#2. The Punishments Are Way Tamer (Just More Annoying)
Chemical restraints and leathers, as cinematically interesting as they may be, are generally only used in exceptional situations (like if you attack a staff member or try to escape from the facility). But everyone has checks. Every half hour, a staff member will find you and make sure you're OK. If you're in the shower, he'll knock until you shout your own name. If you're asleep or in group or reading, he'll just write it down and be on his way. They generally don't show that in films, because your protagonist being lightly annoyed every 30 minutes by her own personal Navi does not make for a thrilling narrative.
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It's the human-being version of a straitjacket.
But if you've been obnoxious or disruptive, those checks are every 15 minutes. Or 10. And the worst folks have a 1:1 rule placed on them, which means they need a staff member within 10 feet of them at all times. The staff doesn't touch you or harass you -- they're just around. They make sure you don't hurt anyone or yourself, or lack for a tennis partner should a mandatory game situation ever arise (it never has).
The places I went were pretty understanding, especially when I punched a dude in the face. He deserved it. He was young, maybe 19, and creepy as hell with his unwavering stares. He took it a step further by whispering stuff like "I'm going to come into your room at night and rape you" every time he passed a woman. And of course, none of our rooms had locks.
And they'd confiscated my wheelgun at the door.
One day, I was reading in my room and he barged in, which is a huge taboo. Patients are never allowed in each other's rooms. I told him to get the fuck out, shoved him backward, and used the door to force him out of my room. But each of our doors had a little Plexiglas window (for those frequent checks) and he kept staring at me through the window.
So I opened the door. He didn't move. I pulled back my fist and looked at him. He still didn't move, so I punched him square in the face. I took the book I was reading (one of the last Harry Potter ones, a big, fat, pre-weaponized hardcover) and chased him, screaming and beating him with the book while he tried to run away down a 20-foot hallway. Not a lot of places to hide in a psych hospital.
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And no places to hide from this big bastard.
Staff members pulled us apart. He got put on 1:1s, but I just got a warning ("Please don't punch anyone else"). It probably had something to do with the fact that, as a rape survivor, I don't respond well to rape threats or assholes barging into my room. So yeah, gonna go with "He deserved it."
#1. You Don't Usually Know What's Wrong
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When someone in a film has a mental disorder, it's always clear exactly what's wrong. It takes a movie doctor 12 seconds to lower his glasses and throw out a diagnosis of schizophrenia. But one of the most frustrating things about a serious mental illness is that you almost can't know exactly what's going on.
"Shit, let's just call it a headfuck cocktail."
It took me more than a decade to go from my first therapy session to knowing what I had. I started with a diagnosis of major depressive disorder, but after my first episode of mania, it turned into bipolar disorder, then bipolar with psychotic features, and finally schizoaffective disorder, bipolar subtype (and no, there's no fun little acronym for that one because it would be SAD-BS). Your brain changes as you age, so it's possible for your disorders to evolve like terrible crippling Pokemon. I started therapy at 13, but I didn't have a full-on delusion until I was 21. It was not very effective.
Since the doctors can't be 100 percent sure what's wrong, they can't be sure that the treatment is going to work. It could even make you worse. If you're secretly bipolar, but have only outwardly shown signs of depression, then antidepressants could throw you into your first mania. That's besides all the normal risks and side effects of medication. If you only get dizzy, sleepy, nauseated, or jittery, consider yourself lucky. Bad side effects include fainting, dangerously low blood pressure, seizures, the beginnings of Stevens-Johnson syndrome, and muscle stiffness to the point where you can't stand up. And those were only the side effects I personally experienced.
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Others were rather more severe.
Delusions are pretty confusing, too. One Friday night I came home and instantly knew my boyfriend had been replaced by an alien doppelganger. He looked the same ... but somehow off. I knew it was impossible and screwed up and wrong. That's one of the things about mental illness they don't show you: You can know what you're thinking is abnormal as you're thinking it. Here's the other thing about mental illness: That doesn't help one fucking bit.
If you suddenly hear a voice telling you that your neighbor is Satan, you don't go "Well, golly gee, time to kill him with a screwdriver, I guess." You'll fight it and disbelieve it, until you start seeing Satan in everything your neighbor does. By the time you confront him, you have tons of evidence. The evidence doesn't make sense to anyone else, but your brain makes it make sense to you. So when your neighbor ignores your hello, it's clearly because he's Satan and not because he didn't hear you.
Those damn horns he keeps wearing sure don't help.
And my alien delusion? How would I disprove that? My boyfriend would say he wasn't an alien, but that's exactly what an alien would say. Eventually, I got over it ... by ignoring it. My thought process went something like this: "If he is an alien and I blow his cover, he might beam me up to the mothership right now and whisk me away. If he's not an alien, he'll get upset that we're having this argument again. If I act normal until the alien leaves, I'll be fine."
The only way to fight your delusions is to ignore them. Not that this is a comfortable thing, since my brain is now convinced that I've had sex with an alien.
Hymn Herself has written a novella about her time spent inpatient in McLean Hospital. It's called House Full of Insects, and you'll buy it if you're cool.
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