Being bipolar sometimes necessitates extreme actions for extreme behaviors. Hospitalizations are frequently required for these extreme behaviors dealing with the darkest depressions or the high flying manic episodes. Not everyone who is bipolar ever needs to be confined to a mental hospital, but it does happen more often than not. My own experience includes more hospitalizations than I can remember. Maybe it’s because there have been so many times, or maybe it’s because it’s such a traumatic experience that the brain just blocks out the memory.
I distinctly remember the first time I had to go to the hospital. I had been in a full blown manic episode when I separated from my first wife. After the mania wore off however I quickly spiraled down into depression. The euphoria of the manic episode along with the high feeling of freedom carried me for about two weeks after the separation. I was living alone for the first time in years, and I started drinking again. My ex was totally against drinking, so with my new freedom I could drink every night; and I did! Every night. A lot. The loneliness and the alcohol quickly took their toil and I found myself sitting alone, drunk, thinking about all the negative things I was now realizing. I accidentally burned my wrist on a lawnmower muffler, and ended up with a big bandage to cover the wound. When I went into my weekly therapy session, my therapist, who knew about my depression and how much I had been drinking, took one look at the bandage and had me committed. The burn was truly an accident and not a suicide attempt, but no explanations would convince her that I didn’t need to go. But she gave me no choice, and I was locked up. This was back in the early 80’s, and the therapeutic approach was a lot different than it is today. It was a good week before I was required to attend any groups or therapy sessions. I met with my Doctor once a day, and then was left to myself where I spent the majority of the day sleeping. After a while I was encouraged to attend the twice daily group sessions, and one of the hospital staff spent at least 30 minutes each day in a personal one-on-one. Along with the therapy sessions there were other activities as well to keep us busy. We had a morning meeting that everyone (who had been there at least a week) was required to attend. It was a formal meeting, where we elected Officers for a term of one week. The third week of the confinement I was elected wing President! As the weeks progressed the therapy became more and more intense. A skills group was added as I stabilized and I began to meet with a social worker to develop a post release plan. By the time I was actually discharged I had been in the hospital for six weeks!
Over the next five or six years there were several other hospitalizations for depression, but they left no impact on me and I can’t remember any details other than the fact that I was there. Then I was back inside yet again, and after another 20 days without any real improvement my Doctor recommended I be moved into a more long care facility that provided even more intense therapy and skills education. So I was transferred. What a beautiful facility! It was located on top of a mountain, and it was during the fall and absolutely breathtaking. It was set up pretty much as before, with the daily meetings and officers, group therapy sessions and individual therapy. They also did some extensive testing, and I went through a battery of psychological evaluations and physical exams. Probably the most interesting exam was a sleep deprived EEG. I had to stay awake for 24 hours, then had my head wired up which they used to record my brain waves while flashing a strobe light right into my eyes. It was so overstimulating that I actually had an out of body experience. Awesome! This was the first time I was diagnosed as bipolar, but I didn’t believe them and wouldn’t accept it. By the time it was said and done, I had been inpatient for a little over 60 days.
Time passed, and I went a fairly long time without needing to be readmitted anywhere. But when I did have to go back in, what a change! Instead of a place that they treated the illness, it was a clearing house focused on stabilization and quick release. I had barely been there two days before I was being pushed to be discharged. I had stopped being a danger to myself, but felt like I was in no means prepared to return to the world.
The last time I had to be admitted however was a real turning point. I was in an out of control manic episode, but had convinced myself that, because I was so angry that it was just an ‘agitated depression’. My own doctor wasn’t allowed to practice at this facility, and I was assigned an inpatient physician. It turns out that this doctor was a widely recognized expert on bipolar disorder. In our first session it took him about 15 minutes to convince me that I was truly bipolar. Finally, after all those years and many many times in mental hospitals I actually accepted the truth. I am bipolar. And even though I still don’t have my symptoms completely under control, that knowledge and acceptance have made a big difference in how I deal with it all. And I now have a much more appropriate treatment plan that ultimately may at least help me manage the illness.
So which is better? The long, therapeutic approach that hospitals used to have, or the ‘get safe and get out’ approach that seems to be in use today. I’m sure that others have had their own experiences and opinions, but with my experiences, even though I did get a lot out of the extended stays, I’m not sure that I benefited any more than I have in recent stays. The month or more confinements of the past did have a huge impact on employment and much harder to explain the long absences. The protocols of today do make sure you are not a threat to yourself or others, and the medications are so much better than they used to be that perhaps it is better this way.
Hospitalizations are nothing to be ashamed of. I have an illness, and sometimes that illness has to be treated in a specialized way. Now however, I’m reasonably sure and very hopeful that now that I know what I’m dealing with, taking more appropriate medications, and under the care of a fantastic therapist my last time in will be just that; my last. But if not, I know where to go. And whether a long or short stay, I’ll be in a safe place that I can trust.