Why I started smoking in hospital

Arriving at the psychiatric ward, in which I stayed for the last three and a half months, the first thing you spot is the so called “smoking pavilion”, basically the most important place up there. It’s where you meet before and after therapy, it’s where you get visited by old fellow patients out of visiting time, it’s where you go when you’re upset, because you’ll always find someone to talk to. It’s where you meet in the middle of the night, because almost everyone in there has some trouble sleeping. It’s where the nurses and therapists walk you, when they need to have a talk with you. It’s the place you go to when you’re hungry, but you’re running low on snacks. It’s the place you go to when you’re bored, almost every time someone will lurk around the corner after a few minutes. You spend the sunny days in front of it, the rainy ones inside of it.

After you’ve seen the famous smoking pavilion it won’t take you long until you spot either a single smoker or a whole group of people smoking. There’s no in-between. And whilst a single person smoking is rather rare, the groups of smokers belong to that place like the trees that seem to have grown there all along.
You might think these groups are limited to patients, but nurses, therapists and doctors seem to not have learned so much during their education. It’s actually pretty hard to find a person that doesn’t smoke. Everyone’s doing it. The head physician, the well-educated therapist, the nurse that doesn’t even smoke at home, the trainee, the nursing student, even the addiction counsellor.

When a patient is admitted and tells the physicians that they do not smoke, they’ll probably hear the same thing every other non-smoker did on their first day: “Oh, one of the very few non-smokers here, that’ll be fun.”

I got to hear that sentence, too. But a few weeks later, when I lit up my first cigarette there, everyone was left in shock. Maybe, because I was one of the few that didn’t smoke when they were admitted. Maybe, because they thought I wasn’t ‘that type of girl’. I heard it all.

Now, being outpatient, I quit again. But I’m still getting horribly judged for even starting.

But, you know, it’s hard to explain to non-neurodivergents. And now, that I left it behind, it makes even less sense.

As a person who’s among other things being treated for depression, I as well went under treatment for suicidal thoughts and suicidal ideation.
Staying in hospital, you obviously can’t easily act on these or any other self-injurious ideas. I mean, you can, but it’s attached to a lot more stress and talks and justifications, as well as incredibly annoying behaviour analyses.

Not being able to actively harm myself all the time, my incredibly smart and disfunctional brain figured, that smoking could be an alternative.
It was something I didn’t like and I was kinda afraid of, the perfect thing to cause some harm to myself. Not forgetting the harm it causes to the body.

Some days I was sitting there hoping that this cigarette I was smoking might be the one that finally killed me. Other days I was just trying to numb the thoughts and the pain I felt. On even other days I just didn’t have stuff to do and I figured, that it would be a better option to smoke some cigarettes than to cut or burn myself.

If you never experienced this situation yourself, it’ll probably be hard to understand the feeling of having a little bit control over the damage you cause yourself, when most of it is taken away from you by rules the hospital put on you.

It was a way to cope, a way to numb my feelings, a way of limiting the damage.

Now that I am outpatient after a quarter of a year, I am proud to say that I quit.
But there are still days on which I can’t refuse, either because I am feeling okay, but not okay enough to not cause any harm to myself; or because I am just so fed up with everything, I have to turn it into a rebellious act against myself; or because I feel like it would be the better and less damaging option I have in that moment.

It were never my fellow patients that pressured me to start smoking, it was never out of peer-pressure, it was me that made that decision and it is me that has to be able to control whatever I choose to do.

I hope, that unlike a lot of people in life, you will question the things a person does, before judging them for their actions. Their behaviour might not fit your idea of reacting to certain events in life, but yours might not fit their idea either.

“Everyone deals with unimaginable pain in their own way, and everyone is entitled to that, without judgement.”

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What happens if I am suicidal at an open ward or treatment center?

This is a question almost everyone who’s been inpatient and deals with suicidal thoughts or suicidal ideation asked themselves. Quiet often patients that are at risk of hurting themselves go unnoticed, because they’re afraid of what will happen if they tell anyone.

Please remember that I am in no way a mental health professional or a person that worked in a mental hospital, everything I write is based on my own experience.

First I’m going to talk about what it was like when I stayed at an inpatient psychosomatic treatment center that wasn’t a psychiatric ward at the hospital.

If you were known to deal with suicidal thoughts you had a talk with the staff once or twice a day and probably were classified into how likely you were to act on these thoughts or ideas. Depending on this information they had a timespan, like 5 to 30 minutes, and if you didn’t show up for the meeting within the given time they had to call you, and if you wouldn’t answer, the police.
In these meetings they would always ask you how you were feeling, what you were doing and what you were planning to do, if you felt suicidal and if you felt like hurting yourself.

As a patient at this open station you were reassured to tell the staff as soon as you start to feel yourself slipping into suicidal thoughts. You then had a talk with the staff and if you could believably distance yourself from these thoughts you could go on like before and just had to come to your check-ups.
If you weren’t able to believably distance yourself from the thoughts you were taken to a room that was under video surveillance and had to talk to a doctor. Most of the time you would have to sleep in this room for a night on an incredibly uncomfortable doctor’s couch with all the trouble of doctors talking to patients and staff or patients coming in for medication going on around you.
On the next day you were supervised during breakfast and then had to sit in front of the staff room glass door and wait for your therapist, your doctor and the consultant who’d be coming in for a crisis visit at your room.
In this crisis visit they would ask you a lot of questions so they could see if they could trust you that you’re safe. If you were, you had to promise them via handshake and would probably get a so called anti-suicide-contract. If you weren’t safe, you would be taken to the local psychiatric ward and stay in the closed ward for a few days. If your stay would take more than 4 days your bed at the treatment center would have been given to a new patient and you would have to come in for the next free bed whenever you got out of hospital.

If you’re at an open psychiatric ward it would be a lot easier to transfer you to the closed ward and therefor they would send you there faster, even if it would be just for a night, because it’s just such a high risk for them to let you stay on the ward without being supervised all the time. If you were to actually do something that could take your own life it would be their fault, so if there is the option to let you sleep in a room that is under video surveillance they would probably take it.

Never be afraid to tell anyone that you’re suicidal, because all they want to do is help you and keep you safe. You won’t be sectioned under the mental health act or anything if you collaborate and try to keep yourself safe as well.

Suicide is a permanent solution to problems that may not feel temporary but are! You are worth to keep living and your life matters. If you tell someone about the struggles you’re facing they will be able to help you.

I know it’s scary, but it’s important.


Need help now?

  • Call 911 or your national emergeny number.
  • 1-800-SUICIDE (1-800-784-2433)
  • 1-800-273-TALK (1-800-8255)
  • Text: 1-800-799-4TTY (1-800-799-4889)
  • International Suicide Hotlines

What being inpatient really is like

I might or might not have written this to convince myself that going inpatient isn’t as scary as it seems. Yes, I’ve been inpatient before; no, that doesn’t mean I’m not scared of doing it again. So here you go:


Thinking about inpatient treatment for mental illness, the first thing that comes to peoples minds is probably a lot of scary stuff.

Sure, it is scary as hell, but since you’re fighting a war inside of your mind, fighting to get your life back, doing things you never wanted to do and so on, that’s pretty normal.
It’s okay to be afraid, it’s okay to fear it, because IT IS SCARY.

But there is so much more to this.

Being inpatient on an open station isn’t sitting in your room in a hospital gown crying all day, it’s walking around in pyjamas all day every day and nobody cares what you look like.
It’s playing video games with other patients and fighting about who gets to be Peach in Mario Kart to distract yourself, trying to get into the staff wifi for free and watching at least two movies a day.

It isn’t eating the same gross hospital food alone in your room everyday, it’s sitting at a table with your friends, eating like a family and building stuff with bread and tooth sticks.
It’s playing games like “Who am I” on the table, so those with an eating disorder have something other than food to think about and those with social anxiety have something to talk about to the others.

Staying in the hospital over night isn’t always hearing the alarm go off, people screaming outside your room or ambulances arriving every night.
Sure that happens too, but sometimes it’s sneaking out of your room at midnight to wish your friend in another room a happy birthday.
Sometimes it’s begging the staff to allow you to stay outside of your rooms until midnight and them being okay with it.
Sometimes it’s staying outside until locktime watching the stars and listening to music.

Being there for a really long time isn’t missing home every single day and wanting to escape all the time.
Sure homesickness is real and will come along quiet often, but eventually you’ll meet the most wonderful people in there, with which you’ll be in contact for the rest of your life and still talking about the time you spent inpatient together 20 years after.
Maybe it’s finding out that you’ll consider this place your second home for the rest of your life and that it will always belong in your heart .

It’s experiencing things you’d never imagined before, good and bad. But it for sure isn’t just scary.