The Bipolar Disorder Manual: Hospital Edition

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Foreword

It has been about two years since I wrote “The bipolar disorder Manual”. It was written completely on a whim, with no future plans to sell or distribute it. I was unemployed for a few months after graduating from college, and my parents suggested that I take advantage of that time and do some writing. I wrangled with the idea for a while, already pretty busy with the website I’d been running for a few years, but I finally decided that “The bipolar disorder Manual” should be written. Even if no one else ever read it, I would still get satisfaction from the creative process.

Since I was unemployed, the writing portion only took about a month or so. I would write a new chapter every few days, and soon enough I had a nifty little book. I filed it away with all my other projects, and within a few months I had all but forgotten about it. Shoot to a year and a half later.

I’d gotten what I considered to be a dream job, working in the IT field under the management of one of my best friends. The company that employed us turned out to be possibly the best bank in America. I had married the woman of my dreams the previous year, and our house was already filled with three wonderful pets. Things were going so well that I could barely imagine what else there was to do in life. Then it struck me.

In the first few months that Kelly and I were married, I had sold a bunch of our excess belongings on eBay. The process had been quick and easy, and I marveled at the power of the website. It only took a few days to realize the opportunities that lay before me; I could sell my writing! Within a few months I had four books selling on eBay, “The bipolar disorder Manual” being the most successful. The eBay success led me to look into other distribution options, and at the present moment I can say that my books are flying around the Internet faster than I can track them. They are sold in some places, given away for free in others, and all I can do is marvel at the glorious ways in which God has blessed me.

For awhile I thought “The Bipolar Disorder Manual” had covered everything. I felt that I had touched on every single topic that a new Bi-polar patient would be interested in. Then one day I’m driving home from work, my mind wandering as usual, and it came to me. The most important topic in the manual needed more attention. It needed its own book. It was in that moment that “The Bipolar Disorder Manual – Hospital Edition”, was born.

You’ll find that the information you’re about to take in is invaluable. You’ll discover ways to deal with the people and events that make up a visit to a mental health facility. My five visits have given me insights to help guide you in the right direction. As you learned in the last book, my methods are proven – I’ve got everything a person could ask for: an amazing wife, plenty of friends, a dream job, and the most important thing of all, inner happiness.

Pay attention to what is in this book. Study it as carefully and dutifully as you can. Not only can it help you through your next hospital visit, but in certain circumstances it can save your life! This is not just another advice book, this is knowledge that comes from a first hand source, straight from a guy who has been through it. Don’t be surprised if you’ve never heard about some of these methods, because unless you know someone like me, odds are that a group therapy session or psychiatrist’s couch haven’t supplied you with them. I know, because I’ve been there.

Enjoy your time with “The Bipolar Disorder Manual – Hospital Edition” Keep it handy. Send it to friends who might benefit from it. Most of all, don’t hesitate to whip it out when you are wondering about something. I do know the path through it all, and aside from Jesus himself, I may be the best person to hear this from.

Good luck, and God bless!

Your Episode

Your episode was probably similar to my episode(s). For weeks, the people around you were able to tell that something was wrong with you, but you were completely unable to pick up on it yourself. Your ego probably inflated, you might have been delusional about who you were or what you could do, and you might have experienced some paranoia. This is all completely normal for a serious bipolar condition. People such as myself, who are Bipolar I, experience these symptoms to an extremely serious degree when we have an episode. Sometimes a hospital visit is the only thing that will snap us out of our trip down the rabbit hole. That’s okay though, because the fact that there is help in the first place is a beautiful thing. For less fortunate people throughout history, there have not been any options. In this time, in this country, we are truly blessed.

hopefully you were not violent during your episode. Violence changes the whole spectrum of your experience. If you were violent, it is possible that you were arrested. If you were arrested, then after you are released from the hospital you may be going to jail. How do I know this? I was violent during one of my episodes and I was subsequently arrested and tried for these acts after I was released from the hospital. I was lucky, though, because I never had to spend any time in jail thanks to a kindly worded letter from my psychiatrist, and with my parents support, the judge decided that I had learned my lesson and the charges were dropped. But it can happen, and so do your best not to be violent. While TV and movies might have you believe that people get off scot-free when they have a mental illness, this is not completely true, so watch it.

During your episode you were probably impaired due to lack of sleep. When a Bipolar patient is revving up to their eventual break, they usually have been influenced by several nights of little to no sleep. The wonderful thing about going to the hospital is that this long string of sleepless nights will fall by the wayside. You’ll finally be able to sleep as much as you would like. The staff will provide medication that will calm you down and enable you to relax the way you need to. This is yet another wonderful perk of going to the hospital. You get the rest you need, so take advantage of the opportunity. Some people go through their whole lives without really being able to get proper rest.

The most important thing to remember about your episode is that it is indeed forgettable. You can walk away from episodes. You can get to a point in life where there is no need for them to happen. You can get the proper medication and therapy, and life can definitely return to normal. My last hospital visit was six years ago, and during that time I have flourished. I’ve gotten a four year college degree, I have a wonderful wife, and my career is progressing in an extremely positive fashion. All of this was possible because I was able to take advantage of my time in the hospital. I used it to get what I needed – the right medications, the right therapy, and the right downtime. I relaxed, I made friends, I contributed to other patients’ progress, and I succeeded in getting out in a timely fashion. The amount of time you have to spend in the hospital depends completely on how you approach your stay. If you are positive about things, and cooperate, then you will probably be out in less than two weeks. If you take a different approach, then you could be looking at months.

I strongly suggest that you pay attention to the rest of the chapters in this book. The advice is valuable, the language is simple, and the knowledge you gain from it could help you for the rest of your life.

Emergency Room

Once upon a time, in another life, I decided to throw a swing at an emergency room attendant which is what lead to the arrest described in the last chapter. I’m not proud of it. I try to forget about it. The next time I had an episode I actually apologized for it. Why did I throw that swing? Because one of the doctors asked my why I thought I needed to be there. My dad had brought me there in the middle of the night because I was feeling horribly manic. After four hours of observation with no symptoms they told me to go home, so I proceeded to give them some proof of my condition. My dad felt badly because he didn’t act fast enough to jump between me and the doctor, but it all happened too fast. Please don’t follow in my footsteps. I am including that story here so you understand how important it is to verbally get your message across to the emergency room staff without using force. They need to understand what is going on in order to treat you properly, so verbally help them as much as you can. At the emergency room the policy is pretty much observation. If you do not feel you are a danger to either yourself or to someone else, and you are not producing psychotic symptoms, then you might as well be at home. If you don’t need emergency room attention, then you shouldn’t be there. You can wait until regular office hours and call your regular doctor. On the other hand, if you’re suicidal or a danger to someone else, the ER is heaven on Earth. There’s no better place to be. A psychiatrist will evaluate you, you’ll get the proper medication, and if necessary you’ll be hospitalized. I highly recommend an emergency room trip if you feel like you need it.

Your average trip to the emergency room could last three hours or more, so get ready to wait. You will not be rushed in and rushed out. They may set you up in a separate room to wait, but you’ll basically just need to be patient. Don’t make problems, don’t be violent, just wait your turn.

During one of my trips I was under the impression that I was a key member of the Second Coming of Christ. When a clock struck eight o’clock in the morning, I went berserk and started screaming. I fell on the floor in self-induced convulsions, positive that I was contributing to God’s Master Plan. Was I right? Probably not, because a few seconds later I was strapped to a gurney headed to the hospital. A few years of experience have shown me that several mental patients experience the exact same thing when under the influence of a severe manic episode. My advice to you if you find yourself in the same situation is this: tell somebody. Let somebody know what’s going on. The best thing you can do for yourself is to let someone in on the madness flowing through your mind. Not only will you receive help faster, but you’ll feel a whole lot better after you unload those thoughts.

Sometimes during emergency room trips, neophyte bipolar patients get scared, and don’t really want to tell the evaluating psychiatrist what’s wrong. This is the worst thing you can possibly do. That is what they’re there for, after all! They are there to help you! They are there to listen and get you the help you need! Keep in mind that this isn’t always the hospital! Sometimes they will just set up a doctor’s appointment for the next morning. Emergency room visits don’t always end in the Quiet Room, which we’ll talk about later. So remember that when you make the trip to the ER, you are taking care of yourself! You are making sure nothing crazy happens while your disorder is doing a number on you!

A lot of new patients have no idea what it is like to really go full force into a manic or suicidal episode. Well, let me tell you, it is not fun. A lot of folks don’t even make it out of them alive. Speaking as one who has, I want to convey to you how important it is to have a cutoff switch. You must work really hard at training your mind to just pull the switch if need be. You must be able to sit or lie down, and allow others to care for you. I call it the “Prime Directive”. You must be able to say to yourself, “I will not die today. I absolutely positively will take every step necessary to stay alive.” This is a must. I suspect most successful bipolar patients have one of these. We are able to just stop the actions, and just lie down. Without this ability you are in trouble. If you don’t master this, there will come a time when people will have to bring you down. You may have to spend time in jail, or you may be severely drugged for long periods of time. Take my advice and develop a Prime Directive. It could save your life some time, or like it did for me, many times.

Getting Evaluated

During the end of your trip to the Emergency Room, you’ll receive a visit. Not Santa Claus, not the Easter Bunny, but someone who holds the key to where you will spend your next two weeks to two months – a psychiatrist.

In most major cities across the United States, for every hospital, there is a team of psychiatrists that is on call for cases such as yours. It may take them two or three hours to get to you, but be thankful they’re there. Don’t think they’re taking their own sweet time in getting to you. They are usually in another part of the city seeing someone in another emergency room. Remember that on any given night, there can be quite a few people who come to emergency rooms with mental health issues. Your case does matter to them, though, and they will get to you. When your visitor does come it may be just one person, or it may be more than one.

When he or she shows up, tell the truth. Don’t hold anything back. The professional needs to know everything that is circulating inside your brain. A lot of folks are tempted to lie, but to be honest it doesn’t do any good because it is not just what you say that lets them know you are sick. You may not realize it, but when you’re really screwed up there are a million outward signs,, and the psychiatrist can pick up on all of them. It really helps the situation if you just come out with everything. It means that your medication and therapy needs will be more quickly and more accurately determined.

The psychiatry team members are usually really nice. A lot of folks see them as “members of the establishment”, or as “people who judge you”, but that’s not true at all. They are important members of an important team, the team that is going to try and get you healthy again. So take them seriously, answer their questions truthfully, and do your best to stay in their good graces. After all, your goal is a speedy hospital stay, or, better yet, no hospital stay at all, right? I’m fully convinced that the first time I went to the hospital (twelve years ago) I literally bought myself an extra few days by being kind of a jerk in the beginning. This was the first and last time I took that route. So be nice, cooperate, and you’ll get through this thing. It’s a piece of cake, as I’ll show you throughout this book.

Ambulance Ride

Ah, the joy of the ambulance ride. Two guys show up, cart you off, and the whole time you’re wondering, “What did I do to deserve this?”

During one of my ambulance rides I was fully convinced that I was already dead and this was one of the ways people were delivered to heaven, via the heavenly ambulance. You can imagine the crazy stuff that was coming out of my mouth. I was talking to the attendants like they were angels. And explaining to them how I was so happy to be going to heaven. I was fully gone, essentially. But It’s okay, because these guys do this all the time and they’re used to it. So don’t worry about what you say, just relax and don’t fight anything. They’ve got everything under control.

In my opinion the best thing to do during the ride is to sleep. You’ve got twenty or thirty minutes on a nice comfy cot, so just relax and let the Z’s begin. At the moment all you have to do is kick back and be happy that you’re somewhere safe. Your mind has been putting you through a lot lately, so now’s the time for the relaxation to begin.

Once again, the main tip here is to relax. Don’t fight these guys and don’t be aggressive. Just be kind, chill out, and let them do their job. They’re in it to help you, just like everyone else during your hospital stay. You’ll be okay as long as you realize that. Too many patients want to fight it every step of the way, but my method is much more successful.

Relax, relax, relax. You’ll be back in the swing of it in no time, but for now, its healing time. Use it wisely.

Quiet Room

While you are in the hospital, you have one goal that is more important than all the others – you MUST stay out of the Quiet Room!

The Quiet Room is the classic rubber-walled room that you have seen numerous times on TV and in the movies, with one difference: there is no padding on the walls. “Why not?” you ask. Because you probably won’t be touching the walls or the floor. Instead you’ll probably be strapped to the bed for your own protection.

Yep, there are leather restraints in Quiet Rooms and they are used. If you are seriously out of control, you’ll find yourself in them. Don’t think that the attendants won’t leave you in there, because they will if your behavior warrants it.. If you can’t get it together, then you’ll stay in there. If you don’t respond, you will stay restrained. And trust me, it is not fun at all. The medical staff will be doing their best to juggle your meds properly, so while you’re in the Quiet Room take your meds the way they ask you to. Granted, these meds may make you really sleepy, and you may wonder where the last few hours have gone, but that’s okay. Like I’ve said before, you’re in the hospital to rest.

There are all kinds of ways you can be restrained in the Quiet Room. They can completely restrain you, or they can have you on your stomach or your back. Or, they can just restrain your feet, or there can be no restraints at all. In fact, they may even leave the door open and ask you not to leave, all to see if you can obey their orders. So listen to them, do what they ask, and you’ll be spared unnecessary time in there.

Remember, like everything else in the hospital, this room is there to help you. It is meant to keep you safe when you may be a menace to yourself and/or other people. So take my advice and don’t rebel against it. It will only cause you more stress and buy you a few extra days or weeks in the hospital.

Roommates

The great thing about your roommate situation in the hospital is that the powers that be have taken care to match patients accordingly. They are not going to put you in a room with someone with whom you will mix badly. At least they will try not to!

During my five visits I roomed with a number of people. Usually folks only stay in the hospital for a couple weeks, therefore there is frequent roommate switching. This is usually not a hassle, because you will probably only have a few belongings in your room anyway. If you are asked to switch rooms, just gather your stuff in your arms and walk to where you are told.

One of my roommates was considerably older than me by about fifty years. This created a little bit of a problem because he constantly had medical personnel coming in to check on him, sometimes while I was sleeping. He was a kind gentleman though, so it didn’t bother me a whole lot. Be prepared for this, because sometimes a mental hospital is just a stop-off for someone that is on their way to another type of medical facility.

Something you need to keep in mind is that often you will be in a room with someone who is suicidal. Now, these people usually have an attendant with them 24-7, but sometimes someone slips through the cracks. If you are ever on the receiving end of a “suicide plan confession”, the first thing you do is tell an attendant. Trust me, you don’t want someone to make an attempt when you could’ve done something about it. While you are in the hospital, you will probably see some patients with bandages wrapped around their wrists. Those bandages didn’t get there by accident. Unstable patients can do some pretty crazy things sometimes.

In general, you will probably not have to worry about your roommate. You will go about your business, he/she will go about theirs, and you’ll both be out of the hospital without incident.

Meeting Time

In mental health facilities there is usually a morning meeting where all the patients, their attendants, and possibly some other staff meet to discuss everyone’s progress. As with just about every other aspect of life, the hospital expects you to perform as a patient. You set personal goals, you do follow-ups, and your behavior is critiqued just as if you were an employee at a job. If you do not meet the expectations that have been set, then the negative consequences are quite simple – your stay lasts longer.

During my five hospitalizations, I have seen patients treat meeting time and their personal goals in very different ways. Some patients took the meetings seriously which helped them get discharged in a few days while others had to wait. That resistant behavior probably contributed to their lengthy stays. Now, if you are an adult, and all of the expense that goes into a hospitalization is on YOUR shoulders, make that an incentive to get discharged as soon as possible. If you are a kid, odds are that you will not be the one picking up the check.. But it is always good to keep in mind that each hospital day runs about $2,000 to $3,000 dollars. Now, God-willing, you have insurance of some sort and you won’t be paying all of this yourself, but it is still a good incentive to take things seriously. Besides, policies have limits on how may hospitalization days a person can have in a twelve month period. It makes sense to use them wisely.

During meeting time make sure to pay attention, take things seriously, and also be supportive of other patients. If you typically have trouble respecting other people, now is the time to work on that skill. Everybody is equal in the hospital and should get treated like the important human beings that they are. So, don’t disparage anyone and don’t get in any fights. Remember, the less conflict the better. There will always be some patients who act out, but make sure you are not one of them!

Remind yourself constantly that you are being observed during your entire stay. In the meetings you will be given feedback on those observations, and you will have a chance to give your opinions too. Make sure you always tell the truth, and don’t get angry if some criticism doesn’t please you. These attendants, doctors, and nurses, are doing their best to get you healthy enough to be discharged. Don’t slow your own progress by being impolite or haughty. Your hospital stay is a two-way street, and you don’t want to create any red lights that don’t need to be there.

You will be given a set of levels to work with. This means that depending on your performance you will move up and down the ladder. The goal is to reach the top level – being discharged. Some people move faster than others, so don’t get discouraged if others seem to be progressing faster than you. A typical stay is probably at least a week, but it could be less and it could be more. Some patients manage to do it in a few days, but these folks usually fall into a different category of patient. Perhaps they have been to the hospital a few times before and know how to fast track their progress. I have been one of those patients. Of course, I’ve also been the patient who bangs his head on the door of the Quiet Room. You live, learn, and use your experience to your advantage, just like every other part of life. The hospital is no different.

If you use the Golden Rule in the meetings, which means that you treat everyone else the way you would like to be treated, you’ll be fine. Keep in mind that no one is in there without reason. Everybody has their own problems and is doing their best to deal with them. Don’t extend your stay by mouthing off unnecessarily or giving attendants issues to use against you. They are interested in seeing you leave, but they do not want to discharge you until you are ready.

Leisure Time

If you have ever seen the movie “One Flew Over The Cuckoo’s Nest”, and been amazed at the amount of time that the patients spent just milling around, then I have some news for you – that is not far from the truth.

Yes, there are activities. Yes, there is therapy. Yes, you spend time speaking with your psychiatrist, and you spend time eating. HOWEVER, there is still a lot of time that is not predetermined for any given activity. There is at least an hour or two like this in the beginning of the day, and there is an hour or two like this at the end of the day. This is partly because patients often need lots of time for naps, and partly because you are in the hospital to relax! So they are just providing the time during which you can fulfill those aspects of your recovery.

Take advantage of these opportunities! Make friends! Play games! Be happy! These actions will all help to produce what you are really looking for in the first place – a quick trip home! The predispositions you project during your leisure time have a big effect on the length of your stay. If you spend time brooding by yourself, or smoking constantly, then you won’t be getting out as fast as patients that participate in positive activities! Believe it or not, leisure time is extremely important. It is observed, as is everything else that you do. So don’t let it go to waste!!

Of course, leisure time can also mean nap time. There is nothing wrong with taking a nap once a day if you need it. The meds you’ll be on will probably sap a decent amount of your energy, so don’t stay up if you really need to hit the sheets for a little bit.

Here’s a small tip that you may also want to keep in mind – don’t spend every minute of your leisure time watching TV. While I don’t have hard data supporting this conclusion, I’m of the opinion that too much TV watching could be looked upon in a bad light by the powers that be. If you fill your three to four hours of leisure time with nothing but soap operas and talk shows, you’re probably not as well off as the guys who are taking walks around the yard and visiting with other patients and staff.. As in most aspects of life, it pays to make friends, so you are better off doing that than becoming a couch potato.

Sessions With Your Psychiatrist

I will preface this chapter by saying something extremely pertinent to the discussion. During my hospital visits my psychiatrists were attentive, caring, enjoyable to work with, and very in tune with my needs. Not all of them are like this, so here is some advice to help you in either situation.

The psychiatrist during my first two hospitalizations was a very experienced doctor who actually turned out to be the father of a childhood friend. He was able to quickly and accurately diagnose my condition which helped shorten my stay. While there my visits with him were usually short and sweet. I made sure to be up front about what was going on in my mind. Also, in 1993 the medication list for Bipolar Disorder was not all that expansive, so the medication choices for me were few. Also, as one of my doctors told my mother, determining which mediations to use can be as much an art as a science. He said the reason is that each person is unique, and their reactions to the same drug can never be predicted. My first bipolar medication was Lithium, and I was on it for four years.

The psychiatrist for my next two hospitalizations was another kind gentleman. These two stays lasted half as long as the ones two years previous, and that was probably because my condition was already diagnosed, but the medications still needed some tweaking. I learned something important during these visits. I learned that I could ask for privileges and, if at all possible, my psychiatrist was willing to grant them. For instance, I asked for a field trip with my parents and he gave it to me. I also asked to have an extended visiting time with my friends and he gave it to me. If I wanted to take a hot tub bath, he provided permission. My point in telling you all this is that you should not be afraid to ask your psychiatrist for things. Usually he will be the one who grants permission and there is no harm in asking. Even if he/she doesn’t think it is a good idea right then, that doesn’t mean it might not be okay in a day or so. So make sure you ask for anything you need or want.

When I was twenty-two, and my visit only lasted five days, my psychiatrist in the hospital was my psychiatrist in normal life. Which reminds me to tell you that my experience has been that while hospitalized a patient has a doctor other than one’s regular doctor. These doctors are on the hospital’s in-house staff and usually do not see patients outside the hospital. However, sometimes a doctor may do rotations which means he/she will do both at different times. That is what happened to me when I was twenty-two. My personal psychiatrist happened to be on an in-house rotation the day I was admitted. So he knew exactly what I needed, my medication adjustments were fast and effective, and all I did to faciliate things was tell him the truth. The reason for this visit was that we had been experimenting with one of my dosages, and made the mistake of letting one of them go too low. We both knew what the problem was, so during this visit we just put it back where it was before and that is where the dosage has been ever since.

Treat your psychiatrist like one of your friends, because that is what he is. He really is your best friend in the hospital. His judgment has the biggest effect on your wellness, so you need to make sure that if anybody in the entire place knows what’s going on with you its him.

Another thing to remember is that your pyschiatrist has several patients in the hospital, so his time is extremely limited. You may only be able to see him for a half hour or so each day. You’ve got to be happy with that, and don’t fuss about it, because that will only buy you trouble. In the hospital you will constantly be seeing patients asking to see their psychiatrist, and the only thing this gets them is a negative notation on their record. Be patient! You will see him when you see him, and trust in his judgment. Remember, you do not know the medications better than he does!

Attending Counselors

You will come to know several people at the hospital quite intimately. These folks will be there when you are crying, they will be there when you can’t sleep, and they’ll be there to discuss your progress at the morning meetings. They are the attending counselors, and you’ll need them more than you know.

When I first got admitted to the hospital back in 1992 at the tender age of sixteen, I was put on suicide watch. I hadn’t attempted suicide, but that was the designation I was given due to the state of my mental health. When you’re on suicide watch, you have a counselor with you twenty-four hours a day, seven days a week, no matter what you’re doing. I thought this was a silly idea, until I ran into a couple nights where I couldn’t sleep and I was relatively scared to be in a hospital for the first time. The counselor was there to talk me through it and provide the support that I needed.

You won’t have the same attending counselor all the time. After all, It’s a job like any other and they have to go home at some point. But if you’re in a good hospital, all the counselors will be extremely helpful and even though you’ll have some favorites, everybody will take good care of you.

One of the number one things to remember with counselors is that they are people too. Several of the patients I spent time with treated the counselors like servants. I always found this practice to be ridiculous. If those patients ever knew how many extra hospitalization days they were probably buying themselves, I doubt they would have acted like that.

My advice is treat the counselors like friends. They are there to hear your problems and they want to help you so make it easy on them! Not only will you get out of the hospital sooner, but you will enjoy your stay more because you will get a reputation as a well behaved patient. Just be kind, polite, and you will be on your way home in no time.

Field Trips

During one of my hospital stays, we were offered a deal. If we progressed well for the next few days, and exhibited excellent behavior, we would be able to participate in a field trip. You are probably laughing at this, but It’s true! One of the incentives that hospitals offer are field trips. They can be with family chaperones or with attending counselors. They can be for a few hours, or possibly even overnight. The one that I was a part of was a trip to an ice skating rink.

The funny part about my experience was that practically no one had the ability to ice skate. Sure, a few of us gave it a shot, but mostly it was an excuse to eat hot dogs and play video games. Granted, the goal of the trip was to get us some fresh air, some away time from the inside of the institution. But if you ask me, I would have appreciated a movie or a trip to the mall a whole lot more.

Now, don’t expect these. I’ve been to the hospital five times, and I’ve only been offered this once. So, don’t get angry at me if you never get this opportunity. The best thing to do is be on your best behavior, and if one of these chances rolls around then you can be included.

During one of my hospitalizations, a fellow patient was given a personal field trip. His father-in-law was being honored for an achievement of some sort, and the powers-that-be allowed his wife to pick him up, take him to the event, and then bring him back the next morning. I’m sure those of you who are inexperienced with the inner workings of a mental institution are questioning this practice, but let me assure you, these privileges are only given to patients who are very close to being released anyway. The patients who are still knocking around in the Quiet Room do not get these opportunities, believe me.

So, once again, notice how good behavior produces the reward. As I’ve already mentioned a few times: the better you behave, the sooner you’ll get out. Life is all about producing the correct result at the correct time, and your stay in the hospital is no exception.

Game Time

The key thing to remember about game time is that it is an opportunity to get some physical activity. It is not really an opportunity to win, or dominate, or beat up on your opponent. The attendants don’t want to see anyone be overly aggressive, or really even try that hard to win. They want to see participation. This isn’t a tryout for the NBA or NFL. This is a chance to get beyond the realm of your TV room, or bedroom, and just get your arms and legs moving.

One time I spent an afternoon playing volleyball with some other patients. I turned a keen eye to this opportunity, essentially looking to play vigorously for a while, and then take a break. Other folks were more interested in messing around, not taking things seriously at all, and just not even staying organized. This is a key thing: staying organized, staying focused. The main reason anyone ends up in the hospital is because they can’t behave properly, and behaving properly always includes an organizational component. What the attendants want to see is that you can stay within the confines of the game, keep things under control, and not get too upset if things don’t go your way.

During one of my first stays, when I was sixteen, we got the opportunity to play soccer. Once again, I played a little, not getting too rambunctious. But some of the other kids decided that the best thing to do was to aim their kicks at other people. So, I just stopped playing and watched as they were reprimanded for their actions. What did this do? Well, they probably enjoyed an extra four or five days at the hospital. That’s all acting out gets you, more time! Just like jail, the better you behave, the sooner you get out!

Enjoy the playtime, and don’t let it get out of control. Keep a cool head even if the folks around you aren’t doing so.

Visitor Time

Visiting time was always my favorite time of the day. In the two hospitals where I was a patient, visiting time was an hour a day, every day. It’s a great opportunity to see friends you haven’t seen for a while, or for your parents to bring you goodies. One time my mom bought a multiple course meal from my favorite restaurant and brought enough to share with several other patients as well.

The best thing I can tell you about visiting time is that you should cherish it. It is a full hour, but that hour goes by really fast. Before you notice it, the time has passed and it is back to the same old routine. So take advantage of the time as best you can.

One time I had three sets of people I had to fit into one visiting session. So, each pair of friends got twenty minutes. This may sound kind of silly to you, but all those in question really enjoyed the time. If you haven’t seen your best friends for several days, you’ll find yourself cherishing the time you have.

Another time I had my best friends bring by a deck of cards and we just spent the whole hour playing Rook, a variation of Spades. We really enjoyed it, and my friends truly appreciated the opportunity to help me out. You’ll find that even though you have a small amount of time to work with, everybody involved really won’t mind. When you’re truly sick, friends and family go out of their way to help you.

Just keep visiting time in its proper perspective. It is a chance to show everybody that you’ll be back on your feet again, so try not to make mistakes. Take it from a guy who has been there: you don’t want to be dragged off to the Quiet Room while your parents are standing there watching. While theoretically your parents will always love you, it is not the most respectable position to find yourself in.

Making Friends

During my first trip to the hospital (at age sixteen) I really didn’t know how to deal with the other patients. Some of them were so off the wall that I was almost too scared to even approach them. Over time I realized that they were just kids getting the help they needed, but that first visit was a real shock to my system.

I did eventually realize that the best way to get through a stay was with a few good friends. So even if I was only going to be in for a short time, I would try to get close to two or three folks. Typically they would be people I had things in common with, some times not. Probably the best friend I ever made while I was in the hospital was a guy named Michael who was in for the first time. He caught me during my third trip, so by then I knew the ropes, so to speak. He was a kind, intelligent guy who was really confused about everything. He was a little older than me, and was thankful that I was there with a few choice words of advice for his stressful stay. For the last ten years Mike has called me every Christmas to chat. How did I manage to make such a good friend? I’ll tell you.

I reached out. When he was crying in a corner, I would go over and give him a hug. When he asked if things would ever get better, I told him the truth – yes, but with some work. When he wondered about the deeper aspects of life (as many of us do when we’re in the hospital), I would share with him my thoughts on philosophy and the meaning of everything. Mike was looking for answers, and I must have given him some that made sense, because each year my wife is blown away when he calls, yet again. And I look forward to it. I really do, because it means that I changed someone’s life for the better. Nothing is more rewarding than that.

Reach out to people. Help as many folks as you can. Be the light in a dreary place. Most of the folks around you will be thankful that someone is willing to listen to what they have to say.

Your Meds

Two words: Take them!

Yes, there will be people in the hospital that will put lots of effort into not taking their meds. There will be people that lie about it, that hide them, that even try to take five out of six of their meds, all in the hopes that somehow they are accomplishing something by rebelling. Not true! Nothing is accomplished! If you try something like this, all that you are doing is slowing your progress. All that you are doing is making sure you leave later rather than sooner. One of the key things that the doctors look for is a patient that is willing to take his/her meds.

I experienced quite an adventure with my first set of meds. I slept so much that you’d think I was being paid to do it. But I didn’t have any choice, because the meds took that much out of me. This situation wasn’t just a week-long event, this was a four year marathon. From the age of sixteen to twenty, I spent very little time progressing with life and instead did my best not to go crazy. While in high school, before I got sick I had been a stellar overachiever. After I got sick I was reduced to going through college at a snail’s pace, and spending most of my awake time having fun. Why? I had to. If I didn’t I was risking a relapse, and that would have been worse than anything. So I stuck with the meds, and eventually an amazing thing happened.

My original psychiatrist retired, and his replacement had a different opinion about what I should be taking. He put me on a new combination of meds and I could tell the difference almost immediately. During my previous four years I had put on over a hundred pounds. Within a year of having the new meds I lost that weight. My energy skyrocketed, and I was pretty close to being the old me. My college performance improved, I landed some great jobs, and life was pretty kosher. But you need to read between the lines – for four years I put up with hell. It was necessary. It had to be done. This may be necessary for you, too. If this is the case I suggest you do your best to enjoy it, because when you come out on the other side, life really does improve.

Take your meds, listen to your doctor, do what needs to be done. You’ll get through it! This is a temporary situation and life really can come full circle!

Getting Discharged

Cooperate. Cooperate. COOPERATE. COOPERATE!!!!

Just do what you are told. Take it easy. Treat the hospital like a vacation, but at the same time make the changes that they suggest. In therapy and during doctor’s visits you’ll be asked to do some things differently. Take these suggestions to heart because they can help! The reason you are there is to get some help, so don’t waste your time.

While I was in the hospital there were a few things I learned pretty quickly. They really just wanted to get two things from me: a promise not to hurt myself or others, and a willingness to take medication. This is probably one of the first places you will start, too. These are the two biggies. If you can master them then you are at least guaranteed to stay alive, which is a great first step to take. Some patients never get this far, so make sure you are not one of them. Once you get these two down, you are probably just a week or so from getting out.

As I said earlier you must also learn to speak honestly with your doctor. The fastest track home is by telling your psychiatrist what is truly on your mind. If he really knows what you’re thinking then he will be better equipped to prescribe the proper medications. This is key! Be up front with him, be honest, and you will be walking out the door sooner because you will be properly medicated.

Go to all the meetings, be on time for the various activities, and treat the other patients well. If you cover all of those bases, as well as the previous tips, you’ll have no problem executing your exit strategy.

Getting out is a piece of cake. As you are leaving, remember to thank the folks that helped you out the most. They will appreciate it!

The End

So now you’ve read everything I have to say. You know how to stay out of trouble, communicate with your doctors, treat other patients the way they should be treated, and use your hospital time in the most productive way possible. Everything I’ve conveyed in this booklet comes from my personal experience. Use these tools as I did and I hope they help you as much as they did me.

Remember, a mental hospital is not a bad place to be. You get to sleep as much as you want, eat pretty well, and make friends you wouldn’t otherwise have made. As in every part of life, you are just being asked to do your job. Stick to the straight and narrow, thank those who helped you, and continue taking your prescribed meds after you leave.

The world can use more people that have beaten this illness. We need role models that are willing to stand up and declare that bipolar disorder is a beatable disease. For too many years it has gotten a bad rap for killing people, destroying families and relationships, and knocking folks out of the game of life. Be a winner! Be somebody that other folks can look up to!

During my life I’ve read a lot of quotes, but in my opinion only one perfectly sizes up the formula for achieving success in life: “Never, never, never give up!” – Winston Churchill.

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