A Letter to Anyone Considering an Inpatient Stay

March 5th, 2018

You are much stronger than you believe you are.

I used to see having a stay in a psych unit as a sign of weakness. To me, it meant you were no longer the kind of strong you thought you were. I guess in a way I was right. But when I say I was right, I mean that you aren’t the strong you once were: you are stronger. You’ve learned to accept that sometimes, you need to get away for a while, and take care of yourself. You’ve learned that accepting and receiving help for your symptoms isn’t selfish or some terrible thing. It means that you are taking necessary steps towards mental and emotional wellness. Take pride in that.

I just ended an 18 day stay at a psych unit. I pushed it off for so long, but the pain kept building up. The depression, anxiety, and unprocessed trauma constantly running through my mind were torturous. I was having nightmares. Night after endless night I’d wake up either in a panic, in tears, or both. That started leading to my insomnia. Not sleeping for days on end, terrified of what happens behind my eyelids. The depression and anxiety came crashing in, each day worse than the day before, due to the lack of sleep.

I felt out of control. My trauma had taught me that silence was my enemy. It taught me that I wasn’t worth much at all. Fortunately, I got to get a lot of my trauma out of my head, having been able to talk about my feelings every day. I was under constant monitoring, and although at times I hated it, this stay made me realize, even more than ever, that everyone deserves time to be human. That even those who put on a brave face for everyone else has to get the help they need.

Inpatient stays are scary. I’m not going to sugarcoat it. You have a lot of time to think. You have time to realize just how hard life has been lately. But you also get to talk through and process a lot of things you’ve been burying deep into yourself. Things you never thought you’d share, things you thought you’d take to the grave.

Not every unit is suitable for every kind of person. I personally loved the unit I was on (as much as you can love a psych unit), but not everyone there found it helpful. Regardless, you must try to trust the process. You must try to get the help you need, no matter who you work with. Advocate for yourself. Speak up for what you need, but also what your values are.

If you are currently struggling, I want to let you know that your feelings are valid. A lot of the time, we don’t hear that often enough. You have every right to be upset, mad, depressed, anxious, or tired. But I promise you, it can get better. You can find the light at the end of the tunnel of darkness you’ve been in for so long. It’s right in front of you. There will be obstacles. There will be barriers. But you are strong, brave, and resilient.

I believe in you, even if you are currently lacking the belief in yourself. Remember, an inpatient stay doesn’t equal weakness. It equals a strength that you never believed you had. And when you realize that, you have the power to accomplish your goals. I hope this letter has helped you. And I hope you realize the amazing things you are capable of.


Rachel is a young adult who hopes to someday become a peer mentor or a peer specialist. They are currently working on writing and publishing a book of poetry.

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My grandfather, my son and the right thing

February 19th, 2018

I was 9 years old when I noticed that my grandfather dropped my grandmother off for church services every Sunday but never went inside.  Oh, he went to church for weddings, funerals, fairs and Saturday bean suppers.  But he never once attended Sunday services.  My grandmother would say he didn’t like sitting in the pew or that she simply needed a ride.  I asked my mother about it, feeling a little anxious, trying to make it fit into my limited understanding.  “Your grandpa doesn’t believe in God,” she explained, “But he believes in Good.”

I sucked in my breath and my little-girl understanding shifted.  Until then, I had Good, God, having morals, doing good deeds and being a good person firmly super-glued together in my head.  You couldn’t have one without the other, right?  I began to understand the different shape of each thing and how they were not identical.

I saw in my grandfather, whom I adored, a warm, generous, very kind man who adhered to a strong code of conduct.  If you left a dime at his house, he returned it to you at the next visit. But he was agnostic, not religious. I noticed others who did the “right thing” every time, even when it was uncomfortable or a stretch for them, but they had beliefs about the world that startled me.  I gradually became comfortable with the idea that our inner guidance systems are unique and help us navigate the world in singular ways.

Many years later, this would help me understand and love my son during the hardest times.

My son was 7 when I realized that he saw and heard things that no one else did.  He was too old to label it magical thinking and his therapists and teachers were reluctant to call it psychosis.  What he saw and heard often scared him and that fear followed him all day, often even into the night, resulting in nightmares.  His fear, frustration and despair would overwhelm him and he would lash out or fly into a frenzy, hurtling objects and even hurting himself.  In those hours, he changed into someone else, shedding the things that gave him joy: his laughter, his creativity and his curiosity.

Sometimes the voices and visions told him to hurt his younger brother and I would hold him tight while he raged.  I would urge his smaller sibling to close himself in his bedroom, to be safe and out of sight. We did this again and again over the years, our family’s version of a safety drill.  His younger brother went from telling people that “I have a very, very good brother who does very, very bad things” to simply announcing that his brother was bad.  Very bad.  Once, when someone asked what his brother was like, he replied, “I have a bad brother and he is a very bad brother to me.” In his mind you couldn’t do such bad things and not be bad yourself.

It’s hard when you are in the midst of daily chaos to unstick the superglue that binds together your ideas about what children are like, especially your own children.  I thought children were naturally resilient, absorbing life around them, sometimes being silly.  That wasn’t my son’s life at all.  He was emotionally fragile, sometimes lost in his own world and unable to laugh. It was my job to untangle my assumptions and instead put in plain view the things I wanted others to see.   It was my job as a parent to paint that picture, showing the world outside my family that my child could be good and do bad things.  That my child had lots of moments where he was brilliant and vulnerable and caring.

He could be loving and smart, hold my hand, give great hugs and say funny things and still have moments and hours where he made me cry, made me angry and pretty scared for him.

There were no guidelines to understanding my son; I had to create my own.  I began to understand that while he did not always understand what was real, he could understand what was right. Even more, he cared about that. Often, after his rages and being lost in his phantasmic world, he would feel deep remorse.  (He was still unable to stop himself the next time though.)   His sense of what was right and wrong vied with the voices and destructive impulses.

When he was a little older, he announced he had made what he considered a better moral choice.  He began directing the raging and hurting only toward himself, sometimes viciously, sometimes persistently and away from his brother and me. His inner guidance system was trying to make peace between the storms in his mind and his sense of what was right.

We are all nuanced people with complicated beliefs.  It doesn’t get any better when you throw mental health issues into the mix.  On those parenting days when I came up for air, I would channel my mother.  I would talk about my son saying, “My son is not always sure what is real, but he loves knowing what is right.” Then I would add a story or two which showed the shape of our lives, hoping to unstick others’ ideas about good children and bad behaviors.

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What is sick enough?

January 28th, 2018

What is sick enough?  Is sick enough a meaningless number or stupid hospital band?  Is sick enough the size of your thighs? Or that dead look in your eyes?

Is sick enough really what we are trying to achieve? What even is “sick enough” besides some bullshit phrase our eating disorders engrave into us?

I can tell you one thing, I have never felt “sick enough.” Even when I was on my death bed I still didn’t feel sick enough. And why? Because sick enough isn’t real, there will always be another demand from the disorder, inpatient or not, weight loss or not, there will always be more.

Take a moment to think about the stigma around eating disorders.  What does a stereotypical eating disorder sufferer look like, both in society, with this idea of an underweight cis-gendered white woman even within the recovery community and with professionals who deem the severity of this mental illness through the severity of the physical side effects shown on someone’s body. If there is one thing I’ve learned through my various hospital admissions it is that how someone looks has very little to do with what’s going on within their body and mind. Someone may look healthy and can still be severely ill, and gender means absolutely nothing.

That some false measure of “sick enough” exists is engraved into our heads the moment the eating disorder comes in.  And even when we open ourselves up to treatment, many people fear reaching out to ask for help because they are concerned they won’t be taken seriously. The eating disorder and frankly, some treatment providers intentionally or not, preach this idea that in order to be sick enough you have to reach some sort of bullshit status. Whether that be inpatient, a diagnosis, or a weight range this idea of sick enough manifests in various ways. When in reality it doesn’t really exist and everyone is “sick enough” to deserve help.

To go a little further, I’m now going to swim into the pool of treatment centers, how do you get into treatment for your eating disorder? Through a mental but primarily physical exam, which is a whole different issue in itself. If you’re lucky you’re in, assuming providers decide that you are “sick enough”. But what happens when you have an eating disorder plus other mental health issues? How can you receive help for both? Unfortunately overlapping help is often not accessible, so people are treated for one thing or the other, but rarely both. I’ve been turned away from receiving treatment for my eating disorder due to my other mental health disorders and I’ve also been turned away from treatment for my other mental health disorders due to my eating disorder. There is always a major fear factor when treatment centers are faced with multiple issues within a patient, so these other issues are commonly ignored.

Something providers lack is the knowledge that these mental illnesses are completely intertwined. With an eating disorder there is a lot of anxiety and OCD and eating disorder behaviors can be extremely connected. Underneath the eating disorder there are surrounding issues. Eating disorders are often avoidance behaviors, meaning that there is an underlying issue, but when turned away from help for these underlying issues due to fear from providers; what’s left is a lack of coping tools.

The solution, while hard to achieve, is entirely possible.  It’s a more collaborative approach. Because these illnesses are very connected it is valuable to have treatment that is unified. In my opinion, the line between treatment for psychiatric disorders and eating disorders is much thicker than necessary since both disorders are mental disorders.

Emily is a young adult who uses art and social media to express emotion, educate and provide support and hope for peers struggling with eating disorders and mental health challenges.  Follow her on Instagram @ reconstructingemily

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Residential programs, partnering and loud music

January 16th, 2018

When my son was 16, I drove him two and a half hours to his new residential program.  Amazingly, we both stayed calm, chatting about inconsequential things and turning the music up when things got emotional and we needed to stop talking.  This was a moment I had staved off since he was eight, the first time someone suggested he go into a residential.  I’d thought of it, scowled at the thought, rejected it, marshalled arguments against it and yet, here we were.

His arrival was anticlimactic.  The staff grabbed his things and he went off to browse DVDs and video games he wished he had at home.  I was reassured, signed things and was given a list of ways to reach the program.  On the two and a half hour ride home, I alternately gave myself a lecture, sobbed and turned the music up.  (Yes, it’s a family coping mechanism.)

The first night was really hard.  I woke up a lot, half listening for my insomniac child to wake up and wander in the night, feeling an emptiness in his room down the hall.  Our dog, Bonny, who usually slept on the foot of his bed, meandered around not sure where she should sleep. We got through that night and the next and the next. We adjusted to having space where he used to be, a space that would be filled only when he was home some weekends.

Over the next couple of years, I made that two and a half hour drive a lot.  Some weekends I would drive out Saturday morning, take my son on day-long outings, return him to the program and then come home at night.  The next trip I would make a round trip on Friday so he could come home, then another round trip on Sunday to return him.  I listened to a lot of loud music in the car.

Sometimes I say that if my family were a game show, we would be Let’s Make a Deal.  This time, my son and I had made one of our deals – if he went to the program, I would be there on most weekends. It was a long drive, but he was part of our family. I called a lot during the week, calls to him, to his program therapist and often to his teacher.  When staff wanted to treat his eating issues as a behavior, I called, explained, begged, threatened and called up the ladder to resolve it.  When there were conflicts with others or medication issues or he had a favorite item stolen, I jumped in and advocated for him. I took him for his haircuts, to buy clothes and all the things a mom does.  I held on to my rightful place as his parent with an iron grip and didn’t let go.

It turns out this was one of the best things I ever did.

Residential programs in this state and others are changing, or trying to, so that they shift to make space for parents as partners.  Lots of times this is still aspirational instead of reality, but with each little change there is no going back.  The national initiative, Building Bridges for Youth, tells residential providers that children have better outcomes when their parents visit, stay in touch and are involved both in the short and long term.  They also have the research to back it up.  Children go into residential programs as family members and when they are there, they remain part of their family too.  Families have incredible knowledge and resources to offer and parents have enormous expertise to draw on.  Yet, sometimes parents are welcomed, sometimes ignored, sometimes disrespected.  Often, all three attitudes can be found in a single program.

By the time my son entered a residential program, I was pretty exhausted.  I had been fighting, advocating, collaborating and juggling for a very long time.  We both had mixed feelings about it, but had limited options.  He had been turned down by six day schools and eight residential programs.  He needed someplace to receive therapy and finish high school.  I needed someplace where they had had teens like him before and I could trust that they knew what they were doing.  I already knew that clinical and program expertise didn’t always come with a parent friendly attitude, but I figured I could change that.  My exhaustion might have initially looked like acquiescence or passivity but it was soon apparent that advocacy had taught me a few things

It also helped that my son would ask staff if they had checked in with me when there was a change.  Even better, he often told them that he had to check in with me himself before he made a major decision.  The two of us didn’t always agree, but we talked things through and figured out how to get what was needed.  Sometimes, we made a deal.  I frequently told him that advocacy was the family business.  He would say, “I guess I’d better learn it, then.”

Like many parts of the mental health system, residential programs are usually designed to operate in a way that works for the program.  Routines and schedules are the same for everyone.  Same for meals and activities.  Parents can see the program as unwilling to be flexible and programs often see parents as unwilling to change.  When an engaged pushy parent like me comes along, programs have to decide if they want to cheer or groan.

Being very involved was one of the best things I ever did, lengthy drives and all.  At first I was involved because, well, that was how I parented a son with mental health needs that mushroomed over the years.  I was also involved because it was part of the deal I made with him and keeping promises was important to both of us.  I came to realize that my regularly showing up, calls, chats with staff and meetings with therapists set the groundwork for troubleshooting when we needed it.  It blurred the lines between us so we were more of a team.  It created respect and sometimes, admiration among us.  It probably led to better outcomes, too.  Cue the loud music.

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The middle child against the hallucinations

December 18th, 2017

It was a cold day in the winter and I remember my older son screaming like there was a criminal in the house. I ran to see what was going on and it was the misplacement of a book that startled him. He was saying over and over he was sure that someone took it.  Or someone planned to take it, because he was thinking about the book at school and it was taken so that he could not use it.

This was actually a better day then most. In the past, he would lash out  physically when he did not have something, or he thought that the world was planting things to make it difficult as the voices told him during the day.  I would be the one who would remain calm but get attacked as he tried to find words to come to his lips from his brain. It would be so very hard to try to figure out the antecedent prior to the behavior (ABC Charts),  Have you, too, ever had to try to figure things out at midnight, when you finally have a moment to think about the events of the day?

I remember sitting night after night trying to figure out what could I, should I, plan to make it all easier in our house. With three children (and often another few that needed a place to be) planning was most important. It took lots of planning on what and how I would explain the transition of lots of things. We had a large white board, charts, rules and ideas for the emergencies.  We also had it simplified into this-is-the-way-life-is-going-to-be-today.  Many people would tell me that it was like a mini behavioral plan all around.  What many did not realize is that board was just as much for me as it was for them. My lord, some days I was lucky to remember the schedule and get things done.

There was one time that I remember the voices arriving when they were not wanted at all. It was my middle son’s eighth birthday and we were planning for his cousins to come over and spend time with us all. We were going to make pizza and have ice cream sundaes after. That was the afternoon that the voices came, only to create hell in the house for my older son who was ten at the time. He would not listen, settle down. He could not tell me what was going on and I was having a challenge figuring it out.

We knew something was up and we had planned for the “safety” word as we did most days. This is the word that you say so that the other children get to a safe place. Our safety words were always words describing the beach. This time it was “ocean” and it was clear that the place to go was the living room, bring the dogs and use the electronics.  We had discussed it prior to the party and also practiced once. We were all on eggshells as the party went on. Did we need to use the word? What had happened? I hoped that the voices were gone.  You never know when you are with a child who experiences this and can’t really plan well. So we continued to go through the evening. It was peaceful but we were walking on eggshells awaiting the drop.

Finally morning came, along with play dough, music and fun.  We were set for the day and ready. Unplanned, not practiced and surely not wanted, the voices arrived. Off went the items and I was in the line of fire. I remember the first punch to the face and the kicking on the floor. As the safety word was used everyone did great but my middle son. He wanted to reason with his brother. He got everyone to the living room but, like many of our children who have brothers and sisters with hallucinations, he wanted to protect both his sibling and his parent.

I ended up sitting on the floor finally with safety hold on my son. My middle son sat back to back with me rubbing my head and saying nothing. I held my oldest until it was done and told him that he was safe, he was loved and I was there.  After several minutes– that felt like hours –he calmed down. He was finally able to cry and breathe. My head hurt and my legs wanted to crumble but I just sat there and started to cry. To this day I remember what my eight year old said: “Mommy he didn’t mean it.” He was completely right. And I did not mean for him to have all the pain as a sibling to brother living with trauma and hallucinations.

Sometimes you learn to accept and live with the voices as part of your family and other times you wish they would never come back.  It is hard because the hallucinations are with my son all the time and we love him. So in those situations we will learn to deal with those darn voices.

Meri Viano is our guest blogger.  She is the parent of two sons and a daughter who continue to inspire her blog posts.

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