Voices from the Inside
By H.
What am I doing here, sitting in a dingy room filled with tables and chairs? Several are occupied by people
smoking, talking, or rocking back and forth restlessly. A thick blue haze of smoke hangs in the air.
Intake/admission notes: Female aged 26, states she is in fear for her life. Stated hospital was "the only safe place she
could go." She claims communications with the Mafia and the FBI. She appeared to be staring into space, "looking
through" me when questioned. Initial assessment: Paranoid schizophrenia (will need to rule out drug/alcohol-related
psychosis.) J. Raalancah, MD
This place is called the funny farm, the rubber ranch, the nuthouse, the cuckoo's nest. I asked to leave but they said "no."
I remembering signing myself in voluntarily, evidently there is no difference between voluntarily and involuntarily...once
you're on the inside.
Who are these sadistic people? Oh, they're called "aides"? Aides to what? Aides to interrogate? Aides to antagonize? I
just want to be left alone!
At 6:00 a.m. I was awakened by a male aide, "Get up, breakfast in a half hour."
"I'm too tired, I want to sleep." I had spent half the night huddled in my bed crying. The inexplicable sadness hung over
me like a shroud.
"Hospital rules--get up, NOW." Something in his tone voice told me I'd better comply.
Breakfast consisted of lukewarm oatmeal served in paper cups, toast, and a carton of milk for the oatmeal. I didn't touch
my food, convinced it was poisoned. After breakfast the twenty odd people retreated to smoke or just walk up and
down the long hall. I wanted to return to bed but discovered my room had been locked.
I heard my name called. A nurse told me I was to see the doctor. An aide led me down the long hall, and we stopped at
the last door on the right side. He pulled a large ring of keys out of his pocket, selected one, and unlocked the door. He
motioned to a dingy couch covered with green plastic, indicating I was to sit down and wait. A bearded man, probably in
his forties, was already sitting there. He was rocking back and forth and having an animated conversation with someone
named Charlene:
"Charlene, you stupid bitch, you should've talked to me...now look at what you've done..." Charlene
was, unfortunately, no where to be seen.
"No thanks, I'll stand." I said, eyeing the man warily. He looked as if he hadn't bathed for a week and hadn't combed his
hair for twice as long.
The doctor was an Indian man, complete with turban. He seemed very kind but kept looking at his watch. He made a
few notes on paper, then put the paper in a manila file folder and closed it, thus dismissing me.
Patient extremely agitated and depressed. Delusional. She states she did not sleep well. Will start haloperidol 5mg
for psychotic features. Prognosis: Guarded. J. Raalancah, MD
After I saw the doctor, I was marched up to the nurse's station. It was a small room, separated by Dutch doors from the
room we had eaten in. An old, tired looking nurse handed me a paper cup with one pink and one white pill.
"What are these?" I asked.
"Just take it-- the doctor prescribed it for you." she replied.
"But I don't want to take it--just tell me what it will do to me." I said exasperated.
"Another word out of you and it'll be the quiet room for you." she said. She was actually beginning to have an expression
on her face, not a pleasant one.
A young red haired man who was listening to the entire exchange said to me, "You'd better do it, you know you don't
want to go in there." Something in his tone alerted me, although I had never heard of this "quiet room". I took the
medicine.
About twenty minutes later I noticed that my neck was tightening up. It felt like a severe cramp. My head lurched
backwards, seemingly of it's own accord. My jaws felt frozen. I tried to speak, but could only slur out the words because
of the ever increasing tightness in my neck and jaw area.
Patient experienced mild dystonia. Prescribed 10 mg 0f Cogentin IM with oral to follow prn. J. Raalancah, MD
(Dystonias, I learned later, are not uncommon. Since psychiatric drugs are fairly new, the hit and miss approach is often
utilized when administering them. Antipsychotic drugs often suppress dopamine, the brain chemical thought to be
responsible for some of the psychotic behavior. Unfortunately, the suppression of dopamine often results in an excess of
choline, a complementary brain chemical. This can cause side effects, dystonia, similar to the ones I experienced. Of
course no one thought to mention this to me!)
How did I get here? What was happening to me that previous spring? I do remember becoming acutely over aware of
everything around me. Colors seemed brighter, music was more melodious, people were more charming and
interesting.
Maybe this hyperawareness was the reason I wasn't sleeping well all summer long. Then I began hearing things. Not a big
deal, right? Everyone hears things all the time. Noise is all around us. What I didn't know then was the sounds (which
would eventually progress to voices) were being generated by my own mind.
If this sounds incredulous, consider this, we are taught from birth on to trust our senses. Our five senses are our only
means of perceiving life, and we depend on them to send us accurate information. When my brain chemistry became
unbalanced and sent my senses incorrect data, I assumed, as I had all my life, that my perceptions were still correct. Why
wouldn't I? Since I had no previous experience with aural hallucinations, I had no reason to believe my perceptions were
false. I merely figured it must be the rest of the world going crazy. Therefore, the onset of my psychosis was so gradual
that I almost wasn't aware of it until I was locked up.
Gradually, the sounds grew distinguishable as voices, sometimes one, sometimes two or three. They addressed me,
sometimes kind, sometimes vicious. They began calling me names like "slut" and "bitch".
Each individual responds differently to psychosis. Someone who has been extremely religious all of their life may decide
that the voices are God, addressing them individually. This may not be a problem unless they decide to act on what the
voices say, ie: Sell all of your possessions and give the money to passerbys", or, worse yet, "Jump off this building and
meet me in heaven."
Someone equally religious could believe that they were being persecuted by the devil (think of the cult leader Jim Jones in
his last days).
Soon, I began experiencing delusions along with my hallucinations; the two are often mixed in together. According to Mary Moeller, RN, MSN,
an authority on psychiatric illnesses, a delusion is a "fixed belief that is unchanged by logic." A person can't be talked out of a
delusion, no matter how illogical it is.
Jim Winningham, founder of Lithium Alliance, a national support group and information center for psychiatric survivors,
has stated that delusions may be amplified by "enabling events". An enabling event is something that reinforces an
individual's erroneous belief (delusion). For instance, Jim was in jail, psychotic, and pointed his finger at the television.
Immediately the television comes on! What Jim did not know at that time was that all the jail's televisions came on
automatically at 6 p.m.
Jim had just experienced an enabling event. This particular one reinforced his delusion of having power in his
fingertips.
Many psychiatric patients have reported these enabling events and each one has their own versions. A simple example
would be thinking about the color blue and then having a blue car drive by. For somebody already in a paranoid state of
mind, the thought turning into reality is the enabling event.
My particular rendition involved a plot between the FBI and the mafia. At a time when my aural hallucinations were
getting worse, I believed the individual who lived directly above me was sending me " mind messages". When I finally got
a look at him, he was an older man who wore a hearing aid or earphone in his ear, the kind with a cord attached.
"See," I thought, "that proves it. He is working for the FBI, otherwise why does he have that special radio in his ear?"
(The gentleman in question turned out to be in need of some psychiatric help himself, and his strange, furtive behaviors
only served to reinforce my suspicions about him.)
My psychosis got worse. I faded in and out of reality like a weak radio signal. One night, convinced I was the target of
the Mafia, I fled.... to County Hospital.
Here in the hospital, time no longer had meaning to me. Day or night, impossible to discern in this windowless place, was
compounded by the dream-like quality of the psychosis. Meals, medications, and cigarettes given out--just once an hour--
were the only elements that divided and connected time.
As I stood watching the television in the meal room one afternoon, I noticed that the TV had a teletype on the bottom,
similar to the stock market type. I read in fascination the nonsensical words. How did they get it to do that, I wondered. I
gaped, unbelieving. The teletype had changed and was printing things about me! Personal things. I ran to tell the tired
faced nurse.
Suddenly without warning, I found myself being half dragged, half carried down the hall by four big male aides. I was
taken to a small room.
The infamous quiet room.
The door was locked behind me. The aides stripped me of all my clothes except my underwear. They forced me to lie
down on a cold metal table and quickly secured my arms and legs with thick leather straps; shoulders, wrists, waist,
knees, and ankles were tightly bound. I couldn't move an inch in any direction. One of them plunged a large needle into
my left buttock, and I felt a burning sensation spread through my thigh. I still didn't know what I had done. I figured I
must have committed an awful crime and was being tortured for it. Perhaps a political prisoner? Maybe I was a modern
day Jesus Christ.
My torturers told me to go to sleep then walked out leaving the light on. My mind was racing at full speed, no way could
I sleep. The room was empty except for the table I lay strapped on. The door had a small window, about 8" by 8", and
every so often a face would peer in, adding to my anxiety.
I had no idea this "treatment" still existed.
Patient reported hallucinations and was immediately put in five point restraints in seclusion. Dr. Raalancah ordered 50
mg haloperidol IM, with 10 mg Cogentin to follow prn. P. Burns, RN charge nurse.
What could be next? Only execution by firing squad I decided. I figure I was entitled to choose the time of my death.
When my torturers returned, I tried to tell them, but the medicine/poison had dried me out so badly I could not
speak.
Eventually they let me out of the quiet room. I have no idea if has been hours or weeks until I see a newspaper. It is July
3, 1987. Today is my twenty-seventh birthday.
I smoke. I think. I can do nothing else. I tried to write, but the medication has changed my hands to claws, to an old
person's arthritic hands, unable to hold a pencil or pen. I am pumped full of medicine, a chemical straightjacket even
Houdini couldn't extricate himself from.
I was discharged three weeks later with a new diagnosis, bipolar affective disorder, or manic-depression as it is more
commonly known. For the last ten days, I have been taking 300 mg of lithium carbonate 4 times a day for this illness. The
drug leaves me constantly thirsty and tired, but things are normal again... seems the world is not going crazy after all.
"How long do I have to take this stuff? How long until I'll be cured?" I ask my doctor. She replies that I must think of my
illness like diabetes; although there is no cure per se, the illness can be controlled with medications and other
strategies.
My doctor tells me not to work for a while; that I need both physical and mental rest. She offers no illumination however,
as to how I should meet my daily expenses such as food and cigarettes.
My sister found a Reader's Digest article about mental illness and wrote them for the address of the local chapter of the
"Alliance for the Mentally Ill."
Eventually we hear word back and attend a local NAMI group and COPEN
(Concerned Outreach for Personal Empowerment Now) meetings. GO-AMI offers information and support to families
of the mentally ill, while COPEN, a group run by and for psychiatric patients, focuses on education and empowerment. I
immediately felt at home at COPEN. As with any good support group, the empathy of the individuals who have been
there is key. COPEN's monthly information meeting usually features a speaker such as a doctor or pharmacist. COPEN
also has social events, fundraisers, and other activities.
One of COPEN's most visible projects is our Speaker's Bureau. We address nursing students, medical students, and
other interested parties. They are always attentive and gracious. They seem interested in hearing a "Voice From the
Inside", and I am anxious to tell them. I wish to change the attitudes of the public, especially those working in the
psychiatric facilities. I want to show them that we are people just like them.
Since my diagnosis and involvement in COPEN, I have attended three "psychiatric survivor" conferences in California
and Ohio, co-facilitated a support group with a physician's assistant, appeared in two national training videos about
mental illness, and served on an Advisory Board for the Department of Public Institutions (DPI), Nebraska's largest
coordinator of public services.
In 1990 I decided to go back to school. I have about 30 hours to go to receive my B.S. in Journalism, averaging about a
3.3 GPA. I'm not exceptional, but I was determined to fight my illness and fight for my health. To paraphrase Oscar
Wilde, staying well is the best revenge. I have not been rehospitalized and have had more fun in the last few years than in
my whole life.
I guess it's because "seize the day" takes on a whole new meaning after you've spent time "on the inside."
I was diagnosed with bipolar disorder ten years ago (today or tomorrow as a
matter of fact). I was pulled out from a half frozen bay. I had left my
vision impaired daughter, who was out of school because she was sick, and
my two year old twins (son and daughter) at a local restaurant. My oldest,
who was 11 at the time was in school. The one who was vision impaired was
10. I scared the shit out of everyone including myself. It wasn't a
suicide attempt in my mind. It was the first time I had ever been
psychotic. In 18 months, I experienced the loss of my grandmother, who was
very close. On the night before her funeral my husband couldn't breathe.
He was soon diagnosed with lung cancer. All four of my children came down
with the chicken pox. My brother was diagnosed with Hodgkins Disease. My
daughter began losing her vision and I didn't know why. My husband died
one year after being diagnosed. I had people hovering over me. I even had
some wanting to date me. I moved with my four children to a small town on
Lake Michigan looking for peace. I couldn't sleep. When I walked on the
bay, I thought I could walk on water.
In the ten years that I have been recovering, I have been amazed how
individual this thing is. I was told I am mostly manic and grandiose.
Even when in remission, I have alot of positive energy. Sometimes I wonder
if that's what help me heal. I have been hospitalized three times and
treated at home twice. My mania is always psychotic and lasts about two
weeks. The depression that follows lasts about six months. It has all the
negativity of depression and all the energy of mania. I had a doctor call
it dysphoria. I have been doing very well for over two years.
I had to find my own road to recovery. When I turned 40 a year and
a half ago, I took a long, hard look at myself. I quit smoking, alcohol
and pretty much all caffeine. I began to excercise regularly, watched my
fats, and tried to figure out what work to do. My background was business
and computers. That left brain stuff made my head spin. I began to learn
watercolors four years ago. I pursued it stronger and began to sell them.
I also work at a nursery (gardening). They let me paint there during slow
times. It's great.
I've been married eight years to a very understanding man. My
children have grown, especially in maturity. They are very supportive.
I'm proud of them. They went through some hellish times.
I do keep researching. I want a cure. Remission is nice, but I
still get scared it will happen again. Each time it does, I never know if
I can battle back. This web page is a great resource. We need to stick
together and help each other out.
I forgot to include the topic of medication in my story. I'm lucky that
lithium has worked for me for ten years. I still have a hard time with the
fact that I HAVE to take medication. I did have a bit of a side effect
with it. I developed a goiter in my neck about 7 or 8 years ago. I had
hypothyroidism. I was prescribed synthroid ( which I still take today). I
just weened myself off mellaril (anti-psychotic, but it helped me sleep).
I am also off of ambien (sleeping pill which was given in place of
mellaril). I've been off of those since I cut out almost all caffeine.
That's it for now.
They say that there is a "trigger" incident that starts the ball
rolling for Bipolars. . .some situation that sets the person off who already
is predisposed to the illness.
My "trigger" was when my mom divorced my dad and two weeks later
married his *brother*!! All of the family thought it was wonderful. .
.except me!! I knew something was going on before the divorce.
Mom asked me to be her bridesmaid. I guess she thought it would
helpme feel better about the situation. NOT!!! I was real derpessed and
wouldn't talk to anyone. She told me that I was *not* going to ruin her day
with my sulleness. Well, damn, make me stand up there and *act* like
everything was great. HA!!
We moved to Maryland where my uncle-step father lived. School
started later up there. It was to be my Junior year of high school. My
brother was in about 4th grade.
I hated everything! Hated my new school, new church, new home, new
friends, new life. I kept myself locked up in my room, woudln't talk to
anyone!! I acted happy around my friends. Sometimes I got really hyper
(duh. . .now I understand!!! )
During my jr. year, I started talking my teacher who was the school
pastor (it was a christian school) and he taught my bible class. He was
real supportive and the only one who knew the story at school.
My Sr. year, this pastor convinced me to talk to the school
counselor. I spent so much time in her office! I would live for the moments
when she would get me out of class for a session. She was the first one who
was able to make me cry!
The counselor wanted me to go to a professional because we kept a
record of my moods. . .whoah! what a rollercoaster!!!
Gave my mom the name of the person and she told me it had to be
someone else because she heard bad things about him!!! Oh, I was mad!!!!
I graduated from high school in 1989. Was accepted to a college in
Chattanooga (one of my church's school.) This was my freedom!!!
My major was Elementary Ed. I wanted to be a teacher. I was so
depressed all of the time. I was miserable! Long story short, I failed. .
.flunked. . .bomned out!! All F's! Was told I couldn't come back! My
mother and ste-father were livid. But he begged them to let me back on
academic probation.
I changed my major to secretarial stuff. Mom said it would be easy.
Hated it!! By then, My depression was so out of hand that I didn;t care!!
Started seeing a psychologist. Wonderful man, helped me alot. I
was skipping classes, refusing to go any where with my friends, hating life.
One day, the psychologist asked me if I was going to crash and burn.
I told him yes and he said he wanted to put me in the hospital becasue he
didn't want to see me get any worse.
We didn't tell my mom until I was packing and she called. As far as
she was concerned, no one said I needed the hospital. "Just tell me the
problem", she pleaded. I told her I was going.
I was there 2 weeks ( those details in an upcoming article). Got
kicked out cause insurance ran out. Went back to school with the diagnosis
of depression. Everyone was gone on Spring Break and I was so behind in
school work. Overwhelmed, I took to doing what I learned in the hospital. .
.self-mutilation (also in a future article).
Long story short (I know, too late!) I was diagnosed Bipolar
shortly after returning to my home of Nashville, where I live now. Pdoc
tlaked to me for a few moments and said, "You need Lithium!"
Started therepy and all that good stuff and the battle had just
begun. . .
PLEASE WRITE ME...
robbie@siscom.net I want YOUR story too!
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