A woman with bipolar disorder provides her experience of being on a locked psychiatric ward.
Personal Stories on Living with Bipolar Disorder
Please note: The information presented here was obtained from one of my hospitalizations at the Johns Hopkins Hospital in Baltimore Maryland. The hand outs are written by the doctors and staff of the hospital. They reflect the programs offered at Hopkins. Please keep in mind that other psychiatric wards are different. This was just my experience.
I have been hospitalized more times then I want to remember. Each hospitalization is different. It varies because most of the time there are different doctors and other staff members and very different approaches. Each facility is different as well. Sometimes the programs change. I can tell you that the best place I have ever been hospitalized is Johns Hopkins Hospital in Baltimore, Maryland. It's located about 3 hours from my home. They have an excellent medical team and approach. I have been a "guest" there more times then I'd like to remember. Prior to going to Hopkins, I have been in and out of my small local area hospitals on numerous occasions. It wasn't until I went to Johns Hopkins that I started on my journey to some stability.
In my experience, it's a strange occurrence to be on a locked psychiatric ward. They tell you that the locked aspect of the ward is for safety purposes. It's odd not to be able to come and go but when one is in a critical state, I suppose it is safe to be "locked in." Each hospital has its own set of rules and expectations of the patient. They are some what similar in my experience. When you arrive you are evaluated by a nurse and then the doctor. They ask a series of questions regarding your affect. At Johns Hopkins, they give you what's called a "mini mental" exam. It's a series of questions designed to see how you function and what your memory capacity is at the time. The psychiatrist will evaluate you and then give you a physical examination. When I was at Johns Hopkins last July, the exam with the doctors was about 90 minutes. They have a "team" approach at the hospital.
The team is made up of an attending doc who is the primary on the case, and an resident doc who does most of the work and sometimes a medical student. They do rounds in the morning to assess how you are doing. The rooms are comfortable and the baths are shared by two rooms. They have private and semi-private rooms. Fortunately, I was able to get a private room. I was glad of that. The daily routine consists of educational groups, support groups, occupational therapy, relaxation therapy and gym. Not all hospitals offer these programs. Twice a day you meet with your assigned nurse to discuss how you're feeling. This gives the staff an opportunity to write down your progress so that the team can review your status each day. The majority of the nurses at Johns Hopkins were excellent and very comforting. Meals are served three times a day. One is allowed to select meals from a provided menu. The food was pretty decent and the selections were adequate.
I usually end up in the hospital because I am suffering from very severe depression or mixed states. I had an excellent and very skilled set of doctors thankfully. After my assessment, the team put together a proposal for me that I was not comfortable with however. They suggested ECT for me which threw me completely. Because of the nature and duration of my depression, they felt that ECT would help break the cycle. I had been in bed for months on end with no hope in site and finally I developed a plan to take my life. I was a wreck when I went into Johns Hopkins. After four days of careful consideration, I decided to ask what plan "B" was. My doctors had examined my lengthy records and decided that I had not had a long enough trial of Lithium. Thus they decided to put my back on that drug. They felt I needed two mood stabilizers and I was already taking Depakote. I went through days getting my blood drawn to check my levels and suffered some side effects to boot. However, I decided I wanted to give this a fair chance. So I went through the daily routine each day in the hopes I would start to feel better soon. Just a note about ECT. I did see some improvements in some of the patients who were undergoing ECT. It just wasn't for me at the time. (Update: I no longer take Depakote (Divalproex). I'm on Lamictal (Lamotrigine) and Lithium Carbonate (Eskalith) now).
The first and second days being hospitalized are the hardest. I cried and cried after my husband had to leave. It was very difficult on me. I felt totally isolated and all alone. My depression seemed to get a bit worse because of these intense feelings. You feel like you're under a microscope with all the docs and nurses watching you, not to mention the other patients. Eventually, you make friends on a very deep level. It's easy to relate to someone who shares a similar illness. At first you're very quiet at the groups and don't want to talk or look at anyone. Then in due time you warm up a bit. It becomes easier to look people in the eye instead of away. It also becomes easier to speak if you choose to. The main thing to remember is that your there to get stabilized. That should be your main goal. It takes a lot of work to get there, however.