – to fall right back where I was. She made arrangements for me to see a mental health provider at the VA. I saw her about three days later. This is when I first met Dr Black.

I was very nervous. I always get nervous when I have to talk about my mental state or health, especially with new people. I looked like shit, had barely got through a shower that morning and my long hair stuck out everywhere. She started by having me do the PHQ, or patient health questionnaire, which measures depression. My score was as high as it could possibly be. My GAD scores were also so high, they could not be any higher.

I started crying the minute she prompted me to talk and she let me sit there and cry awhile, did not push me. It was awkward but I felt so shitty I didn’t even care. I finally sputtered some words.

“You can’t talk to anyone. You can’t let people know, they are not interested or helpful, they can’t help you, you’ll just be considered incompetent and no one will take you seriously anymore…” I rambled like this for awhile, my words tripping over each other, trying to explain how I felt but my mind was rather spinning. This has been a common worry and preoccupation of mine for some time – the feeling that people will see you as incompetent or stupid when they learn you have a severe mental illness and do things strangely sometimes. I think that people really will stop taking you seriously. It is like the national discussion of mental illness and guns – we like to say they are mentally ill, and this applies to other types of shocking crimes too, but I don’t think they are mentally ill. This just adds to a terrible stigma. We know right from wrong. We know what we’re doing. We have complicated inner lives, interests, fears, and thoughts just like everyone else. The mentally ill are far more likely to be victims of crime rather than perpetrators of it. Don’t write me off. I am of sound mind.

So I told Dr Black I’ve been isolating and trying to hide the pain like my cats – staying in my room away from my mother, withdrawn and quiet at work, ignoring any communication from friends. She asked if anything happened, was there a triggering event? I thought about that. I could not think of anything specifically. It was just life being an asshole, life seeming so unimportant and pointless and painful for no reason. She asked about medications and I told her about the smaller cocktail I’d been on – citalopram for an anti-depressant, depakote for mood stabilization, and Latuda for psychosis. I had been compliant with my medications, for the most part. Once in awhile I just plain forgot to take them. I still randomly forget sometimes. She then did a general assessment, determining my mental status and suicide risk. Was I eating? Sleeping? Poorly, and plagued with nightmares and bad dreams. I was flagged as a patient at high risk for suicide because I admitted to making plans and final arrangements. Then it was safety planning – I had to commit to being safe for the next week, to hang on one more week, till I saw her again. I determined a few coping skills – taking care of my cats, listening to music, watching stand up comedy. And the next couple weeks I complied with the safety plan.

Until I didn’t.