Month: April 2022

Day 4: Knowing Who’s Who

fourdaystil1 Comment

**This week’s blog posts are dedicated to advocating for effective mental health treatment and educating patients, family, and friends in all areas of inpatient psychiatric care. The perspectives shared here are not that of a mental health professional, but rather someone with lived experience. Information shared may not align with every circumstance or viewpoint of readers, but is meant to offer guidance in an area that is often confusing and holds little resources.**

One of the thoroughly confusing things the first times I was hospitalized in inpatient psychiatric care was who all the people who were not patients were and what their role was. For a while, I didn’t even know they had different jobs and would get frustrated when I would ask one person a question and they told me to ask someone else. It left me feeling as though I was an afterthought and they didn’t want to deal with my problems. At first, I just stopped asking questions. Eventually, a kind mental health tech explained the entire structure to me one late night and my stays were so much smoother from then on out. So here they are, in no particular order:

#1 – Mental health technicians – Sometimes just referred to as a “tech,” these are sometimes the hardest working, least appreciated employees in a hospital. You will find techs spending all of their time in the general population area, amongst the patients. They handle all practical requests such as needing an extra blanket, wanting to get into your room (if rooms are locked during the day), requests to take a shower or sharpen colored pencils, really anything you can think of. Their actual job is maintaining a safe environment, observing behavior, taking vitals in the morning and when needed, doing safety checks for individuals on suicide watch, and providing physical security if the need arises. They likely will be asking you questions throughout the day regarding your mood, level of depression/anxiety/suicidal thoughts, and charting the information for the nurses and doctors. They will lead group sessions with or without curriculum to teach coping skills, address concerns, or bring up morale.

#2 – Nurses – Nurses are usually stationed behind a desk or even a wall with a glass window that opens and shuts. They are there to monitor physiological and medical wellbeing and are rarely the right resource for general questions. They administer medications several times through the day to the appropriate individuals and chart any medical concerns. Occasionally, personal hygiene items will be held behind the nurses desk for check-out, but first ask the tech what the procedure is for receiving this at morning/evening/shower times. If you are not feeling well, aren’t sleeping well, feeling extremely anxious, or have any need for medical attention, you can go directly to the nurses’ station. They are not usually up for chatting or keeping company as their jobs are demanding and require every minute of their shift to complete.

#3 – Psychiatrists – The doctors will come in once a day, usually at different times. Some will come the same time every day (always the morning, or even late at night). You will be assigned to one doctor you will see throughout your stay and your first visit will be with them within 24 hours from arriving on the floor. From then, you will see them once every weekday and once over the weekend. They typically will meet with you for a brief time (can range from 2 minutes – 15 minutes). Any requests for items that have been restricted from you should go through your doctor. For example, if you brought a personal item like a stuffed animal that didn’t make it to your room, you can ask if they can write an order for you to have that comfort item. Be sure you know before-hand what questions you need to ask because you won’t have contact with your doctor for another 24 hours. Their role is to assess your mental state, prescribe medication and treatments, and determine readiness for discharge.

#4 – Therapists – There are several types of therapists you may encounter in a psychiatric hospital. The most common will be licensed counselors or psychologists. They, like the doctors, will come in throughout the week. Typically, they will only come once or twice a week. You may have a chance to meet one-on-one with a therapist for a 30-60 minute session, but these do not happen often. For the most part, therapists will come in to lead group therapy sessions or even educational groups about mental health. Another common type of therapist you could see, depending on the facility, is an occupational/recreational therapist. They will come to lead low-impact exercise group sessions or recreational game sessions. You can ask the nurses’ station if you would like to speak with a therapist to get put on their schedule.

#5 – Social Workers – This person is the main connection to the outside world for the patient. Along with updating authorized family members about inpatient treatment, they work to find resources for the patient after discharge from the hospital. Closer to the discharge date, they will meet more often with you to go over your plan for care in the days and weeks following discharge. Typically, protocol is to have an appointment scheduled with an outside psychiatrist within 48 hours of discharge and have first therapy (whether individual or outpatient group therapy) appointment scheduled to happen within 1-4 weeks of discharge. For people who are in need of other resources, such as housing, occupational, food assistance, healthcare, etc, the social worker will handle this as well.

It definitely takes a village to bring mental health to someone in crisis. In my experience, even the other patients can play a process in your journey to wellness. The key thing to keep in mind is these people are really here for you only for this season. You very likely will never encounter the patients, the techs, the nurses, the doctors, or the therapists again in your lifetime. Some will make the biggest impact on your life and you will never know their last name. Be sure to show your gratitude while you can and thank them for what they do.

Day 4: Knowing Who’s Who

Day 3: From the Outside Looking In

fourdaystil1 Comment

**This week’s blog posts are dedicated to advocating for effective mental health treatment and educating patients, family, and friends in all areas of inpatient psychiatric care. The perspectives shared here are not that of a mental health professional, but rather someone with lived experience. Information shared may not align with every circumstance or viewpoint of readers, but is meant to offer guidance in an area that is often confusing and holds little resources.**

From the moment you walk away after helping a loved one to be admitted to inpatient psychiatric care, you can easily feel powerless and unable to provide any additional support. However, there are a few avenues of care that can still be maintained from the outside. Significant others and caregivers may feel a large range of emotions stepping away, from relief in knowing their loved one is finally in a safe place and no longer requires constant attention from them to helplessness in not knowing how to fill their time now they have been removed from the process of caring for that individual. Here are some steps to fill this gap:

#1 – Do your research – It is most likely you will receive very little information from the hospital, especially if you must part ways from your loved one before the admitting process takes place. In many cases, an ER will even transport your loved one to a completely different facility based on availability of beds without your knowledge. This can be a terrifying ordeal when trying to contact this person later, as confidentiality laws prohibit hospitals from confirming or denying the presence of a psychiatric patient. This is why it is suggested to demand for a significant other, family member, or friend to remain with the person in crisis throughout the process until they are walking onto the psych floor of a facility. The only other method of obtaining this information is by the patient initiating contact through phone once admitted (don’t forget to have full phone numbers written down on a paper the patient keeps with them in their pocket – they will not have access to their contact list on their phone once admitted).

Once you know the facility in which your loved one will be staying, search online for the facility website. Make notes of visiting hours and procedures, patient phone numbers and times open for incoming calls, and any other nurse or information phone numbers. Some websites will have general descriptions of the facility’s programs, daily schedule, or family resources. Typically, you will need to wait for the patient to make the first contact as communication with family can be restricted for the initial period of time they are hospitalized. In some cases, the admitting nurse will allow the patient to make one phone call when they arrive on the floor and that call needs to be mostly about obtaining the necessary information for future communication. Ask general questions of your loved one, such as: when can I call you next? what number do I call? is there a security code you set up that I need to give the nurses when I call? when can I first visit? what time is visitation? All of these questions could involve your loved one asking the nurse or tech close by for information.

#2 – Maintain contact with nurses and doctors – Families should designate the best person to be a main contact with nurses and doctors regarding the care of the patient. Don’t have too many cooks in the kitchen. This person should be someone who is assertive and proactive in obtaining information and persistent in contacting the nurseline daily at a minimum. Establish this relationship with the nurses early, calling within 1-2 hours of initial contact with the patient. It is a relationship that must be built and may not be fruitful in the first few attempts. Once the nurses, doctors, and social workers realize you are determined to stay involved in your loved ones care and feel respected by you, a cooperative effort in getting the patient well can start. The first contact can sound like this, “Hello! I am calling about my daughter XXXX XXXXX, her security code is XXXX. I wanted to speak to a nurse or her assigned social worker about how she is doing so far, and see if there is anything I can do to assist in her receiving the care she needs while she is there.”

Follow up the next morning, saying “Good morning! I am just checking in on XXXX XXXXX. I called yesterday and spoke to XXXXX. How did XXXX sleep last night? Will she be seeing a doctor today? I would also like to plan to visit during visiting hours today. Is that permitted at this time?” The more you become familiar with the staff working, the better the information you will receive and the more effective your help once your loved one is discharged from the hospital will be.

#3 Make regular phone calls to your loved one – Psychiatric hospitals usually have common areas for patients to spend time between time in their rooms resting, meals, and group therapy sessions, and have phones to make and receive calls from family and friends. It is better to start small, with only closest family and friends making contact and sometimes waiting for the patient to reach out to others. For this reason, it is best practice to let concerned friends and extended family know you will give your loved one their phone number for them to call when they are ready to talk. Ask your loved one when the best time for you to call them (does dinner happen from 5-6 when phones are open but they are in a different room? have they been going to bed at 8 even though phones are open until 10pm?). Set up a time you plan to call at least once a day so they will be in the area to take the call, and make sure your loved one knows they can call you as much as they want outside of that time. Set a reminder on your phone to call at the planned time and always make an attempt every day. Save the phone number you receive your first call from the community phones as a contact in your phone so you recognize it as them calling.

You may struggle at knowing what to talk about the first few times you get on the phone with your loved one. Avoid asking how they are feeling or if they feel better unless they have demonstrated to you they want to talk about these things. They are likely overwhelmed with a lot of techs, nurses, doctors, and therapists constantly asking these questions, and this should be a time they have a break from that and have contact with the outside world. Be ready with a few lighthearted stories about what has gone on in your day and your world. Ask about general, concrete things such as “Is your bed comfortable? Do you have a roommate? What did you have for lunch today?” Be ready to be the one who initiates the end of the conversation as your loved one will probably feel uncomfortable telling you they are done talking. Have a good excuse (“Well, I have got to get dinner started. Call me later tonight if you want to. Otherwise I will call again at this time tomorrow.”) Expect your first conversations to be very brief and generally for calls to last less than 10 minutes. It may not seem like anything to you looking in from the outside, but it will make a difference to the one on the inside to receive communication and love from the outside. It lets them know they are not forgotten and gives hope their life will be there waiting for you.

#4 Visiting the patient in person – This can be one of the most challenging activities in the entire experience for both the family and friends and the person in the hospital. While one hour at first seems like not enough time every day or twice a week (depending on the facility’s structure), you will find yourself searching for something to talk about ten minutes after arriving. Be prepared to see your loved one in a state different than you normally see them. They might be very nervous and even feel a sense of shame being seen in the hospital and can change the way they behave or communicate. Avoid making big sweeping statements such as “You look great!” or “You look like a trainwreck! Have you been sleeping at all?” Speak the truth of your observations but soften it. “It looks like you might be feeling better. Does it feel like that to you?” or “How did you sleep last night? Is it hard to sleep in a different place?”

Try to bring something to do together to fill the time with something other than talking. I have found one of the best things to have for visitation is a deck of cards. Bring it and set it on the table, maybe start shuffling the cards, but don’t have expectations of playing. Conversation may flow and your loved one may have a lot to talk about, but if the conversation lulls and awkward silences come in, suggest you play a game. Suggest a favorite game you have played in the past, or teach a simple new game. A somewhat competitive game can lighten the mood and even at times be a great release of positive emotions between the two of you. Be careful not to disturb the other visiting guests and patients. Even playing a game of solitaire together can help connect you. If you feel the visit has had quality connection only 30 minutes in, don’t be afraid to ask your loved one if they are ready to go back or if they want you to stay the entire time. Sometimes a short visit can serve a better purpose than sitting in silence to take up the entire time. Before leaving, ask if there is anything you can bring them next time they may have forgotten at home (slippers, more socks/underwear, chapstick, a new notebook to write in).

#5 Set up support for yourself after phone calls and visits – Remember to take care of yourself in the midst of all of this. The hospitalization may be happening to your loved one, but you cannot support that person very well if you do not have an outlet for emotion. Give yourself time to feel and reach out to someone outside your ring (see yesterday’s blog post) shortly after times you communicate with your loved one. It can be very beneficial to set up a few therapy sessions for the time your loved one is hospitalized to process the experience as it is happening.

I will close by saying the most important day to visit, in my opinion, is Sunday. For most facilities, groups, individual therapy sessions, doctor visits, and treatments occur Monday through Friday. Saturday seems to be a good day to rest from all the activity, but Sunday can feel very isolating and alone. Whenever I was hospitalized, I would tend to reflect a lot on Sundays about family and where I was and a full gamut of other things that generally would leave me melancholy. Suddenly, not receiving a visit can leave you feeling abandoned or trapped without outside contact. Remember, the self esteem of the individual in the hospital likely is at an all time low, so reaching out and asking for what they need is rare. Take the initiative to call daily, visit whenever available, and keep up to date on how treatment is going from the staff.

Day 3: From the Outside Looking In

Day Two: Ring Theory

fourdaystil, , , , Leave a comment

**This week’s blog posts are dedicated to advocating for effective mental health treatment and educating patients, family, and friends in all areas of inpatient psychiatric care. The perspectives shared here are not that of a mental health professional, but rather someone with lived experience. Information shared may not align with every circumstance or viewpoint of readers, but is meant to offer guidance in an area that is often confusing and holds little resources.**

Oftentimes when we know someone facing a crisis, whether it be a close friend, family member, or just an acquaintance, we don’t always know the right words to say. We may also have a difficult time processing the crisis through our own emotions and actions and before long, the wrong words come out to the wrong people at the wrong time. Several years ago, I was introduced to something called the Ring Theory and it became a very simple tool to use in any crisis, mental health related or otherwise. It saves friendships, relationships with family members, and ourselves from embarrassment and bitterness.

Essentially, this is how it works:

  1. Draw a circle with the name of the person in crisis written in the middle. In our case, this is the person being admitted to a psychiatric hospital. This is the first ring.
  2. Draw a second circle and name the person(s) closest to the person in crisis in terms of relationship. This is most likely a spouse and any children.
  3. Draw a third circle and name close family that is not part of the second circle, such as parents, siblings, very close relationships with aunts, uncles, cousins, or grandparents. For minors, this circle would actually be the second circle.
  4. The next rings are completed unique to whomever is using the tool. For example, if the person in crisis is your family member, the fourth ring and beyond will people in relation to you from closest in relation to furthest in relation. These rings will likely be filled with people that may know of your family member but don’t know them directly, like your coworkers, friends, church leaders, and your personal therapist.
  5. Using the tool: When communicating about this crisis and how it impacts you, the rule is “Comfort In, Dump Out.” What that means is anyone in a smaller circle than where you place yourself should only receive support and desire to understand. Anyone in a larger circle moving outward from where you are on the rings are safe to vent to, seek advice, and generally receive support from. The closest outward ring from you is typically the safest group to disclose details in confidence and less details should be shared the further you get from the center. Likewise, be accepting of negative dumping from anyone in a smaller circle than you, including the person in crisis. See below for a diagram of what this looks like.

In practice, this would look like a close aunt to their adult nephew in crisis phoning their best friend to entrust their emotions regarding their nephew being hospitalized. But when she is getting updates from her nephew’s spouse, she should refrain from expressing these emotions (don’t say “I can’t handle this! I have never seen him like this. What in the world are you going to do?”). She would offer comfort, help, and advice if solicited to the nephew’s spouse, and dump out the stress and fears and emotions to her best friend.

So what do you do if you are on the same ring as someone else? How do you communicate to other close family members? or what if one of your tight-knit group of friends is hospitalized? This is where judgment comes to play. Evaluate if factors exist that would place you or the other person closer to the situation or the person in crisis and apply the theory. Seek an outer ring connection to be safe if it is unclear. But, in reality, this most often looks like mutual support, a give and take from both people. Share when the other person is strong to support you and be strong when they need support.

As the rings go in, the emotional stress of the situation increases. This means the highest stress level outside of the person in crisis is usually the spouse and children. In the same respect, the further in, the harder it is to reach out. Many times, a spouse struggles to share with anyone how the situation is making them feel. My best theory for why this is, is because when they are in personal crisis, their closest confidant is usually the one who is in the center of the rings at this moment. The person they usually dump everything on should only be receiving support right now. It can leave a person feeling isolated, alone, and seeing their negative emotions build up. Empathy and understanding in the silence can go a long way, and providing practical help is sometimes the only avenue we can take to support.

In closing, there is one person that trumps all of the rings. And that person is your personal therapist. Having a therapist, you can always rest assured you are dumping everything to an appropriate person without question and you can ensure you are receiving the support you need to be better equipped to be an asset to the ones closer to the crisis. It is typically overlooked when someone has a mental health crisis that anyone other than the person in crisis is in need of professional help. In reality, friends and family members having an outlet in speaking to their personal therapist actually is in benefit to everyone involved. Practice using this tool in small ways and prepare for when it can be used in the hardest of days.

For more information on Ring Theory and its origins, please click on this link.

Day Two: Ring Theory

Day One: Intake

fourdaystil, Leave a comment

**This week’s blog posts are dedicated to advocating for effective mental health treatment and educating patients, family, and friends in all areas of inpatient psychiatric care. The perspectives shared here are not that of a mental health professional, but rather someone with lived experience. Information shared may not align with every circumstance or viewpoint of readers, but is meant to offer guidance in an area that is often confusing and holds little resources.**

Whether you are the person needing acute psychiatric care, a loved one directly involved in the process of getting someone to help they need, or an indirect bystander, the first day in inpatient care can be a mind-numbing experience. Tensions and emotions run high, those directly involved are at a point exhaustion, and what’s important may rush past you before you know it. The most important factor to keep in mind through all of this is this is the necessary step to wellness and as is with all temporary things, it will get better.

#1 – Getting to the hospital – There are many paths this part takes. Some may take an ambulance to an emergency room from their home following a 911 call. Others may check in at an ER after a sleepless night in crisis. Walk-ins to standalone psychiatric facilities is yet another way. Based on what is to follow, I believe the best method in arriving for intake, if available, is to contact your established psychiatrist or psychologist to see if they have connections to nearby facilities so they can contact the facility directly and act in their capacity as a healthcare provider to secure a bed. This will make the rest of the steps much shorter.

#2 – Packing for your stay – This is a step that is not always available, but when it is, can alleviate a lot of stress and confusion along the way. Most psychiatric facilities hold similar restrictions on what items can be brought by a patient to be used during their stay. You will definitely notice what makes it to your room is much less than you arrived with, but all restricted items are safely inventoried and held by the hospital to be given to you at a later time (1-2 days after intake) or returned when you are discharged. Items to leave at home are tennis shoes with shoestrings, electronics, jewelry, any clothes with drawstrings, and spiral-bound notebooks. Personal hygiene items should be packed together (fit into a gallon ziplock bag as a rule of thumb – remember to pack chapstick!). You will not be given these items, but may be able to access them later in your stay. The hospital will provide the basic necessities. Generally 2-3 outfits are permitted. The hospital is very cold always, so pack layers – warm socks, house slippers, long sleeve tees, sweats, and a comfortable sweatshirt. Comfort items I suggest taking are a pillowcase from your bed at home and a small throw blanket. Know that you will likely not be allowed these items, but if you request these from your doctor the first time you meet, they can literally write an order/prescription for you to have these items and it makes a difference in an otherwise unfamiliar place. The last and most important item to take is a single piece of paper with names and phone numbers of anyone you could possibly want to contact, including therapists and doctors. Keep this on your person as you won’t know when the rest of your belongings will be processed and provided to you.

#3 – Hurry up and wait – While it may seem like a life-threatening crisis would instill a great sense of urgency to admit a patient, the reality is there is a huge shortage of beds available. In fact, the sad truth is in this system, the best way to be admitted quicker and to the best quality of care is having solid private health insurance. Be prepared to sit in an uncomfortable room guarded by police officers for 12 hours or more with very little communication or care. Don’t expect to be admitted to the hospital you arrive in, as they may have no beds available but are not allowed to let you leave once checked in. They will transport you via ambulance or police car to the nearest facility with the first opening that accepts your insurance. Ask if a family member or friend can sit and wait with you, though it will not always be allowed in the secure setting. If you do end up being admitted where you originally check in, you will speak to an administrative person to give insurance information, meet with a doctor/nurse practioner to assess whether you need inpatient care, and possibly be visited by someone to take urine and blood samples.

#4 – Parting ways with friends/family – This may happen at any stage from the moment you walk in to when you walk onto the psychiatric floor. Advocate for yourself up to the point of being admitted to have your loved one with you. If you feel comfortable, they can even be by your side as you talk with a professional, have labwork done, and wait in a secure area. Know that the moment you allow separation to occur, it is very hard to regain being together and it is also the moment any information to that support person ceases. In most cases, they will no longer have the ability to know where you are (even if you are transported to another facility) or any knowledge of visiting procedures, ways to contact you, or what care is being provided to you. In most facilities, contact with the outside world is restricted for 24-48 hours. This is where the written list of contact information is integral. Usually one phone call once the patient arrives on the floor is allowed. This person should be ready to take a call from an unknown number. Let them know the name of the facility, patient contact phone number, any required secret access codes in order for people to contact the patient (usually they will ask for you to choose a four-digit code that must be given over the phone before any acknowledgement the patient is in fact there), and information on times allowed for incoming calls. This person should then be responsible for searching online to find visiting hours and procedures and communicate to the rest of the family and close friends all of this information.

#5 – The first 24 hours – During the first 24 hours of being on the psych floor, it can be the most challenging and confusing time for everyone involved. The person on the inside will experience what feels like their dignity being stripped away as all of life’s comforts are immediately removed. The people on the outside can find themselves worrying more than before their loved one made it into the facility due to no contact and lack of information, as they have just handed the reigns over to strangers in the hospital. The expectations of emergency care quickly are realized to be very different from reality. In most cases, the first thing a person will do is be offered a meal or snack to eat while the nursing staff complete paperwork. Given the circumstances of how long their wait was and if they have been up all night long in the ER, the patient may be shown to their room and given a sedative to sleep or rest. At some point in the first 24 hours, you will be seen by the doctor who will be meeting with you daily. This is a very short visit typically (sometimes lasting only a few minutes). Be sure to ask as many questions as you can, request your comfort items (you won’t have a chance to do this again for another 24 hours), and give a good history including any medications you are currently on or have had success with in the past. Remember to give yourself time to breathe, let your body rest, and relax in knowing you took the hardest step in getting help. Ask when the next group is meeting and if you can attend. Generally, they will not disturb you in the first day while resting to attend every group, but the sooner you participate in the process, the sooner you will feel better.

Day One: Intake

When the disease takes control

fourdaystilLeave a comment

TW: suicidal ideation

Today was a hard day. A person I care about required immediate intensive care for suicidal plans. I have mulled over and over what to speak on in this post. The last time this happened for them, I was inspired in the moment to begin a YouTube channel. I think I even created it and made the first video post introducing myself. But that was all I did. From my lengthy experience with severe mental health treatment, I have carried a deep passion and vision for changing the mental healthcare system. I don’t know how or when my impact in all of this will come to fruition, if ever. What I can do now is advocate and speak up in the midst of the way things work in today’s world.

Let me preface everything I am about to say with this statement: The most qualified and equipped people to provide guidance in effective change to the mental health system are ones who have needed the mental health system. Yes, even more than the doctors and therapists trained in all specialties and definitely more than politicians and policy makers. With that in mind, know that everything I have learned about how the system could work better came during a time when I was mentally ill, but was developed and fine-tuned when I was mentally well.

The best advice I can give to anyone facing a severe mental illness and their family and friends is to remember what you are fighting for and what you are fighting against. So often, when the disease takes over control, it seems as though we are fighting every tactic and justification and pleading of the person we love to get them help. Know this is far from the truth. You are fighting against the disease and fighting for the person locked inside. It is just at this very moment, your loved one has lost the ability to fight the disease any longer. We all have the same enemy, the disease. Too often, the desire to maintain control looks like the mentally ill person fighting against any help from family and like the family is fighting against the mentally ill person to strip away their freedom. If we do not step back and instead give in to this idea, this is when the disease thrives.

So what can we do? When emotions are at an all-time high, and words and actions are internalized by everyone involved? When a life is on the line? When we feel powerless? We can join together and turn our anger and frustration away from each other and place it all on the despicable monster, the disease. Take the power away from the disease! Tell all its secrets, lies, and manipulations! Expose it for what it is and deny it any more power. For a time, this has to be carried by the family and friends. Speak truth in love, maintain as much dignity and control as possible for the person suffering, and know when action must be taken. And trust in the body’s natural response to threat to life. Just as when we naturally fight to breathe when drowning, the body will fight for that last ditch step to save their life.

I realize much of what I said is conceptual and not practical. This practical guidance is what I hope to achieve into the future, and plan to shift gears this week. I will dedicate my blog posts to a beginner’s guide to inpatient psychiatric hospitalization this week. Please feel free to share with anyone you know could use this now or in the future.

When the disease takes control

This is Us

fourdaystil, Leave a comment

If you are following along, you may have noticed there was a missing post yesterday. While I aim to blog once a day, I recognize the need to always give myself grace. And there are just some days when nothing comes to mind and a post would really serve no true purpose. That is not to mean I will not ever post random ramblings, because I feel like that could happen.

I have been contemplating all the topics I could cover in my blog, and truly there is nothing off the table. For now though, this blog is the start of a conversation if you will. A way you get to know me in my entirety as a person. It might be a one-sided conversation for now and maybe for a long time, but I am okay with that too. So, I thought today I could introduce myself as the divorced mother of two.

I was married at the age of 21, had my first son at the age of almost 26 and my daughter at 30. And I was divorced at 34, 13 years after marrying. It always feels strange telling people that I was married for 13 years and have been divorced now for 5 years. I definitely don’t feel old enough to have that much life experience in a marriage. And people often are surprised as well, thinking the same.

Tonight I was watching the most recent episode of ‘This is Us’ (may be some slight spoilers if you need to wait to read the rest of this), and I loved what was said by Kate right after she and her first husband Toby signed their divorce papers (I warned you of the spoilers!). She told him “Just because our marriage ends, it doesn’t mean that our story ends. We were meant to be together, and now we are meant to be apart.”

I know this is a fictional dramatic, emotional television show meant to pull at our heartstrings and end up with everything and everyone exactly in the path they are meant to be. But I definitely feel like this part is my story. Believe me, I didn’t always see it that way. I, like Toby in the show, wasn’t sure I could ever see it that way. I might have had a great deal of hope and desperate longing to reach this point of mutual understanding and respect, but when it all was happening it was like an unreal night terror.

I know this isn’t every person’s story too. For some, healing doesn’t bring reconciliation. For others, safety of one’s physical and mental wellbeing requires distance. So why is it different for me? Luck. That’s it. I was going to say God’s protection and blessings, but that really isn’t right either. God doesn’t choose to protect my relationship with my former spouse and ignore others. It’s not that we are more enlightened as human beings, or better people. We just are lucky. We have two amazing children with two engaged parents who are now meant to be apart. We are better apart. And how weird is that?

Whenever I am on a first date and the man asks me, “So, why did you get divorced?” (btw, men should not be focusing on exes ever on a first date), I always respond, “We just couldn’t make decisions together anymore.” I guess I don’t know how else to explain it. It was more than that, obviously. But that is the most concrete reason I can come up with. Whenever any decision, big or tiny, we needed to make as a married couple came up, we found ourselves on opposite sides of the world. Compromise wasn’t even a possibility because any “give” from one person would “take” it all away from the other side.

However, today, I would say we do exceptionally well in making decisions. It really wasn’t about the decisions. It was about us, feeling free to be who we really were in our core. I couldn’t be who I was without feeling like I was infringing on his ability to be who he was, and vice versa. It took me learning exactly who that person was over several years to realize this, and to realize that we were meant to be, just not anymore.

I don’t think I will ever be the ex-wife who wears matching jerseys with my ex-husband and his wife or goes on joint Disney vacations with both families. I know they exist, but that is the exception. I am grateful that I am the ex-wife that can have a twenty-minute text conversation about what exactly we can do with our 8 year old daughter’s hair that gets so tangled we spend hours getting the knots out, or sending a sweet picture of our kids being silly just to share the moment. And that is what we have become. We had a great marriage for a time when we needed it, and now this is us.

And here you were, thinking you wouldn’t get a random ramblings post!!

This is Us

Time to Talk

fourdaystil, , Leave a comment

The thing I love about a daily blog is there are so many directions I could take this. I could speak one day about personality types and the next day about a global crisis. I could vent about dealing with the flu last week as a single co-parent or reminisce on my birth story 13 years ago. Above all, I hope that what I can bring to you, the reader, is something to think about that you might not have come across before.

Today, I think it is time to talk about perinatal mood and anxiety disorders (PMADs). Somehow through my recent activity and categorization of this blog, it was suggested for me to follow the Postpartum Support International group. I was blown away by the organization and everything it is here to do, and wondered why I hadn’t ever heard of this before especially during my experiences before and after the birth of my son.

I quickly jumped head-first into every opportunity I had to be a part of this group, which led me to applying to be a PSI Coordinator Volunteer. In a few terms, I would be someone who could refer those experiencing symptoms of perinatal mental disorders to local resources and help educate and advocate in the community regarding this prevalent experience.

Why does this all mean so much to me? Because I was one of those impacted in a significant way by the struggle of dealing with a severe illness following the birth of my first child. I am lucky to have had the guidance of my midwife, my family, doctors, and therapists to recover fully over the first year post-partum. Since that time, I have always wondered why we don’t talk about this more. The stigma and self-shame surrounding PMADs is overwhelming in America. So, it is time to talk.

So far from my training there are a few statistics that are helpful. From a large-scale (over 10,000 participants) study for the span of one year post-partum, the following was found:

  • 80% of women experience the “baby blues” as hormones regulate in the first few weeks following birth, which is not a mental disorder
  • 1 in 7 women have serious depression and/or anxiety within 3 months of birth
  • 1 in 5 women experience post-partum depression within one year of birth
  • 1 in 10 fathers experience post-partum depression, and
  • 1 in 500 women are diagnosed with post-partum psychosis

I am that 1 in 500. And I have had a hard time talking about this for a very long time. It is easy to say “I had severe post-partum after my son was born.” I always leave out the actual type of post-partum. I thought it meant because I was capable of losing reality in those circumstances, I must have a propensity for psychosis in any other circumstance. And this means I must be unfit for society in general. This is all a BIG FAT LIE. Post-partum psychosis (PPP) typically is onset within the first two weeks following childbirth and can often follow an extreme drop in hormones, particularly adrenaline. It is exacerbated by persistent sleep deprivation. And it really only occurs for birthing mothers, rather than any caregiver like any other PMAD can affect.

This is all because it is hormonally-driven, or biological in nature. In fact, the intrusive and damaging thoughts that occur during PPP also occur in other PMADs. The main difference is for other PMADs, these thoughts seem foreign and “wrong” to the affected individual, while PPP individuals in the moment of those thoughts believe them to be true and in line with their reality. Post-partum psychosis must be identified quickly and treated immediately usually with a combination of hospitalization and intensive medication treatment. One of the other unique characteristics of PPP is the psychotic thoughts/behaviors are generally waxing and waning, meaning the person could have normal thoughts and behaviors for a period of time and then have a break with reality the next moment, and back and forth.

My psychosis began the moment test results came back negative for a metabolic blood disorder for my son, after a week of intense genetic doctor visits and specialized formula and B12 shots and concern of possibly raising a very sick child. The adrenaline carrying me through that week vanished in an instant and the sleep deprivation (meaning zero sleep) of the five days before caused a major shift in my brain. I distinctly remember the second this occurred, because it felt like a rubber bouncing ball started bouncing back and forth inside my head as though my skull was vacant and filled with air. Weird, huh?

Within 24 hours, I found myself in a crisis center and then attempting to fill a prescription. Two days later, I was being evaluated and admitted into a psychiatric hospital. Over the next month, I would be discharged and readmitted to another hospital. Four months after my son was born, I was finally able to be employed in a very low-key data-entry position even though I had just graduated with my Bachelors in Accounting. Ten months after the start, I finally felt normal and began my career in Accounting with a bank audit team.

You have heard me describe my life-long battle with major depressive disorder and might wonder if one caused the other. While having MDD can increase my risk of a post-partum disorder, I to this day hold my post-partum disorder completely separate from any ongoing mental illness. What medical professionals are certain of is that PMADs are 100% temporary illnesses, for the fact they are caused by sensitivity to hormonal/biological changes (along with psychosocial and concurrent stressors).

I will leave you with these three things, which is the motto of PSI:

  • You are not alone – the statistics above show how common this occurs for any person during or after pregnancy, loss, adoption, or fertility treatments (including non-birthing individuals)
  • You are not to blame – having a PMAD does not in any way relate to your ability as a parent or caregiver to your child, post partum is the cause for difficulty in connecting with a child rather than the other way around
  • With help, you will be well – the more we talk about this, destroy the stigma and shame surrounding it, and provide resources for help, the faster people will recover from this; this is temporary

Thank you for taking time to read about something you might not have expected to read about, and please talk more if you or someone you know has experienced post-partum mental illness.

Time to Talk

Keep Going

fourdaystil, , Leave a comment

A friend of mine said to me yesterday, “I may have misunderstood your blog post but does this mean you are not writing your book anymore? Please don’t stop! You have to keep going.” I thought now that I have established a few things like a separate blog Facebook page and structure of the blog, it is about time to clarify a little of what I am doing.

I definitely have not given up on the dream of becoming a published author of a memoir and possibly more books in my lifetime. I have learned an important thing about myself, that sometimes I just have to take one step back to see where my journey is actually taking me instead of pushing through what seems to be the impossible.

This blog is here to help me do that. To help me keep my writing alive and fresh and always in the forefront of my mind. There are times in life where we don’t know what to do and we choose to just do nothing and times when we face this situation by just doing something. I choose something this time!

This medium affords me the chance to speak on the things I am most passionate about, hone my writing skills, and build that audience of readers who care and are impacted by my words.

Once the words “keep going” sparked this post, I was quickly reminded of a dear friend of mine from long ago, who shared a t-shirt I could buy in memory of her father whom my family was close to for decades and died from suicide. The shirt simply said those two words, “keep going,” across the front with the ‘i’ being replaced by a semicolon or the symbol for suicide prevention. I still wear this shirt often and hold it dear.

This is the theme of my life I sincerely believe. It is marked permanently on my wrist to “Give it time,” so I never forget how temporary each emotion or thought or season of my life can be. It is what my blog name stands for (you can click on the ‘About Me’ section from the menu to see more of that). My life is a testament that as long as I don’t rob time from my life, my purpose will be realized.

So, yes friends my book will still happen in time. I don’t know what it will be exactly but it will be a piece of me. It will serve to inform, entertain, and influence change in the world. For now, I hope this blog holds the same weight and mission.

Keep Going

20 and 7 Years Later

fourdaystil, Leave a comment

“This day carries a huge significance to me. I, like so many other Oklahomans, remember exactly where I was at the moment of the Murrah building bombing. For me, I was walking back from the cafeteria at the middle school to the junior high in Chandler by myself. I remember feeling the ground shudder ever so slightly but not realizing at the time what had occurred. But, most of all, I remember that five days later, in the middle of the night, my brother Josh had his first grand mal seizure and was diagnosed with brain cancer. We lost him four months later. It is so hard to believe it has been this many years since all of this happened, and at times, it doesn’t feel any easier than the day it happened. But God of the entire universe desires to engage in the minute details of our lives. He sees ME and knows my struggles. He has us go through the trial to show Himself strong, to sustain us, shield us, and surprise us! Thinking of all those today that have lost a loved one, whether 20 years ago today or any time before or since. May God show Himself strong in your future!”

I wrote this seven years ago and wow how my life has changed since then. I was definitely a broken person in the midst of these words. It is strange how even as I look back into easily the darkest moments of my life of 2015 (darker even than 1995), I brought up words of hope. I wish people in the world could have the footnotes of our words in order to see where we truly are. The words above are the words of a severely depressed and suicidal person. Within four months, I would be driven to sitting at my brother’s grave for hours past the sunset with a bottle of Tylenol and a pair of scissors not sure what the outcome of the night would become. Ten days after that, I would have 17 letters written and placed in a manila folder waiting to be mailed to my best friend, my chosen executor of my last words. And the next day, I would be sitting in a cold ER psychiatric wing, angry about the process, believing nothing would sway my resolve to end my life.

All of this turmoil and devastated identity happened while I offered words of hope. It really goes to the saying, “Check on your strong friends. They may be the ones in the most pain.” I will forever by grateful for my best friend at the time, Carrie, checking on me that day after work and not glossing over the subtle words that could easily be taken as venting after a hard day at work. She took my phone in the parking lot, looked up my therapist in the contacts list (she only knew his first name) and called him right then despite me begging her to let me call him later. She saved my life. She sat with me for 9 hours that evening in the ER waiting for a bed on the psych floor to open up, and visited me when I was too ashamed to even let my family know what was going on. We parted ways since that time, I am sure because going through that experience changed a lot for her and for me. I am blessed beyond measure to have a friend that risked everything to see my pain for what it was.

So ironically, these words today don’t sound of resounding hope in recalling the truth behind a social media post. In fact, I have gone through several more trials since that time. A failed marriage, lost jobs, a clinical trial for unconventional treatment of treatment-resistant depression, major back surgery, and another psychiatric hospitalization to name a few. Seven years later, I can say God has shown Himself strong. This time, I will assure the ones reading these words, there is not grief or depression lingering below. Just a reminder that His promises are the only words that remain consistent despite where we are when we write them.

If you are struggling with suicidal thoughts or plans, please reach out to your friends, family, therapist, or another professional. Call the National Suicide Prevention Lifeline at 1-800-273-8255. Even if it makes you angry, go through the process, and find help.

20 and 7 Years Later

Easter Traditions

fourdaystil, , Leave a comment

Today I reflect on Easter. Growing up, Easter was definitely a holiday but I was reminded by so many yesterday that it wasn’t filled with traditions like most everyone has around me. My Easter holiday was disrupted this year by a rather sick 8-year old girl. It has been a good while since we have had need for wet washcloths, thermometers at the ready, and carefully tucked in blankets. I wasn’t expecting it at all, and it changed a few plans, but in all reality, it only changed what would be a typical Sunday.

When I was a girl, I didn’t really notice that much. I knew a lot of families purchased new outfits for Easter and the attendance at church was a a little more crowded. But, for my family, it meant the same church clothes and pot roast waiting at home and Sunday evening services following an afternoon filled with naps and weekend cleaning. As I got older, I think I held our traditions of having no big celebration in higher esteem. I felt it set us apart that we could treat the most significant religious day as any other Sunday. That we had our heads on straight. And although I face the holiday with more humility than I used to, I still to this day see it as a normal Sunday along with the rest. It was afterall the very thing as a Christian we should be celebrating every day of the week, for it was our ultimate salvation and purpose for living.

This year, I have had a few realizations though. I realized Easter Sunday is a time to recalibrate, to assess whether we are changing and growing or if we are still treating every single day as the next. Both sermons I listened to had one common theme, “Change.” What happened on Resurrection Sunday changed absolutely everything from that moment forward. It changed the life we have before death and it changed the life we have after death and into eternity. It means new life in both spectrums, but it also means adjusting to a new way of communicating to God.

Mary Magdalene wept when she saw Jesus’ body absent from the tomb and she recognized by the calling of her name by Jesus that her “Teacher” had risen. The excitement was quickly quelled, though, as Jesus urged her “Do not cling to me, for I have yet to ascend to my Father in Heaven.” Basically, Jesus was saying “I know I am back, but that doesn’t mean we can go back to the way things were. Don’t cling to the past ways of being close to me. Look for the new way.”

So that is my hope, on a personal level, that I would not hear new lessons and face new trials and quickly revert back to the place that was comfortable. As I completed my local church home membership survey (I consider myself a member to two churches now, local and beachfront), I shared one deep and earnest prayer for my life. I plan to live my life in full expectation of this prayer being answered to the fullest this year. I won’t share what my prayer was, but I will say that it very much embodies the lessons about change this Easter Sunday has brought me.

Disclaimer: My Christian faith is very personal to me, and will from time to time surface in my blog posts like this one. It is not the primary subject of my blog, but definitely a part of me. If you believe differently than I do, that is perfect fine and you can take what parts of these posts you need. If you have questions about my faith or what is written here, please feel free to comment!

Easter Traditions