Shackles, Faith and Hope (Epilogue)

For twelve days my life was regulated. My basic needs were met: food, shelter, sleep, camaraderie. I had a schedule, activities to look forward to, meal times, group sessions, and medication at the same time every morning and evening. How to simulate that when I got back home was one of the first problems to solve. The real world doesn’t revolve around my being “better”. Its events aren’t scheduled, there’s no rhythm to it. I found myself becoming elemental: forage for food, don the same hides each day, sleep with the toy bear, wake up with the sun.

At first I approached it with gusto. I set my alarm to match the hospital’s schedule, showered first to start the day, ate, journaled, even meditated a bit. Replaced group therapy with social media, finding out what my friends were feeling that day. Lunch, exercise, art, then dinner. I actually wrote out a plan similar to the daily routine on the ward and posted it on my fridge. I managed to follow it to the letter for the first couple of weeks I was back, but then something unexpected started to happen. I couldn’t make connections.

It’s not for lack of trying. I’ve called my buddies and gone out to breakfast. We’ve walked in the park and had coffee dates. But when they’re gone, they’re gone. Like they were never there. The same feelings that I have surrounding my flatmates from the hospital. Memories. Ghosts.

It’s not malaise, it’s not the blues. It’s not full-blown depression, either. Life just changes after you leave the care and attention of a hospital staff, especially in the psych unit where emotions, thoughts, and accommodations to the inner person are the sole focus. Mental health every minute of every day. There’s no transition period. It’s a freaking jump-cut. Here one moment, there the next. No amount of teaching in group could prepare me for the extremes of loneliness that I am presently experiencing.

We’d take our thoughts out and share them over meal time. We played like children during occupational therapy, coloring, drawing, bowling together on the Wii. Walks in the courtyard led to intimate discussions of our feelings and emotions, our personal histories. Those worn out footpaths caught a lot of spilled tears as we opened up, becoming fast friends in our recovery foxholes. If we were the soldiers of our own destinies, our individual diagnoses were our countries of origin, our common enemy was suicide. We fought together and became stronger for it, but at what cost? There is no “get well soon” to be gotten to, no “return to normal” when the new normal is a headful of therapy and a bloodstream laced with chemicals. Finding fortitude from within is not for the weak. It is not instant, this isn’t treatment for a broken arm. No one’s gonna sign my cast when the plaster’s applied to the neurological pathways.

Seamless care doesn’t happen as easily with the mental health client as it might with the physical health patient. I’ve had to follow up with my case manager and psychiatrist almost weekly since my discharge, sometimes preempting my regularly scheduled sessions with my therapist, but the appointments focus on matters of finance and medication, not rehabilitation into the stream of daily life. It’s through no fault of the caregivers, it’s just protocol. From my position, that’s an aftercare talking point that needs immediate attention if we’re going to see mental health parity in full bloom some day.

Before I left the hospital, I made sure to share my contact information with as many of my friends from the floor as I could. I’ve been to the zoo with two of them, and lunch with another. We text and talk on the phone. But since each of us is going through our own version of this cycle of reentry, the spaces between meetings and calls has increased as we each learn to live life “normally”—apartment hunting, job searching, grocery shopping, reconnecting with family.

It’s not enough. I wear the same pajamas at home that I wore on the ward. I eat the same meals, read the hospital literature, try to stay active and not allow this depression to gridlock my mind and sabotage all the hard work I did on the wing. My schizophrenia may be in check for the time being, and the future may indeed become a more hopeful one as the medications and I become ever more symbiotic. But the gaps in practice, policy, and coordination of post release care need to be ramped up or the statistical fact that one-third of all patients return to the hospital just might include me, a thought I don’t relish in the least.

That common enemy might raise its flag again and try to plant it in my life. My anxiety is down, my erratic thoughts are contained, but the noted effects of post-treatment trauma and depression are both very real and highly dangerous. Critical continuity of care should be every state’s priority. Suicidal ideation should not even be a term connected with aftercare. It can be avoided, I am certain. It’s a puzzle that needs solving. We need to share the stories, take the issues to voters, and make those changes viable for future generations. We can bring change to mind the best we can, and that change needs to be instilled into the mental health care system also to avoid relapses, unnecessary institutionalization, and heartbreak. Teamwork seems to be the puzzle piece we’re missing globally. I know for myself that I need to keep my eye on the prize: a happier, healthier, more productive life. Even in my pajamas.