And this is why I am still terrified every day: More on universities and suicide attempts

I found a post on the Student Doctor forum of a Clinical Psychology graduate student who faced disciplinary action due to a suicide attempt.

http://forums.studentdoctor.net/threads/suicide-attempt-as-code-of-conduct-violation.1079780/

This is particularly scary to me because one way I try to help myself stress less about the idea of being outed and facing discrimination from my school is that I like to imagine that as a psychology graduate student I should now be in a position to better advocate for myself because I know more about the system. But the reality is I have zero guarantees that I would be able to protect myself against a bureaucratic system with an agenda. OP in the linked post brings up some good questions in his/her post regarding uncertainty of how this event impacts future applications to things like internship and post-doc.

I was “lucky”(if it’s possible to be lucky in how you are discriminated against) in that my school did not treat my leave as a disciplinary issue, but rather an involuntary medical withdrawal. My transcript has a missing semester. There is zero sign that i was withdrawn from classes that semester after the drop date. One of my graduate applications asked about gap in education and I agonized over what I was required to disclose. I settled on a honest minimalist matter of fact single sentence response that did not disclose my mental health history but did disclose that the gap was medical. I worried about whether someone would figure out what the gap meant and lower their opinion of me. It was scary to worry that one sentence I had to report over an act of discrimination from several years prior might impact my career.

The after effects of discriminatory actions schools take against student are tough to navigate. I have talked in this blog a lot about the emotional after effects my forced medical withdrawal had on me, but OP in the linked post also raises a lot of good questions about concrete issues to navigate about possibly being forced to disclose about the event on future applications.

Every time I see that this type of thing has happened to someone else I feel a terrible mush of anxiety and anger and sadness. I feel so powerless when I see it continue after this much time has passed. People like me have filed OCR complaints and won, but for every school that changes it’s policy in a positive way another 10 seems to change the policy in ways that punish treatment seeking.

 

Other posts on this topic from my blog can be found here:

https://psychologytales.com/out/

 

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.