A defining moment.

“Those who cannot remember the past are condemned to repeat it”. (George Santayana)

And with a past like mine, I cannot afford to forget. I can’t repeat it; I won’t. That is especially true at this point in my life. With the right combination of therapy and medications I feel better than I’ve ever felt in my life. I’m living a ‘normal’ life now. I have a good job, a great place to live, and developing a healthy and satisfying relationship.

But it hasn’t always been this way.

The vast majority of my life has been dominated by mental illness. So as I become stronger in my new healthiness I have to remain vigilant and aware of how I got here. Otherwise, I’ll be condemned to repeat it all.

My first hospitalization was the beginning, and set the stage for the next 30 or so years. The second time I was hospitalized was not as significant, but was certainly important. This was the first time I almost killed myself. I’m not going to say I attempted Suicide, but my behaviors and decisions came very close to ending my life.

It was an overdose

Yeah, right… It wasn’t a suicide attempt at all. Actually, it really wasn’t an active decision to take all the medication as a way to kill myself. I knew I was taking too many pills, but it was without thought of the consequence. It’s not like I was depressed or anything. It was kind of a curiosity really. I had been wound up for a while, and it was just a little bit uncomfortable. There was too much energy and I felt jumpy all the time. So one day I decided that I should up my medication, and took two extra pills. I didn’t feel any difference a few hours later, so I took too more. There was still no obvious effect, so two more went down. At that point I began to enjoy the experience. I wanted to push the envelope and see just how much I could take. And I kept taking pills, until my entire month’s worth was gone.

It was lithium.

My normal dose was 300mg per day.   I had been on that dose for quite a while, and steadily maintained a blood level of 1.2, which is right in the middle of the effective therapeutic range. Now, Lithium has a very narrow range of effectiveness, and it doesn’t take much of an increase to cause serious side effects. It also becomes toxic and life threatening; very quickly. An I had just taken approximately 9,000mg of Lithium in just a few hours.

This was not good.

Even after ingesting that much I really couldn’t notice any effects. Not at first that is. But after 5 or 6 hours things began to happen. I felt like I was completely drunk. I couldn’t think, my speech was slurred, and my motor skills were just about gone. It was all I could do to remain upright. Then I lost control of my bladder; then the bowels. My wife had no idea that I had overdosed, but it was damned obvious that something was wrong with me, and she bundled me into the car and took me to the Emergency Room. I was still conscious, and able to walk on my own after a fashion, but I was bad enough that I went straight from triage into a bed. The Doctors had no idea a how to diagnose me and could only work on keeping me stable. It wasn’t until they found out my history and what medications I was taking that they began to get a clue. So a Lithium blood level was pulled.

Blood levels have a very clear range of effectiveness and indications of problems. The ideal therapeutic level of lithium is between 0.9 to 1.2. With Lithium, anything higher than 1.5 is expected to produce some serious side effects and levels over 2.0 are considered toxic and life threatening.

I had a blood level of 3.15.

By all rights I should already be dead. Or at a very minimum I should have been comatose. And probably after a while, I was in a coma. There are about three days that I can’t account for at all.  But apparently I have a very strong constitution, and I survived.  Then, one afternoon, I woke up, and I was back in the mental hospital.

Committed again, dammit.

This time is was a lot different from the first one. Before I felt like I really didn’t need to be admitted. It was just my therapist overreacting. But intentional or not, I had almost died by my own hand. I couldn’t blame that on my therapist or anyone else. I didn’t feel depressed when I started taking those pills, but I was damned sure depressed when I woke up. My mind was in total shutdown. I couldn’t talk, could barely eat and just sat staring off into space, lost in my own misery. Back then there was a system of ‘levels’ that everyone was assigned depending upon the rate of recovery. Level 1 was the first stage, and usually patients only spent a day or so before moving up to level 2 and more privileges. After a week, I was still level 1. I couldn’t leave the ward at all. My meals were brought in and I ate in the dayroom. I wasn’t on suicide watch, but you can believe that the staff kept a very close eye on me. It didn’t even go to the group therapies they had twice a day until I was forced by the staff. Nothing worked however, and I was almost catatonic.

Immediately upon admission the Doctor changed my medications. This is pretty much par for the course as if the medications you’re on are working, then you wouldn’t be in a hospital, right? Needless to say, Lithium was off the list, and I was put on a high dosage of a tricyclic anti-depressive. And over time, it began to make a difference. In my second week I was moved to Level 2. My awareness of my surroundings and the staff increased. I was still miserable, but at least I was functioning again. Progress was slow however. Two weeks turned into three. The doctor continued to make adjustments to my medications; increasing dosages and adding more. All it seemed to accomplish was inflicting new side effects. As I approached 30 days my Doctor filled a petition with the court for my continued commitment. Given my lack of improvement and inability to speak up for myself it was a foregone conclusion that I would stay confined.

I just wasn’t getting any better.

Even though the insurance companies were a lot more liberal in the amount of time they would pay for inpatient treatment, 30 days was usually the maximum. So my Doctor suggested that I consider a different facility that might have another approach to treatment. It was about 4 hours away from my home which I really didn’t like, but the insurance company seemed to be okay with the transfer. And actually, I didn’t have a choice. I was legally committed, and I couldn’t stay where I was because of insurance. So a very nice Highway Patrolman gave me a ride, and off I went. I will have to say, it was a beautiful facility I had been transferred to. It was in a resort town, originally built as a second home for a very wealthy family. Around the turn of the century (the 19th century) however, it was turned into a hospital for the mentally ill. Or, as it was called at the time; an insane asylum. 80 years later it was still in use as a psychiatric hospital, but had evolved into a long term facility rather than the crisis management hospital I had been in. Wait a minute… long term care? Somehow My doctor had forgotten to mention that little tidbit of information. Oh my God…

I had been institutionalized.

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