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13th December 2014

My time in a psychiatric hospital

Eilís Hall describes her time in a psychiatric hospital due to an eating disorder and how it impacted her life.

You tell yourself that routines are healthy. They keep you on the straight and narrow. They tell you how to get through each day. A daily routine can be incredibly useful for the average student, particularly if you struggle to motivate yourself into sitting down and doing your coursework. You might have your daily routine figured out in a way that is completely functional and if you do, I salute you. I have had many different routines since I started university but here was my second year routine:

7am: Wake up. Lie in bed and avoid getting up for as long as possible.
Between 10pm and 2pm: Do all of the washing up in the kitchen. No matter how much there is.
Next: Work out. 200 jumping jacks. 100 leg-ups. 100 – 200 sit-ups.
Next: Shower.
Next: Roll a cigarette, make a cup of herbal tea, eat a banana. Smoke cigarette. Drink tea. Wash mug.
Next: Find anything possible to do to get you through the day without having anything to eat. Aim to find a reason to walk for at least half an hour. Throw yourself into all of your university work and tell yourself you aren’t allowed anything you enjoy until you have read x amount of pages or written x amount of words of the essay that is due in three weeks time.
Between 6pm and 8pm: Do any washing up that has accumulated throughout the day. Find the smallest bowl and a comfortably small teaspoon. Roll a cigarette. Prepare half a tin of soup and a mug of herbal tea. Prepare a slice of toast, provided the bread is below 100 calories. Eat soup, wash up immediately. Smoke cigarette. Drink tea.
Next: Throw myself into university work or reading until it is an appropriate time to drink alcohol.
Around 2am or 3am: Crawl into bed. Probably don’t get to sleep for another two hours or so.

Now maybe this routine would be okay for the average student for one or two days. Here’s the thing: I wasn’t the average student, I did this every day. In bed, I calculated every calorie for the whole week. If I was drinking on a particular night, I would have to have a lower calorie soup. If I wasn’t, I could ‘treat myself’ so long as the soup was still below 200 calories. My ‘workout’ routine was painful but I had to do it because in my head, if I missed one day then this would destroy everything. The only thing that seemed to change was how much activity I did in the day. Sometimes I had work and on those days it was often even worse. I was a tutor for kids in the area and I had to go to different houses for each session, often in the hours that I considered ‘dinner time’—and if I missed ‘dinner time’ I missed dinner. On a few occasions my clients would comment on me looking tired or pale—but none of them knew how ill I really was.

My housemates knew what I was doing, and my family would ask me about my eating habits every day. One night, my friend was lying in bed beside me and she burst into tears. When I asked her why, all she said was, “I don’t want you to die.” I told her neither did I, but in reality, every time I ran or climbed the stairs, it felt like my legs were going to collapse beneath me. Yet somehow it still took me nearly the whole year and two different counsellors before I finally said it: “I think I need to get some real help.”

Admitting I had a problem wasn’t the issue. No, I knew I had a problem. I suppose it becomes a ‘laugh-or-cry’ situation when you realise that you’ve spent half an hour sitting at your kitchen table trying to work out whether or not to eat a satsuma before your blood test and a banana after or whether to just wait until later so that you don’t have to have the extra fruit. My ‘issue’ was that I felt like going into hospital meant that I was giving up a part of me or throwing it all away. That and, I felt like everyone would forget me and when I came back, I would have no one. I felt like my illness was my identity and that when I lost it no one would find me ‘interesting’ or care about me. Now it seems ridiculous that I somehow believed that my closest friends preferred the girl who would literally flap her arms about squealing if unable to find a clean teaspoon at teatime to the functional human being they had met in first year.

Cut to me, an in-patient.

Deciding to go into hospital is probably the most important and mature step I have ever taken, but this does not mean I immediately became a well-adjusted functioning adult. The next step was getting me to agree to anxiety medication, which was an interesting battle. When I was feeling more ‘sane’ my argument was “well clearly I’m managing my anxiety very well on my own.” When I wasn’t, my argument was “I REFUSE TO BE A LAB RAT IN YOUR CAGE, I WILL FEEL MY FEELINGS.” The clincher for me was the day I had an argument with the nurse who was serving our food at the hospital on the grounds that I was certain that parsnips were not a vegetable. Often people will refuse medication on the simple basis of pride—myself included. A lot of people refuse to even acknowledge that they have a problem because they are so determined to simply be stronger.

The day after the parsnip melodrama, I had a cigarette with one of the nurses and explained to her my fears; I wanted to feel in control. It was through talking to this nurse—and a few others—that I realised that this need for control was controlling me. I’d spent the past two years obsessively trying to keep my life structured and it had been exhausting. Maybe trusting them was frightening, but in the environment I was in I had no choice but to trust them. So I started to try to alter the way I saw things. Thinking “I can’t control this” had been sending my anxiety sky high and re-affirming my determination to reject the anxiety medication which, at that point, I needed. They could take control of my physical health but I’d be damned if they were going to take away the crippling sense of dread that made me wake up at 5am and smoke three cigarettes in a row. However, changing the emphasis of that statement seemed to change the way the whole world looked: “I can’t control this” also meant “I don’t have to control this.” I didn’t have to obsessively calculate everything I consumed and time my walks and obsess over the order in which I would make my dinner and do the washing up and which spoon I would use. They were doing this for me, until it became less exhausting. They were giving the overheating system that drove my actions a break. And they knew what they were doing. Suddenly that didn’t seem so scary at all; it seemed liberating.

In the hospital I met a large variety of people and regardless of whether we were friends or enemies—and I won’t say there were no enemies—I am glad I met every single one of them. One girl is now one of my best friends and I expect will remain so. This is not just because we had our illness in common. Nor is it because we were able to understand the frustration caused by the dietician telling us that we were not allowed to put mayonnaise on fish fingers because this is apparently not ‘normal’ (though this is still a sore spot for us both). The reason we are friends is because we can both identify greatly with the characters in The IT Crowd, and because we have both fantasized about what house we would be placed in at Hogwarts. We both read about two to three books a week and can probably quote the film ‘Frozen’ word for word. She introduced me to Terry Pratchett and I introduced her to Margaret Atwood. We might have mental illness as a part of us, but we also have our own identities and I feel like a lot of people forget that about people in hospital. Maybe it’s because they think that nothing in their life can be separated from the disorder or maybe they want to glamourise it (because what they really want is a young hot mess for a friend to fantasise about saving), but ultimately they see the illness and not the person. But the people I met in hospital were more than that.

There was an Italian woman in the hospital with me, who was a doctor in anthropology; she seemed to have more artistic talent in her little finger than I have in my entire body. In the time I knew her, she had made a T-shirt, designed several tins for her boyfriend’s antique shop, made two eccentric but glorious hats and designed a poster for an event that was being held in aid of Alzheimer’s disease. On one or two occasions she returned to the hospital from her time out drunk, with a lengthy description of her sexual exploits to relate back to us—she wasn’t perfect. But it was this woman who brought me out of my post-admission slump. I was sat in the corridor upstairs because being alone in ‘my’ room still frightened me. Outside of that room, I still felt isolated but at least I was less afraid. The radio was permanently on and usually it was some kind of cheesy ‘smooth’ programme which played predominantly 80s songs, which I sometimes felt forced to love, but usually wanted to smash the radio repeatedly with a mallet. But this time, when she came out into the corridor and asked if anyone would get up and dance with her, I think I surprised myself when I actually said ‘yes’. I love dancing, no matter how terrible I am at it. When you’re drunk on a night out it’s easy to drop your embarrassment and just make an idiot of yourself. Having the guts to do this sober and with a person I didn’t know was a different issue—but it was one of the first things that really made me feel like myself. And the thing is, in the early days it’s little things like that which will keep you from really going crazy.

I won’t describe hospital as a ‘fun’ place, but you find amusement where you can. Eventually, I think I almost loved the irritating things because they brought us together. It could feel like being a group of naughty children in a boarding school. We mastered the art of dealing out chewing gum like it was a Class A drug and sneaking into each other’s rooms. We learnt the thrill of daring to get a caffeinated drink when we were on our access hours. Fine, breaking the rules isn’t the main point of a hospital admission but I guess it’s the things that make you smile that count. Maybe you find yourself behaving like a child sometimes but in an environment where you have to ask permission to go for a walk and have someone coming into your room every half an hour to ask if you’re okay, it’s not really a wonder that you revert to some old habits. I found the nights the most irritating. I still remember, with gritted teeth, the time an agency nurse came into my room at 2am and stared at me for 10 seconds before stating, “you’re not asleep.” Oh, how impressed I was with his exceptional observation skills! The more experienced staff members would begin encouraging you to actually go to sleep. “We have to encourage good sleep-hygiene.” I understood that my sleeping pattern maybe wasn’t ‘normal’, but having been a student, the concept of going to bed before midnight (sober!) and being woken up at 8am was pretty alien. Now I find myself feeling pretty lame when I am absolutely shattered by 10pm and a ‘lie-in’ for me is if I wake up at 9:30 in the morning. Why thank you, NHS, I am officially my grandmother.

What I came to realise is that all these ‘irritants’ were actually preparing me to face normal life. I may not like getting up early in the morning, but at least I can say I’m able to do this. The first time I was allowed out for the weekend, my mind was blown by my ability to actually go into town with my friends during the day. I found myself dragging my friends through the town with ridiculous enthusiasm; everything from the market stalls (which were the same every Saturday) to the Mormons that stop you on Oxford Road was novel. Every single person that passed me on the street was beautiful. And even better, I went out to get food and genuinely enjoyed food again. Every argument I’d ever had with a nurse or the dietician suddenly seemed practically insane. All I wanted to do was throw my arms around all of them. Am I saying I never freaked out? Of course not. The difference is, I was able to say to myself what I had never said before. If I avoided the situations that scared me, I might find it easier but I also knew exactly how it would go. If I faced the unknown, maybe I would panic, but what if I was missing something I would have otherwise enjoyed? Was that really living? Did I want to look back on my sister’s wedding and think: “I went home early and missed it all but at least I was safe at home with my book and a cup of herbal tea,” or “I freaked out for a bit but then I picked myself up, drank a few ciders and got to see my dad attempt his signature Footloose jump”? Guess what; I decided on the second option and had one of the best nights of my life.

The week of my discharge, one of the nurses—the nurse who took me for my first meal at a restaurant since the illness had taken hold—asked me how I felt. My answer was, “I feel like I’m in a different world,” and she smiled and said to me: “You are. You’re in a better world.” For all the jokes and complaints I might make about the rules and the structure of hospital life, and in spite of the fact I literally wrote on my menu that I was having ‘FREEDOM’ for tea on the day I left, it was emotional leaving. I will never thank the staff enough for the support they gave me and the things I learnt with their help. I’m not saying everyone was peachy-keen or anything, but the people that were, well, they were something special. It is one thing to do your job as a nurse, but it is another thing to see the patients as people as well. It’s something that even people who don’t work in a hospital struggle with and it’s something I needed. There were nurses at the hospital who I hope I will see again one day—on different terms—because they weren’t just staff members to us, they were interesting and caring men and women who went above and beyond in their careers. I even had my thank-yous to give the ‘dreaded dietician’ the day I left; though I did attach a note to her gift explaining my continued disgust at her discrimination against mayonnaise.

The fact is, mental illness will never be something that everyone can fully understand. You take the good with the bad. I have friends who talk to me as the girl I used to be and once again am. I have friends who tell me I’ve got my ‘spark’ back and we dance to our old favourite songs and fall back into that old easy conversation. I also have relatives who say things like, “how are you doing? No, I mean, how are you really doing?” Before I left the hospital I made jokes about the comments I was scared of. Okay, £50 on the first relative to say “you look well,” any takers? But you know what? When someone did say “You look well,” it didn’t hurt the way I thought it would. They told me I look well, because I do. It doesn’t mean I’ve gained so much weight I’m a whale. It means the colour is back in my cheeks and my hair isn’t dry and straggly. It means my eyes are no longer sunken in with big black bags beneath them. It means that I’m not vanilla, I’m not the girl to whom my housemate once said: you never laugh, you just sort of shrug—it is no longer true. Because that was my illness—not me.

So here’s the most important thing that I learnt from my admission to the ED unit: mental illness is not a weakness. I realise now that more people than I could have ever imagined in my life struggle with some form of mental illness. The difference between ‘strong’ and ‘weak’ is nothing to do with what your brain is doing or how often you have those days when you just don’t want to get out of bed. Moreover, recovery does not mean that you wake up one day without any problems. I realised that recovery is about being able to cope with your issues in a practical way, as opposed to crying because there are too many dishes on the drying rack and you’ve just washed the Pyrex jug and have nowhere to put it.

I wanted to write this article but until I began writing, I wasn’t sure why I wanted to write it. Now I think I know what I’m trying to say, and it’s dedicated not just to people with eating disorders or even people with ‘severe’ mental illness. This message is to everyone who has ever felt afraid of what’s inside them whether it is big or small. This is for anyone who has ever found themselves clinging to the negative feelings because they feel like they don’t know where they would be without them. Here’s something I wrote for a friend while I was an in-patient:

You are not your illness. You are not the sadness that keeps you up at night. You are not your eating habits. You are not the panic that hits you before an exam or a job interview. Your headaches and stomach cramps: they are not your identity. You are every quirk that the people around you adore you for. You are the songs you sing in the shower. You are your favourite books and the quotes you remember. You are the things that make you passionate or excited, the face you make when they give you good news. You are the look your lover gives you, the jewellery you refuse to take off, the mismatched clothes you somehow pull off. Your demons try to take away from that but they are not you. Don’t let them take away from that. They are smoke and mirrors and you are magic.

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