In part two of this series, we go into more detail about Gabe’s inpatient hospital stay and focus on what he was thinking while he was hospitalized and what he learned after he was discharged. We talked about what to do if you feel like you need to be hospitalized, the steps you need to take in order to be admitted and the obstacles involved with getting the help you may need.
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About The Not Crazy Podcast Hosts
Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.
Jackie Zimmerman has been in the patient advocacy game for over a decade and has established herself as an authority on chronic illness, patient-centric healthcare, and patient community building. She lives with multiple sclerosis, ulcerative colitis, and depression.
You can find her online at JackieZimmerman.co, Twitter, Facebook, and LinkedIn.
Computer Generated Transcript for ‘Psychiatric Ward’ Episode
Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: You’re listening to Not Crazy, a Psych Central podcast. And here are your hosts, Jackie Zimmerman and Gabe Howard.
Jackie: Hello and welcome to Not Crazy. I’m here with my co-host Gabe, who lives with bipolar and was also the subject of an interview last week on this podcast about what it’s like in an inpatient hospital.
Gabe: And I’m here with my co-host, Jackie, who asked me so many questions about what it was like to be inpatient that we had to break it up into two parts. Like how I blamed you when it was my overtalking that really caused this problem?
Jackie: Last week, we talked about Gabe’s experience and this week we’re going to continue with part two right now.
Gabe: But hey, if you missed part one, you can listen. Out of order, we honestly don’t mind. Here we go.
Jackie: Were you in some kind of? Did you talk to someone when you were inpatient? Is there group therapy? Is there one on one therapy? Is your therapist, John Stamos? Like it was in something I watched recently?
Gabe: I do not recall any of my medical practitioners being exceptionally beautiful, male or female. You know, scrubs, they don’t look sexy. My doctor was nice. I was in a learning hospital. So my doctor had like seven new doctors in tow.
Jackie: Ugh.
Gabe: That’s just the way that it was, though. I did have group therapy.
Jackie: How long was it?
Gabe: Group therapy was an hour to an hour and a half. I’m having a little trouble remembering and the way that it worked in the hospital that I was in is that there was one that was required and then there was like optional ones throughout the day, depending on where you were. The one that was required is the only one that I ever went to, just in full disclosure. And it worked pretty much exactly how you would expect group therapy to work. It was led by a therapist. So it was medical person led, not peer led or or like AA, where it’s you know, the group manages itself. It was led by a medical person, a therapist in this case. And there were rules and everybody talked and shared. And we all bounced off each other and we weren’t allowed to give advice. And the therapist would help steer us along and we would hear from other people and we would share. And then group is over.
Jackie: How were you grouped?
Gabe: I honestly don’t know. I can tell you that there was men and women, there was young and old. We all were there for seemingly different reasons. I remember when I was there, I was the only person that said I was just diagnosed with bipolar. A couple of people said depression, but a lot of people were kind of standoffish. They didn’t want to share it all.
Jackie: Were you mad to be there or upset? If you weren’t really engaging, let’s say, were you sort of like, I don’t want to be here? I don’t need to be here, this is stupid?
Gabe: I never thought it was stupid. I thought it was so incredibly confusing. It was it. It’s unlike anything that I can explain.
Jackie: Were you still feeling like this is how I feel all the time, why am I here? Was that feeling still kind of resonating?
Gabe: When I was first diagnosed with bipolar disorder, the first thing that I thought was, oh, my God, I have to move to a group home. I have to liquidate my assets and I’m going to be institutionalized for the rest of my life. The second thing that I thought is thank God they caught this before I hurt my family. I really associated mental illness and violence very much hand-in-hand. The third thing that I thought is I’m doomed. I’m just doomed. I didn’t know anybody who is diagnosed with bipolar who is doing anything well. And in fact, I only knew one person with bipolar at all. And that was Kurt Cobain, the lead singer of Nirvana, a man who died by suicide. And this is this is a wealthy man. This is a once in a lifetime musical talent. This is his number one singles. Yeah. You know, this isn’t the average person. And the dude was rich and he couldn’t beat bipolar disorder. I’m some slut from Ohio. I’m not rich, my family’s not rich. Frankly, we’re all kind of a bunch of dumb asses. We didn’t even realize anything was wrong. But yeah, we can beat this. You know this dude with millions of dollars, he can’t beat it, but we’ll be fine. So I thought that I was gonna be institutionalized. I thought that I was going to die. And I thought that it was a good thing I didn’t murder my family. These were my first 24 hours.
Jackie: So when you’re in the group therapy and you’re meeting with John Stamos and you’re talking about why you’re there. Are you still thinking that? Are you still thinking those same thoughts or are you still thinking that that thought that you had when your friend brought you there and you really why am I here? This is what I think all the time.
Gabe: The very first group therapy that I ever went to in the interest of honesty and full disclosure, I actually there was a lot of women in the group and I actually thought, wow, these women complain a lot. That’s honestly what I thought. I thought, wow, all of these women are complaining constantly. This is nonsense. The men were all quiet. There weren’t that many of us. And all of the men sat stoic and quiet. All of the women cried a lot. And I just thought, wow, this is just this. I hadn’t been diagnosed with bipolar disorder yet, though. The next day I get there and suddenly I just have a million questions about mental illness because what the hell?
Jackie: Were you diagnosed there?
Gabe: I was diagnosed in the psychiatric hospital.
Jackie: Ok, so that that makes a lot of sense then.
Gabe: Yeah. Yeah. The day before I went to the emergency room that led to my inpatient psychiatric hospitalization, I thought that I was fine. Not that I was normal. I thought that I was beyond normal. I thought that I was exceptional. Aw, shit. That’s kind of the deal with bipolar disorder, right? You’re either God or your garbage or you’re just in between. Right. This is the kind of messed up part about bipolar disorder. It really is this whiplash effect. I sort of refer to it as an intermittent illness. Sometimes you’re symptomatic, sometimes you’re not, and sometimes you’re symptomatic this way and sometimes you’re symptomatic that way. And they’re polar opposites, hence the name. And a lot of this did go into how I reacted to inpatient hospitalization, right? I went in there on suicide watch. By the time I left, I was stable. I kind of want to focus on that. Right? Because it was harrowing and it was terrifying. And there was no ping pong table, and pop culture really let me down on this. Because pop culture always shows a frickin’ ping pong table.
Jackie: Or checkers or cards.
Gabe: There were checkers and cards. But I wanted the ping pong table. I could play checkers and cards at home and I thought, hey, if I’m gonna be in a hospital, I might as well get a ping pong table.
Jackie: That’s fair.
Gabe: And I became very desperate looking for this ping pong table because I needed the world to make sense. And I thought, okay, if I’m in a psychiatric hospital, there’s gonna be a ping pong table for me. In that moment, it was the thing that made the world right again. It would have balanced everything out. It would have centered me. I would have known where I was. And if I could have just found that ping pong table, I would’ve been like, okay, I know what to do.
Jackie: Play ping pong.
Gabe: Well, just obviously, if one piece of information is correct, all the pieces of information are correct. Right? Like isn’t that nonsense? Like like, oh, oh, if one thing is true, the next 30 things are true. This is not reality. People do this that that aren’t bipolar. And in psychiatric hospitals. But I became extraordinarily desperate. I need to be very, very, very, very clear on this point. The nurses had to come after me because I was. I was so, so upset. And like like like finding out your spouse is going to die upset over a ping pong table. To this day that this has been it’s been years. I am still upset. There is no ping pong table. And I have desperately tried to donate ping pong tables.
Jackie: Yeah, that is what I was gonna say. You should donate one?
Gabe: It turns out that you can’t have ping pong tables with their paddles, sharp edges and nets cetera in psychiatric hospitals for people who might not be in their right mind or a danger to themselves or other.
Jackie: Pop culture really did let us down on that one.
Gabe: Yeah, if you think about it for even a minute, you’d be like, oh, yeah, yeah, I can. Yeah, that’s probably a bad idea.
Jackie: Ok, here’s another question that I have that I feel like I am wildly off on due to movies. How long were you there? Because in my brain, it’s either you’re there for a 72 hour hold or you’re there for eight months, because the other assumption that I slash I think a lot of people have is, what can you possibly accomplish in three days?
Gabe: This is a tough one for me to answer, right, because there’s a little piece of me that wants to say nothing. Everybody should be there for eight months. But at the same time, you can’t leave people warehoused for eight months. But some people are so sick, they need more than 72 hours and they’re let go too soon. And some people can be let go in 72 hours. I believe for Gabe Howard personally, that 72 hours was the right amount of time because I was in crisis. I needed stabilized and the 72 hours was enough to stabilize me. And I’m very fortunate. I was released to people who loved me and cared about me. It would just be a few days before my parents came all the way from Tennessee to take care of me and like, make sure that I was okay. I had the woman who brought me to the hospital who helped me fill my prescription and made sure that I got set. I had a job, so I had money and resources and I was on FMLA. I was able to take time off work to get better and still have health insurance and an income come in that’s like really helpful when you’re sick to not have to worry about money. And I had short term disability, so I was covered there and then I was moved into an outpatient program. This was great treatment for Gabe, stabilization, outpatient treatment, community treatment. And then the four year epic battle began.
Jackie: Is this the norm or?
Gabe: No.
Jackie: Would you say as a whole we are missing some of these steps for a lot of people?
Gabe: We are missing these steps for probably the majority of people. Let’s talk about a couple of things that I think are very, very important, understand. One, I was very lucky that somebody recognized the symptoms of suicidality and mental illness. Two, I was lucky that this person took the time to help me. Three, I was lucky that I was taken to the emergency room where they knew what to do and they cared enough to do something about it. Four, I was lucky that there were beds available, literally beds available. Five, I was lucky that I had a payer source. Six, I was lucky that upon my discharge, people who were not me took responsibility for me.
Jackie: You’re going to run out of fingers.
Gabe: Seven, I was lucky that there was an outpatient program where I could go and get immediate follow up care. Eight, I was lucky that there was a psychiatrist and a therapist and a psychologist that could see me within a week. Nine, I was lucky to be in a big enough city where all of these resources were readily available and 10, and this is the big one. I could afford it all. I had all of the money, all of the money. I could afford the co-pays, the out of pockets. I had insurance. I dumped tens of thousands of dollars into my care and the insurance company even more than that. And if any one of those ten things was missing, I might not be sitting here.
Jackie: So let’s rewind for a minute, because one of the problems that I talked about that you just mentioned as three or four in your list, which is, let’s say somebody notices it. You go to the E.R., they say, yes, there’s a problem. There’s no beds. I hear this all the time. Specifically, it must be in metro Detroit where we have like a massive issue because no beds is a incredibly common phrase that I hear. What do you do when there are no beds?
Gabe: Professionally, what you’re supposed to do is find another hospital that has a bed, and ambulance them over.
Jackie: But?
Gabe: Well, you could convince the person that they’re not actually suicidal. You could convince the person that they’re gonna be OK. You could change your diagnosis to say, you know, I think you’re just stressed out. You’re probably fine. Or you could put them on a bus. Send them to another county. Tell them to go to that hospital. You can tell them to drive themselves to that hospital. You could say, I don’t know what to do for you. You could ignore them. You just make them sit in the waiting room and play out the odds that they’re just gonna get tired and leave. Which probably around hour 5, 6, 10, 20, they probably will. All of these things happen with shocking regularity. There’s an advocate in Ohio that calls it greyhound therapy. Where somebody who does not have insurance, does not have a payer source, will show up at a state hospital that’s required to take people like, you know, the health center. Things like that. And they will say, look, we don’t have any beds. They would give them a bus pass.
Jackie: Oh my god.
Gabe: They would tell them to take that bus pass to the next county over and go to X Hospital. And you have to hope person who went to the emergency room because they were suicidal, because they were having symptoms of a psychiatric illness, who is not in their right mind, who is sick. You just want a sick person to get on a bus and go to a different hospital. That’s what you did. And people are cool with it because after all, you can’t abuse the mentally ill. And you think to yourself, society doesn’t really believe that, Gabe. You see the homeless population. Do you honestly believe that all of those homeless people are homeless because they’re making a reasonable and rational decisions? A good, good portion of them are severely mentally ill. We don’t care. We really don’t. As a society, we do not care.
Jackie: We’ll be right back after these messages.
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Jackie: We’re back talking about inpatient hospitalization. Ok, so here’s a question. When I was considering trying to find an inpatient place, what was happening at the time was I was severely, severely depressed, highly, highly ideating on suicide. And I had a friend of mine who was calling local hospitals basically looking for a bed. I don’t know what that looked like on her half because I wasn’t with her. She was just calling and reporting back to me because we weren’t at the E.R. We were calling we were trying to be proactive. If you show up to the E.R., you are the patient there. Let’s say scenario wise, hopefully if somebody with you just hopefully and you show up and they say there are no beds and or you call around like I did and no one anywhere has any beds, like as the patient as me. What do you do if you’re at the E.R.? You say, okay, I’ll try this other hospital and hope that the person with you and you are in the right frame of mind to make that happen. Or if you’re making the phone calls and there’s nowhere you can go. Like, what are we supposed to do?
Gabe: That’s a really good question. And as soon as society finds out the answer for it, I think that people will be better. I can tell you all of the things that I would do because I’m an advocate and I think that these advocacy points are good ideas. You can call your insurance company. You can demand to speak to a patient advocate. You can threaten to sue. You can call a lawyer. You can call all of the other hospitals. You can demand to get care. You can say, I don’t give a shit, that you don’t have enough beds. You can throw your money and your weight and your cloud around. You can say, listen, I’m a pretty white woman. And if you don’t give me help, I’m going to call the news that you were willing to let me go home and die. There’s a true story out there of a really well-known advocate that used to write for The Washington Post, and he literally threatened to call friends in the national media if they did not help his son. And they finally relented and said, fine, we’ll do it. And they did it begrudgingly. This dude had to literally be a national journalist with a lot of money to get his son seen. So the bigger question that you should be asking is, one, will any of these things work? Yeah, they might. And two, does the average person with serious and persistent mental illness who is probably between the ages of 16 and 24, does not have insurance, does not have a payer source, does not have money, and who is actively sick at this moment, have the ability to fight a multi-billion dollar institution? To take on doctors and hospital bureaucracy and finally get society to give a shit about them? Here’s what really sucks. This show is almost exclusively talking about middle class mental health and middle class. Mental health is just so messed up. It’s so messed up. Yeah, it is way worse for lower income mental health and it’s way worse for impoverished mental health. And we haven’t even talked about the large percentages of mentally ill people in prisons and in jails.
Jackie: Which I suppose we touched on a bit in the beginning of saying this is your personal experience, but it is worth pointing out that if the system is failing you a middle to upper middle class, I don’t know your life, but white guy in America, in the Midwest.
Gabe: In a big city.
Jackie: Is failing you. It is hard to even fathom the trickle down effect of that. And to be fair, we don’t even have to fathom it. It’s in the news. We see the terrible things that are happening. Even the media is talking about it. And pop culture also is talking about it in the worst of ways in times. So it’s not that hard to think about how bad it gets it. I’m having a hard time even finding the words to express, hearing your experience of being inpatient and seeing how that can vary for different people, but like roughly the same. Right? Let’s say that. And how hard and stressful and probably even less dramatic and traumatic that was for you thinking about how much worse it can be and how seeing very easily how this cannot turn out this way, how it can turn out very poorly.
Gabe: You asked me what it was like to be inpatient. It’s scary and it’s traumatizing and that’s okay. Things are allowed to be scary and traumatizing and not be bad. I imagine that being a parent is scary. I imagine that your child being sick is traumatizing. That doesn’t mean that your children are bad. It doesn’t mean that your decision to become a parent was bad. But it does mean that you need to get help for that scary. It means that you need support for that scary. And if something happens with your children that traumatizes, you need to get help for that trauma so that you don’t burden yourself or your child for their whole life. The takeaway that I want a lot of people to hear is that I don’t think we address with people who have been inpatient and psychiatric hospitals and wards. The fact that they were scared or the fact that they were traumatized, we say things to them like, well, it was for your own good. We say things to them like, well, it doesn’t matter. You’re better off now. I really think a strong advocacy point needs to be. It’s OK that you were scared. And I understand you were traumatized. Let’s talk about that.
Jackie: Less of the end justifies the means.
Gabe: Right. And I want to be I want to be fair, the ends do justify the means, even though I was scared, even though I was traumatized, even though I had the wrong idea. And even though the very first time I walked into a psychiatric ward as an advocate and the door shut behind me and I heard it bang. These are big metal heavy doors. I had an instant panic attack. I broke out into a sweat. My heart raised. I almost collapsed. It was that terrifying. The person with me realized it immediately. It was like, what happened? And I was like, I was right back there. Let’s talk about that. Let’s move through this. What can we do? Let’s be better. Look what you’ve become. Let’s help. And that gave me a point of advocates say to all of the other people who get out and they’re like, well, I’m scared and nobody cares. I care. I care.
Jackie: Can you imagine if we treated going inpatient or treating people with mental illness the same way we treat physical illness, like when you’re going into the hospital for surgery where your family is there, everything is pretty well explained to you. There is support, there’s compassion, there’s a lot of compassion. And everybody understands that this is probably going to be traumatic, even if it’s routine. Right. It’s probably going to be traumatic. Could you imagine that if when somebody went in and they said, hey, I’m feeling suicidal? If the reaction was that strong, that compassionate, that educational like that supportive as opposed to we’re going to put you here, it’s gonna be good for you. Do what we say, because that’s why you’re here and you’ll think us later.
Gabe: And that’s where I want to get to. I just can’t imagine telling somebody who’s going to have heart surgery, who says I’m scared about the heart surgery, to suck it up. This is for your own good.
Jackie: Yeah.
Gabe: When we get those people casseroles, we clean their houses. We do support their families. We wait in the waiting room for them. And some people with mental illness do get some portion of this. But it’s not regular. It’s not normal. It is a typical I want this to become routine. And I believe that people with severe and persistent mental illness would have a much better outcomes if their trauma and their terror was addressed when they got out or soon after if it was just part of the process. If somebody said to them, what scares you the most? And they talked about it. And some of that did happen for me. I don’t want to say, oh, it was just horrible, and they didn’t address anything. People did ask me how I felt about it. And I had a really good support system. They messed everything up. But they were there. They were there messing everything up. My father and my grandfather moved my like a hundred and fifty pound television out of my house and into my apartment. This is like a 50 year old and a 65 year old man watching their 26 year old grandson sit in a corner crying while they carry this giant television.
Gabe: That’s like real love and support. Right. They weren’t the family that said suck it up, get better and do it. I was really lucky. But a lot of families would be like, look, you need to get back to your life. You need to help us move. You need to do this. You need to do this. I got really lucky. And I don’t know how my family didn’t mess this up because they just mess everything up. But this is one of the things that they got right. And it made a big difference. I think these things just matter a lot. And trauma is not a bad word. And we just so often never want to address people’s trauma because we put some sort of moral value on it. Like if things turn out OK, you’re not allowed to be traumatized. We saw this with soldiers. Why have PTSD? Why? We won the war, you lived. Well, yeah, we won the war, and you lived. But that doesn’t mean that you can’t be traumatized. What? This makes no sense to me for a long time. That was our belief system.
Jackie: Gabe, thank you for sharing that and helping me to separate, perhaps Girl Interrupted and John Stamos from reality. I’m a little bit sad that John Stamos doesn’t just live in the hospitals waiting for us, but that’s a whole other thing. Is there anything else that you want to add or anything that you feel that you just need to tell anybody who’s maybe thinking about this?
Gabe: There is a couple of things first, I want to thank you for asking all of these questions, because some of these questions like saying, hey, did your doctor look like John Stamos? Were you all wandering around like doped up zombies? It sounds stigmatizing, right? It’s like, are you making fun of me? And it’s really important that when people ask the question that way, that you don’t jump all over them and say, of course not. That’s not what it’s like because they don’t know. And if they’re willing to ask you about it, take a deep breath and answer it. That is what you thought was happening in there. And if you wouldn’t have asked me, you’d continue to believe that that’s what my life was like. And we never would have had this moment where you now know that John Stamos doesn’t live in the hospital.
Jackie: The More You Know rainbow just went over my head right there.
Gabe: Exactly. And I think that sometimes we shut down the more, you know, rainbow by yelling at people for asking the question wrong. The next thing and I want to say is anybody who’s listening to this thinking I might need to be hospitalized, but man, he said it was scary. He said it was traumatizing. He said that there were locked doors. He said that they make you go to group. He said that they make you share. These are all true. And I want you to have all of the information. We don’t sugar coat things on our podcasts. It’s one of the things that we pride ourselves on. So believe me when I tell you that I’m not sugar coating, that it will be OK. It will be scary. There could be some trauma. Hospitals are not fun places. Nobody goes to hospitals for vacation, but it can make you better. And it did make me better. And it was the start of making my life go from daily awful to, you know, pretty decent. I’m a pretty content guy. I’ve done a lot of really great things. And all of that started the day that I got help in an inpatient psychiatric hospital. And that really, really is worth it. And it’s also worth moving away from it and hoping never, ever to have to go back again. So I assure you, I’m not bullshitting you when I tell you that just because something is awful doesn’t mean it’s not worth it. And that’s really what I want to leave the listeners with today. I don’t want to scare anybody away, Jackie. That’s what I want to say. I don’t want to scare anybody away. Just because it’s hard doesn’t mean it’s not worth it.
Jackie: Gabe, I couldn’t agree more. There are so many things in this world, including taking care of yourself, your mental health and your physical health that is going to be incredibly difficult, but it’s also worth it.
Gabe: There’s a famous philosopher that said that if it was easy, everybody would do it. And I really feel that that that’s the deal, right? It was it was hard. It was hard to get well. But I’m glad that I did. And just because it was scary along the way doesn’t mean that it wasn’t worth it. And I know you feel the same way about a lot of the physical health issues that you’ve been through. I can’t imagine having the number of surgeries that you had was easy, but it was totally worth it.
Jackie: Absolutely, my quality of life is significantly improved, and I think anytime you look at a surgery or an inpatient stay or anything that looks really difficult, if you look at how it impacts your quality of life at the end, it’s always going to be better.
Gabe: I could not agree more, Jackie. This was part 2 of 2 if you missed part one. That’s OK. It’s literally one week back from this episode and you don’t need to listen to him in order. Just jump back. Hear it out and you’ll know everything that you want to know about Gabe’s inpatient hospitalization stay. We thank you for hanging out with us, please, wherever you downloaded the podcast. Leave as many stars as you feel comfortable with. Use your words. Tell other people why to listen. Share us on social media. Email us your friends. Talk about us in support groups. We want the conversation surrounding mental health to go as far and wide as humanly possible. And our longtime listeners know if you stay tuned after the credits. There is an outtake. Usually it’s Gabe and Jackie shitting the bed. We will talk to you next week.
Jackie: Happy Thanksgiving.
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