Whether to seek hospitalization or family care?

There was a time in my life where I lived in the same city as my sister. For a period of about 7 years my sister invited me into her home and volunteered to help administer meds when I was in the midst of what I call a mini-break. I feel like this treatment time in her home was instrumental in the prognosis of my illness. I was able to hang out with family even when I was severely ill.

In more recent years, I have come to understand that in Europe home treatments for mental illness are more popular than here in the States. I don’t thoroughly know why that is. But I do know it takes a village.

The progression of my illness since about 2008 using clozapine has basically stopped the occurrence of these mini-breaks but there may be a time when I bump the meds up for a particularly rough day. This is generally in step with my doctor.

The relative stability on clozapine beginning in 2008, however, was preceded by a time of hospitalizations about twice a year after my daughter was born. This was about 2004 to 2008. Prior I had had a period of hospitalizations from 1986 to 1988.

Do you think those who have severe behavioral health concerns/break-through episodes should be treated in the hospital or by a family member who is educated about treatment protocols, medications and the general course of the illness? What do you think about hospitalization versus family care? What are the benefits of each? What are the drawbacks?

My Sojourn through Bipolar Illness – Family Then (part one)

There had been no prior established case of bipolar illness in my family before 1985 when I was diagnosed.  There was an isolated incident of an uncle who wanted to drop out of college and sail a boat around the world, though this incident was not widely discussed then or now.  The uncle with the sailing fantasy never was treated for a mental illness though he continued and continues to be highly religious in his outlook and in his behaviors. 

So, like for many families, this incident of bipolar illness was unprecedented at that time in February of 1985.  Upon return from Ivy College my parents placed me in a local psychiatric hospital.  Within a number of weeks from the episode on the runway of the airport near Ivy College, I was diagnosed with bipolar illness.  This was about in July 1985.  The relay of the diagnosis was less than spectacular.  I was in session with the psychiatrist whose name for the sake of this text is Dr. Hamilton.  At the end of the session Dr. Hamilton informed me that I was bipolar and left little to no time in the session to talk about what that meant or how it impacted me and my family. 

As with any developmental story after being diagnosed, I had issues with my parents that would consume a portion of my therapy early on in the years following college.  A lot of this therapy focused on the death of my older brother John who was an infant when he died of spinal meningitis.  He would have been 2 years older than me.  Through extended therapy in the early years, I pieced together memories that would allow me to see that much of my parents’ separation and divorce could be seen in the light of John’s early and tragic death.  Few parents I learned survive in marriage the deaths of their children.  And so it was with my parents.  Once I understood more about John’s death and its impact on my parents I could begin to process my place in the family as “the replacement child” or not. This seemed to be a place in which my parents diverged.

My childhood appears to have been largely uneventful with the exception of this divorce, which included happy re-marriages for both parents.  But as we have seen time and time again, that may not be the case.  On the one hand, I later began to believe that these two second marriages provided me the opportunity to have two examples of working parents but with two very different sets of role models.  My Dad and stepmother lived a very quiet life with few outside stimuli. My Dad was a minister yet he preferred to be working in the garden on his rose bushes rather than leading a congregation.  This was probably due to the stress of stigma that at the time accompanied the divorce of a member “of the cloth.”  My Mom and step-dad were both very involved career people and active in the church where our family attended.  They married when I was 15.  We had the typical turmoils of a mixed family particularly since there were four teens in the combined family.  The remarriage was more difficult for my stepbrother and stepsister.  Just months before they had been with their mother who was blind from diabetes as she was killed in a car collision.  In hindsight, my parents agreed that this might have been handled differently. 

What I am mostly trying to express about family is that my childhood originally seems to have relatively very little trauma or negligence or abuse.  I was raised by caring parents whose marriage did not work out for reasons beyond my control and theirs.  I continued to claim responsibility for that divorce well into my twenties as most adult children of divorce do.  But overall, it appears at first blush that I had very little trauma compared to others with a similar diagnosis.  Oftentimes, I tell myself I did not have a particularly difficult upbringing.

However, with the benefit and hindsight of a few more years of emotional work and discovery, I am coming to terms with the fact that I likely sustained substantial abuse at about the age of six.  This abuse was likely at the hand of a neighbor.  Regarding this potential abuse, I have deep pockets of black-out symptoms.   I also recall certain images (not exactly memories) of sexual assault but they are very unclear and very murky. Abuse at the age of six remains relatively unexplored territory at this time and will continue to be a focus of work with my therapist going further. 

(To be continued.)

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My Sojourn through Bipolar Illness – Fear of Flying

Note – several names and places have been changed throughout this text in order to keep my story somewhat private. Thanks for understanding that need. I hope you will tell me what most interests you from my story so I can focus on that moving forward.

Although I had had no prior fear of flying, my first episode of bipolar illness was in a tiny airport near my Ivy League college (hereafter known as Ivy College).  While I was waiting for the plane to get ready to taxi off the runway and take me to my first interview for a job after college in advertising, I was consumed by runaway thoughts.  My thoughts were anywhere but on my interview for an Account Executive position at Chicago Avenue Advertisers.  I had no specific directions for my fears but I took out some papers I was working on for my undergraduate thesis at Ivy College and was writing and writing furiously in and around the margins of the pages of the papers I previously had written.  The thoughts seemed to co-mingle with the characters in the fiction as well as characters or people I knew in real life.  The writing was fast and furious until I finally heard the flight that I was to take to Chicago on the puddle-jumper called.

For some reason I did not feel safe in myself enough to board the plane once the flight was called and I came to the conclusion that the plane was going to crash.  I did not communicate this fear with anyone.  Instead I determined that I did not want to get on a plane that was going to crash, so I got my suitcase together and asked the airplane attendant if I could check my bags on the plane but not board the plane myself.  For some unknown reason, the contents of my suitcase were of paramount importance.  I recall a navy suit that I had packed and feeling like that suit should reach a friend who I was going to see in Chicago.   The label on the suit became extremely important at the time – it was an Evan Picone double-breasted navy wool suit.  The airport personnel immediately got suspicious and asked me why I was putting my suitcase on the plan and asked me to move away from the plane with them.  When I refused, the safety patrol man exerted more force and tried to get me to go with him.  In my fears, I turned to run down the runway away from the scene of the fears and ran completely down the airport runway up into a stand of pines, one shoe flying off in the process and resting in the snowy runway.  I recall exactly what I was wearing – a plaid pleated wool skirt in muted tones, a long sleeve silk blouse and a double breasted woolen gray or taupe sweater.  I don’t recall a coat or over-coat.   The safety patrolmen at the airport followed me into the woods with snow all around and made a chair with their arms for me to sit on.  I was in some stage of delirium and thought they were providing me some sort of throne to safety. 

Instead the next thing I knew I was being handcuffed to the backseat of a patrol car with the patrol lights flashing blue and white and was being escorted to the police station down the road.  When I arrived at the police station I kept telling the police that I was a Senior and straight A student at Ivy College and they must have made some mistake.  On the walls there were pictures of wanted criminals – I kept trying to figure out what the pictures meant.  There were three pictures:  a young woman who I thought looked like Ayn Rand, a man with a long beard who looked in my state to be like a long-haired Jesus and one other picture of a youngish man whose face I cannot recall.  What I do recall is feeling like a criminal and being treated like a criminal until a kind policeman named Michael started to ask me questions.  Once I started to talk with Michael I began to calm down.

After what felt like days of swirling and runaway thoughts and a myriad of questions, the police finally called my family and called the school clinic and I was escorted there.  Soon after, several of my college roommates arrived to be with me while the admission process continued.  After talking briefly with the clinic staff, I was transferred to the local hospital’s Psychiatric Unit. 

Within the next few hours my parents arrived in town and tried to begin to make sense of what had happened.  I recall my parents visiting me in the hospital mostly my Dad whose anxiety I could sense was through the roof.  Within a couple of days, we made arrangements to go back home to Augusta, Georgia.  I unenrolled from classes and moved back home to live with my parents for the spring and summer of 1985.  No one was sure yet if this was a temporary reaction to stress as a Senior and as a Senior thesis writer or the beginning of a lifelong behavioral health diagnosis and challenge.