I’m Fine – The Reasons I Resisted Inpatient Treatment
When I was diagnosed with depression and anxiety, I was in therapy and prescribed medication. I felt like it was my fault. But I was terrified of my suicidal thoughts and self harm, so I mechanically took my medication every night. As my symptoms grew and changed, my medications did as well. By the time I was diagnosed with schizophrenia, I was already on an antipsychotic and a mood stabilizer. I wasn’t sure if they would solve all my problems, but the mechanical motion continued, as did my heavy steps to the therapist’s door. Had I experienced hallucinations prior to starting this regimen, I don’t know if I would have been as willing because, in my head, schizophrenia was a death sentence with or without medication. The stereotype I knew didn’t allow room for success in recovery. I told myself I was fine.
So as I faced this theoretical death sentence, the pills continued their robotic journey from case to mouth. And I sat on the couch, staring at my therapist and talking about nothing. But that was where I drew the line. I turned my nose up to every other offer – hospitalization, independent study, and a gap year before college without a second thought. Here are the reasons why.
Denial
When the word “schizophrenia” hit the air in my psychiatrist’s office, the back of my mind piped up with a powerful, “no.” This could not happen to me. I had a great future ahead of me and nothing would change this. I told myself it wasn’t real. It was me being overdramatic. I’m fine. If I ignore it, it will all blow over.
In this case, there was no reason to agree to hospitalization or independent study. No thank you, I don’t need those. I’m fine. This will go away. It’s really not a big deal. No need to tell anyone or take any measures further than the medication and therapy I was already utilizing. Those would solve my problems and then I won’t need them anymore and things can go back to normal.
Disbelief
While I understood what the psychiatrist said, I didn’t see how this diagnosis could be correct. I had functioned so highly my entire life that the idea of that being plucked from my hands so swiftly and effortlessly just didn’t seem possible. Me? Schizophrenia? How? How does someone go from normal life to struggling like that? It couldn’t be possible. I was smart, social, and successful. These symptoms can’t just creep in and steal that. That can’t be how it works. I wasn’t going to any hospital. I didn’t need to. I’m fine. This just was not possible. Schizophrenia is something that happens to other people, not me, not in my life.
The concept was far too slippery to grasp. It defied everything I thought I knew about schizophrenia. I just didn’t see how someone could go from top of the world to crashing through the floor in what felt like the blink of an eye. I would continue with medication and therapy because I believed they could help my anxiety and depression. But I didn’t see how a hospital would benefit me, when, as much as I hate to admit that I thought this, I was not the kind of person I believed would go there. I was fine; there was no way this was really happening.
Appearances
Schizophrenia spectrum disorders often come with a heavy blanket of shame. I didn’t want anyone to know that there was something “wrong” with me. To avoid others finding out, I couldn’t go to a hospital or go on independent study because people would ask questions, or worse, theorize behind my back. What if they figured it out? What then? At the time, that almost seemed worse than schizophrenia itself. I told myself I was totally fine.
I was more afraid of being ostracized than of being severely mentally ill. It never occurred to me that I might be outed to others by worsening symptoms if I didn’t take my treatment seriously and utilize all options. All I could think about was what people would think when my desk was empty for weeks and what they would whisper to each other when I returned to school without an explanation. So the answer was no. I would take my medication and continue therapy because those were largely invisible to others. But, outside of that I would do whatever it took to make things look like nothing was wrong at all.
But my symptoms didn’t care about the denial, disbelief, or my image.
I never took time off for treatment, and I felt the impact of that. Though the medication did help stabilize me, it took much longer than it might have had I dedicated time to treatment. And while I wrestled with my symptoms, everything else began to unravel and it became clear to others that something was off.
My academic prowess fizzled like a firework in the rain and my classmates watched me quietly shift from sitting at my desk in calculus to sitting on the couch where I scored tests as the teacher’s assistant without a word. Socially, I acted differently. I was nervous, awkward, extremely sensitive, and couldn’t always follow a conversation without being distracted by a symptom or a fear. Nervous laughter became my sidekick. But above all else, I was not fine, I was lost. Looking back, I wonder if going to a hospital or intensive outpatient program would have helped me learn to understand and accept my illness faster than the snails pace in which I actually did.
Had someone tried to confront me about my refusal to accept hospitalization or other similar treatment options, I don’t know if it would have gone well.
I do know that I am lucky that I was given the decision at all. In many cases, treatment such as hospitalization is a necessity to be secured as quickly as possible. But when it comes to talking about the realities of schizophrenia spectrum disorders, I think what helped me accept it the most was learning about it. My family bought a couple books, but I also began to comb the internet for more information and read memoirs from those with schizophrenia like The Center Cannot Hold by Elyn Saks.
The closest thing to a cure for my denial, disbelief, and fixation on appearances was learning.
I learned that the picture in my head of what schizophrenia is was largely wrong. I learned how to identify and understand my symptoms, which helped me cope with them better. And I learned that, though my life would likely be fraught with challenges, it was not over and I might be capable of far more than I initially believed. Knowing schizophrenia was not a death sentence made me want to take my treatment more seriously so I could explore the space between what I thought was possible and what truly was possible. Though others may refuse treatment for other reasons, including anosognosia, a condition where, unlike denial, someone truly believes they are not ill, understanding your or your loved one’s illness really can have a significant impact on recovery.
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