17 October 2011

How to Be a Patient - Depression Edition

I call this the "Depression Edition" because eventually I'll write a "Crohn's Edition," but depression has obviously been the dominant topic of late so here we go.  We've already explored the importance of acknowledging depression, and I've given you the basics for forming a support network.  But what about your time spent as a hospitalized patient?  Every experience is unique, of course, and each program operates differently, but here are some universal tenets.

It's a Funny Farm/Nut House/Loony Bin

Depression is poorly understood, and this extends to treatment.  People conjure images of white rooms with padded walls, sadistic doctors conducting dubious experiments and lobotomized patients slobbering senselessly.  I'm sure such places exist somewhere, but the truth is that most mental health facilities are just like any other medical facility.  They're (mostly) sterile and orderly.  Food comes round at regular intervals, nurses administer scheduled medications, and doctors speak with you briefly in the mornings.

What's different about being hospitalized for a mental issue, though, is that socialization is often a key part of treatment so unlike recovering from a physical malady, you're encouraged to leave your room and be around other patients.  It's true that some patients don't really want to get help, but for the most part I found all of us at a point where we just wanted better for ourselves, and for our loved ones.  I won't lie: a couple of patients made me uneasy, but on the whole I found myself in the company of people like myself who had simply become overwhelmed by life and needed help.

Be Honest

There's really nothing else as important as this.  You must be honest with everyone: yourself, the medical staff, other patients or anyone else with whom you interact.  You need to be honest about your state of mind.  Some patients simply wished to get out of the hospital, and what we all said to one another was, "Don't leave if you're not ready."  It's tempting to just want to get home, particularly if you feel like the only thing that you can do positive for yourself is to re-engage your life, but it's awfully easy to set yourself up for failure that way.  Better to take some more time and reenter the world a healthy (or at least, healthier) person than to come out too soon.

The medical staff, of course, relies on your honesty to ensure that you receive proper care.  If something doesn't seem to be working right, they can only make adjustments if you inform them.  There's nothing to be gained by "telling them what they want to hear."  They don't really "want to hear" anything (other than to be addressed respectfully, of course).  In my experience, the physicians and nurses who were the most attentive were the ones that I saw being engaged by patients.  People respond to other people, and it's to your advantage to invite the medical staff to respond to you.  (Note: don't abuse this just for attention.  There are other patients who need their attention, too.)

In group settings, honesty is paramount.  You may be surrounded by people whose stories sound much worse than your own, and you may feel tempted to not want to share what led you to treatment.  Or maybe you'll feel the need to embellish, and upgrade your "I lost my job" to "I was in the Peace Corps and my unit was overrun by brutal revolutionaries" just to feel like your reason for being there is "legitimate."  Don't.  It's okay that you haven't endured the same misery as other patients.  It doesn't make your need for help any less real.  Patients can spot liars among themselves, so don't bother.  Just be honest.  Several times I found myself sharing something that seemed trivial relative to what others had experience, but it resonated with them all the same.  I wouldn't have had those moments of connection if I had tried to make more out of my experiences than they really had been.

"Haven't You Ever Heard of the Healing Power of Laughter?"

The Joker nailed this one.  During my stay, there were lots of very intimate, heart-wrenching discussions that led to tears.  Several times, even I just stared with no idea what to say to someone else.  But I also found that most patients wanted to laugh.  It made it easier to be honest with one another--and hence, ourselves.  Sometimes we didn't even talk about our depression or other issues that led us there, but instead just told funny anecdotes and jokes to keep a good vibe going.

I made one patient laugh till she cried when I remarked of the linens that, "They will be towels when they grow up."  Another got the biggest kick out of when I said, "There's a light at the end of the tunnel, and I don't think it's the train."  These aren't terribly original or brilliant gems of comedy, but they were unexpected phrases that evoked a laugh.  I could feel the tension ease once someone laughed, and it was a reminder that I actually am a fairly funny guy, and that there are people out there who need to laugh.  Does it sound simple and unimportant?  Of course it does.  But then I ask you to consider the parking garage Jerry Seinfeld bought to house his collection of expensive cars.  He paid for all that because he could make people laugh.

Cast the Movie
Judy Greer
It's a little thing, but I found a side diversion that amused me (and some of the other patients) was to look around and think of who would play us in the movie version of all this.  I didn't cast everyone, but for starters I would need Rob Lowe as a counselor, Judy Greer as a nurse and Willem Dafoe as a patient.  These kinds of little games gave us something to think and talk about that helped place our hospitalization in a different context from being the embarrassing, big, bad place we went into it thinking it would be.

Talk with Other Patients

In my advice about forming a support network, I insisted that to have a friend, you need to be a friend and that's just as true inside the hospital setting as outside.  The patients who seemed to feel they made the most progress were the ones who socialized and talked with other patients.  We couldn't fix one another, and there were no expectations that we could or would.  Rather, it was important just to have those kinds of intimate, soul-baring heart-to-heart conversations that we couldn't have with people outside of that setting.  It's amazing what someone you've never met will tell you in that environment...and what you'll find yourself sharing with them.  I think those conversations helped the people I had them with, and I know I benefited from them.

"You Should Be All Better When You Leave"

When most people see a doctor or are admitted to a hospital, they leave in better shape than they arrived, and this should be true of your treatment for mental illness as well.  However, the chronic, incurable nature of mental illnesses means that you're not going to be "cured" when you leave.  You should, however, be rebooted in a sense and have a plan for management of your condition that is healthier and more helpful than what you had in place before your hospitalization.  It's a never-ending battle, and people around you may not understand that this isn't a one-stop end to your woes.  Be honest with yourself and with them, and accept that you'll have fights with depression in the future and that's not an indication of failure on your part, or evidence that your hospitalization didn't work.

Ask Other Patients About the Grub

Last advice: ask other patients who aren't first-timers what they think of the food options.  Everyone's taste is different, of course, but it can be nice to know that the hamburgers are actually pretty good and the chicken parm isn't.  Never underestimate the power of having a satisfying meal!


  1. Thank you for helping me to feel less alone in all this mess. I hope we can keep in touch.

  2. You just don't even know how heartwarming it is to read your comment. You're welcome to contact me anytime. I can't do much to treat our mutual problem, but what I can do, and am happy to do, is keep you from being alone in it. I really do wish you well. (By the way, did you get that hamburger?)

  3. When my daughter was 10, I started bringing her to visit her uncle when he was "getting well" on the Psych ward. (Of course, I called first, to ensure there was no one on the ward at that time who might be upsetting to her, or that she would upset.)

    HE enjoyed seeing her, and SHE learned that mental illness is just another kind of illness and is no reason to judge another person. Sometimes we'd go after dance class, and she'd entertain him.

    I always felt that it was great that he had people to talk to, watch tv programs with, have a coffee with, but I always wondered if I was doing anything valuable for him. I like to think that the contact with us was a good thing.

    It is chronic, of course, and over the years, especially in certain seasons, we find ourselves back again: he, as a patient again, and us, as the outside contact.

    Thanks for this perspective, Travis.

  4. Travis I hope and pray some day you put this in a book and sell it, make millions off it. You deserve it, I know it has not been easy to put what you have in words. But what you have done for others and myself is help us know we are not alone and sometimes what waits around the corner. For a lot of us thanks to you we may not make that turn. I thank you and look forward to reading more fiction and the sad reality that some of us share.

  5. I'm astounded that your daughter was able to process and handle it so well at 10. It can be an overpowering situation at any age, and particularly one where most children still think of the adults in their lives as invincible. Surely, that is a testament to the fortitude you instilled in her.

    I can assure you, your involvement with him has been tremendously important to him, perhaps even in ways he himself hasn't recognized. Depression works to insulate the patient; this is why we withdraw from those around us. By continuing to reach out to him, you have proven that he is not alone. It may not seem like much to you, because you're not a professional and you can't quantify your contribution to his treatment in any discernible way but I guarantee you that you and your daughter have played a key role in his management. Thank you for sharing your experiences.

  6. I agree there is a lot more too you. I feel lucky to get to know you and you have helped me in ways that can not be expressed. I look forward to reading all that you publish.

  7. I look forward to selling you all that I publish! ;-)

  8. Can you add me on Facebook? I was going to send you a message there, but for some reason it didn't give me the option.

  9. Isn't it interesting that even in our relationship with ourselves it is important to communicate honestly and openly?

    - Arthur

  10. I would argue that it is in our relationship with ourselves that honesty and openness are most important. Our dishonest selves cannot be trusted to be honest or open with anyone else.

  11. And yet, many people lie to themselves; "I could quit any time if I wanted!", "I know exactly where we are going!", "I don't need any help!".

    Actually, just looking at those, perhaps people are most prone to lying to themselves about needing assistance. I guess we all like to think that we are completely capable of helping ourselves under all circumstances.

    - Arthur

  12. Not only would we like to think it, but we live in a world that assigns shame to not being self-sufficient. It doesn't stand up to logical scrutiny, of course, because nothing in life occurs in a vacuum but we still are expected to "attend the School of Hard Knocks," "pull ourselves up by our bootstraps" and do it all on our own. It's nonsense, but when you become self-conscious, it seems that nonsense becomes intimidating and makes it harder to be honest about needing help.