In April of 2014, I spent roughly two weeks in the psych ward of the University of North Carolina Hospital due to a psychotic episode. I have trouble typing those words because six months later, it seems almost like something that happened to somebody else. But no, I have to somehow integrate this fact into my now relatively normal life: for a while there I went crazy, and I had to be involuntarily committed into a mental hospital.
My slide into psychosis was sudden, with only a week of warning signs prior to the main event. I checked myself into the hospital on a Sunday; on the previous Thursday, I went to a party where we all got stoned, and I got far higher than I meant to. It kicked my anxiety into overdrive, to the extent that I couldn’t put words together and thought that everyone else at the party was constantly judging me. I got home and Googled “obsessive compulsive disorder for dummies” and read a synopsis of OCD thought patterns over and over again until I could finally sleep — my thoughts were so strange and foreign to me that I needed an explanation for what my brain was doing, and OCD was the diagnosis I found in my stoned state. I was wrong, but I clung to this idea later in the hospital, certain that OCD was part of what was wrong with me.
That weekend, I kept getting into conversations with friends that they found hard to follow, because I was talking in circles. The anxiety energized me but made it hard to do any one thing: on Saturday I went to the gym, took my car into the shop, went shopping, and went to a movie — a movie that I could barely concentrate on because my brain was thrumming with anxious energy. I still thought I was fine, just dealing with the aftereffects of a bad drug trip and a skipped antidepressant, until Saturday night, when something I read on the internet triggered a sudden conviction that one of my oldest online friends was actually a stalker who had hacked into my OkCupid account.
I could recognize that this was a delusion, but that didn’t make it seem any less real. I went to a friend in tears and unable to sleep, and she suggested that I spend the night on her couch and then go to the emergency room in the morning to speak to the on-call psychiatrist. This sounded like a good idea to me — I knew that I needed to see someone, and I guess it didn't occur to me that they would try to keep me there. I still pictured myself going to work on Monday.
A term that I learned months later to explain my delusions is "ideas of reference”. Ideas of reference are a symptom of psychosis, and they occur when you interpret outside events as having strong personal significance--i.e., you think the TV is talking to you. My ideas of reference manifested in a number of ways, but in particular the second I walked into the emergency room I thought that the entire psychiatric wing was somehow faked, a theatric event put on for my benefit. I thought that all the doctors, nurses, and other patients were hired actors that were only there for my sake, because I needed to be taught some kind of lesson.
I was also receiving fraught personal communication from each magazine in the hospital. I have very a very vivid memory of the first magazine that spoke to me: it was an issue of Allure. I thought that the issue had been published by my friends and family. I interpreted each article as a secret message from my friends to me, detailing all the ways I wasn’t good enough, all the ways I’d let everyone down. I’m not sure how my brain pulled off this trick: how did I take articles about shampoo and conditioner and the latest spring fashions, and warp them so that they conveyed messages from my friends about how much they hated me? Was I just making extreme cognitive leaps, or was I actually hallucinating words that weren’t on the page? I still don’t know, but at the time there was absolutely no doubt in my mind that the things I was reading about myself were concrete, real, and damning. The articles confirmed every single negative thing I’d ever thought about myself.
The way you can recall some dreams in detailed images, but couldn’t possibly describe them in words: that’s how that Allure issue is for me now. The exact phrases that I read are gone, but the meanings they gave me are left behind, and they still feel real to me even though I know they’re not.
After the Allure magazine, my ideas of reference expanded to include everything else I read or watched. Every magazine spoke to me. Every commercial on the TV was somehow a missive for my ears only. I was both desperate for these messages, thinking that they conveyed important information that I had to remember, and terrified of them. Because I was getting this feedback from everything I looked at, there was no possibility of escaping my troubled mind by watching a movie or reading a book. Even interacting with the other patients offered no respite, since of course they were all actors hired just to mess with me.
When I found out that I was being kept involuntarily, that I couldn’t just leave, I was outraged and absolutely determined to get back to my life. I thought that my family and friends had conspired to trap me in the hospital, again to teach me some kind of lesson, and that getting out would be some sort of game I had to play. It didn't occur to me that the only way out was to focus on healing myself and get saner. I thought I had to make a daring escape.
I kept trying to get out. I had to be physically restrained at two separate points because I was trying to make a run for it. One of these attempts involved me trying to rip a fire extinguisher off of the wall. I don’t know what I was going to with it once it was off the wall or why I thought that that would help me escape, but in my sheltered life it was one of the most violent things I’d ever done.
Getting out was the only thing my obsessive brain could focus on. I got into the habit of walking to each of the doors that led into the greater hospital and testing the locks. Because of my multiple escape attempts, the nursing staff declared that I was to be kept “On Sight”, meaning that a nurse had to keep eyes on me at all times, even when I was sleeping. Each time my family and friends visited me, I hoped that they were there to spring me out, and it was all I could talk to them about.
About halfway through my hospital stay, something shifted — I’m not sure if it was the meds finally starting to kick in or if I just adapted to my environment, but escape started to feel less urgent and I became more compliant. I stopped telling my doctors that I suspected them of drugging the food and that the magazines were talking to me, even though I still believed that they were. Visits from my father (who had flown in from Salt Lake City, Utah) and friends helped tether me to the real world outside of the circus that was my brain interacting with the hospital environment.
I adjusted to hospital life, but it was always painful. Being trapped inside for so long made me romanticize life outside: I wrote poems about how good it would feel to drive again, and how much I missed the sun. I felt like being stuck inside was warping me. I would see things when I looked out the window — the treeline in the distance looked like the ocean to me.
As wretchedly relieved as I was to get out, I can see now that the biggest problem with my hospital stay was that it ended too early. I was still delusional when I left, but I thought that the world had gone crazy, not me. I was noticing patterns everywhere, and each pattern somehow related to me and my condition. My poor father was staying with me for the days right after the hospital, to help me transition back into my life, and he had to deal with my constant ideas of reference. Once I yelled at him because I was convinced that he had sent out a fleet of cars to follow me when I went for a walk.
The worst part about my delusional state was the way it affected my social interactions. One-on-one conversations were mostly okay — I could take those at face value. But when I was in a group, it was awful. I couldn’t be around two or more people talking without becoming convinced that they were somehow talking about me; that the subtext of their conversation was all about how much I sucked. This extended to the internet as well: I examined every tweet on my Twitter feed for innuendo about myself and my situation.
Interpreting conversations this way meant that I burst into tears a lot and no one around me could figure out why. I started crying in my cubicle at work more than once because of completely innocuous conversations my co-workers were having. The most humiliating of these crying jags happened in the middle of my good friend’s bachelorette party: we were all at a bowling alley, and I was anxious and miserable because I thought they were all talking about me. I started crying in the middle of bowling, managed to collect myself, then started crying even harder as we left to go to dinner. My friend asked me what was wrong, and I had no idea what to tell her.
These delusions lasted for most of the month of May. They came to a gradual stop; it became easier and easier to take events around me at face value without seeing unreal subtext in everything. But I still thought that the messages I’d read in the magazines at the hospital were real. I clung to the idea that the magazines had been telling me the truth, because the alternative was that I’d been crazier than I’d realized.
I got my my hair cut in June. While I was waiting for my turn, I read a different Allure magazine. It was a surreal experience because I could see now how ordinary the magazine was; I was reading the same kind of articles that just two months previously had convinced me that my friends had conspired to lock me away in a hospital, only now I could tell that the articles were just about makeup and fashion trends.
I tearfully called up my father after that, and asked him if there had ever been any kind of conspiracy between him and my friends, the way I’d thought there was. He gently explained that no, there had never been any conspiracy, and even though he’d told me this countless times before, finally I was able to believe him.
That phone call ended my belief that the secret messages had been real. Suddenly it felt like I was standing on the opposite side of a ravine from my crazy self. Once the delusions went away, it became impossible to imagine the mindset that had produced them.
I still can’t pinpoint what led me into the hospital, but I know I’m doing the right things to keep myself from going back. In the hospital, I’d thought that I had to make an escape by some daring, fire-extinguisher-weaponry means, but in fact this is what it takes to escape mental torture: I take my medication, I see my therapist, I keep my support network close. I do a really good impression of someone who’s never been psychotic, faking it until I make it.
I am making my escape gradually, crawling out of the wartime trench — where all the enemy shooters were figments I’d made up — that my breakdown left me in. Most people who meet me now would never imagine that I ever had to be restrained by hospital guards, or that I used to think the TV was speaking to me. Recovery happens so much slower than disaster, but I’m getting there.