[SparkySmart]

Sorry for the long post.

I was discharged last night from IP treatment after a 6-day hospitalization in a short-term crisis intervention ward. I need to debrief and hoped that you guys would let me tell the story because I just need to talk and don't know where else to go.

For the week leading to hospitalization, I was clearly becoming unglued and delusional. I was able to discern that this was an emergency because people told me I was speaking too quickly, colors were intense and seemed to pulsate, and people appeared to be wavering which I recognized as unnatural. I began hearing things that I knew couldn't be real. My pdoc called the police, but I left my home before they arrived and left my front door ajar so they wouldn't break it down. I went to a neighbor's house because I was so afraid, and she made me stay at her home until she was assured that there was no immediate danger. The next day, I knew I was in crisis, so I packed a bag and drove myself to the closest psych facility which is part of a large medical complex. Driving 45 miles was risky, but I just couldn't burden any of my friends. I parked outside the facility but was accompanied to the intake unit up in the main hospital.

I didn't realize the following until I was discharged, but the admission diagnosis was Bipolar I, manic with psychotic features, emergency involuntary admission; the bipolar I diagnosis had been determined some 45 years earlier, so this was not a surprise. I didn't realize the rest. So anyway, I was held in the intake unit for 4 hours to achieve stabilization following a shot of Geodon which I refused, but a security guard held me while a nurse administered the injection. Finally I was stable and then admitted to the psych acute ward. Funny how the night's details are clear to me following review of the medical record. The people on the unit were SO sick; schizophrenia, schizoaffective, actively suicidal, psychotic. Oh my gosh...so sick that you can't imagine. Conversing with these people was utterly useless.

The 6-day hospitalization was really quite good. The nursing staff was indescribably kind and attentive. I already had a relationship with my pdoc, as I had been seeing him as an outpatient, and I saw him daily. Anyway, my meds were changed on the unit to:
Geodon, 40 mg a.m., 80 mg p.m.
Wellbutrin, 150 mg a.m.
Lamictal 200 a.m., 200 p.m.
Trazodone 150 p.m. for sleep
Whoa...I achieved stability very quickly on this regimen.

Here are my problems: I have a persistent and pronounced tremor and can't hold my legs still. I have loss of balance and a disturbed gait. My vision is blurry. I have a dry mouth that causes my tongue to be stuck to the roof of my mouth and requires drinks of water throughout the night. Overall, I feel overmedicated. Last night, I cut the nighttime meds by half, although my pdoc warned me not to without his approval. The symptoms are no different. My memory is severely impaired, and my ability to concentrate as well. That I can type this post is miraculous since I can't focus on the screen; it took me well over 2 hours of concentration and multiple reviews for errors, holding my PC 3 inches from my face and without my glasses. I type about 100 wpm, so this wasn't a problem. I have deep creases in my forehead that weren't there a week ago.

I live alone and am afraid. I can't confide in anyone because of the stigma.
I just needed to talk to someone, so thanks to Psych Central for this forum, and thanks for listening.

[99fairies]

Thank you for posting. There are so many horror stories about IP, I'm so glad to hear about a positive visit. I'm sorry about the side effects. They can really suck. Glad you're home now. I hope you can find someone to confide in, if not, keep posting as much as you want.

[wildflowerchild25]

I just had the same experience. I’m glad in the end it helped though! Mine did too. Hang in there! The transition home is tough.

[icreateidestroy]

I am sorry you are having to go through this. Thanks for posting and sharing. Wish you heal soon and return home.

[SparkySmart]

From original poster: Gosh!! I had a great night's sleep and a delicious breakfast. The fireplace is roaring, and I'm all snuggled up. I'm grateful that I had the opportunity to be in a safe place and cared for by people who were invested in my recovery. My tremor is decreasing already and my balance is improving, and I can somewhat objectively review the incidents of last week. Mostly I remember being treated very well and patiently, being furnished every tool to succeed. This was a great opportunity, and I was determined not to squander one precious moment.

Thank you all for the hugs...they really made a difference!

[bioChE]

Thanks for posting your story. The thing I thought of from your first post was what I hoped and you shared in your second post. There’s a good chance the side effects will subside to a tolerable level and you’ll be OK. Give it time, your body and brain have been through a lot of trauma in the past week.

I'm glad you posted and glad you found the forums, SparkySmart! I hope your side effects continue to subside, because those are quite problematic ones(!) Are you able to have quick access to your Pdoc? Would they get back to you promptly? It'd be a shame to have to deal with any more than necessary of that over the weekend.

If you've gotten ahold of them -- do they think the side effects will subside? Do they think maybe they should lower something(s) and see if they need titrating up so as to lessen the side effects? Swap something out? Though I'd be a hypocrite to say don't fiddle without permission, just having come out of a pretty intense episode, that's something that should be approached with great caution (if at all), you know? (I've done it too, also to no effect, but really, DO check in with them about it, ok? )

(100 wpm? SO jealous! I'm lucky to get 30, lol!)

[Nammu]

It's so great that the hospitalization helped. Sorry for the side effects glad to hear they are diminishing. to psych central. Lots of us here have been though similar stuff. There's been times when side effects have been bad including leg tremors and tar dia like symptoms thankfully they went away with time. I too felt much older as well as looked older after an intense episode but sleep and time helped. Living alone can be great but it's scary when your dealing with an illness. I used to live alone, for almost 20 yrs so I know how vulnerable it can feel. Take care.

[tecomsin]

Thanks for posting SparkySmart,

Great that you had the motivation to get a roaring fire going and eat a delicious breakfast. You also seem to have a lot of insight into your condition when you are unwell, which is not true in my case. I only realize that I'm depressed and when I'm manic I feel thankful I'm not depressed... I also live alone and found your posts inspiring.

[Carmina]

Can they force people to have injections like that in the States even if admitted voluntarily?

In the UK they would need a section.

[SparkySmart]

Carmina, this admission was involuntary, so I think they were within their rights. Actually, they injected me with Geodon, which I've been on for years, so at least I had no unexpected reactions. The administration of the injection was like One Flew Over the Cookoo's Nest (how on earth do you spell cookoo?). Very frightening and traumatic...can't quite process it.

Thank you, everyone, for your support. I can't express how much it helps.

Oh...in case anyone thinks I'm arrogant, Sparky is my dog, and he is Smart. LOL

My typing is so fast because I was a medical transcriptionist (working from home for national companies) for years. This was a great job because it allowed me to keep my stressors to a minimum. Most of the work nowadays is offshored, so it's no longer a viable means of support.

Innerzone: Yes, I'm an experimenter. How could I NOT be? I mean, I know when I feel awful. If I know the specific drug that is likely to be the culprit, I decrease it, even when that means tapping powder out of a capsule. My pdoc knows that I can't bear to be controlled by chemicals, but he also knows that I'm not nonadherent just for fun...I just want to function again.

[Sunflower123]

Glad to hear you had a positive experience and got help when you needed it. Best wishes for continued improvement from those side effects.

[tsrc78]

That is wonderful you had a good experience at IP! I never have, in the two times I was hospitalized, I had no idea it was possible to have positive experiences at IP until I read about others up here.

Since you improved so rapidly with the med changes, I'm glad the side effects are starting to wear off, and hopefully the ones you describe will completely subside soon. I think getting so many med changes at once, to stabilize your behavior, is a huge shock to your body and makes side effects more prominent. But hopefully they will get better over time.

I am so glad you are home and on a positive path with your recovery.

[glennk]

Thank you for sharing your story. Just so good to hear that you're healthy and safe. Sounds like the side effects of the Geodon are calming down. Do you have a living will with a mental health component? You can leave instructions of what types of treatments (and medications) you want administered in an emergency situation.

[Carmina]

Originally Posted by SparkySmart

Carmina, this admission was involuntary, so I think they were within their rights. Actually, they injected me with Geodon, which I've been on for years, so at least I had no unexpected reactions. The administration of the injection was like One Flew Over the Cookoo's Nest (how on earth do you spell cookoo?). Very frightening and traumatic...can't quite process it.

Ah sorry - I was reading you drove yourself there so that sounded voluntary - not sure what the law behind forced medication is in the states

frightening experience, glad you got out

[SparkySmart]

Carmina...Yes, it IS interesting, isn't it? I mean, I DROVE to the hospital and was accompanied to the intake unit. I wanted help and asked for it. The ER doctor came to the intake unit to assess the situation very quickly and stated that he was afraid I would leave (after I expressed that I thought I was possibly exaggerating my symptoms and was having second thoughts). This was a highly charged situation, of course. I think it's common to have "buyer's remorse" and change your mind. My power to make decisions was thus eliminated completely. My belongings were taken from me and locked up, and I was changed into paper scrubs and put into a locked room. This all heightened my fear, naturally, and I became paranoid (who wouldn't?). After 4 hours, post-Geodon, I was fine and was driven by police the 500 yards over to the psych building and escorted inside like a criminal. Once inside, though, I was really quite calm and no longer frightened.

[glennk]

Had the similar experience almost 15 years ago. Stripped of clothes, stuff to lockup and up to the ward. My anxiety was out of control, heart rate was above 180 all the time, thought I was going to die constantly.

[Teddy Bear]

Good luck with the side effects

[wildflowerchild25]

Originally Posted by SparkySmart

Carmina...Yes, it IS interesting, isn't it? I mean, I DROVE to the hospital and was accompanied to the intake unit. I wanted help and asked for it. The ER doctor came to the intake unit to assess the situation very quickly and stated that he was afraid I would leave (after I expressed that I thought I was possibly exaggerating my symptoms and was having second thoughts). This was a highly charged situation, of course. I think it's common to have "buyer's remorse" and change your mind. My power to make decisions was thus eliminated completely. My belongings were taken from me and locked up, and I was changed into paper scrubs and put into a locked room. This all heightened my fear, naturally, and I became paranoid (who wouldn't?). After 4 hours, post-Geodon, I was fine and was driven by police the 500 yards over to the psych building and escorted inside like a criminal. Once inside, though, I was really quite calm and no longer frightened.

Literally the same thing for me. I asked to go to the ER but somehow the psych hospital wouldn’t accept me unless I was involuntary. I got sent to a hospital about an hour away from me and the whole time I thought I was voluntary but I just found out by reading my discharge paperwork that I was
Considered involuntary there as well! I don’t get it, I was begging for help.

Thankfully I’m usually able to control myself so I didn’t have to get a shot.

[Carmina]

Originally Posted by wildflowerchild25

Literally the same thing for me. I asked to go to the ER but somehow the psych hospital wouldn’t accept me unless I was involuntary. I got sent to a hospital about an hour away from me and the whole time I thought I was voluntary but I just found out by reading my discharge paperwork that I was
Considered involuntary there as well! I don’t get it, I was begging for help.

Thankfully I’m usually able to control myself so I didn’t have to get a shot.

So what is the legal oversight around this (in the states). This is interesting, I know the UK law around mental health pretty well and there are all sorts of safeguards in principle, although in practice I also know the MHA and MCA can still get misused on occasion. Is there any sort of legal determination of capacity for example, representation, advocacy etc?

[SparkySmart]

I've been wondering about your question regarding safeguards, and also why psych hospitals often seem to assign involuntary admission status unnecessarily. No better time like the present (3 a.m.) to contemplate these issues, huh? I'm a lifelong insomniac, BTW...cold winter mornings make me irrepressibly happy, if not delirious.

In terms of admission status, I wonder if this isn't insurance-reimbursement related, justifying longer stays? It must be monetarily driven, wouldn't you think? This isn't my first involuntary admission, sad to say, and the ER drama only serves to agitate me more. This isn't a reality show, folks...just get me a BED, K? Like someone else said, I was desperate for help, so why not just get on with it? It's humiliating to be treated forcefully when you're wearing paper scrubs.

Because some here have spoken of terrible experiences being hospitalized, and this grieves me deeply, let me say that I've never had a BAD experience (I mean other than my intake experience this time, obviously). Being bipolar pretty much guarantees repeat performances, I guess. I've never hesitated to seek treatment because of this. There's an occasional angry/bitter healthcare worker with an agenda, but, by and large, they really care (in my experience). I wonder why this is so? ...and it's not regional, either -- I've been in hospitals from Anchorage to New Orleans and in between and have had uniformly excellent care. Whoever is overseeing these services, if anyone at all, has dropped the proverbial ball for many of you.

Oh! For anyone who's curious, I feel wonderful!! Kinder, gentler, sweeter (yuck, but it's true), less judgmental. I'm happy, tranquil. I like my new self a lot! I've visited this country before, but the meds turned on me after a few months and made me miserable, so we'll hope for a better outcome this time. BTW, the problem drug for me was Trazodone. I switched this back to Ambien, and voila! Even my hair looks good now, and I have a spring in my step! No, I'm not hypomanic at all...my neighbor said she'd never seen me without my typical screaming, annoying intensity.

Have a wonderful day! ❤❤

[bizi]

I hated trazadone for those reasons. awful stuff!
it also made me manic.
I am surprised they put you on welbutrin.
Glad that you are on the road to happier days.
((((HUGS))))
bizi

[SparkySmart]

Curious about your Wellbutrin statement. SNRIs are used cautiously in BP, I know. My pdoc thinks it's OK if a mood stabilizer and AP are on board. I have a tendency to be in the ever-popular mixed state so thought this cocktail made sense. As a wanna-be pharmacist, I've tried eliminating one drug or another at times and felt pretty awful, but one never knows for certain if this represents a re-emergence of one's original BP craziness or a withdrawal syndrome. I'm inclined to suspect the latter. The STEP-BD lengthy clinical trial, I think (?), addresses these issues.

My pdoc seems knowledgeable about and experienced with BP, but this doesn't stop me from second-guessing his every move. I'm always open to new information, so let me know your thinking, K? ��

Ya know what I wonder? If a BP person and a well person each took the same cocktail, and the well person had no reaction while the BP person experienced relief, would that be diagnostic? For instance, when I take Geodon (w/food), I get a really cool, mellow feeling that lasts for a while. I'm thinking that if a person unaffected by BP had the SAME response, why wouldn't Geodon be a controlled substance, subject to abuse? Who WOULDN'T want to chill out? But if only a BP person has this yummy response, then pdocs ought to trial the drug on patients FIRST, before making a diagnosis, and save everybody lots of time. Clear as mud?

[SparkySmart]

Originally Posted by glennk

Thank you for sharing your story. Just so good to hear that you're healthy and safe. Sounds like the side effects of the Geodon are calming down. Do you have a living will with a mental health component? You can leave instructions of what types of treatments (and medications) you want administered in an emergency situation.

Hi, Glenn. Very good suggestions. When I'm asked about these matters, I usually reply, "Who? You're talking to ME? Dude, it'll be DECADES before I have to think about stuff like THAT!!" I'd better grow up, though. Thanks!