Psychiatric In-Patient Care aka I couldn’t think of a better title

TW – discussion of mental illness, suicidal thoughts and psychiatric wards

I always held the societal misconception of in-patient care – that they were filled with strait-jackets and padded rooms. Psychiatric wards are not like the “loony bins” you see on TV. I detest that phrase – like hospitals are some kind of place to rid the world of the ill.

Sometimes, it seems like everyone supports those with mental illness, until they start showing symptoms that aren’t the image of the “cute and quirky” girl with social anxiety. The ward is a cruel reminder that mental illness comes in many forms. From the boy with cuts up his arm to the girl with psychosis-based delusions, the two wards that I’ve been on served to remind me of the realities of mental health difficulties.

I remember my first night in the adult ward. I went to my room and there was a cuddly toy tucked into my bed and a soaking wet hospital gown on the floor. At first, I was scared, but then I thought about how ill the girl who did this must be. The adult ward was not a pleasant experience for me, but it did one thing – it kept me (and all of my fellow patients) safe.

I was admitted to the psychiatric ward when I told I mother I couldn’t keep myself safe, that I was concerned that I was going to commit suicide if left unattended.  I suffer a lot with impulsivity, a sudden urge surging through me to do something self-destructive. I never usually planned the attempts to end my life – my instincts take over and I feel like a helpless puppet; my unwell mind pulling at the strings, willing me to take the pills

The first time I went into in-patient care was when I was 17, so I was admitted to an adolescent ward. The night before, I couldn’t sleep. It was five-forty-five in the morning and I was standing outside. I felt the air marginally warm as the sun began to rise and the light wash over me.My breath was visible in the cold air and the night heavy with silence (or as close to silence you can get, living in London suburbs). From my early teenage years, I enjoyed standing outside at night or early morning. My friends and I used to go to the park in our pyjamas and I loved the feeling of freedom you get when nobody is around.

When a reasonable time came around, it was time to formally get up and get myself ready to leave. As I arrived, I watched the group of teenagers stretch their necks to look at the new arrival. Scared? Understatement. ‘Fucking terrified’ may be a more accurate turn of phrase…

Near enough instantly, I felt welcomed. The group, as per tradition, had made me a door sign with my name on and welcome messages neatly written around where my name stood. It was decorated with glitter glue and crepe paper, two things which always made me feel nostalgic to the artsy-crafty childhood I had.

It was hard being in the ward and away from home. The first night I was there was rough; one of the patients attempted suicide in their unescorted leave (this meant you had 15 minutes to walk the grounds or go to the shop unattended, but usually meant that you bought some cigarettes and smoked half a pack, returning and the nurses commenting on your “new perfume” and you feeling a bit sick). The ward was in crisis, people were crying and I thought to myself “how nice it must be to have people care about you so much”. Selfish thought, I know. It seems to be the people who care the most, also hurt the most. This group of people I met in the adolescent ward were the most caring and supportive people I’ve ever met in my life. One person is feeling down? The whole ward comes together to cheer that person up.

There is one moment in the ward I will never forget. We were all sat around in the group room idly chatting when we started throwing glue at the ceiling to see if it would stick. I have never laughed so genuinely as that moment. When you’re stuck in a psychiatric unit, you gotta laugh at the little things! It remained on the ceiling for the two weeks I had left on the ward and a small part of me hopes its still there

I want to leave on this note – there is no weakness in seeking help and admitting you need help. Being admitted into in-patient care is not a sign of weakness; rather it’s an indicator of strength. Whether you it was a voluntary admission or you were sectioned under the Mental Health Act – you are strong. You are surviving through torment in one’s head and that, my dears, is what I call strength.

The Double Edged Sword : Understanding Psychosis

Psychosis is a strange phenomenon, but experiencing it certainly does not make you a freak! Almost 1% of people reported psychotic symptoms in the last year, according to the charity Mind’s website. When you think of 1%, it doesn’t sound like a lot. But scale that up to the population of the UK and you’re talking around 650,000 people.

Psychosis is a double pronged attack, and people can experience both sides or just one of the sides of this sword.

The first edge of the sword is hallucinations and this edge can cut any of the senses. For me, the auditory cut was the worst.

I always used to refer to the voice inside my head as its own entity – it could think and say things and had its own speaking voice that was different to my usual thoughts. It would turn my feelings into tangible thoughts – something that I struggled with a lot. Everything in my head felt like a jar of paper clips being shaken; each paper clip being a thought and the thoughts overlapping and interlocking with little structure. To add to the mix, they were being shaken up. The paper clips ricocheting off the glass insides, getting more and more tangled with each movement.

But the internal voice, if it did one good thing, was make what I was feeling clearer. Don’t get me wrong, it would call me horrible names and verbalise my insecurities, but at least I knew what I was feeling.

I remember the day the voice inside my head became a voice outside of my head.

I was in sixth form, on my way to a Politics lesson when I heard an echo-y voice whisper “stupid”. It was a strange voice – I couldn’t place whether it was masculine or feminine, or even its age. I thought it was someone passing me, as the corridors were abnormally narrow and always bursting with people. I turned around, scrunching my face up to whoever said it. Then they said it again  – “stupid”

I walked faster.

“Stupid, useless, failure” It said.

I looked around. Nobody seemed to turn to see who was saying such horrid things. Nobody even batted an eyelid.

“I’m going fucking crazy” I said under my breath as the realisation hit me –  it wasn’t another student. I realised it was a voice that didn’t belong to a person. A voice only I could hear.

I texted my mum – “the voice inside my head is outside my head and I don’t know what to do”

She replied within seconds, telling me to go home and that she’d leave work early. This panicked me even more – my heart beating like a buzz and my breathing so quick and heavy I could probably have kept a hot air balloon afloat.

I called CAMHS later that evening and they wanted to see me the next day. They explained what I was experiencing were some psychotic symptoms of my depression.

“Psychotic? Does that mean I’m a psychopath?” I asked

My psychologist smiled. “No, it just means you need a little extra support as you experience these things”

I didn’t really feel like she explained it very well. Everything with CAMHS was very fluffy. I kind of wished someone would have sat me down and explained it all a bit better rather than having to gage how ill I was from “how much support I needed”. I left the building somewhat more confused than I had entered it.

Later down the line, as my psychotic episodes grew worse and more frequent, I began to experience visual hallucinations – seeing spiders everywhere or even the faces of the voices.

I hear three distinct voices – a female voice, a male voice and a voice who’s gender I cannot place. Cassie, the female voice, is the scariest. She screams and shouts; her high-pitched voice sending shudders down my spine every time. She plays on my insecurities and my irregular thoughts.

This brings me onto the other edge of the sword – delusions.

A delusion is where an individual has a thought or belief in something that is completely untrue. This belief is unshakeable and one cannot dispel such thoughts from your head.

Delusions are a shapeshifter and your delusions can change one day to the next. When I was at my most unwell, I genuinely believed that people could read my thoughts. I became paranoid and even more anxious, unable to leave the house. Some often report believing that an individual or organisation is plotting to hurt them. Some report that the media has special messages for them. The list of delusions one may experience are endless but the overriding aspect of them is that the individual wholeheartedly believes them to be true.

Be patient with those who are experiencing psychotic symptoms – it is incredibly difficult and so terrifying. It may be frustrating, that they do not understand that it’s not real, but know that this time is critical. Psychosis and psychotic episodes regularly leads to destructive behaviour like self-harm and suicide attempts.

I have found a few things that seem to work for me

  1. When hearing voices, listening to music through headphones seems to block out the majority of the hallucinations.
  2. When experiencing delusions, fact listing with somebody, or even in my head, is useful. For example, “My name is Annie…. I’m 20 years old….I have green eyes…..I have a brother named Joe….”

Overall, I would urge anyone experiencing these kinds of difficulties to seek help as soon as possible.

Stay safe all x