A Break from Reality

Image: Yale-New Haven Psychiatric Hospital
In March, I was having trouble with my boyfriend. We were arguing a lot about what I considered to be very small things. Then, after a sudden betrayal of my trust, I broke up with him and didn't look back. Also, at work, I was facing some moderate stress. In addition, the season was changing from winter to spring. I often become hypomanic when the days grow longer and the temperatures start climbing. I felt like I was speeding up, but I was still sleeping, though, as I now recollect, not very much. I had made a promise to my psychiatrist that I would call her if I started missing sleep. I wasn't exactly missing sleep, but I was racing through my days and not sleeping as many hours as usual. I had things to be upset about, but I felt good anyway. Maybe it would be better to describe it as energized. I was enjoying the sunny weather, and I felt productive - likely more than I really was. It's hard to describe this time accurately, because I was moving through it in a blur. It was almost dreamlike. As I look back now, I am sure I was hypomanic.

The day after I broke up with my boyfriend, the owner of my company, as well as the president, came to ask me questions about my breakup, my work, and my mood changes. They said they had noticed that I was acting different (hypomanic). They had seen it before, a couple of years past. At the end of our discussion, they told me that they would be giving me paid leave for as long as I needed it to "get healthy". I knew that I was hypomanic, but I was still sleeping (for the most part). My parents had plans to go visit my sister in Connecticut the next day. It seemed like the perfect opportunity to see my sister and nephews and rest. I felt like all I needed was rest, and then my hypomania would subside. So, I left, with my parents, for Connecticut, the next day.

As it turned out, when I got to Connecticut, I didn't rest. I barely slept at all. I woke up before everyone else, at the crack of dawn, and would quickly put on my clothes and start walking to the town center and all around the town. I would come back around noon and meet my family for lunch. They left the back door open for me. I think I probably walked at least 5 miles each day and some days I think I walked about 7 miles. I would describe my walking as roaming and exploring.

Everyone in my sister's town seemed extremely friendly, and they greeted me warmly. It's a small town, so I'm sure that many people knew that I didn't live there. The highlight of my time there, was the first morning, when my sister and I went for a walk on a beautiful beach near her house, but I spent most of my walking time by myself. I would first walk to Starbucks, the earliest place to open, and I would talk to the people there who were getting coffee before work. Everyone in the town seemed so kind. When I looked at their expressions, I felt like they were sending me secret messages. I felt really welcomed, loved, and taken care of. It was beautiful, but I know I was imagining a lot of what was going on.

We went to the Easter service at my sister's church the day before I was supposed to fly home. While I was in church, my mother, who was sitting behind me, grabbed my purse and moved it. I was extremely irritated by this, as I didn't understand why she had disturbed me. So, in the beginning of the service, I reprimanded her, not quite yelling, but speaking to her loudly and harshly. I then quietly walked out of the church and started walking around town again. I went back to Starbucks, and, surprisingly to me, because it was Easter Sunday, it was crowded. After I drank a couple of iced herbal teas, I began wandering again.

After church, my parents called me. I agreed to walk back to my sister's house and then we went to a special Easter Sunday Brunch at a nice restaurant. After the church incident, I was on edge whenever I had to deal with my mother. We were supposed to fly home the next day. I was becoming increasingly agitated and upset. A couple of hours before we had to fly home I realized that I was going to lose it on the plane if I had to fly back home. I asked to go to a hospital. A few minutes later, my sister drove me to Yale-New Haven Psychiatric Hospital where I was admitted because of my manic behavior and my delusions of people psychically communicating with me.

When I arrived in the psychiatric emergency room, it was discovered that although my lithium level was low, I had lithium toxicity. The reason my lithium level was low, is that the lithium toxicity was causing extreme thirst, and I was drinking huge amounts of  water to quench it. Because of this, lithium was being washed out of my system. So, I was put on water restriction for 24 hours and when my lithium level was taken again, it was toxic, because I hadn't been allowed to drink nearly as much water as I had been drinking before.

The psychiatrist in the emergency room explained that I would have to take less lithium, or even no lithium, and add an antipsychotic medication to prevent further episodes of mania. When I got out of the emergency room, where I stayed for three days, I was admitted to the psychiatric hospital, where I stayed for seven days. The psychiatrist in the hospital decided to lower my lithium dose from 1800 mg. to 1350 mg. He then ramped me up to 400 mg. of Seroquel and kept me on 200 mg. of Lamictal. I felt better and better each day.

When I was in the Yale-New Haven Psychiatric Hospital, I received the best care that I have ever received in a mental hospital. It was such a relief to be listened to and taken seriously as a human being. I had been complaining of my extreme thirst for about two years, including another time when I was hospitalized in Kentucky. My complaints were always dismissed, even though I had measured how much I was drinking each day. I told three doctors about this, and I told them I was drinking about eight quarts of water every day, and they just told me that nobody knows how much water an individual needs, so I should just drink when I was thirsty.

When I explained this treatment to a nurse at Yale-New Haven, he became incensed and yelled, "What are they, retarded? Nobody should be drinking eight quarts of water a day. You could have died! Your organs were failing!" All I can say, is that is the difference between mental health care in Kentucky and Connecticut. The only person in Kentucky who noticed my extreme dry mouth and irritated tongue was my dentist, and she considered it to be a problem worth addressing, so she gave me some special mouth spray to use (Biotene). It did help my mouth, but it didn't take away my thirst. I just told her that my doctors had advised me to drink whenever I was thirsty, and I was doing so, but my mouth was always dry anyway. Doctors in Kentucky don't believe you when you say you're drinking eight quarts of water a day, but your mouth is still parched. In Connecticut, it is considered (correctly) to be a medical problem.

I love Kentucky, but if I ever have a serious medical problem again, I'm going to Connecticut for a second opinion. Kentucky is not known for its brainpower. We are among the least educated states in the country. There are many reasons why people choose to live here anyway, but one of them, is that if you are educated, it's much easier to get a job here than places where there is more competition. I've always considered Kentucky to be a backward state, but I have grown used to it, and have had many good experiences here anyway, and have made many good friends whose companionship I treasure, but I often feel that if I hadn't been stricken with a severe and persistent mental illness, I would have left right after high school and never come back.

2 comments:

  1. Hey, LizaBrown here. I'm just glad to hear that you are OK and that you got the help that you needed. How scary to learn that you had lithium toxicity. Yeah, Texas isn't much better in the mental health care department. I'm glad you are OK now, I was worried about you. Hugs, Liza

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  2. Thanks. I'm glad I'm okay too! We can't always help where we live, but I learned, from this experience, that second and third opinions from doctors in the same city may not be that meaningful, because they have similar levels of expertise. I really think now, after this experience, that if you are having a persistent problem, it may be worth it to leave the state, or even the country, in order to find a doctor who is qualified to handle the particular condition. Not every health problem can be solved, but it is also true that not every doctor has the knowledge to treat every condition that he or she encounters. I think a lot doctors just ignore problems that they don't understand, and the patients suffer.

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