So in October 2014 I started actually seeking treatment for my Horrific Brain Problems. I've been treated before, but sporadically - I saw a therapist for a little bit as a teenager and later did some EMDR therapy to cope with trauma that helped but unfortunately had to be stopped too early because of insurance complications. BUT ANYWAY here's some stuff I wish I had known about the process back then that I know now. I'm still working on it - I'm sure I'll have more lessons to learn. But I hope this can help you if you're thinking about seeking treatment, or even just to read at all. There's no sense not talking about this stuff.
This post is so disjointed SORRY
Please note: I'm obviously not a doctor. I'm a little gremlin who stays at home and writes a lot. None of this should be taken as medical advice. Gremlins can't even get medical degrees
If you're feeling low or you already have a diagnosed illness and are seeking treatment, either way - keep a journal. I can't understate how important this is. You don't have to go off on multi-page "Dear Diary, you'll NEVER guess what happened today" entries, unless you want to. Keep a little notebook with you and jot down a few notes about your mood. This is important. A big part of depression (and plenty of other mental illnesses) is being really bad at tracking time and the permanence of feelings. Tracking how you feel helps you spot red flags more easily. You can't brush off "oh, I've just been having a bad couple of days" when you have evidence in front of you that says no, it's been a bad couple of months, and that's not good.
Journaling is doubly important if you're taking medication for your mental illness. If you're scatterbrained like I am, you can even use your journal to check off if you've taken your medication that day or not. If you find yourself feeling awful again, even if you're currently on medication that you seem to agree with, you can look back at your journal to see if you really are just having a bad day or if you should call your doctor to talk about increasing your dose or switching medication.
On the subject of medication: the meds that work for your friends might not work for you. Early on in my treatment, after I'd stabilized a bit, I wanted to try taking Wellbutrin, as it helped out a lot of my friends and I knew it could potentially help manage some of my autism symptoms as well as depression. My doctor agreed it could be great for me, I tried it out, and it was a fucking nightmare. It made me feel worse than I did before I was hospitalized, and I wasn't sure that was possible. Meanwhile, later on when I tried Concerta, I asked my friends what their experiences had been and the replies seemed overwhelmingly negative. It's worked incredibly for me. Brain chemistry is fucking weird!
Something you'll hear over and over about brain drugs is that "things will get worse before they get better". This can be true - generally, you start to see improvement after 6 to 8 weeks of using a drug. Whenever I've increased my dose of Prozac I've been a jittery, anxious mess for a few weeks before it evens out and I feel better. (More of why journaling is important!) However, if something is getting unbearable for you - like my experience with Wellbutrin - STOP TAKING IT. Don't force yourself to "push through" even worse depression or suicidal thoughts, because the drug probably just isn't working for you if that's how it's making you feel! Call your doctor and make a new appointment and talk about your next course of action. (On this note, stopping a drug completely cold turkey is probably inadvisable as well - this is why calling your doctor is important, because I am a gremlin, not a doctor.)
It can be really fucking disheartening when something doesn't work. Logically, we know it's just because brains are weird and it's not our fault, but at least for me, I felt like a failure whenever a drug didn't work. Like I was too fucked up to fix, you know? But that's not true. It sucks, and it can take way more time than you'd like, but you can find something that works.
Find good doctors. This applies to psychiatrists, therapists, and regular doctors too. It's hard, I know. I still haven't found a good general practitioner. But you'll definitely know a wrong fit when you meet them. You deserve quality care from someone who actually gives at least somewhat of a fuck about you. One of the first therapists I tried seeing literally used "gay" as an insult during our second appointment, and I just left. I met another and thought our first meeting had gone really well, until she called me back and told me she couldn't take me as a patient because I was too depressed for her to properly treat. THAT MADE ME FEEL GREAT, LET ME TELL YOU.
Here's an important thing, though: don't lie to your therapist. Don't even, like, omit truth from your therapist. I started seeing mine in October and it's taken us (and my psychiatrist) until June to realize that the reason my depression wasn't going away was because I don't have depression, I have OCD. It took this damn long because I was too scared to tell my therapist about my intrusive thoughts and obsessions. Because there's "I'm sad about my parents :(" crazy and then there's "I routinely imagine violently injuring myself when I pick up tableware :(" crazy, and I didn't want her to... I don't know, judge me, I guess? Even though HER JOB is to HELP ME. Once you've found a therapist you trust and like seeing, don't hold back. They can handle it, trust me. If you give them a clear picture of the inside of your gorgeous little fucked up head, they can help you more effectively and that's less time spent weeping under your blankets and more time churning out 30,000 word Dragon Age fanfiction.
Psychiatric hospitals are not as scary as every urban horror game ever made wants you to think they are. Are there still bad ones? Yes, absolutely, but this is not the norm. And they're bad because society encourages us to think of mentally ill and developmentally disabled people as subhuman, which impacts the quality of treatment they receive, not because they're rust-covered Silent Hill hellscapes. I was involuntarily hospitalized and it was mostly just awkward. The EMTs who took me to the hospital in an ambulance were friendly and kept cracking jokes to me and sincerely wished me well when they left.
Here's what happened at the hospital, so if it happens to you too you might know what to expect:
- Ambulance ride to hospital, which felt weird and unnecessary considering I wasn't physically injured and yet still had to be strapped to a stretcher.
- Had to change into a huge hideous hospital gown. Immense regret over going commando that day. They showed me to a little private room with a bed and a TV in it and made me wait around for a while. I couldn't have my phone or any of my other belongings, but I could use my phone if I asked the security guard (who was also very friendly). I did this to call my family to let them know what was going on.
- My husband was allowed to stay in the room with me when he got to the hospital - he couldn't have his phone in the room either, but at least he didn't have to wear a gown.
- A nurse came in and asked me a bunch of questions about my physical health. I peed in a cup. Great times had by all.
- After a little while longer of waiting, a nice young lady came in and talked to me with a laptop. She worked for a crisis center, I believe, that partnered with the hospital I was at. She was kind and friendly, and very sincere about wanting to help me out. She asked me about my past, about how I felt, past trauma, blah blah, family history and all that jazz.
- When we were done talking (which took a while), she gave me some options for how to proceed. I could do a two week inpatient stay at a nearby psychiatric hospital, which would have been the absolute fastest way for me to start seeing a psychiatrist and therapist and getting help. I turned this down because I knew being without my husband for two weeks would fuck me up. Another option was that, since she had determined I wasn't a danger to myself or anyone else (and I really wasn't - my GP fucked up by hospitalizing me and this lady told me as much), I could just go home and get an appointment with a psych in about a month. I turned this one down too, because that was way too long to wait. What I ended up doing was a 10 day partial hospitalization program at a psychiatric hospital - I think some other places might call it "intensive outpatient".
- She explained the program to me, told me where to go and what time to be there and what would happen, and gave me her business card. After a little more waiting, I was free to go. I didn't have to stay overnight, but the whole thing did take several hours.
- The partial hospitalization program was also done through a psychiatric hospital. It was basically intense group therapy, every day, from 10 AM to 3 PM, as well as getting you an appointment with a psychiatrist on your first day there. Group therapy sounded like a nightmare to me - I'm autistic and shy and talking to a group of strangers about some really heavy shit just sounded like it was going to make me worse. It was actually wonderful. The people in my groups were supportive, empathetic, and kind - just good-hearted people who needed some help. Listening to other people's experiences and viewpoints can help you look at your own situation differently. This program was also structured, so it wasn't just general chatting all day every day. They taught us a lot - different coping mechanisms, thought stopping, etc etc. I felt like it was a huge help.
- We also did get one on one time with a counselor who checked in with us, but it was mostly group therapy. We had weekends off, but had to be there Monday through Friday. If you were going to be late or couldn't make it that day and you didn't call in advance to let your counselor know, and if your counselor couldn't reach you, they would send police to your house to do a wellness check.
- When my counselor (and I) felt I was stable enough to leave the program, she searched for a therapist she thought would be a good fit for me, and who accepted my insurance. She matched me up with the therapist I've been seeing since October (who I love) and helped so much with that whole process.
- I finished after 10 days and started seeing my therapist that same week. The clinic I go to for therapy also lets you see a psychiatrist in the same building, on the condition that you regularly turn up for your therapy sessions.
And now I'm going to therapy and still trying to find my right dose of brain drugs. Recovery is a long process. It sucks. I'm impatient. I keep feeling like I'm over halfway through the year so I should be better now, dammit! But I am better than I used to be, even if it's hard to look at myself and see it. It takes time. So much time. I have to keep reminding myself that I won't just wake up and emerge from my blanket chrysalis as a fully functioning human with a brain that isn't a lying asshole. Feeling bad about not feeling better helps no one. You'll get there when you get there!
It'll be worth it in the end. I'm glad you're still around to read this.