Ironically, it was nursing school that made me realize that my symptoms of self-perceived madness weren’t just eccentricities. I’m sure we all were self diagnosed hypochondriacs but the shoes actually fit and it clicked that I was the symptoms and cluster of behaviors that I’d wondered about in my high school psychology class. What kind of teenager thinks to themselves, “If I had any sort of mental illness, it would probably be bipolar disorder?” I’d never done much in depth exploring of mental illness prior to being plunged head-first into it while taking my psychiatric nursing class in undergrad.
Hell, I minored in psychology and had even taken abnormal psychology, but it was learning the nursing interventions that made everything come full circle in my head. It was the group projects about coping skills that had me thinking that perhaps I had more in common with people with psychiatric illness that not. It was only when I started questioning whether I was just overthinking things and began to apply my classwork to my mundane life, like coping skills and . It turned on a switch that triggered me to seek wellness and health and to organize the clutter inside my head.
Despite the fact that my mother and I saw a therapist while I was in high school for what she remembered as six sessions and I remember as two, I was constantly told that I was just “moody” and (my favorite) “just a teenager”. Somehow, my early symptoms of hypersexuality, irritability and impulsivity were me “acting out” or “attention seeking”. That didn’t stop my mom from calling my after-school job, picking me up in the middle of my shift with silence, and then her and my father threatening to ground me and take away all of my privileges and electronic devices because I was writing sexually explicit notes with a freshman although I was a senior getting ready to graduate and was in a relationship. I spent way too much of my french class thinking of getting into people’s pants rather than realizing the similarities between the Spanish I’d already learned and the French that was placed in front of me. That night, I threatened to walk out with none of my possessions and never come back, and I was serious. I screamed louder than I ever had in my life and though my mother threatened to drive me an hour and a half away to the only psychiatric hospital in the state that she knew of, she had no idea of what to really do with me. I spent the night at my grandmother’s house, swearing to never talk to my parents again.
There were other warning signs, like the deep pits of despair that caused me to stop “applying” myself in my classes, nearly failing AP English Lit and Biology, even though I ended up acing both of those exams at the end of the school year. There was my very first panic attack, during my timed AP biology exam where I felt like I couldn’t breathe and that I was going to implode if I couldn’t get out of the room. There were my nights of staying up until 0200 and getting up at 0600 without any problems OR caffeine. There were the notebooks full of exceptionally morbid poetry.
I’m not even going to go into more depth about my dysfunctional relationship with my family because although it certainly doesn’t make my diagnosis of mental illness any easier, it’s *MY* problem to live with. Whenever clinicians ask me about my family history of mental illness, I always have to clarify, “You mean are there *symptoms* of mental illness, right? Nobody gets diagnosed in my family.”
I spent most of my spare time at the beginning of the Fall semester reading my psych nursing textbook cover to cover, devouring everything I could about bipolar disorder, GAD, anxiety disorders and it wasn’t enough. I had quickly conceptualized what was wrong with me, but it wasn’t until I found myself sitting on the floor of my apartment after having run out to the grocery store at 0300 to buy glitter glue, die cut letters, stickers and colored paper to embellish my teaching plan for my the next day, where presentation was only worth 5% of my grade for the assignment that it actually clicked that I was likely driving everyone else around me absolutely insane and that I might be having a hypomanic episode. I was working 2-3 on campus jobs in addition to my classes and that still wasn’t enough for me to keep the bills paid and afford everything that I thought I just *NEEDED*.
I promptly scheduled an appointment with the counseling center on campus to see a therapist and then the school psychiatrist shortly after. I don’t much remember the counselor that I saw at the time, but I do remember the psychiatrist and the first few words he said to me. “I’m no better than you are. I have the prescription pad and you don’t, but you know what’s going on in between your ears better than I do.” He started me on Klonopin after our first appointment and then he started Lamictal shortly afterwards.
It’s been a whirlwind of ups and downs, back and forth, and side to side ever since. I’ve scared a therapist, who had no idea how to get me to the hospital after a session in which I told her that I just couldn’t handle things anymore. (Gee, why didn’t she just call 911?) She actually let me drive home to pack some things for the hospital, on the promise that I’d keep her posted.
It’s been almost 5 months since my last medication overhaul and although things are still shaky in my world, I feel more grounded than I ever have. I pull out all of my prescription bottles at the beginning of the week and fill two medication calendars, one for my AM/PM meds, and one for my afternoon meds. I know I’ll probably never be able to work straight night shifts ever again. I know that I need to work harder at setting limits with patients than any of my colleagues will ever have to do. I know that I need to check and double check things and then still spot check because I end up letting myself get over-confident.
It will always sting when I hear a co-worker say, “Oh that patient is just attention seeking.” (Maybe if you pay attention to what they’re doing or saying, rather than how that makes you feel, you’ll remember that they’re in the hospital for a reason.) I’ll bite my tongue when I get told, “That patient needs PRNs around the clock because they’re out of control.” (Is there something that’s triggering them that we should be more mindful of? Are we doing our best to notice warning signs and address them *before* the patient gets out of control?)
They say “It takes one to know one,” and I think that’s a pretty accurate statement. I’m not saying that you need to have mental illness to work with patients suffering from mental illness, but a.) it helps and b.) we all have our issues and lie somewhere on the mental health/illness spectrum. It helps to acknowledge that we’re human and mental illness is the most pervasive illness among those 18-25. Take a look around and recognize that it’s not a death sentence but it can become one if it’s ignored or not treated.
After all, we’re all a little bit mad, right?