It would have been nice to end on a multiple of 5

I’ve seen more therapists than I have years that I’ve been alive. I started therapy when I was 14.

How am I? Oh well I’m emotionally dysregulated. How are you?

I’ve gone and fired therapist number 25 before I even had a chance to write an entry in here about the start of therapy with him. I met with him for 2 and 1/2 months or so.

Only a handful of sessions in I started to feel really attached to him. It terrified me, because that doesn’t usually happen and was and felt way out of proportion to how little he knew me.

That idealization was crushed shortly after. Because I felt over-attached, I rushed into some tough topics.

I think an important role of a therapist is to keep an eye on the patients level of affect and ensure that it is neither too low or too high. The optimal rage is different for everyone every day. Too low and the therapy is too superficial, but too high and it will be too overwhelming to be therapeutic. The optimal level varies based on how much time remains in the session. As the session nears its end the therapist needs to find the way to bring the affect to a level the patient can manage outside of the container of the therapeutic relationship.

I realize this can often be a difficult task, but he did about as poorly with this as possible. The session ended abruptly, leaving me in a vulnerable emotional state. This left me feeling wary about the therapy, realizing that he and I were very out of sync. I picture this session as a chart where x is time and y is affect. We both started at low affect and his line was straight across with no slope, while mine got higher and higher.

We did talk about this after, but I think he took the wrong message from it. I wanted him to be more aware of when things were escalating too far, while he took this to mean he shouldn’t press certain topics at all.

A couple of weeks ago I wasn’t feeling great. I won’t get into the reasons right now, because retrospectively I’m embarrassed about how trivial they were.
I cut in the bathroom of his building before my appointment. I felt extremely out of control. I bled through my pants leg. I spent the session with my purse held over the blood spot so he wouldn’t see.
Obviously he can’t read my mind (Although once a therapist accused me of wanting him to do that, probably with some justification) but I really resented him for not noticing something. I always keep my purse on the floor rather than holding it. Clearly I wasn’t meeting with Sherlock Holmes for therapy.
He was so focused on convincing me that I shouldn’t feel how I felt, that he didn’t get around to understanding how I felt.
He asked me if I was going to be okay over the weekend and I very unconvincingly said ‘Yes’. He didn’t question it.

That weekend I was not feeling well. I had some oxycodone left over from a medical problem I had over the summer (This is a topic for another post) I took that, some klonopin and some seroquel too.
Unfortunately I only slept for 13 hours as opposed to forever.

This is the first time I’ve ever misused prescription medications like this. I felt incredibly guilty about it. I’ve always only used over the counter medications for overdoses. I feel like doing this is betraying a level of trust between me and the perscribing doctor.

I rationalized this somewhat by not going over the daily limit for the klonopin, and only doing so with the oxycodone, because I care more about the trust between me and my psychiatrist than me and random doctor from the hospital who will never know about this.

With a lot of reluctance, I told therapist number 25 about this, but it took me two sessions to fully get out. At the time when I told him about this I wasn’t feeling suicidal any more. I came early though to that session to plan out my escape routes in case he tried to hospitalize me and I needed to bolt. I tossed a hat and sunglasses and change of clothing in my bag as well.

I brought up the idea during that session that my period may be relevant to some of my more serious mood problems. I’ve brought this up before with therapists. I never really can feel sure. Is it confirmation bias? I don’t have a good way to keep track of if my mood changes around my period. I don’t buy into those mood monthly calendars. All self report measures of mood are highly subjective and because I wouldn’t be blinded to when I have my period I question their validity.

I mentioned feeling conflicted about this due to my identity as a feminist. I don’t really have a fleshed out coherent argument about my feelings with this, just an uncomfortable feeling. Somehow I think that if I say the words feminism and menstruation enough my feelings will be clear to everyone.
The feelings have something to do with the society wanting to view women as overemotional on their periods, the medicalization of a normal process and the validity of PMDD as a diagnosis, but again I’m not good at expressing myself here. I can see both sides of an argument about PMDD.
He seemed confused about why feminism would be relevant to a discussion of PMDD. I can handle disagreement, especially since both sides of the argument are dueling it out in my brain. But I was shocked that he wouldn’t even be aware of the possible relevance of feminism to an issue involving menstruation. He seemed very perplexed and I was horrified.

He did apologize the following session without prompting, but still it was unsettling.

Then to make things even more exciting and wonderful (note the sarcasm) The therapist who kicked me out of school (I need a shorter way to refer to him) was on a major news network promoting his book.
Every bit of publicity feels like he is taunting me.

I sent him 3 angry tweets from my twitter account. This twitter account is public and associated with my real identity (not my real name, but the username I mostly use an also people I know in real like follow me there). Probably not my most brilliant idea ever, but I’m leaving them up. If any person searches for his @replies they will know that at least one person out there is very unhappy with him. They’re vague enough that if a person didn’t know the background they would know I was angry with him, but the reasons would be unclear.
This means he now has access to most of my social networking pages. That’s fine though as I put my best foot forward on those, unlike in this blog.

When I went to therapy to talk about this I was very let down. Awhile ago I made a comment about how klonopin makes me stupid, which it does. The stupidity occurs in varying degrees, but to have any relief from anxiety thoughts rushing around, some of the good smart thoughts are slowed down as well. Sometimes thoughts can even be of both types.
I commented on how I had to stop what I’d been working on (Probably for the better as is it was slightly destructive) when the klonopin kicked in, because I wasn’t able to think well enough. He decided to take this time to argue with me about wither I am on the correct dosage. I have had the dosage fiddled with to the point of adjusting it by increments of 1/4 of the smallest pill size. This is the right dose. I’ve been taking it at this dose for a couple of years. I’m not messing with it. He was convinced that there is some ideal dose where I won’t be anxious or stupid. I don’t believe this is possible, because the two are so intertwined and the impact of the same klonopin dose varies depending on the day.
The comments felt accusatory too. Like he thought I was abusing it, although I have never ever gone over my prescribed limit. In the context of previously telling him about my oxycodone and klonopin adventures I was very sensitive to this sort of comment, because I feel so guilty about it.

He was taking a super ego guilt inducing role. My super ego is super at making me feel guilty already thankyouverymuch.

I told him about something I had thought of doing, but did not do and he took his guilt induction much too far. I can’t write about the details here, but basically he took a thought of mine and turned it into a worst case scenario. I tried to protest, but he kept making it worse and worse. The things he was saying were already fears in my head. I didn’t need him to give them credibility.
I have far worse thoughts in my head that I haven’t told anyone. If he reacts with such a judgmental extreme to something less horrible then there’s no way he can handle the worst of me.

I felt like he was treating me like he thought I was a sociopath. He was playing this role of a conscious for me as if I had none.
If he had even a basic personality conceptualization of me he was working from to base his comments he’d have realized that I am already very skilled at guilt.

I stopped talking. I stared out the window for a bit.
Then, I pulled out my Nintendo DS and resumed the game I’d been playing in the waiting room. Really juvenile, but I don’t care.
My brother called while I was ignoring the therapist. I refused the call, but then he called again and I took it, upping my rudeness level by +10. He just had a quick answer to a question I’d had about the game I was playing.

After about 20 minutes of ignoring the therapist although with the occasional yes or no answer to a question I said “I think I should just leave”. And I did. He asked if I wanted to make another appointment and I said “No”.
There wasn’t anything he could say at the point that could have made me comfortable continuing therapy with him.
I hate myself already, I don’t need a therapist thinking I am awful as well.

I rushed out of the building, worried that I was going to be followed or stopped by security. Psychiatry departments are never placed near an easy exit and I think we all know this is not an accident.

I arrived home and decided to take some ibuprofen. I think the reason I am still alive after all these years is that I am awful at swallowing pills. If I were better at I’d have succeed years ago. I had liquid gel filled capsule type ibuprofen. I decided that if I dumped the liquid out and drank it that might work.
Turns out this is the worst idea ever. I tried opening one up, but it didn’t work well, so I decided to just put it in my mouth and bite it. It was extremely acidic. I ran to the sink to rinse my mouth out to stop the pain. My mouth and throat felt sore after, like I’d been vomiting.
With that method ruined, I gave up to the time being.

It’s a few days later and I’m okayish now. I’m not being very productive with school work. I’ve mostly been sleeping and eating ice cream. I don’t know what I’m going to do about the lack of a therapist situation. I hate starting over again and again.

Imagining Self-Injury and Therapy

I think about self-injury a lot. Most days I don’t self-injure, but most days I think about self-injuring.

In the earlier days of my self-injury the thought would pop into my head and in most cases I would do it as soon as I could following the idea.

I didn’t care about getting blood on my clothes and often wore dark pants that would hide the blood stains.

I wanted to self-injure and then it was off to the nearest bathroom. That’s an exaggeration. I still thought of self-injury more than I acted on it, but I acted on it much more quickly when I did. Certainly external events would sometimes prevent me from doing it, but I’d often find ways, even if it meant secretly scratching myself with a safety-pin under my clothing.

That was high school. Things shifted in college.

It’s obviously more comfortable to self-injure in my bathroom than in a public one. In high school waiting until I got home meant waiting until the end of the day. In college, waiting until I got home often meant waiting however long it would take me travel there. Sometimes that means waiting until a class is over, but rarely the long waits I would have in high school.

I began opting to wait a bit to have the better self-injury experience at home rather than the scared “I hope I don’t get caught” one in a public bathroom. I don’t always do this. I still punch trees, sign posts and walls while walking places, but those days are more extreme than most.

This waiting has stretched out more and more. When before it was waiting 3 hours for a class to end, now I’ll wait the whole work day. Almost all of my self-injury now occurs at night. Self-injury at night is routine, but in the day time is a sign of trouble.

The freedom is crucial. It’s not that anyone is telling me I can’t self-injure then. I can do it if I want to, but often opt to instead wait for the preferred environment.

I picture the self-injury in my head. Imagining the cuts on my body. Sometimes I move a finger briskly across the location I will cut. I think of watching the blood drip down my leg.

And these images in my head are soothing. I plan, “I’ll self-injure when I get home”. Knowing that option and plan is there helps.

I fully intend in the moment to self-injure when I arrive home. But often by the time I arrive at home, my mind is on to other things. Sometimes I self-injure and others I don’t. The intention is the same when the initial thought arrives, but the intervening experiences vary, leading to different outcomes.

I want to be sure to differentiate what I am talking about from therapy techniques where a therapist authoritatively tells a client that they should stop self injuring by trying to wait X amount of time and then revisit the idea.
This is a process that has evolved on its own rather than being artificially forced upon me.

I am not waiting as a means of ultimately avoiding self-injury. As I have said, I don’t think self-injury in moderation is objectionable.
But do I prefer to bleed through a pair of pajama bottoms rather than a nice pair of pants? Yes.
Do I like looking down at my leg throughout the day to be sure blood isn’t visible to people? Not really.

In the moment, I believe with a high degree of certainty that I will self-injure when I arrive at home.
It just turns out that I am not very good at predicting this.

I recently had an occasion where I was concerned I might need to change clothing in front of another person. I wasn’t sure and it turned out not to be the case, but I was very worried about it at the time.
If no fresh cuts are visible I can angle my body so that scars might not be seen.
I had to avoid self-injuring for a few days after I learned of this event. I go weeks without self-injuring fairly regularly. I thought a few days would be nothing.

Once I told myself I couldn’t self-injure my stress skyrocketed. I couldn’t visualize the self-injury. It only worked when I believed in the moment that I would do it for real when I was home. The images were nothing without the hope of reality.

I’d not been fully aware how often the thoughts were in my head. As soon as you try not to do something it becomes so much worse.

The thoughts themselves are soothing. I need the possibility to be open.
I can’t force any of this. It only works if the thoughts are spontaneous.

I was able to avoid self-injuring, but it was not an enjoyable few days.

I’ve found a similar phenomenon occurs with my therapy.
When I am in therapy I have frequent conversations in my head with my therapist. All the conversations are ones I imagine I could have with the therapist. Often they are difficult topics I’m struggling to bring up and I replay the scene over and over looking for the right way to present information.
My actual therapy sessions only vaguely resemble their imagined versions. Some topics from my visualizations do get brought up in my real therapy, but most do not.
The pretend therapy in my head is a useful tool for sorting out thoughts and often by the time I get to therapy I don’t need to talk about that issue any longer.

When I am not in therapy this process doesn’t work. I have to be able to think the conversation could take place. Without it my brain becomes a cluttered mess.

When in therapy that doesn’t seem to help much in session, the pretend therapist in my head that I gain access to can be more valuable than the session itself.

Without therapy I sometimes shift to imagined blogging, which is not as good as imagined therapy, but serves a similar function.

A roadbump while looking for records

Last week I was speaking in therapy about the therapy I had been in during high school, this included my experience with DBT.
It inspired me to google my DBT therapist. I found his website. He’s moved to a new location very far from where I met with him.
I looked at the list of articles he’s written. There was one on psychodynamic therapy. That threw me off. Nothing about the time I met with him would have led me to guess that. It somehow made me vilify him less, because now the possibility exists that we might have some similar theoretical views.
It’s strange though because everything else on his page is about DBT and CBT, all but this one out of place psychodynamic article.

I decided to read the psychodynamic article.
Looking at the abstract I realize, “I think I’ve read something else that cited something similar”.
I continued reading, “No. I’ve definitely read something else that cited this exact study.”
It only took looking up two recently-ish read articles to find the one I was thinking of.

I’d had this other article folded open on my desk for weeks to the page he’s cited on and not had a clue.
I had that particular page open, because I’d highlighted some interesting quotes. I’d been thinking of writing about it here. I feel the quotes address the key problems I had in DBT.
The highlighted quotes had nothing to do with his contribution to the article, but what a strange coincidence that he would be on the same page.

I decided I want to contact him for my records. The idea is in my head. I’m stubborn and don’t want to let go of the idea once it is there.

As I’ve mentioned before, I am collecting my psych records bit by bit. It started as a effort to get closure with the therapist who kicked me out of school and then spread to all my other treatments as well.

Private practice records are harder to obtain, so I have fewer of those, but gathering as many as I can is a project I pick up from time to time.

I called the number on his website. It was disconnected. Maybe I dialed wrong, I tried again and again and again. Definitely disconnected.

Double checked the website, looks like it may not have been updated since 2008.

I checked the whois info, but it was set to private via a third party.

After some debate, I decided to send an email. Less than ideal for this situation, but I included my phone number and address so he could contact me.
I don’t have anyway of knowing if he still actively checks this email address. It is associated with his domain name and if he’s not updated the website enough to fix his phone number, I have doubts that he would also check the email.

The next day I received two phone calls from a “withheld” number. They didn’t leave a message and I was unable to answer at the time. I wondered if it was him. I’ve been waiting since then to see if this “withheld” number will call again, but they haven’t. I’ve been kicking myself mentally for not excusing myself to answer the phone.

I decided to pursue other options, while waiting.

I looked up his lisence. It’s active and was renewed in Jan 2010, so I know he didn’t just decide to stop practicing.

I called a former employer to ask if they knew a way to contact him. They didn’t.

I called his state license organization to see if they could help. They had information, but couldn’t disclose it due to privacy reasons. Understandable.

I called ABCT(his website said he’s a member). They said that for $54 I could join and gain access to their member database which maybe had the information I was looking for, but couldn’t guarantee.

I realized I could look in the APA member database for him. I ran a search. He showed up, but I received a notice saying “This Member has opted not to publish information in the directory”.

I’ve google searched his name and location in every imaginable combination, including yellow page searches. I only find his old office and the new number that is disconnected.

I googled for obituaries to make sure he’s not dead. Nothing came up, so I assume he is alive.

I’m tempted to send him another email asking if the “withheld” number was him and if so apologizing for not answering and then listing times I am more available to answer the phone. But I don’t feel confident enough that it was him. I have a guess of someone else it might be. If it was him why wouldn’t he send me an email saying he’d tried to reach me by phone unsuccessfully?

It’s funny. A reason I left was because he wanted me to call him whenever I was going to cut. I objected. He said he couldn’t meet with me if I couldn’t agree to that. Now here I am trying to find a way to phone him.

Besides sending him another email, I am out of ideas.
It’s a strange situation. I have a right to my records, but what is one to do when the person holding the records is unreachable?

Escape and Keeping things seperate

When I tell people why I switched schools/majors I try to put a happy spin on it. ‘It was purely for academics’, I’ll say.
The reality is that after I returned from my involuntary leave, I did not feel welcome.

I was placed in freshman dorms again and harassed by roommates who’d heard rumors about me and dug through my prescriptions, running google searches. They google diagnosed me with schizophrenia and decided I was out to murder them in their sleep. If they were really so scared of me why did they yell at me so much?

I was only able to take one class in my major, because the prerequisites I needed were not offered that semester. My semester off left me a year behind. I hardly saw the classmates I’d known when I was there before. They’d moved on without me.
I avoided large sections of the campus. I couldn’t go near any of the offices involved in forcing me out. I hid when I spotted people involved.
It was not a welcome return.
I just wanted to pick up where I left off like nothing had ever happened, but it was impossible.

I felt so on edge and unwanted. I needed to escape.
I couldn’t transfer and stay the same major. I couldn’t justify that to myself.
I was enjoying my Intro Psych class and reading a lot of psychology books. I’d thought before it wasn’t an option, but as I learned more I reconsidered.
I told my therapist I was leaving to get an MBA. I refused to talk over my decision in therapy. I didn’t tell him I was switching to psychology. I felt uncomfortable telling a therapist I was going into his field. I justified this lie by telling myself I could get an MBA after I got the psychology degree, but didn’t really believe it.

I hate to make it sound like I don’t love what I’m doing now that I am a psychology major. In retrospect I realize now that I have much more enthusiasm for this than I had for my previous major, but the decision will always be tainted because it was made to escape one thing rather than pursue another.

So I escaped to a new school. Except the escape didn’t work. Changing location wasn’t enough. I can’t escape the fear of it happening again.

No matter how well I do academically I am still at risk of it happening again. My last school didn’t care that I was a good student, this one won’t either. The fear is in my head guiding every action I make.

I see a person who looks like the therapist who kicked me out. I know it’s not him, but what if it were him? What if he showed up at my new school? I run through scenarios of what I would do. I get lost in my thoughts.
It’s like I have two images layered on top of each other. One is reality and one is my fear scenario. The opacity is being adjusted up and down. I see one then I see the other. Volume alternates between the scenes. I can forget that I’m only in my thoughts.
I react as if it is happening. Fisted clenched, heart pounding, tears welling up in my eyes.
It goes until something jolts me back into the real world.

I’ve tried all sorts of reactions in my head. Sometimes I scream at him, sometimes I glare angrily, make sarcastic comments. I sometimes try explaining to someone how much he hurt me and that he needs to leave. Or maybe I quietly make an exit and other times the exit is dramatic.

I also go through scenarios where my new school tries to kick me out. Sure I’m better prepared this time because I know my legal rights, but I’d still have to fight for it. The new school becomes tainted because then they also don’t want me there. All my effort to hide things and I end up in the same situation as the old school.

There’s never a good resolution. In every imaginary situation I dig myself into a deeper mess.
I think part of it is my brain trying to find a way to deal with it. If I had a good solution, should the situation arise, maybe I wouldn’t need to fear it so much.

Another part of it that I realized recently is that part of me wants a confrontation with the therapist who kicked me out. I sent him a much too nice email awhile ago which he ignored. I want to him to see my rage. The damage that his own fear caused me.
Even in my head seeking him out for this is unacceptable. But if he invaded my territory, then I’ve every right to defend it. I could show him my anger without as much guilt.

My favorite professor has a number of things in common with the therapist who kicked me out. I’ve been through many scary stories in my head where it turns out they are friends. The rational part of me had been able to say that this was unrealistic. They have similar research interests and theoretical perspectives, but so do a lot of people who don’t know each other.
This semester has been rough. I have a class with that professor and have learned more about him. Like how he enjoys going to conferences of a organization that once named the therapist who kicked me out as their therapist of the month.
My professor recently mentioned reading a blog and recommended it to me and a few others. It was a blog I’m familiar with. This blog has repeatedly endorsed the blog belonging to the therapist who kicked me out. The therapist’s blog is one of 13 links in a recommended blogs section. That therapist’s blog has a word in it’s title that is my professor’s primary area of research interest. If he were scanning that list of blogs this one would stick out.
It is fairly likely based on this information that my professor has read/reads the blog belonging to that therapist.

This potential merging of parts of my life is terrifying.
A whole new set of fear scenarios has been launched. Even something that might seem as small as my professor mentioning the therapist’s blog is scary. How would I react to it? Am I able to hide my reaction?
What if my anger towards the blog isn’t concealed? What if he puts things together, realizing that that therapist worked at my old school?
It’s possible that the reason that therapist no longer works at my old school is at least in part due to my legal action. What if he talked to people about it, without saying my name? What if he talked to my professor about it. What if then my professor put two and two together and realized it was me who the therapist kicked out?

It’s impossible to escape fully as long as I still live in fear of being kicked out of my new school. Even once I graduate I won’t be safe. It’s not just about being kicked out of school. It’s about stigma.
There’s nothing I can do to keep myself safe from the stigma other than hiding everything. It requires large amounts of mental energy. I have to be several steps ahead of everyone. I can’t say something that would elicit a question that might lead to showing too much.
And ironically the problem causing me the most distress is the anxiety surrounding escaping stigma. If I didn’t have this worry I’d have better mental health, certainly not perfect, but better. Trying to hide my crazy is making me crazier.

Partial Hospitalization #1

A partial hospital program is sometimes also called a day program. You spend the day at the hospital, but then go home to sleep.

My first partial hospital program was right after my first hospitalization. I lasted two days there.
This is the program that I mentioned in my post about how they sent me someone else’s records.

The social worker in my hospitalization set up the intake at the partial hospital program for me.
I told her two requirements I had for it:
1. It needed to be an adolescent program
2. I did not want to do DBT

When the social worker informed me it was set up, she told me my requirements had been met.

When I arrived on the first day, I quickly learned neither request had been fulfilled.

I realize now that avoiding DBT in this type of program is likely an impossibility, but I’d have appreciated her being upfront with me about this. To be fair she probably didn’t know the program contained DBT. But the reason for this is probably because she didn’t put any effort to find out.

My request for an adolescent program was reasonable. I was 19. My inpatient hospitalization had been with adolescents (their cut off was age 21).

There was a group of about 6 others in the program. I was by far the youngest. Most were old enough to be my parents.
I was very uncomfortable. I listened to people complain about their children and spouses. I couldn’t relate.

At my intake meeting a ‘No Harm Contract’ was presented.
‘No way’, I said ‘I will self injure if I want to and forcing me to sign that just will force me to lie. I’d rather not need to lie.’
The contract was pushed aside to be reevaluated in the future.
I left that meeting with the understanding that I had in no way suggested I would refrain from self-injuring.

I was very angry and aggressive (verbally, not physically). Largely because I was stuck at this partial hospital program because I’d been kicked out of school and possibly also in a small part because of a bad reaction I was having to Celexa.

I was under the impression that successful completion of this program was necessary to help my return to school. Despite despising the program, I felt I needed to stick it out.

The first day was a Friday. That weekend I returned to the school to move everything out of my dorm room.
Most was removed Saturday. Sunday morning I came to retrieve the last few items and discovered another person sleeping in what had been my bed and a large bong in the bathroom.

Monday I returned to the partial hospital program. The first day I had left my sharp items at home. I wasn’t sure what I was getting into (would my items be searched?) and decided it was in my best interests to leave them at home. Monday, the second day, I came prepared with a swiss army knife in my pocket. This seemed fine based on my experience the first day.

Inpatient hospitalizations are under-structured. Too much time with nothing to do. Partial hospital programs are over-structured. One group after another. Spending the entire day dwelling on problems, because the structure prevents one from going out and doing anything enjoyable.

I was frustrated with the way the people leading the groups spoke down to us, as if the depression meant we were cognitively challenged.

During the lunch break I made a few little tiny cuts on my leg. Very minimal, close to zero blood draw.

In the afternoon I had a daily check-in meeting with a social worker. As a side note I mentioned cutting a little during lunch. I didn’t think it was a big deal to mention. I’d never agreed to the no harm contract.

I was transported into an office with another woman (someone with a higher level of authority). She demanded to see what I’d used. I handed over the knife.
A lecture proceeded in a disgusted tone, wondering how I could have possibly thought it was acceptable to bring a “weapon” (aka a small swiss army knife) into a hospital.

She demanded to see the cuts.
I refused, explaining they were minimal and did not need medical attention.
She argued that because I had done it “on the premises” she had to see them.
I continued to refuse.
“I’d have to take off my pants to show you”, I protested.
She seemed unconcerned.
I was scared and eventually intimidated into giving in.
I tried rolling up the pant leg to show the cuts, but as I’d suspected the leg wouldn’t push up far enough.
I unzipped, pulled down my pants and showed her the cuts.
I felt very violated.

“Well there’s not too much damage this time“, she huffed.

That was it. The last straw. I announced I was leaving the program.

She bombarded me with questions assessing my current suicidal risk, trying to trick me into saying something to allow them to keep me there.
I didn’t fall for it.

My knife was returned and I went home.

I still didn’t have a therapist. While making phone calls to find one, many therapists refused to see me on the basis that I’d not properly completed the partial hospital program. I only was able to get into therapy (although this was my fake therapy, because anything I said was at risk of being reported back to my school) eventually when I left out the bit about the incomplete partial program.

Confidentiality Struggles on Inpatient Psych Units

I’ve found that during my psychiatric hospitalizations working to maintain my confidentiality has been an issue.

I’ve never been hospitalized for non-psychiatric reasons, so I don’t have a perfect comparison. From observing while visiting family in the hospital I can tell that any hospitalization seems to result in some level of decreased confidentiality. When there’s a shared room it’s near impossible to keep everything private. You might not know details, but there is often at least a vague sense of what your roommate’s problem is. Family members who visit, often speak with the doctor without the presence of the patient, creating a risk that information will be communicated that the patient might have not wanted shared.

At my first hospitalization there was some posturing about confidentiality. Cameras including camera phones were banned and the lack of names on doors was emphasized.
I had a terrifying experience of 24 hours in the ER and was refusing to sign the form to be admitted. I wanted to go to a different hospital, but they wouldn’t let me. I asked if I could maybe see the unit first to see that it wasn’t scary. I was told I couldn’t have a tour because of confidentiality issues. This seemed reasonable. Eventually I gave in a signed the form.

A couple of years later I heard from a friend who was considering going inpatient at a different hospital for medication adjustments. He had been given a tour of the unit he would stay on before making his decision. So it appears this rule is not consistent between hospitals.

It seems the most significant confidentiality difference between general medical hospitalizations and psychiatric ones is that for psychiatric admissions patients are specifically encouraged to interact.
In fact, not interacting with other patients will likely be looked upon as a symptom.
Rather than staying in your room in bed all day there are common areas and group activities.

It might seem like that activity group is purely recreational, designed to break up an otherwise empty day. Wrong! In all of my records there are notes of my behavior during those types of activities.
One form for an arts activity group says simply that I attended and comments, “Very quiet- worked with no discussion with peers”. Never mind that I was focused and enjoying that I was doing. All that mattered as a record for that hour was my silence.

The problem of communicating with other patients is that all of a sudden your hospitalization is no longer just a relationship between you and medical professionals, now others are added into the mix. These others have no ethical responsibility to uphold confidentiality.
I know that sometimes outpatient group therapy groups discuss that what is said there should stay confidential, but I’ve never heard any sort of similar comment discussed in an inpatient setting.

Despite this, I have found the unstructured social time of inpatient settings to be one of the few helpful things I have gotten out of my hospitalizations.
I’m so secretive in general that it’s nice to be able to talk without the fear that I will be judged for my ‘crazy’.

But information besides what I choose to disclose also gets revealed. If I was in my room crying all morning, people know. There’s no hiding it. If I go back to one-on-one security, people know my suicide risk was deemed increased.

Sometimes check-in meetings with psychiatrists were conducted in the hallways where anyone could hear. I’d whisper everything and usually reveal less information as a result.

This makes visitors a very anxiety provoking experience. On the one hand it’s nice to get a visitor, on the other hand those visitors are generally my parents. I don’t tell my parents much of anything. They receive the most vague information possible. I worry about another patient blurting out something private about me in their presence.

At the first hospitalization visitors were let onto the unit and were allowed to all the same places I had access to. So much for that “No Tours” rule.
There was no private place to meet. They could go in my room, but I also had a roommate. I was on edge during all the visits, trying to steer them away from anyone I’d communicated with.

The second and third hospitalizations had rooms where visitors and patients could meet for more privacy. The second still allowed family access to the rest of the unit thus compromising confidentiality of anyone there. What if a visitor ran into someone they knew there besides the one they’d come to see? In a general medical hospitalization the chances of noticing someone you know are much less likely unless you were peeking your head into each room.
The third hospitalization restricted visitors movement more, only allowing them in that one room.

Some point in the middle of my first hospitalization my doctor asked me to list the top things bothering me at the moment. One of the top items on this list was the distress my hair pulling was causing me. I later learned that this had been relayed to my Dad. He didn’t understand why I was stressed about my hair (the part about pulling it out got lost it appears). I can’t imagine how that doctor believed that it was appropriate to share this information with my Dad. I was so visibly upset upon learning this that I worry my Dad held back telling me more he might know to keep me from getting further upset. I have no idea if he was told more.
I believe him when he says that he didn’t try to get information out of the doctor and that this was shared more spontaneously. The hospital only had my permission to talk about about logistics (such as arranging affordable outpatient care) with my Dad but still information gets shared that shouldn’t once a line of communication is opened.
My Mom is banned from speaking to any mental health professional of mine, because she tries to manipulate people into giving her information.
I banned her from visiting at all during my second hospitalization and unfortunately it wasn’t very effective because they kept allowing her on until I started to scream that she wasn’t allowed there.

Family meetings seem to be encouraged, again creating the risk that something will be said that I wanted private.

My third hospitalization was the worst with regards to confidentiality. The central issue became my efforts to protect my privacy.

First they told me they were going to contact my school to let them know I was there. I strongly refused.
Anyone who’s been reading this blog regularly knows that letting my school know about my psychological issues is a touchy subject.
‘But it’s our policy’, they said. ‘We have an agreement with the local schools’
I called my lawyer and they called theirs.
After creating a huge amount of panic and stress for me they backed down realizing they had no leg to stand on.

While this was still being sorted out I noticed some student nurses were visiting the unit. I spotted a name tag. My college’s name was on it.
I fled the room. Had they seen me, had anyone recognized me?
Student nurses from my school came twice a week. No one had thought to mention this to me.
It happened too fast for me to spot any faces. Did I know any of them?
I spent the morning hiding in my room.
“Isn’t their being here putting my confidentiality at risk? I don’t want them to know I’m here. Can’t they leave?”
I go to a small school. People know each other.
No one seemed concerned.
I spoke to the apathetic Human Rights Officer.
I wasn’t allowed to ban them from the unit, but I could ban them from any activities I wanted to attend.
But I couldn’t attend the activities, I couldn’t walk down the hallway to get to the activities room without risking being seen.
The only way to prevent them from knowing I was there was to hide while they were on the unit.

When got out of the hospital I sent an anonymous email to the heads of the nursing department to let them know what had happened.

Here’s the email I sent:

I am writing to inform you about an issue I had recently relating to the *college* nursing department. I do not believe that anyone at *college* was at fault in this problem, but I hope that by bringing this to your attention perhaps something can be done to fix it.
I am a student at *college* and I was recently a patient on the inpatient psychiatric unit at *hospital*.
My confidentiality is very important to me, as I have previously had my confidentiality broken and suffered discrimination as a result of this. I understand that not everyone will react the same way others have, but because of these problems, keeping my psychological issues separate from my education is very important to me.
One day while on the unit I spotted someone wearing an ID saying ‘*college*’. I bolted from the room to speak with a staff member and learned that a number of nursing students from *college* would be there that morning. The staff knew where I go to school, no one thought to warn me of their arrival. I didn’t want to be seen by them. The staff informed me that they couldn’t be kicked off the unit or restricted to a less central location and that my only option was to hide in my room(or the isolation room) all morning. So I was stuck doing that. The stress of hiding there and the isolation it involved were not things I needed piled on top of the reasons why I was already a patient there.
The staff I spoke with (including the human rights officer) were fairly apathetic towards this problem, citing that they have an agreement with the school to allow the students on the unit. I argued that allowing peers of mine to see that I am there is a breach of my confidentiality because them seeing me there involves receiving information that I don’t want disclosed.
I understand that the students themselves are sworn to confidentiality. (Though from my experience when people break confidentiality it is hard to prove and they end up getting away with it), Were I to run into one of these students in a social or academic situation at *college* the interaction would be colored by their knowledge, knowledge that I didn’t want them to have in the first place.
I feel that as a patient my needs, particularly my rights to privacy, should be taking priority over the educational needs of the nursing students, because there is the option for the school to find an alternate assignment for the students in this sort of situation, but I don’t have the option of being in an alternate psych ward for the morning.
I can’t imagine that I’m the first person to run into this problem. And I understand that having the students not be there when someone from their school is a patient there who objects may not be a reasonable option.
I understand that the teaching hospital is a very successful concept, but that doesn’t mean it can not be improved. The current way that it is being implemented at *hospital* is taking too casual of an attitude towards privacy. I do not know if this experience is representative of other hospitals.
At the very least, if you could help me out by giving me a list of all hospitals where *college* students are on the psychiatric units, I would appreciate it. So I can know to avoid them. Because at this point I feel that if I am in need of inpatient psych care I am unable to get it because I fear a confidentiality violation.
Thank you for taking the time to read this.

I now have a note behind my ID in my wallet listing 8 hospitals I can’t go to because my confidentiality would be at risk. Basically I would have to travel fairly far to get to a hospital free of my school’s nursing students. Even further if I wanted to get to a reputable hospital.

I got a couple of more sympathetic, “We’re taking this seriously” emails in reply, but basically the end result is still that I can’t go to those hospitals.

Confidentiality should not need be one of my primary worries when hospitalized, but it has to be because I have to protect myself.

Primary Care

I used to believe there was never a legitimate reason to withhold information from a primary care doctor. Now I feel that information is only to be given on a need to know basis.

In late high school, my therapist (M.S.) gave me three choices, I could go on medication, go back to DBT or go to my primary care doctor to get my cuts looked at. If I refused select one of them, she wouldn’t meet with me anymore. I resented the ultimatum, but decided to go for the primary care option. Medication and DBT would be continued disruptions to my life but a trip to the doctor could be done and over with in a day.

I didn’t have any control over making my own doctor appointments or transporting myself to the doctor. My parents don’t know about my cutting so I couldn’t tell them why I needed to go.
I invented a vague medical issue (I can’t remember what, maybe a stomach ache?) and asked to go to the doctor. Given my Mom’s hysterical tendency to overreact to physical symptoms, this was all I needed to get an appointment.

I went to the appointment and no surprise, my cuts did not need medical attention, but the therapist didn’t trust my judgment.
I thought I was done with the primary care task, but the therapist kept insisting I periodically return.
More vague medical issues were invented. My cuts were fine. I make a lot of cuts, but the depth of each individual one is nothing to worry about.
One visit, my regular doctor wasn’t in and instead I met with an overemotional doctor who grabbed my arm and made me promise not to kill myself.

When I was hospitalized for the first time it was partially related to losing my virginity. Although I know that with lesbian sex the risks are lower, I decided to ask for a STD test. The HIV test was done while I was in the hospital, but the other more general test was not.
I was 19, but my primary care doctor was still my pediatrician. Google says that up to age 21 people sometimes still see their pediatrician, but for me age 19 felt much too old. I didn’t have control over making doctors appointments yet and hadn’t been comfortable asking my parents about switching. The doctors at the hospital helped me out by writing in my discharge report, “Recommend the patient establish care with gynecologist”.

Upon release from the hospital I had an appointment with the new primary care doctor. I got my STD test (Results were fine). That was the only appointment I ever had with her.

Much later, I was trying to find a therapist. A local hospital’s psychology department said they could get me one, but first I needed a primary care doctor in their hospital. I made an appointment to see this new doctor (I will call her Doctor A). I gave a fairly lengthy psych history to her, because I needed her to help me get a therapist within her hospital. She seemed very nice and insisted she’d help me get a therapy appointment quickly.
The hospital wasn’t able to follow through with getting me a therapist. The wait list was a month long and even after the wait I wouldn’t be able to have a high enough frequency of appointments.

Another local hospital said they too could find me a therapist if I had a primary care doctor in their hospital. Again, I went to a new primary care doctor who I told more about my psychological history than my physical history. This hospital was also not able to follow through on their promise of a therapist.

I decided to switch back to Doctor A because her hospital had a more convenient location. Both hospitals are affiliated with the same prestigious medical school so I believed they were of comparable quality. Turns out the USnews rankings feel strongly otherwise, but I didn’t know this at the time.

I had a handful of appointments with Doctor A. I needed a form signed for school, the HPV vaccination, I had the flu etc.
I wasn’t pleased with how she handled my medical form for my new school. She put much too much information down about my psychological history. I felt the only appropriate information was the medication I was on (klonopin) and a small reference to minor anxiety as an explanation. I didn’t feel comfortable using her form with what had happened last time I had a school know my psychological history.
I never gave my new school the medical form. I’ve avoided the student health center. I worried they would track me down looking for it, but it never happened.

My third hospitalization was at Doctor A’s hospital. The many ways that that hospitalization was the worst I’ve had are a subject for another post. When I was discharged they insisted I make a follow-up appointment with my primary care doctor. The next available appointment was many months outward. The appointment was made and although I felt it was unnecessary I kept in in my calendar book.

After the hospitalization at Doctor A’s hospital I requested a copy of my records. I really only cared about the records from my inpatient stay, but because I was already going through the effort of making the request I also checked the box asking for my primary care records.

In my initial appointment with Doctor A I had mentioned that I am a lesbian. I was also asked if I am sexually active. I find that a hard question to answer; I explained that I only had sex once. I was asked if it had been consensual and I told her it was. At the time I didn’t think much of the question about consent, it seemed like a reasonable follow up.

In my records I was surprised to find this:
“She has had one sexual encounter with a man 1 year ago, but has not had intercourse since. She considers herself a lesbian but does not have a girlfriend and is not sexually active.”

I definitely never said anything about having sex with a man! I’ve only had sex with a woman. At the follow-up appointment I called her out on this. She was very insistent that I had told her I had sex with a man.

She heard the statements “I have had sex once” and “I am a lesbian”. I think this was likely not conscious, but I believe she was biased to assume that “sex” is a man plus a woman even though intellectually I believe she understands the alternatives. So following that she asked the question about consent, because it didn’t make sense for a lesbian to have sex with a man unless it was rape. There are of course exceptions to this, such as when a person begins identifying as a lesbian later in life. Instead of asking for clarification she assumed I was one of those exceptions and entered the incorrect information into my record.

I wasn’t pleased to learn that my doctor had an implicit bias against homosexuals. I realize there are some leaps and assumptions in here, but I think it is the most logical explanation of what happened.

I decided I was done with preventative medicine. I have chronic suicidal ideation. Although I wasn’t going to take action to kill myself then, I shouldn’t take action to keep myself alive. Basic needs such as eating and sleeping were okay, but no need for check-ups. Maybe I would come down with a horrible disease and would die without needing the effort of killing myself.

Eventually, I loosened up on my boycott of preventative medicine. I found a new primary care doctor (Doctor B), one at a clinic with a focus on the LGBT community. I told Doctor B the bare minimum of psychological history; I let her know the medications I am on, and mentioned nothing other than occasional panic attacks and ADHD. That’s all she needs to know. If she doesn’t know more, then she can’t tell more on any forms I need her to sign.

In September when I had my most recent overdose, I wanted to go to a doctor to get checked out. I couldn’t go to to Doctor B, because I don’t want her knowing about my crazy.

I waited a week to avoid the risk of being forcibly hospitalized. The more time between me and the overdose the less of a case they would have that I was an immediate danger to myself.

Doctor A was a resident and no longer works in the same hospital, but the hospital assigned me a new primary care doctor who I have never met. As far as Doctor A’s hospital is concerned I still have a primary care doctor there. I just haven’t been to an appointment for awhile. This gave me access to their walk-in clinic.
I met with a doctor who insisted I needed an emergency appointment with their psych department. Because it was after hours and I wasn’t an immediate risk she said she’d call tomorrow with a referral for an urgent appointment. I didn’t argue because I didn’t want to say anything that might force me to stay there. But it was frustrating, because I’d come for the physical issues only.
Everything was fine physically in her tests besides my reported GI symptoms (they eventually faded away).
I dutifully followed up with all of the hoops to get the urgent appointment. I was without therapy so I figured it couldn’t hurt. The appointment never materialized. No surprise there.
I would probably go back there if I needed other medical attention related to my psychological issues. I don’t like them but they’re capable of running a blood test or giving an X-ray. Doctor B is still my doctor for yearly appointments and anything else .

I don’t know which doctor is my real primary care doctor. Neither has the full story. Each has their specialized purpose. It works, so I’ll keep it like this.

Hidden Self-Injury Tools

I should preface this post by mentioning that I don’t feel self-injury is inherently bad, it can be helpful so I find efforts of others to prevent me from doing it frustrating. You might with to read my other post about self injury first.

When I began self-injuring I also began hiding tools to accomplish it. This way I would always have access should I feel the need. Safety pins were hidden in most articles of my clothing. I had a pencil case filled with razor blades and bloody gauze.

In my first hospitalization I secretly brought in a safety pin. A small item I impulsively decided to hide when I realized what was happening. Turned out this was unnecessary.

They did an awful job of searching my things. When my searched bag was handed to me the first thing I did was open a compartment and pull out a brand new razor blade. My roommate had packed the bag and handed it to my parents. The razor blade had been left in the bag previously.

To make it seem I was healthier than I was I promptly handed the razor to the mental health worker who had given me the bag. My manipulation was wasted. This interaction was never entered into my records and I don’t believe he told anyone because it was him who had missed the blade in the search.
Upon later inspection I realized all of my buttons (the kind with little sayings on them and pins on the back) had been left on my bag. I had accumulated a very large assortment of sharp items.

Initially I had decided I would respect the rules of the hospital and not self injure while there, but after a series of frustrations with the hospital I decided there was no reason for that.
I scratched up my arm a bit one day. Hardly any damage, it’s tough to do much with a pin. I didn’t hide it but also didn’t show it off. It was noticed and I handed over some of the pins.
A threat was made, “Is this everything? We can search all your things again if you want”
“Search if you want too”, I said
I made good eye contact. They bought my pretend confidence.
Later, feeling manipulative again I walked to the nurses station with a pin and said, “Here, I found this in my room”
The nurse made a big fuss about how proud of me she was, not knowing I still had my original safety pin. This was entered in my notes.
I scratched a bit at times following and was not caught.

In the weeks preceding my second hospitalization I knew I was feeling unstable. I had destructive plans running through my head with no specific time set.
In the event that I needed to be hospitalized I decided I should ensure I would have materials to self-injure with in the hospital. I hid razor blades in many items that are always on my person.
Sure enough when I was rushed to the ER I had a nice assortment of sharp new blades. None were found during the search. No one expects the lengths I went to conceal them.
I had quite the stash of blades. I cut a lot during that hospitalization and was not caught.
The closest I came was when I was cutting and punching a wall in the shower. The wall punching made more noise than I anticipated and nurses came barging into the bathroom. Fortunately through feigned modesty and angling my body in ways to hide the cuts, I was able to get enough privacy to get clothing on without being caught. I admitted to the wall punching but the cutting and razor blade were not discovered.

On the day I was being discharged, minutes before I left, I passed a clean new blade to a friend I’d met there. She’d mentioned wanting to cut and being friendly I decided to help her out. It’s a fuzzy moral area for me. It’s one thing for me to cut. I know I won’t go too deep, but other people are uncontrolled variables.
Later I heard she cut up her arm pretty badly and was discovered. She wouldn’t give up my name though when the psychiatrist was demanding the information from her.

At my third hospitalization I also arrived well armed with razor blades. The ER room I sat in had a spare unused blood draw kit. I was bored with making balloons out of latex gloves so I took it and hid it for later.
An accomplishment I shouldn’t be proud of but am is that during this hospitalization I cut in the shower while on one to one security. Meaning, I had a person who’s sole job was to babysit me and make sure I didn’t do these sorts of things and still managed to not get caught.
I tried to draw blood with the blood kit. I thought it would be neat to try and bleed until I passed out. I was doing it wrong. It didn’t work. I tried calling a friend with a history of heroin abuse (the same one who I gave the blade to the previous hospitalization) I thought maybe she would have advice regarding sticking a needle in an arm. She didn’t answer the phone.
I later learned those kits are set up to only work when the blood tube is attached. I didn’t have any tubes.

I was trying to express to the doctors how not okay I was. I gave them useless the blood kit and some of the razors that had become rusty from the shower. I wanted them to know what I’d been up to. It didn’t work. I was discharged the next day despite still being very suicidal. First thing I did upon arriving home was OD on a bunch of pills.

Having so many sharp things hidden in my possession makes airplane travel very stressful. I’m fine with sneaking sharps into a hospital, but not fine with sneaking them onto a plane. The consequences of being caught in the hospital are very low, but being caught with it at an airport is serious business. Before a trip I have to carefully comb through every single possible hiding spot and remove the blades. There are so many I don’t remember them all. I’m incredibly anxious while going through security. I worry if i missed one.
To make matters worse I nearly always have my bag searched additionally. I travel with at least three cameras on the average trip, along with assorted other electronic devices. No matter how I pack these items, my bag appears suspicious under X-ray.
Fortunately it appears I’ve never accidentally left a razor blade behind in my bag, but it continues to be a source of worry every time.

If you are someone who works at a hospital I hope you don’t take out of this post that security needs to be drastically upped for everyone. I think a better message is that if a person wants to do something badly enough they will find a way to do it. Also it is important to note, that most of the in hospital self injury I did was directly following attempts to reach out to staff for help verbally that were unsuccessful.

Adderall and Ritalin

As you can tell from my post about food, I am very particular about what goes into my body.

It was an ordeal for my parents to get me to take any kind of medicine as a child. Any occasion where I took medicine was a rarity. I had no understanding of the cause and effect. The idea that something I ingest would alter how I felt (possibly in a positive way) was hard for me to understand.

My freshman year of high school my parents decided they wanted me to begin taking Adderall. I refused initially. I wasn’t worried about potential risks of the drug. Taking a doctor prescribed drug as directed seemed harmless. I knew cognitively about the idea of side effects, but had no personal experience and therefore was not concerned. My reason for objecting was taste.
I’ve never learned to swallow pills. I have to place them in food. The bitter taste is inescapable.
My parents offered to pay me to take the Adderall. I forget how much. It was a one time payment in exchange for taking the drug indefinitely. I’m not much of negotiator, I probably could have gotten a better deal, but I accepted it.

I began the Adderall.
I have no memory of ever being told by a doctor what side effects to look our for. My parents were told, but I wasn’t.
So when I stopped needing to eat or sleep much I didn’t connect this to the new drug. I just thought I didn’t need these things anymore.

I’d sneak over to the computer at night and play games online. Go to bed at 3 am wake up at 7:30 am? No problem!
I loved my alone time at night. I had free reign of the house, provided I was quiet.
Why would I tell my parents? They’d just get mad at me for sneaking out of bed.

I didn’t need lunch anymore. I’d save my lunch money for various odds and ends.
Couldn’t tell my parents that either, they’d get mad.

Classes were boring. I’d look around the room going pondering the different ways I could kill myself before the class ended. Could I jump out the window? Hang myself with the flagpole? It was half serious and half a game.

I exploded at a friend at school. She asked where my boyfriend and I were going on our date. I accused her of trying to follow us. I never repaired that friendship following this incident.

I started self-injury during this time. Was it something that was bound to happen even without the Adderall? I have no way of knowing.

Based on how long standing my problems have been and my family history I believe I’d still have had difficulties without ever taking Adderall. I think they may have just been accelerated.

During this time I feel something in me broke. I’ve spent the rest of my life trying to fix it, but I never get back to where I was. I have times when I think I am fixed, but a little bump makes me fall apart again.

My fabulous, amazing godfather commented that I looked drugged. And he would know, what with all the time in the 80s he spent being punk rocker, hanging around the east village.

There were a lot of dramatic, loud arguments with my Mom. One resulted in my running into a snow storm in only a t-shirt and jeans. I figured I’d freeze myself to death in the snow. I hid in the backyard, then I got cold, so I decided to live.

I re-entered my home. My dad was on the phone with a local psych unit. Had I stayed outside a few more minutes I’d have been dragged to the hospital.
This was my first threat of psych hospitalization. It began a series of nightmares I had for years about being forcibly hospitalized. (This is a topic for another post)

I wonder sometimes how things might be different had I been hospitalized that day. If some type of intervention had been made earlier would things be less severe today? My parents were and still are for the most part clueless about how bad my problems are. It was a year until I began regular therapy and it wasn’t due to a specific mental health diagnosis except for a little about my ADD. It was primarily for dealing with conflict between my mom and I.

After the snow storm incident, my parents finally realized the Adderall was not the best idea for me and I was taken off it.

Life improved after quitting the Adderall, but never quite to where it was before. The self injury tapered off, to the point where I thought I was done with it forever. There was almost a year where things felt close to normal. A rough patch during my junior year brought everything back. It was much easier to fall apart the second time.

You’d think this would have scared me away from stimulants for good, wouldn’t you?
It did for awhile. It scared me away from all drugs.

Out of desperation, my freshman year of college, I tried some other psych drugs for my anxiety and depression. (This is a topic for another post) This loosened up my fear somewhat. I’m still very distrustful of drugs, but if desperate enough I’m willing to look into the option, occasionally.

When I transfered schools I was terrified about how I would do academically.

During my second hospitalization I asked my doctor if he could prescribe an ADD medication besides Adderall. I thought it would be a good idea to try it while there so if I had a bad reaction I would be in a safe place.
The doctor said no. He had a theory that I was bipolar type 3 (didn’t seem to care that this diagnosis doesn’t exist) and thought it would make me manic.
In art therapy I spaced out while the directions were being explained. I dedicated my piece of colorful scribbles to him and called it “My therapist won’t give me ADD drugs, so I spaced out during the directions”. In typical art therapy fashion the facilitators talked about how even though I’d not heard the directions, my scribbles somehow related to the assigned topic.

During my 3rd hospitalization I asked again. They put me on Ritalin. Was the only helpful thing to come out of that hospitalization. Originally they had me take it every day. I wasn’t comfortable with that.
Now I take Ritalin just on days I want to. I like being able to compare how I feel on the drug versus off it. It has worked out very well.

Everything in my brain organizes itself better. I don’t stare at a blank screen for hours trying to start a paper.

It’s not perfect. I’ve had horrible mood swings when it wears off. I learned this happens when I skip a meal. I make sure to eat (even if I’m not hungry) and things are fine.

Careful self-monitoring is important.

Ritalin is shorter acting than Adderall. I find this helpful. I can’t go for weeks accidentally depriving myself of sleep and food like I did on Adderall.

Part of my Adderall problem was that I wasn’t informed about anything. I was 14. I was young, but old enough that I should have had a more active role in my health decisions. Someone should have let me know that my body still needed food and sleep even if it was saying otherwise.

I need to be heard

I need people to know what happened to me. I need people to know this happens. I want dialogue and awareness.

But I’m terrified of being blamed. There are people who will think this was my fault, not the fault of a flawed system.
These fears keep me silent.
There are so many things I can handle different options on, but not this. It is too personal. Defending them is an attack on me.

I don’t have the perfect way to tell my story. I have started so many drafts, saved on my computer, forgotten. I’m going to give bullet points a shot. I need to, if nothing else, get out the key points.

-A bit over 2 years ago I was feeling very depressed and suicidal.
-I felt terrified of myself and made an emergency appointment with my therapist so I could get help. He was a therapist in my college’s health center.
-He decided I should go to the hospital. I was not surprised by this and, though terrified, I agreed to go.
-When in the hospital he suggested I take the rest of the semester off. I said ‘no, school is too important to me’ and he said ‘well let’s see what the doctors at the hospital have to say’.
-I was feeling better and getting ready to be released. A meeting was held with my therapist, the hospital doctors and I. The hospital doctors said that when I was released it would be fine for me to return to school. I had decided I would drop a couple of classes, but that I wanted to return. My therapist disagreed with this.
-My therapist told me he was going to talk to the school and ask them to place me on an “involuntary medical leave”. He said he was going to talk to them whether or not I gave permission.
-After he left a hospital doctor told me “This is discrimination”
-After my therapist spoke with the school my parents spoke with a woman there to plead my case. They asked for her to please talk to the hospital doctors who had a different opinion. She refused, she was only interested in hearing what her employee (my therapist) had to say.
-The decision was made that I would be forced out of the school until they decided I could return.
-I moved out of the dorm and back in with my parents.
-One condition placed upon my return was to meet with a therapist and have that therapist speak with the school to discuss my return. On the surface this seems reasonable, but it isn’t. How can I have real therapy knowing anything I say might hurt my chances of returning to school? As a result, I had about 6 months of ‘fake therapy’.
-I stumbled upon a newspaper article telling about people who were in similar situations as myself. They had won legal cases against their school. I contacted the lawyers who had helped them.
-My case was taken pro-bono. They helped me file an OCR (office of civil rights) complaint. This was not a lawsuit. There were no financial damages. The complaint only asked for their policy to be changed, so what happened to me couldn’t happen to others.
-I won my OCR complaint and returned to school

Okay I’ll end the bullet points now.
It’s not such a happy ending though. When I returned to school things were not the same. I was a semester behind in a very small (40 people) program. It worked on a yearly cycle. The semester off put me a year behind and my absence had been noticed. People knew things. I don’t know how, but they did. No one knew the whole story, but there were rumors.
Based on these rumors I was harassed by my roommates who dug through my things and found my seroquel. From google searches they concluded that must mean I have schizophrenia ( I don’t) and that I was dangerous (I’m not) . They made demands to the RA wanting to be told why I had left the last year. In general they made my life miserable, trying to force me out. They succeeded. I not only left their room, I left the school.

In my new school now I’m paranoid. I extend a lot of energy protecting myself from the same situation repeating itself. I have trouble making friends because I worry if they get to know me too well they’ll realize how crazy I am and then the school will find out and somehow it will be used against me to kick me out. I know it’s illogical, but it shows how much this impacted me. I’m better informed now. Kicking me out would be hard if not impossible, but the thought terrifies me. It doesn’t help that I know this school did something similar to a classmate.
I have nightmares about this happening again. I see people who look like my old therapist and worry he’s gotten a job at my new school.
I love school and want to stay here.
It wasn’t damaging just from the lost semester. They kicked me when I was down. It damaged my ability to trust. It hurts me every day still.

If you know someone who is going through a similar situation send them here
http://www.bazelon.org/Where-We-Stand/Community-Integration/Campus-Mental-Health.aspx

Here’s an NPR story about this issue.

There’s also a facebook group I found today. It’s existence means so much to me.
I wish there were a support group I could go to with others who’ve experienced this. I feel like only people who’ve been through this can fully understand.

I want people to know they’re not alone and there are resources. When this happened to me I had no idea this was a widespread issue. It was a fluke I read that newspaper article.

Just to elaborate on some things:
-Justifying the schools actions by saying “I was a danger to myself” is not reasonable. If I had been a danger to myself then the hospital shouldn’t have been releasing me and it would have been an issue to take up with the hospital, not my school. School is for learning, not for judging my mental health.
-A major issue was my therapist’s duel roles. He wasn’t just my therapist, he was also an employee of the school. He was acting in the interests of the school, not for me.
-Another issue was my school refusing to talk to the hospital doctors. They couldn’t make an informed decision without hearing all sides.