Saturday, June 28, 2014

A Trip Into the Belly of the Beast: My Local Emergency Room

   I am writing this not to engage in public self-pity but as a warning to others who may be in the same situation, or whose friends or relatives are at risk. I have a psychiatric diagnosis--many,in fact, since doctors do not always get these things right. If you say the wrong thing at the wrong time, or even the right thing, you can be labelled with a wide variety of words which fit into insurance codes. (This is why the labels exist). Without debating what mental illness is and is not, which would require a very long article, I will just say that I get terribly depressed and fearful often for no good reason, and that this has been going on since my childhood, that it has roots in my childhood, and that not many doctors have been able to do anything at all to treat it. Because I believed in modern psychiatry I suffered over 15 years alternating between zombie and shrew, depending on what meds I was prescribed at the time. There is no rhyme or reason to most of this kind of prescribing, and I know this because doctors have medicated me rather extravagantly with every kind of weapon in their arsenal. And I do not use the word weapon lightly. If you are concerned because mentally ill people refuse their medication, try to understand that no one will refuse a medication which is actually helping him or her, but humans will refuse medications which cause numbness, loss of emotion, hyperactivity,mania,irritability anxiety, and/or a reduction in their ability to function or to  function daily in a minimally human way. You would too.

     Anyway there was a morning with a particularly extreme attack of anxiety, and there was an increased heartbeat, dizziness, things that caused my kids to urge me to visit the ER. Which I did. After deciding not to put me through a whole cardiac song and dance (because my heart is pretty good) the doctor left. I never saw him again, but he was followed by a succession of lab techs drawing various fluids, and someone called a "clinician". (This is a meaningless word, and can be applied to a licensed counselor or someone with just a bachelors degree--I have seen it used to describe both. But in between the lab tech and the "clinician" the hospital played what I consider to be a dirty trick. After sitting in a small windowless room with a camera on me for about 3 hours, in the middle of a panic attack, a pleasant young nurse came in and brought me a pill to alleviate my anxiety. Which I gobbled up. If I could have inhaled or injected it, I would have. Unremitting and seemingly causeless fear is a hideous thing to experience.

       After about half an hour (there are,of course, no clocks in these rooms--the feeling of powerlessness is pretty complete) in walks a "clinician" with a clipboard, a rather severe looking middle aged female with a no-nonsense hair cut. By this time I was calmer, thanks to the pill, and I am absolutely sure that this is the way things were planned. She grilled me on my history--not once did she ask me how I felt at the time. It was all about hospitalizations, family history, and what kind of treatments I have had. I mentioned I had stopped all meds a year before because the therapy I am in requires that one experience emotional pain in order to recover, but that I was having some unmanageable anxiety and thought I needed relief. The particular disorder I have is not in the Diagnostic Manual, as far as I know, and my therapist does not take insurance. So I am pretty much out of the system and my diagnosis got a blank look and a quick change of subject.  I was never told what she thought was going on--or given any feedback or sympathy as I spilled my guts in true drug-fuelled fashion. (In the Soviet Union political prisoners were given psychiatric drugs to make them talk. I was thinking of this as realization slowly dawned on me that I was being milked for information which, under normal circumstances, I did not want to give anyone but my own personal doctor).  This person was getting gory details of incidents from the 80s, incidents which were irrelevant to my current condition. Or so I thought, in my ignorance.

     More waiting as she went to consult the doctor. On her return she mentioned an intensive outpatient program (this is for an anxiety attack, mind you) but thankfully I do not have insurance to cover it. She had a gleam in her eye which told me she would have admitted me to the psych ward if she could have--I get that a lot when I am organized and articulate with these people. I think they judge me to be in some kind of manic state. But when you are being scrutinized for signs of mental illness your first response is to act with as much dignity as possible. Which is what I tried to do.

     Since I couldn't go to their program, they referred me to another one, less intensive, as kind of a trade-off for getting anti anxiety medication for a week. (Which was given in a pediatric dose, but I wasn't about to complain. I just wanted to get the hell out of there..) They also prescribed something very heavy --the kind of drug I would describe as a chemical lobotomy. Since I am not delusional and my therapist has never indicated anything about me needing something for numbness, I just threw that rx in the trash, and planned to go to the alternate program the next day and explain everything to them.

     The next day at the other program was worse. I was grilled about every detail of my past not once, but twice, without being asked what my symptoms were. I had been given a label, and the label is what they were typing into the computer. And they typed a lot of stuff into that computer.

     I've been to these things before;they involve group therapy and prescriptions mandated by a doctor who has read what the computer says about you, and known you personally for about 5 minutes tops. . Sometimes the experience was helpful, sometimes not. But since treatment centers usually buy into the biological psychiatry myth nothing ever got much better until I found a good therapist with a lot of patience, stopped taking 8 pills a day, and started talking to God on a regular basis. I decided that my self-respect, and the functioning of my intellect and free will, mattered more to me than numbness, even if the numbness killed the pain. The one comfort of any mental health hospital or group is that one is no longer the only one with thoughts and emotions which most people do not understand or wish to be around. People with a psychiatric diagnosis are extremely sensitive and well aware that we are looked upon by most "normal" people as dysfunctional freaks whose behavior and emotions need to be put under control. Being around each other, even if we are being herded like sheep, can be  a comfort.

     Our culture is so materialistic most people who are crying hysterically even in a hospital will never be asked why they are crying, or what about. If they are angry, they are automatically drugged. A woman who was a doctor at a mental hospital told me the medications were to control behavior. A psychiatrist told me to my face that how I felt was irrelevant to the prescribing process. When people receive a diagnosis of depression (which is real) bipolar depression (which is also real but so trendy now with doctors that the diagnosis is undependable) borderline (over-diagnosed to women who cry and get angry, because psychiatrists do not seem to respect the emotional make-up of women, or wish to understand it) or schizo-affective disorder (which is a very real and terrible disease, but which I have seen diagnosed of people so mentally normal they are almost dull--it is another trending diagnosis) they announce to their friends and family (if their family is still speaking to them) that they have a "chemical imbalance". Besides being false (there is no scientific evidence so accurate as to be able to make that kind of claim) it is vague, and explains nothing except that there is something wrong with one's brain.  Then they are given some pretty powerful meds which vary according to the diagnosis.( I won't get into the really vague and unprovable diagnoses like Asperger's and ADHA which can be diagnosed of basically anyone if you catch him on a bad day. )  The real reason I was being sent to a program instead of being given a prescription like a regular grownup, is that someone gets money for every patient assigned to a program. Someone gets money and someone pays money. And there is a lot of money involved in the metal health industry. The nonsensical theories and thought-stopping diagnostic questions exist because this is not anything remotely connected to science, or to real medicine. Real medicine has to work. Science has to rest on evidence. Not so with mental health. Lies abound because the public is desperate for answers to this kind of suffering, and there are very competent snake-oil salesmen waiting with promises and more promises. And if one promise fails, they will make up a new promise for a new drug.

     As I spoke to some of the patients attending this program, I found that most of the women were taking very strong medications which caused weight gain (up to 60 pounds), that a man with PTSD was prescribed Depakote, which used to be given only to the violent and aggressive and severely psychotic, and who admitted that his VA support groups were the only groups that helped him. A lot of women I spoke to were on some kind of social assistance, seemed mentally impaired--slower--because of the drugs they were on-- and seemed as if they had become children again. And this, I realized, is really what this system does to people. It makes them helpless and childlike and dependent on the government for financial support, and takes away all hope of recovery. One is always "in recovery" but never recovered.  I have witnessed more genuine cheerfulness when visiting a maximum-security prison.

     If people in the insurance, drug, and health-care industries didn't make billions of dollars off of the backs of these people, I don't suppose I would be as angry as I am. It took some effort to up and quit, because I really hate feeling anxiety. But no degree of emotional pain is worth becoming an animal. And that's what people were becoming in that place. They were just a collection of biological processes which were malfunctioning, and the experts had been given permission, carte blanche, to experiment on them for years and years even without any signs of improvement. I often say that the mental health business is the only industry I know of which blames its own failures on its customers--and gets away with it.

     All hospitals aren't bad, all doctors aren't inhuman monsters, all of these health care workers are not cold and indifferent. There are some real saints in these places, who help patients on a human level. Many of them. They are usually not the ones in charge, however. But please think, the next time someone you know hears voices, sinks into a major depression, or goes into a manic phase, about who you are giving them to. Educate yourself on the medications, the diagnoses, and look over the shoulder of every prescribing physician. And most of all, listen to the crazy person. I like to quote something I heard that John Paul II said to his doctors when he was hospitalized after the assassination attempt:
I am not the object of your studies. I am the subject of my disease.

Here are some useful books about the medicalization of human suffering and mental illness:

Anatomy of an Epidemic:Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker

Creating Mental Illness by Allan V Horwitz

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