The DBSA Young Adult Council (YAC) develops unique resources to support other young adults living with depression and bipolar. They use their own lived experience to help inform the way that DBSA provides hope, help, support, and education. In this piece, Olivia talks about transitioning across different levels of mental health care. Content warning: suicide, self-harm, disordered eating.

“Man, it sure would be nice to be back in inpatient treatment,” I think to myself. I’m in my office at work, with the door closed, worrying about all my responsibilities and the extra commitments I’ve made.

“I wish I was in inpatient again,” I think from time to time. Of course I don’t mean it. There are things I miss, or perhaps long for: the simplicity, the consistent schedule, and being surrounded by peers. But there are also things I’d never want to experience again; things I wouldn’t wish upon anyone.

Entering Residential Treatment – Age 18

“That’s a really stupid thing you did, you know.”

That was my introduction to residential treatment.

I attempted suicide in December 2016. I stayed in the general hospital for a couple of days before the doctor discharged me to a psychiatric hospital. I was transported there by ambulance, and I didn’t get the “warm handoff” that is considered a best practice in health care. I think my experience would be better classified as a stinging or icey handoff.

The two men on the ambulance wheeled my stretcher into the intake room and left. My parents and I waited for a couple hours, before someone eventually came in and explained what was going to happen next to my parents. I’m sure they tried explaining to me too, but I couldn’t focus.

Then it was time for my parents to leave me alone, for the first time in days. The employee who was responsible for taking me to my unit arrived. As we walked down the dark, quiet, sterile hallway, she turned to me and said, “That’s a really stupid thing you did, you know.”

As if the guilt, embarrassment, and shame I was already feeling weren’t enough. I’m reminded of the horrible phrase “failed suicide attempt”. After all my struggles with emotions, relationships, and self-love… I couldn’t even get that right. Sometimes, an intrusive thought (maybe I should have tried harder so she couldn’t have told me that, so I couldn’t have heard it) pops into my head. I learned how to manage that thought a few years later in therapy.

The best counselor I’ve ever had told me, “Thoughts can be like fish in a river. You’ll have negative thoughts, but you don’t have to catch them and keep them with you.”

Onset (and worsening) of Symptoms – Age 13 (and 18)

My introduction to mental health care happened in a middle school counseling office. I had been self-harming for almost a year, and I confided in my best friend. He did the responsible thing and told the counselor.

My counselor called my parents, who drove me to the pediatrician as soon as the next appointment was available. I got a prescription for an antidepressant and a referral to a licensed clinical social worker. My parents and I didn’t know much about counseling, so we went with the pediatrician’s first recommendation and stuck with it even when I got the feeling it wasn’t the right fit. I stopped my sessions when I got fed up with it and decided to give it a go on my own again.

Without the right tools and supports, I fell back into self-harm and disordered eating. By the time I graduated high school, I was comfortable with the frequency and impact of my bad habits. The self-harm was happening every couple of weeks, and the disordered eating was only a few days or weeks at a time. And, like in middle school, I was still good at hiding it.

Looking back, I think the antidepressant my pediatrician prescribed to me back in eighth grade stopped working after a few years. You can read more about that experience in the Young Adult Council Q&A “12 FAQs about Medication and Mood Disorders”. I think I was able to maintain a personally-acceptable level of mental wellness because I was surrounded by a strong support system.

The wheels started to fall off during my first semester of college. I was two hours from home, and I wasn’t doing anything to build a new support system. I was either in class, at the gym, or hiding or sleeping in my dorm. Things eventually got so bad that I couldn’t hide them anymore. My suicide attempt forced me to get the help I needed.

First Day in Residential Treatment – Age 18

I isolated myself during my first semester of college, and I did the same during my first day in the psychiatric hospital. Most of the people in the adult unit were in their 30s or 40s. I was 18. I was the second youngest person there; there was another 18-year-old who was still in high school.

In addition to isolating myself socially at school and in the hospital, I also distanced myself mentally. Isolation is one of my most powerful, overwhelming symptoms. I think to myself, “I’m the only person with these thoughts, feelings, and compulsions. Even if I wasn’t, even if I told someone, they wouldn’t care.” I knew these thoughts were absurd, but that didn’t (and still doesn’t) stop them from coming. In the hospital, for the first time, I learned those thoughts weren’t true.

Group therapy was a big part of everyone’s treatment plan in the hospital. We’d all get together for several hours every morning and afternoon to talk about different therapeutic topics, like cognitive distortions, coping strategies, and healthy relationships.

For the first day, my whole body shook with nervous jitters, and I only spoke when spoken to directly (and even then, I spoke as little as possible). But even that first day, I started to pick up on something.

Every time someone said something about their thoughts, experiences, or concerns, at least one other person nodded or raised their hand, signaling (or even saying out loud), “Yeah, I’ve been through something similar.”

That experience changed my life, and it’s what led me to DBSA. It’s also what allowed me to feel comfortable sharing my story and what assured me that openness and connection are crucial in improving outcomes for myself and others living with mood disorders.

Understanding My Changing Needs – Age 25

Worries in the hospital were either very minor, like what channel to put the tv on, or very internal, like the trauma, emotions, and thinking patterns that landed us there. What I think of as “mid-level” worries were non-existent. I didn’t have to stress about meeting expectations at work, arguments with family, or schoolword. Being in the hospital gave me the much-needed opportunity to focus on deeper, internal challenges with my thoughts and emotions.

When I say I wish I was back in inpatient treatment, what I really mean is I need to take time to focus on myself.

Of course I miss the connections I made there and the extra downtime I had to read, color, and work puzzles, but there are also plenty of things I don’t miss. I don’t miss being cut off from loved ones, limited to one weekly visit and a 15-minute phone call every other day. I don’t miss being told when I could eat or go outside. I don’t miss being away from my dog. And, as an introvert, I certainly don’t miss not having a private space of my own to retreat to when I need some time by myself.

Now, more than six years after my stint in inpatient treatment, I’m finally starting to understand what I really mean and need when I say I wish I was there again.

I think most people reading this would agree that mental health is just as important as physical health. The two are so closely tied that it can sometimes be hard to separate them into two distinct categories.

It took me years of mulling over my experiences to fully accept that mental health days are just as valid as days of rest for physical illnesses.

I might not need to go back to an inpatient level of care, but that doesn’t mean I won’t benefit from stepping away from day-to-day life for a day or two.

I’ve realized that transitioning across levels of care doesn’t have to be as dramatic, defined, or official as insurance companies dictate. My mental health fluctuates, and some days I’ll need more self-care time and support. I don’t need to pick between two extremes- going at it on my own and being hospitalized. I could enter an intensive outpatient program, see a therapist weekly, or even go to more peer-support meetings, like those DBSA offers. There are plenty of options in between that I can choose as needed.

Inpatient treatment will always be there if I need it again, but I don’t need to wait for things to get to a crisis level before making changes or seeking more treatment and support.