The New Business Model in Psychiatry

I checked myself yet again at the hospital. It became my full time job really.

Shame on me, I ain’t strong enough to survive outside more than a few weeks. But is it really my fault?

Not more than 24 hours later, yes you know it, I checked myself out. I wasn’t scared of the environment this time. I liked the room. I even met a couple of people with whom I could have a decent conversation – shout out to K, L, N and N!

My problem was the medical body. My sessions with them were more of open ended questions like in qualitative research. I felt time had no essence to them. Like progress cannot be measured daily.

When I went to London, and I am not being payed to say this – if you only knew how expensive it actually is to get treated there out of pocket – every single word I said was taken seriously. Every little side effect was looked at. I was seen as a person; a real person and not a spoiled brat complaining for no reason.

Secondly, the doctors would not dwell endlessly on what to do. They took calculated risks. Because if they agreed to the status quo then nothing would happen.

I was always reassured and never ever did anyone tell me this drug or this method works for 20% of the patients. I was given hope – in abundance and also had the opportunity to chat with other patients who are now truly healed.

While I was completely fitting the box of patients in the clinic, my individual voice and needs were immediately heard.

That is why I felt I was wasting time at the hospital and that is why I left 24 hours later instead of staying for a whole 10 days.

My business teachers at university always said a good product or service starts by answering a customer pain.

Very well, mental illness is filled with customer pain; be it the patient herself or her family members.

I have been treated and admitted to hospitals both in Paris and Cairo. Although the settings could be strikingly different; there are major similarities.

Patients have little control over the course of their treatment; unless they happen to well read – and still that could be interpreted as a personality disorder.

Here, business people, here is a business model for you to follow. Instead of keeping the one patient coming back for 10 years, you can have thousands of them and most likely very happy ones too. Am no mathematician but get your excel sheets out and do the works. It doesn’t need a genius to tell you where the money is; and coincidentally health too…

TBC

I am committed

I am committed to coming back to this very hospital

I am committed to receive every form of therapy there is under the sun

I am committed to doing whatever it takes to raise our children, see them graduate and organize their weddings

I am committed to loving and honoring my immediate and extended family in every possible way

Meanwhile I am finding my happy middle

It is a mirage

But I need to keep on looking

I will check out tonight if it is the last thing I do

I will come daily as an outpatient

I am committed to heal

I am committed to survive

I just checked myself in a few hours ago and now I want to run through the iron gates and never come back.

I cannot deal with my thinking, my needs, my wants, my moods.

Is this a magic spell?

Get me in here

Get me out of here

My patience is nonexistent and my insight is blurred with my tears.

End this torment for I am at the end of my rope

This song is on a loop and it won’t stop

TBC

Call for interviews

As part of a bigger life project, I am conducting (anonymous) interviews on how to live/cope with bipolar disorder. Send me a message here or through my Facebook page if you are interested in participating.

Bless

https://m.facebook.com/happilydepressedblog/

If I were

If I were at the hospital

I would wear my pyjamas all day

I would say good morning to everyone

I would wake up on time

I would have breakfast at the communal table

I would go for a smoke when the nurses say so

I would wear a nicotine patch To get me through the day, and I would be allergic to it

I would use the communal shower and dry up with a bed sheet; I would find hair everywhere and stay with my slippers on

I would wait for the doctor to pass by and say the daily bla-bla-bla;

I would play Sudoku- pen and paper sir not online

I would stare at my family’s portrait hung on the window and imagine them touching my face

I would move my chair around to be in the sun, seeking emotions and failing to find none

I would be disconnected; off the grid and not feel guilty about it

I would pretend it is doing me good to be here

I would take my blood pressure and temperature every day

I would talk to others about side effects of this or that

I would fancy getting better

I would know it is good for me, it has to be; it better be

I would feel guilty about the kids, my husband, my father; my kids, my husband, my husband, my husband, my father, my father, my father, my father….but my kids…

I would wait for 2pm when visits start, no no tears this time

I would wait for 7pm when I can call the kids and ask them to sing me a song, sometimes they would

I would give them imaginary baths and diners

I would blow imaginary kisses and I would make belief that I am tucking them to bed

I would kiss my husband good night and say a silent prayer, god let tomorrow be normal – one more day

I would beg for the drugs to black me out at 8pm

Dinner would be sprouts and more sprouts. Some borrowed olive oil here and some salt

The other day I took the kids bowling and felt so self accomplished just as if I landed on the freakin moon

I am sitting by the louvre sipping my Bloody Mary with tears

People are standing up here and there trying to get a perfect picture

They bend and jump into strange angles to look like the pyramid is on the palm of their hand

It is all make belief, looking for the perfect moment

A tour guide has an umbrella up for everyone to follow her

Where else would they go I wonder? Isn’t this the perfect moment? To follow someone without thinking? Tick this box and that one. Been there, done that…

We talk and talk and talk and talk

We shut up and up and up and up

We should know better

I am writing compulsively, but you don’t have to read me

It is building up

I know myself, I wish I didn’t

Solve it; for you god brought me here in the first place

No shame; maybe some

No regrets; just a few

Oblivion where are you?

TBC

Fighting demons

I left the hospital about a month ago.

I didn’t write earlier for many reasons. Initially, I was denied technology for the first 10 days of my hospitalization at the closed-up ward.

They took everything. I was allowed my bed and a few magazines. My luggage was searched. Chargers and electronics were sent home. Glass was separated from plastic. Belts were taken away from clothes. Everything else went into either a small closet to which the nurses held the key, or to the nurses’ office, access to which was upon their discretion. My cigarettes and lighter were locked up too. I got about 3 to 4 smoking breaks; always accompanied.

Interaction was limited. The idea was to spend time to heal without any distractions. Noises were rare – except for the TV that was on low volume. I remember watching Forest Gump while sitting (luckily) on one of the three recliners. Lights were dimmed.

I had visits from my family daily. I was eventually allowed to go down to the yard and cafeteria with them. I would have coffee and sometimes a kinder bueno. I slept 12 hours and ate together with the other five patients at the common table. My diet was mostly derived from the cabbage family. I think this was the cook’s punishment for vegetarians. I surely don’t have vitamin K1 deficiency.

We traded food as we complained about it. It was the highlight of our day. We also shared two bathrooms and a shower. They gave me a bedsheet instead of a towel. Sometimes people forgot to flush. I had to return my shampoo as soon as I finished. At night they sometimes did random searches of the rooms. They would put things back in the closet or their office. This period always reminded me of the Jungle Book song “The Bear Necessities”…

I had daily visits from either one of the doctors or the intern. They would ask all sorts of questions initially to establish my story, my case. It was intense in the beginning then it became more of a routine. I was weaned off my long list of drugs and little by little I had 3 instead of 8.

Without a mobile, we had access to a phone line from 2 to 8 pm. It was religious for me to call home at 7. I would then speak to the children. I would beg the little one to sing me a song.

I began to cry after a few days. I missed my kids and although I could see my eldest in the garden, it was very impersonal and cold. My problem was my youngest. I was dying to hold him. He had never been away from me all that time and I had plenty of time on my hands. I obsessed about seeing him. I dreamt of him, heard him calling my name. I held his tiny blue car I had taken with me to the hospital. I looked at his picture most of the time. I was itching inside to see him.

Doctors had mercy eventually and I was moved to the open section. It basically meant that I could soon have the right to go out for a few hours. I was in a triple room though, I had absolutely no privacy. At the time it didn’t matter because all I cared about was holding my children tight.

My phone was given back to me but I could neither connect to social media, nor write. My stay at the closed ward influenced me to a degree I cannot explain. I thought it shall pass. I thought I will eventually answer calls or at least reply to messages. I am still in my bubble. This is where I feel safe. I still have dinner at 6 PM.

Eventually I was let out. I was on Prozac and lithium. After a few painful blood tests done by intern nurses, the doctors agreed that it is time to move to the real world. I could manage my nausea then. I hadn’t talked about this side effect to anyone. I feared they would change drugs again. I had had a few “mock” stays at home for 48 hours, and as these went well, they had no reason not to let me out.

I was extremely happy. Cured I thought. I was on a cloud. I savored my sheets, my coffee, my family. I felt liberated and free from the weight of all the previous drugs that left me with countless side effects.

I was managing my own medication. No suicidal thoughts. I could get dressed and go out for dinner. I didn’t fall asleep by the time the starter arrived. I did not snore or have awful nightmares. I didn’t wake up at 3 am to empty the fridge.

Yet, I could not write. It drove me crazy. It was as though my mind was emptied – literally. This caused me great pain. Little by little the cloud of happiness was disappearing. Gravity hit in fast and I was left with my initial illness of 2 years ago that hadn’t been treated till now. I felt all the personality changes that follow taking so much drugs. I look at the mirror and wonder who is looking back at me. I barely recognize myself, although I guess we keep the same values.

What keeps me afloat is my family. I cannot break my husband’s heart by falling again. I cannot imagine not seeing my baby boy. It is unthinkable to put my daughter through this one more time. And I honestly don’t know if my father can survive one more of my attacks.

You get the general feeling. I am scared. I also tremble. It is from the lithium. My hands are shaky and my face twitches sometimes.

I look like all color has been taken away from me. My world is black and white. I laugh sometimes, but it is momentarily. The thing I love doing the most is staying in bed alone, but my doctor says I shouldn’t.

My main concern is that this illness has taken over my brain, my life. It is the first thing I think of in the morning and the last thing I have on my mind at night.

I sleep poorly and have had some ugly panic attacks. My husband sits me through them and holds my hand to help me breath. He tries everything from rubbing my feet to aromatherapy. It eventually passes and leaves me incredibly tired as if I ran a marathon.

Now, I have to start therapy but I don’t feel like talking to a stranger. It has been three weeks since I had to take an appointment. I am scared of the slightest changes. When will I say I am me again? Oh dear, do I really want that?

TBC

The day before my hospitalization

As I smoke the day’s first cigarette, I wonder…

It has been decided yesterday that I will be hospitalized tomorrow.

Dread is all what comes to mind. A new place it is, specialized in mood disorders.

The ward I will be occupying will have 6 patients. Six individual rooms isolated from the outside of the hospital; from the outside world.

I worry about small details; will the room be warm enough? Will the charger reach my bed? Will they let me out to smoke?

I also worry about visitation rights. It is no prison I know, but there will be strict rules to follow.

How long will this stay be? When will I graduate to the open ward, where I will have access to the courtyard and the cafeteria? Will I get permissions to go out? When will I see my children again?

Soon enough all these mundane questions will be answered, and other ones will surface.

I will write as much as I can….

TBC

I don’t want to hurt myself

I don’t want to hurt myself. I do not want to end up in an emergency room.

My only weapon is my writing.

I have to fight myself as much as I have to fight the system. What on earth am I supposed to do not to end up in an emergency room? How can I control my impulses?

Could my pain make my heart explode? Is this physically possible? Will I let my children see me this way? What does the system offer to those in my position? Waiting and some more…

I wish I could feel numb like the last 48 hours. Today it hurts like an open wound. Will I keep on bleeding endlessly? will I hold this scream till the end of time? Will my tears ever dry? What can I do to protect my children from me? Leave? Go where? Die? They will be motherless just like me.

I have given all my strength in this fight. There is nothing left in me, not even pride. All what I ask is for is that it be quick. This separation that is tearing me apart, could it happen in the blink of an eye?

I am rambling, scared like a lost child in a forest. How can I be a mother when I am like that? God, if you exist help me… and if you don’t, then let me be…

On waiting

I want to be readmitted to the hospital, but there is no place for me today. Maybe there will not be either till Monday. That means I have to keep my will to go for hospitalization alive till then. That means I have to give my family and specifically my babies the cold shoulder. Otherwise, I will change my mind again.

I know no one else understands the cyclical problem I am facing. Today is the last day before the weekend. This means today is the last day before total meltdown. I want to be safe before it. For others all days are the same. The dread of the weekend is creeping up on me like a thousand ants…

Will I have the will to go after the weekend? What will happen? I keep my drugs with my father. I will not go out alone. I do not even want to go out. I have to wait and waiting is what I hate the most about this whole process. If I could manage to sleep it through…

We have to wait for doctors’ appointments, for drugs to kick in, for drugs to taper off, for places in hospitals, for visits at the clinic, for permissions to go out, for the right moment to leave the kids when on perm, for the nurse to give you the pills, for the lunch tray, then dinner tray, for healing to occur, for convalescence to endure….

We have to wait to kiss our children goodbye, we have to wait to greet our children… We have to wait to explain over and over again what is wrong with us.

To hell with this waiting, yet we even have to wait for hell..

TBC

When your are dumped by your therapists…

Betrayal is the feeling of having been left alone, stabbed in the back, having someone take action behind your back or against your will.

Abandonment is the act of betraying a promise – written or otherwise for no logical or understandable reason to the person being abandoned.

Ethical Framework to the counseling professions is about Ethics (values, principles, and personal moral qualities) and it is also about Good Practice (putting clients first, working to professional standards, respect, integrity, accountability and candor, responding to ethical dilemmas and issues etc. )

I have been chewing on these few concepts since last night. I slept because I took a sleeping pill, which for once was quiet useful.

I would like to dwell today on values. I like the word values, it is tricky because it is personal. It is related to morality, because why would something be valued if it is or is not morally viable? hmmm

You might perhaps be wondering why I am asking or putting forward all these philosophical and linguistic babbling. Here it goes:

I was betrayed and abandoned by both my psychiatrist and psychologist agasint the ethical framework binding the helping professions. Ah, much better to say it in writing.

I am not interested in pointing fingers, or mentioning names. I like Jesus, this wise man decided to give the other cheek. I take to his way of doing things, though am neither religious nor wise. But you see, Jesus had a point. When you give the other cheek you force the person in front of you to start questioning their moral stand point. They start thinking of their actions and reactions. They question themselves. Maybe, if one is lucky, they discover that they could have acted differently.

The reason I am being denied treatment by both my helpers is that I refuse to be hospitalized. I prefer daily monitoring, while being close to my children. I am  in no danger to others and I have vowed not to pass to the act of self harm under any circumstances. I was not once offered an alternative solution to hospitalization, I was not once talked to about the benefits of being closed up. It was just decided, with a strong authoritarian approach  that no hospitalization equals no treatment.

Is there something called middle ground? Let’s try and find out in the dictionary. Yes! There is dear people something called middle ground,  and it means and I quote the Cambridge online English Dictionary: “a position between two opposite opinions in an argument, or between two descriptions.”

Very well, So if the argument of my therapists is that they wash their hands from the blood a potential suicidal person – whose suicide has now been established to be induced by anger – is valid. What does it actually mean? Here are a few options, you may add your own:

1- Protecting their “practice” is more important than protecting their patient: Self evident really. I wash my hand from thee blood on me chart of dead patients.

2- Protecting their “practice” is more valuable than the life of a borderline personality disorder (BPD) patient: By default a BPD fears, like seriously fears being left alone or behind. But again, thee blood is not on me finger (choice of finger left to you my dear reader)

3- Protecting their “practice” is a manipulative: Aha, yes let us tell the patient we shall not be responsible for you anymore and then wait behind the theater’s red curtain for the moment when the patient falls into the ground and starts begging them to control her life and take her back into the bliss of treatment.

There must be many more reasons, one of which is plain stupidity. Not once was I asked to find anther therapist, or helped in finding one. What about the period between ending your mighty help, and me finding someone else to help me? Lexomil, Dolipran, cutting my own veins?  What was going into your tiny minds, with your tiny neurons floating around in this state of reduced mental capacity for judgment?  I would seriously reconsider careers if I were you… But you are not that smart

You did me some favors though:

I learned that I alone own my destiny. 

I learned that I alone control what goes into my body and in my mind.

I learned that I alone decide whom I will share my life.

I refuse to learn that people are bad until they prove otherwise. 

TBC

 

4 reasons Why you should avoid going to CAC 6 in France

Yes I know I am sick as a dog, but if you read me out, you will understandably know why I hate this institution.

1- You might be refused help: I went with my own packed bag to the CAC* of the 6th arrondissement in Paris (emergency psychiatric center). I was seeking help, and mostly protection. I was refused by a psychiatric nurse CATHERINE – she told me to rely on my inner resources (smiley face) while I have suicidal thoughts )gesture with third finger and black dark pitch black ideas.

2- Mistreatment, under-treatment or non-treatment could be a nuisance: Next day, it started. I had my headphones on most all of the time to avoid any contact with the staff. I think it was the smartest thing I did. Next day, unfortunately there was still again no place at the private clinic to which I would be transferred to, so confrontation was a little less possible.

3- Spare yourself from unnecessary anger: Small things, like you cannot get access to your phone at 8:55 but at 9:00. That I have no visitation rights except for one hour. Small things like forcing you to take an ambulance to the other clinic while they have absolutely no right to do so. Small things that I could go home and have a proper shower (wearing same socks for two nights). Small things, like going home to pack my bags and kiss my children goodbye.

4- Food sucks: Just kidding, but unfortunately true!

Admission to CAC meant that I used my mind – a ruse – I managed to get admitted by waiting for the next shift of nurses to arrive, angels like FABIEN, MARTINE and BENJAMIN. They let me in, gave me something to sleep. I felt sad to be away again, but nothing weird – just the fact that I was not able to leave my husband and be away from home.

For a full review click here

*CAC: They are part of the 5 psychiatric institutions in Paris. They provide a hotline and psychiatric consultations. They welcome, treat, or offer short time hospitalization, but do not take charge of hospitalization without consent….Ils font partie de l’offre de soins des 5 établissements psychiatriques de Paris. Ils assurent une permanence téléphonique et des consultations psychiatriques. Ils accueillent, soignent, orientent ou hospitalisent pour une durée brève, mais ne prennent pas en charge les hospitalisations sans consentement.

Waiting for Monday

It is inexplicable what bipolar means. It sounds simple enough; one day up one day down. Yet, this dam type II has most of the time down periods.

I noticed it is mostly Sundays that I don’t tolerate. I think I never liked Sunday. When I went to school, I had Friday and Sunday off, so I always looked forward to Thursday. Till now, it is my favorite day. Sunday reminds me of regressing to routine, of boredom, of loneliness, of responsibility…

I decided to press the panic button today and went to the emergency day center CAC. I couldn’t open my eyes this morning without crying. I cried when I saw the bed empty, when I heard the sound of my husband talking to the kids. I cried to the sound of TV in the background. I cried because my children were beautiful. I got dressed, i even put on make up to look normal for them. I am sick of them seeing their mother crying and shattered in a million pieces.

I fought the feeling and went to make their favorite breakfast. Fuffy eggs. Everyone ate, tears came down even more because they ate. It was going up, the feeling was growing… The void, the meaninglessness of my life, my love to them..

Today my feelings are like a song, With a beat, with percutions in the background and a soft singer whose voice breaks through your heart with its depth, its high notes travelling through your veins.

I do not know what to expect from myself, from CAC, or from today. I am in terrible pain.

I see other people in the clinic, some gazing with their eyeballs made of glass. It scares me, I was like this once and I do not want this to repeat itself. But I like to talk to other patients. Their pains and stories make mine legit.

I feel nauseous, not from the stomach. I feel I want to throw my “guts” out. I wish one could throw up their mind and feel this amazing void afterwards.

The psychiatric nurse and I spoke and we decided I should not be sedated. I have to have feelings, but they hurt. It is like a fresh wound on which you throw alcohol and scream each time – perpetually…

We will see what will happen. At least Sunday will be over soon and Monday will come. It will be grey yes, it will be freezing, but it will be Monday. My roller coaster ride will slow down, and there will will be at the dawn of a new day.

I know it hurts to be here. But I kept my promise and pressed the panic button. I want my family to know that I love them more than anything and despite everything. I just wish they have the patience to wait for me, for this darkness has to cease. They say there is light at the end of the tunnel. If one saw it, I can too.

Not religious, but praying to see this light for more than one day, i saw it for the most for one week…

May you never experience my pain.

See you Monday

TBC