Posted by Adam on October 9, 1999, at 12:24:33
In reply to Re: Selegiline for depression?, posted by Elizabeth on October 9, 1999, at 3:18:21
Ahh, Blake 11...
What can I say about being hospitalized? Let's see if I can recall some of the events around that time. I had
just completed about three spectacularly uneffective months on Serzone, and when a particularly traumatic event
happened around that time, my depression and OCD*-driven anxiety went into super-overdrive. I was literally being
reduced to a quivering ball of flesh. I remember one particularly horrifying experience where I was driving on
the Mass Pike and had to pull off the road because I was shaking so badly I could't hold onto the steering wheel.
I couldn't sleep or eat. I couldn't think. Why I didn't run my car at 120 MPH into concrete divider (which crossed
my mind) at that point I don't know. I really, sincerely just wanted to die.Instead I went to the emergency room at MGH, and found myself a few hours later on the 11th floor of the Blake
building getting about every diagnostic they could throw at me. It was actually helpful almost immediately, just
because I felt safe and the confidence displayed by the doctors and the nurses lent me the belief that something
soon would be done to make me feel better.From what I understand, inpatient psych at MGH is considered world class. Having never been anywhere else before
or since, I have nothing to compare it to. In general I found the people there to be professional, and genuinely concerned
about the wellbeing of the patients. I think there is a certain amount of world-weariness displayed by some, esp.
the MDs, who are all super busy and seem to have "seen it all". I'm not sure if they do it this way in other hospitals,
but in Blake 11, everyone was sort of mixed together. It wasn't like I was in the "depression unit" and somebody
else was in the "shizophrenia" unit. I'd never spent any quality time with people who were certifiably insane, and
given my own state of mind, that definetely made some group sessions and dinner-table discussions a bit surreal.
The days were long, with not a great deal to do except look forward to meals and groups, neither of which gave much
satisfaction. Hospital food is still hospital food. The groups were often of little more help than to cut the boredom
of the day. Examples: On day x we had "art", and on day "y" we had "body motion". Both were silly and geared intellectually
toward the lowest common denominator, and thus satisfied nobody really. I would sometimes try to inject my collages
or diamante poems with a little sardonic irony if I was feeling especially frustrated, but nobody got it, not even the social
workers. There were information sessions that were given periodically, and were usually presided over by some very knowledgible
(and I'm sure highly lauded) doctors from the "Partners" ivory tower. Unfortunately, these presentations were also rendered rather
pedestrian and unilluminating ("generalized anxiety disorder is a very distressing illness that can be treated with medications like
Prozac..."). I sometimes piped up and asked some questions about, say, the mechanistics of serotonergic drugs in treating OCD and
how the dopaminergic system was involved and thus the extent that SSRIs acted directly or indirectly, what brain imaging was telling
us about the functional and physiological differences of individuals with affective disorders, and so on. I always got very pat and
sometimes rather condescending answers, which gave me the impression that these guys weren't interested in doing much more than
repeating the contents of a brochure, and didn't consider the admittedly academic interests of a psych inpatient much worth entertaining.
After a while I gave up on trying to derive any therapeutic or intellectual benefit from these unstimulating busy-time hours and
focused on observing those around me. I befriended this one completely delusional man named Simon, who also happened to be very kind
and bright, and since he wasn't particularly distressed at the time by his otherworldly convictions, I mostly just listened to him
talk about a variety of subjects he found fascinating and got a little lost in his skewed reality. It was strange that his insanity
did so much to maintain mine, and I hope I was of some benefit to him, if by doing nothing else than lending a willing ear. No one else
seemed interested in what he had to say, and I think he was lonely. So was I.Anyway, the most simultaneously beneficial and traumatic thing about being in the hospital was the ECT. I remember all of us who were to
be wheeled into the OR being awakend at some ungodly early hour and led in our trazadone-induced haze to gurneys where we laid for what
seemed like hours under bright fluorescent lights in the hallway in a long line to wait our turn. I remember some who didn't like needles
or the hot sensation of the injections sort of moaning before the anesthesia put them under, and how hearing this didn't do much to calm
my axiety as I lay there unable to do much of anything but stare at the ceiling.Like I said, I've heard that MGH is first-rate, and I have no reason to doubt this. I found the one-on-one time (which was unfortunately
quite rare) with one of the physicians and a couple of the therapists (one a social worker, one a psycologist) quite helpful and comforting.
I guess putting myself completely in the care of others at that point helped me regroup, and I responded very well to ECT, so I left the
hospital in much better shape than when I went in. I found the access to a host of referrals to arguably some of the best p-docs and psy-
chotherapists in the area who could follow me after I left of enormous benefit. Playing HMO roulette prior to that and the inadequacy of
the care I got through that approach (hey, after a few months with some of these people I went from fairly functional to being hospitalized,
hence I conclude I derived no benefit, if I was not in fact harmed more than helped) has given me such an appreciation for the need to get
hooked up with good people.My experience in the hospital certainly wasn't an altogether pleasant one. I have a feeling that the deficiencies I found at MGH are more
or less endemic to the world of inpatient psychiatry, and given the need to limit costs, probably can't be helped in any great way for those
who can't afford to be sent to posh private clinics. Given some of the stories I've heard about state hospitals and so on, if I had to do
it again, I'd go back to MGH.
*Yes, I have OCD too, but it has been very much under control because of therapy I did in the past, and I think it
only rears its ugly head when my defenses are completely down - that is to say, I'm so severely depressed I can't
think straight. My OCD fears have been mostly body dysmorphic or other somatoform symptoms, but have run the gamut
from issues with contamination, and even one bizarre flair up where I became conviced I must be gay, which I knew with
the rational side of my head was patently absurd. For the curious...
>
> (How was MGH, BTW? Never been there except for emergency late-night (and weekend) x-rays when I was an undergrad. )
poster:Adam
thread:5905
URL: http://www.dr-bob.org/babble/19991001/msgs/12903.html