When I Went Crazy: Day Care at the Psych Ward

This past summer, I was in an intensive out-patient program housed in the psych ward (the “Behavioral Health Science Center”) of a large hospital in my hometown of Bethlehem, PA. The events of the summer – graduating college, some nasty health problems that affected me downstairs, and a prolonged break-up – had led me to a complete break down.

I am not unfamiliar with mental health care; my parents work in the field, and nearly everybody in my extended family is or was on psychiatric medication. I had not been on any medication, but I was no stranger to therapy. But I had never imagined that I would end up in the hospital. I had never imagined that my level of depression would become so alarming.

Before I went to the pysch ward in Bethlehem, I went to the emergency room at the hospital in the small New England town where I went to college. I had not been sleeping for about four or five weeks, and I simply couldn’t keep on going like I had been, moving about in a haze and obsessively thinking about why I couldn’t be happy about anything anymore. There is a term that I learned after all this – “safe.” It perhaps seems silly, but it does capture what I felt: I did not feel “safe” to go home from work that day and resume as I had been because thoughts of suicide had gripped me with a fear that I couldn’t dismiss.

It was, in a sense, a relief to finally just say, “I give up,” and allow the full force of my emotions to overwhelm me, emotions that I really didn’t comprehend at the time. There is a way in which depression creeps up on you – you don’t realize how bad off you really are, and then all of the sudden it is like everything explodes. I felt a sense of relief because I thought, ok, now that I’m admitting to myself that I’ve reached the depths, I can begin to pull myself out.

I didn’t really know what to expect out of the ER for a mental health issue; I just knew that I had to go there because I didn’t know how else to address how I was feeling. I had been working at the college library and two friends who also worked on campus drove me there. In the waiting room I saw my friends Dave and Dan Lomax, and this made the whole thing seem like some tragicomedy for a few moments. They were walking down a corridor and I ran after them and called their names. It turns out that Lomax had twisted his ankle in some sort of drunken accident. The hospital staff thought I was really crazy when I ran after them.

When they called me in, a nurse asked me for a brief summary of why I had come. Then she drew blood to check if there were any physiological reasons for my mental state (thyroid level, illicit drugs, etc.). I was sent out to the waiting room again to wait for the social worker to arrive.

At this point, my girlfriend arrived at the hospital. I came outside to meet her, tears pouring from my eyes. “I love you, Dan,” she said as she hugged me. I imagine that as overwhelming as all of this was for me, it was not especially pleasant for her, either – to have watched me slowly deteriorate, put up with me breaking up with her several times out of confusion, and now to be visiting me at the hospital. When she told me she loved me I became even more overcome with emotion. It seemed so beautiful that beyond our convoluted break-up and beyond all of my indecision about what I wanted to do with my life she could still plainly state, “I love you.” At the same time it was exquisitely painful to hear this phrase, because one of the principal reasons why I was losing it was that I didn’t know what to do about her anymore. We smoked a cigarette together, one of our favorite pastimes, and talked about how we might salvage our relationship. Eventually the social worker came outside and told me that we had to talk.

The social worker’s purpose was to evaluate my condition and advise me on what steps to take. For about an hour we discussed why I was there. I explained as best as I could that I had a health problem that was affecting me sexually, that I had just graduated, that I had to decide whether or not I wanted to go to France to teach English, and that above all I didn’t know if I could be with girlfriend anymore. The social worker listened patiently. The best she could really do was to say that she could see it was a difficult, transitional time. She offered to have me admitted to the psych ward there, but since my parents were coming up to have me stay in a hotel room with them, she didn’t think it was necessary. After that, I saw the ER physician briefly; he gave me a prescription for Trazadone, a sleeping pill, and I was discharged.

It seemed to me that this had to be my lowest point; surely, things had to go up from there. The next day, that appeared to be the case. I made the choice to stay in the United States and to remain in that small New England town. A large part of my distress had to do with indecision, and I thought that maybe just by simplifying things a little and not being in such a hurry to move on to something new I would feel a lot better.

My girlfriend and I met up that day and took a walk along the Connecticut river, a walk we had taken several times that summer. I felt better than I had in weeks; I was affectionate, engaged, alert, caring. It was as if the last month or two had been just a protracted nightmare in which I stopped being who I was to her and to myself. I didn’t realize it at the time, but this was the last time I would connect with her in an unequivocally loving way.

The following day I headed back to Bethlehem with my parents so I could hang there and cool off. It seemed like the appropriate thing to do, after all I had been through. Even on the drive home, I started breaking down again, worse than before. I began to feel so awful that I couldn’t handle being alone. The only thing that moderately occupied my attention in a distracting way was watching TV, and when I ran out of things to watch, I would have a fit and start crying.

I was able to see a friend from high school at this point who was also in town, and I explained to him everything that had happened. He was able to see in a way that I couldn’t at the time that part of what was happening was an over-involvement with my girlfriend, to the point that I had lost touch with myself. He could see that a great deal of my distress had to do with the ambiguity of the situation. He could see that I had to make a clear, firm decision and that obviously that couldn’t be to stay with my girlfriend and live in my college town.


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  • http://brianmcelmurry.blogspot.com/ Brian McElmurry

    Very brave! I enjoyed and want more.

  • anonymous

    Although I haven't been hospitalized, I've had similar experiences, and…It's true. You do have to go back, or else the journey of the hero will never be complete. You'll never be complete.

  • fluff

    damn Africa what happened?? but really, “In effect, I never had the sense that anyone cared much about what had happened to me, because I was just supposed to stop dwelling on the past.” <–story of my life.

  • i won't rot

    It seems to me serendipitous that I should have somewhat randomly found your blog (my friend sent me a link to your article about being a 20 something). So much of what you have described really resonates with me – because I have had a lot of the same feelings in the past few months.

    I definitely agree with you that depression really creeps up on you, and you don't realize it is there until it's twisting your arm behind your back and holding a knife to your throat! But when it does hit you, it is a great relief in a way, because you can finally put a word – a concept – a feeling on all the restlessness and confusion you had been feeling for a while before.

    Now I am not sure what to do – I got 'hit' only a few weeks ago and my mood keeps fluctuating between the 'dark and empty place without a future' when I feel like I desperately need help to get out – and a more optimistic, comfortable state of mind where I think I can deal with this on my own and it's just a phase…
    I do think it might be time to ask for help though.

    Thank you for sharing your experience. Please share more if you feel comfortable doing so!

  • http://twitter.com/MissKimball misskimball

    'I headed back to Bethlehem with my parents'
    r u jesus? :O

  • http://hannahscribbles.wordpress.com Hannah Scribbles

    Amazing tale. Also amazing because I live five miles away from Bethlehem, in Easton, Pa. Small world, isn't it?

  • diddly

    Sounds a lot like my hospital experience. Except I was in-patient. We envied you out-patient bros. I really actually liked the psych hospital. Group therapy was ace, the kids in there were really cool. I met a really hot dude in there.

  • http://profiles.google.com/sarah.eliz.baker Sarah Baker

    Thank you for sharing something so personal and sometimes difficult to put into words. I plan on sharing this with my Intensive Out Patient clients. I know they will appreciate and relate to this experience. Best wishes on your road to recovery.

  • RamonaCC

    I relate to this, it made me feel sad, but in the end I really liked reading it. It's inspiring.

  • earlobe

    beautifully introspective and it truly makes you wonder about all kinds of things. thank you for sharing, dan.

  • Claire

    I found this post really insightul and helpful, as a person who also suffers from depression. I tried one-to-one counselling for a while and found that it didn't really help me in the fact that, like you said, a lot of what was said felt like bullshit. I think, like you mentioned at the end of your post, that the only way to begin to overcome depression is to realise the problems that got you there and to try as best as you can to address them. Hiding from the past will only make tihngs worse. Thank you for being so candid and honest about your experience – truly one of the best blog posts I have ever read.

    • http://twitter.com/Dan_Hoffmann Dan Hoffman

      Thank you, Claire. I rarely get comments that are so encouraging and positive; in fact, I get a lot of shit most of the time. Your comments and the other comments here are very meaningful.

  • Katie

    I just wanted to tell you that I really, really appreciate this post. As someone currently in the middle of a major depressive episode, I can really relate to a lot of what you've said, and it's strangely comforting to see in words things that I would never know how to describe. I've thought a lot about going to a “psych ward”, be it in-patient or out-patient care, but I've been kind of terrified. I think maybe I'll just continue my one-on-one counseling and my medication. But yeah. Thank you for sharing your experience. It couldn't have been easy for you to share all of this, and it means a lot to me.

  • VoluntaryMadness

    Just came across this great site today… and I enjoyed reading this very much.

    I've battled depression most of my life. (41) Fighting the body's chemical malfunctions is one thing, (tougher) …but I've found that winning mental battles has always involved some sort of clear decision. As in nature I often feel it has everything to do with order — fighting chaos and bringing order to your thoughts… an order and focus to your day's work.

    A focused day becomes a meaningful week… a series of meaningful week becomes a fulfilling month… and so on.

    Wish everyone strength in their own exhaustive battles with depression.

  • BKid

    Really amazing article; so encouraging!

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