"One Flew Over..." Life On a Psychiatric Ward

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My Space                               Photo: Nick Ray

I clearly remember the first time I was admitted to a psychiatric ward. It was 1998 and I was in crisis with deep clinical depression, very thin and underweight. Then, as I walked onto the ward with the Community Psychiatric Nurse who had brought me in, I remember two emotions flooding my limbic system. The first was fear - a fear of the unknown, the fear of becoming mad, the fear of "One Flew Over The Cuckoo's Nest". As the loudly alarmed door to the ward closed behind me, the second emotion then enveloped me and this was by far the most useful one. The sensation of safety and the relief of no longer being totally at the mercy of my depression.

Eighteen years later and this is my fifth psychiatric admission. I wouldn't say that I'm now an old hand but I do know what to expect and the fear of the unknown - the fear of entering a world of madness from which I may never escape, has long since disappeared. It's an odd experience for me to feel a sense of normality in an environment where 'normal' is a concept which many folks here are struggling to determine. However being here does seem familiar and comforting. This comfort is largely due to the healthily warm therapeutic atmosphere created and embodied by the staff team. The ward is a safe environment where apart from physical and verbal violence, anything goes. Expressions of human emotion in all its guises are OK here which is a psychological release for many - like myself. In our society we filter how we express our core emotions of Joy, Fear, Anger and Sadness because we may harbour shame and reticence in doing so. Here on the ward, my tears of sadness are unapologetic. My anger is not extinguished but allowed to burn out naturally. My fear is not quashed but encouraged to be faced and somewhere amidst all these, there are increasing moments of pure joy which burst through the vacated chinks in the emotional armour I have created.

We are a transient, sometimes ragged band here on the ward. Each of us carries our own wounds and we require healing in individual ways. There are unwritten and unsaid laws of existence here. We do not delve into each others lives apart from asking where we live and what family we may have. Any other information which is offered up by a person is warmly received but even then we do not unpick at any loose threads of information for fear of unravelling more than either party has bargained for. We accept each other for who we are no matter what behavioural traits we exhibit. In a way, we are a model social community where each person is met with openness and trust and where no unfair judgement is meted out. Nevertheless tensions do arise and we can choose to interact less with folks we have little in common with.

There's an awareness too of the intimacy in how we live and share our lives on the ward. Sleeping space is shared four to a room, meal times are shared, there are two television rooms and a quiet room and the seating in the entrance hall is a favourite place for folks to hang out. Many on the ward are not allowed off the premises either at all, or unaccompanied. This means that for many of us we are living together 24/7. We learn the valuable lesson of tolerance very quickly and in doing so we accept we each have our personal foibles.

Routine is key to our happy existence here. Very quickly I slipped into being governed by the times for breakfast, lunch and dinner. In between these are set times for tea and coffee breaks. I soon identified what is important for me and I established a routine to meet my needs. I rise at six for my first coffee of the day and to watch the morning news. Often I will be the only person up (apart from the night staff) and I enjoy the calm and solitude. I enjoy the time between getting up and breakfast at eight because of the relative serenity around me. Our time on the ward is very much our own - we are not compelled into any activity though we are encouraged to participate in what is on offer. I enjoy the pottery sessions on a Thursday and the art and craft sessions on a Tuesday. Other than these two I entertain myself with reading (avidly) and teaching myself watercolour painting through the university of YouTube. Very rarely I will allow myself to sleep during the day and when I do it is a delicious luxury. Even more rarely I will sit and watch daytime television knowing how alluring "Homes Under the Hammer" can become after a while. You'll pleased to hear, I hope, that I avoid watching "Jeremy Kyle" at all costs! Dinner is at five in the evening. I find the time after this drags a little where I drift in and out of the television room or sit and read. I sometimes watch a film or programme on BBC iPlayer. After the tea break at eight I then begin to count the minutes to 10pm when I get my medication and a sleeping pill. I need this fast acting sleeper (as we call them) to knock me out before the snoring commences in the room I'm in. My three erstwhile companions are pretty loud and it's impossible for me to fall asleep if they tune up before I have dropped off.

So the routine of life here marches on. Days blend into each other and the weeks slide by just as effortlessly. It's certainly not an uncomfortable existence but neither is it one that I hope to continue indefinitely. It is serving its purpose. I feel safe, I feel cared for and importantly, I feel acknowledged. There is power to be gained from living in the moment - the power of now. I am healing - there is no doubt about this.

I think that in general society is far more aware and more accepting of mental health distress than it was when I first encountered the service nineteen years ago. The view of mental health hospital provision has moved way beyond the one portrayed by Jack Nicholson and his cohorts in the renowned 1975 film. I am confident of openly sharing my mental health experiences and not hiding them away for fear of judgement or shame. However I am less confident about making an admission of my mental health history when it comes to seeking employment and I find this very sad.

I am ready to leave hospital now. The routine has begun to grind and I am missing home terribly but I have to accept that I'm going to be here for a good few weeks more. My ECT treatment is due this Friday and so begins a new phase of treatment for my depression. I can put up with my life on the ward in the knowledge that I am tackling this weight I have carried with me. However I look out of the windows at the budding plants and trees longing for the freedom of the open seas and the cry of the Gulls above. It won't be long now.

The Inner Storms

My last post was in early February. Since the middle of that month I have been a patient in the wonderful care of the psychiatric ward in the Mid-Argyll Hospital. I have severe clinical depression, an affliction that has dogged me much of my adult life. This time though, this particular bout has been unusually tortuous and I have struggled at times to make sense of the world and my place in it. Suicide is a subject many of us find challenging to openly speak about which is why depression can be such an insidiously serious illness. For me, suicide is not a simple 'get out' clause, it is the seemingly obvious resolution to my inner turmoil. The struggle I have in believing that I have value to offer and I am valuable to the important people in my life. My desire for completing suicide offers me a sense of deep and timeless peace - a peace that I often struggle to find in my life.

Thankfully, despite the emotional anguish I experience, there is within me a strong desire to continue living. This is why in mid-February I was able to seek the assistance first from my GP and then the psychiatric team of the Mid-Argyll Hospital. The sense of safety I experienced once I was admitted to the ward was an overwhelming one. At the point of admission there was the usual tussle within myself to follow or not to follow the advice of the GP and the ward staff. However once I made the decision to accept admission, I was able to relax (somewhat) and allow the pent up emotional tensions within me to be slowly expunged. This process has not been straightforward nor particularly pleasant. I have time and again slumped to the depths of my soul and faced my demons head on, believing at times that these would ultimately triumph. These demons continue to combat me and my sense of self as a worthwhile individual is far from complete. My recovery from this depression is slow and tenuous to say the least.

In a few days time I begin a course of ECT (Electro-convulsive Therapy) in the hope that this approach will knock my depression on the head - pardon the pun. It is not known how many sessions I will require but it is generally thought that six to twelve are the normal amount. From all accounts I understand this to be a safe and effective approach to curing severe clinical depression with odd renewal sessions from time to time as required. For me, the prospect of no longer feeling and experiencing the deep emotional anguish I have been is of course hugely attractive. It means quite simply that I will be able to smile with the world again.

I am not ashamed of my depression though I do feel shame when I recall some of interactions with people while deeply depressed. I am happy to speak of my condition in the hope that it helps others who may be experiencing depression or living with a loved one who is. As I have always been told - it's good to talk.