My 4th Mania and 4th Hospital Stay

If you go back and re-read (or read for the first time) the blog entries for March 2015 it's pretty evident that I was headed for a manic episode. I was having sleep issues, I was posting more to social media, I was extra productive and creative, I had pressured speech (speaking quickly), and I had racing thoughts.

The mania started to surface in February 2015. I was grandiose in a job interview, basically told the interviewer "I'm the shit." There were other signs too (as mentioned above).

March 11th to 14th I was in Kentucky presenting at a conference. While there my manic symptoms escalated. My sleep issues worsened and I became extra emotional. The pressured speech and racing thoughts were worsening as well. My acupuncturist said the spring-like weather (it was warmer in Kentucky than in my home state of New Jersey) and the excitement of presenting a workshop did not help the mania. As I've written previously, spring is a trigger for my mania. All my manias, all four of them over the last eight years, have happened in spring, March to June.

Leaving Kentucky further worsened the mania. The flight was delayed, causing me to miss my connection in Charlotte, NC. There were hold ups at the airport and hotel. When I finally got to my hotel room it was after midnight. I had to be to the airport at 7am, so I had to be on a 5am shuttle. I only slept three hours that night. This was Sunday March 15th. Sleep, like spring, is also a huge trigger for me. I knew I was in trouble. I made an emergency appointment with my psychiatrist and acupuncturist for that Monday, March 16th. My psychiatrist increased my meds and told me to let her know if I still wasn't sleeping. My acupuncturist tried to bring the mania down. This session was my most intense acupuncture session in the two years I've been receiving treatment. I cried during the entire session. From the pain of the needles - I never cry from the needles, they're not very painful, for the most part, but the mania had me emotionally sensitive and physically sensitive. Each needle was incredibly painful. I talked through most of the session, explaining to my acupuncturist that I did not want to be manic. I lamented the fact that every spring for the last three years I had been manic (and also hospitalized). I wrote how the gospel song Withholding Nothing was extremely cathartic for me. I listened to it on repeat during my treatment. After this emotionally draining session I felt tons better. Calmer.

The next few days I slept three to four hours per night. Then, Tuesday night/Wednesday morning I slept an hour, at 6am on Wednesday morning. I was up all night on the computer. Being hyperproductive. Researching and writing. I knew I was in trouble after I woke from the one hour of sleep. I don't drive, so I text five of my closest family and friends asking for a ride to the hospital. It didn't occur to me to call an ambulance. Even though I had seen my psychiatrist two days prior, I knew that the mania had progressed too quickly, too fast for her to treat me outpatient. I either needed IOP (intensive outpatient program) or a hospital stay.

Even though I was in the throes of a heightened manic episode, I had enough sense to pack my hospital bag: loose fitting, comfortable clothes; underwear; toiletries; notebooks; and my bible. My mother returned home, my aunt, who I text for a ride, must've called her. When I woke I knew my mom wasn't home, but I wasn't sure where she was so I didn't think to text her for a ride. But my mom is the one who took me to the hospital. My aunt met us there.

The ER visit was pleasant enough. Since it was still early in the morning (in the past I've gone to the ER in the afternoon or evening) I didn't have to wait in the ER that long. I'm not sure if you're familiar with the process for a mental health hospital stay. But first you go to the Emergency Room. They have a crisis counselor assess you: they ask you a bunch of questions about your behavior, mood, and drug use. If you were accompanied to the hospital they also talk to your family member or friend, to get another perspective on your behavior and symptoms. The crisis counselor might also talk to your providers (therapist or psychiatrist). Next, a determination is made: inpatient (hospital) or outpatient (a few days per week of intensive therapy, but you get to live at home). It was decided that I'd be hospitalized.

Once I got to the behavioral health unit, it felt like returning to a second home. I hugged the nurses that I knew from my three previous hospitalizations. I updated them on what had been happening since my last hospital stay, only 10 months prior.

I don't remember much from the first few days. But the salient memories for me from this hospital stay are:

• I really liked my psychiatrist. Every psychiatrist I've had while hospitalized has been great.
• The food is always really good. But it took me about an hour or so to eat each meal. When I'm manic I'm easily distracted. I'll do anything but eat: talk to another patient, talk on the phone, wander around, etc.
• I didn't get many visitors this time. I normally have at least one visitor per day. I don't know if people were busy with their own lives and concerns or had conflicting schedules or no babysitters or whatever, but for whatever reason, less people visited me. It snowed one day while I was there and no one showed. I cried. I was on the phone calling everyone trying to find someone to come visit me. Understandably, people did not travel in the snow to come see me.
• I was supposed to be discharged on a Friday. That morning the psychiatrist told me he was concerned that I was only still sleeping three to four hours per night. So he was going to keep me until Monday. Three more damn days. I cried hysterically at the news. So instead of 10 days, I was hospitalized 13 days. This would be my second longest hospital stay. My longest stay was 17 days. To give you some perspective, most people stay, on average, 5 to 7 days. I doubled that number. It is incredibly hard to be "locked up." Meal times are scheduled. Computer and phone time, your links to the outside world, are rationed. Visiting hours are only two hours per day. You can't have any technology: phone, laptop, tablet, iPod. And your expected to attend group therapy and process why you're there in the first place. Plus, you can't go outside; there's no terrace or courtyard we have access to. So 13 days is a long ass time.