In front of the guards, a fellow patient plants herself on a chair and raves: “I am not being paranoid, but all you [expletive] are against me! I came here for protection!”
I didn’t come here for protection, I came here to see a doctor who can prescribe the same antidepressants whose withdrawal has me alternating between suicidal thoughts and emotional self-flagellation. I’ve had success with selective serotonin reuptake inhibitor antidepressants, or SSRIs, in the past, but eight months ago my symptoms worsened. Under the supervision of a psychiatrist, I began weaning off Zoloft. I wanted to try nontraditional treatments that adversely interact with that SSRI.
These nontraditional methods did not work.
In New York City, where I live, the wait time to see an in-network psychiatrist can be weeks. When I told my internist this morning that I had been having suicidal ideations and wanted to go back on the antidepressants, he called a psychiatrist friend of his, who offered to see me right away for $350. This was cost-prohibitive, so my doctor made me promise to go to an emergency hospital psych ward for an observation that, he assured me, wouldn’t last longer than 45 minutes. I had to be at work two hours later, but I obliged.
“I’ve been having suicidal thoughts,” I told the nurse at reception. She asked if I had weapons on me. I should have clarified that I wasn’t having suicidal thoughts right at that moment.
Last week was low. I thought of how I would do it, but then I reflexively called members of my support network, a motley bunch of six people who love me, and I laid my mind bare. With their input, I came to the realization that although my SSRIs forced me to stop exploring alternative depression treatments such as ayahuasca (a hallucinogenic herbal brew used in South America), they did prevent suicidal ideations for the nine years I was on them, which is a good thing.
I feel at odds with the self that brought me in here. That self thought I would stay for an hour of observation and leave with a Zoloft refill. Then he told the nurse about the allure of the water under the Brooklyn Bridge and that although he knew he’d never jump, the thought of it provided momentary relief from the throb of depression.
So here I am, held against my will on suicide watch at a psych ward. This is Hour 3.
A resident physician asks another patient, as he asked me, “This might sound like a weird question, but why didn’t you kill yourself?”
I shouldn’t have mentioned the bridge. It wasn’t worthy of a footnote, and now it’s the foundation of the medical case against me. It’s not that I hate the world enough to leave it — I just don’t always see a place for myself in it. The lens of my experience is so clouded with negative self-talk that nothing jibes between my awareness and the outside world. A feeling of depression arises first, and my thoughts race to justify this feeling, giving the depressed mood a stickiness through depressive logic.
This hospital wants me healthy — or, alive — not happy. Here, health is a fluorescently lit room and a fire-retardant mattress, topped with a sheet on which I use my safety pen to sketch Pez dispensers of different antidepressants. Here, health is a cranberry cocktail and roast beef sandwich from the vending machine. Here, health is, as the attending psychiatrist assures me, “keeping you safe.”
I thought that willingly checking myself in would earn me some sort of agency in my stay. I was wrong. I want to leave. Sitting in a padded, windowless room is no cure. It has not the serotonergic effects of an SSRI, nor the subduing warmth of alcohol, nor the clarifying awareness of LSD. The therapy of this place is its bleakness: When you leave, you reclaim the joie de vivre you lacked upon admission.
I suspect my depression will always be with me. These acute episodes, I know, are temporary. They subside with time and treatment. Forcing myself to be social is beneficial: Distraction helps while I allow depressive thinking and feeling to wash over me. Recognizing that this wave will pass is the key to surviving a depressive episode. This knowledge is the antidote to hopelessness, depression’s most dangerous symptom.
I have trouble admitting there’s no magic cure. Perhaps a megadose of LSD, or a shroom trip, or one more ayahuasca ceremony will finally heal me. These are palliative treatments, and sometimes therapeutic, but my SSRIs are essential.
On top of my intake paperwork lies folded a scrap of paper with my girlfriend’s phone number on it, which I’ve finally committed to memory (better late than never). Is she worried? Should she be?
I keep writing only because it feels social when boredom and isolation dominate this mandatory vacation. I’ve considered trying to persuade the doctors to give me Xanax or a sleep aid to get through the time, but such a request will certainly extend my stay. I’m desperate for conversation. I try small talk with the guards, but they douse my pleasantries with one-word responses. I empathize — after all, I avoid conversation with other inmates myself. Are we afraid that mental illness is contagious? That if ideas can go viral, so can insanity?
“Acute major depression with cognitive delusions,” I overhear a doctor say outside my room.
The nurses move upstairs to an extended observation area. By now I’ve learned the game: Fake it profoundly. “Have you had further thoughts of suicide or self-harm?” asks the doctor. I shake my head vigorously and ask him why I must stay until tomorrow afternoon. “How did you think this was going to go?” he asks. I shrug my shoulders. Protest will prolong my stay.
The following evening — Valentine’s Day — I’m out with a prescription. Clutching my safety pen.
Leach lives in New York City, where he records and performs as @leachmusic, scores podcasts, delivers consumer electronics and teaches songwriting.