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

Words for anyone in recovery

You ARE “sick enough”.
You don’t need to get worse in order to be “sick enough” to get help. You don’t need to get worse for your pain to be real, recognized and treated. You don’t have to get worse in order to be taken seriously.

You DESERVE to get help.
You are allowed to ask for help and to accept it. You are worth the time it takes others to help you. You are worth getting better. You deserve to get better. You are not weak for getting help.

You ARE NOT a bad person for feeling like this.
You are allowed to feel weak, angry or exhausted. It is ok to feel like this. You can’t feel strength without weakness, there isn’t just one of the two, they coexist.

You CAN’T fight all the time.
You are allowed to rest. It is okay to feel tired. Relapses happen. You are not a bad person because of your coping methods. You can’t just be fine over night.

You DON’T have to cling to your illness in order to matter.
You will be cherished whether you’re ill or not. People aren’t gonna stop loving and supporting you once you’re doing better. You are not your illness.

Recovery IS hard.
It is okay to feel like you can’t fight anymore, there are days like this. Focus on yourself and survivng, be yourself and not some kind of recovery idol. It is okay to sometimes avoid events that stress you out.

TAKE CARE.
You can do this, even if you feel like you can’t. There are better days to come, even if you can’t imagine it yet. You are perfect the way you are and you do not have to change to make anyone else happy. Focus on making yourself happy.

A friendly reminder

Mental illness doesn’t take a break over the summer holidays.

Just because we don’t have to go to school doesn’t mean we’re suddenly doing okay. Our fears and thoughts don’t stop the moment we get out of school for a few weeks, they don’t care about relaxing or swimming pool time.

Having a lot of time now doesn’t always make us feel better and less depressed or anxious, no sometimes it makes us feel even worse, because we’re lacking the daily structure and have even more time to overthink.

Just because we don’t have to get up for school doesn’t mean that getting out of bed is easier when we’re on summer break. No, it might be even harder because we’re not forced to get up in order to be on time.

Not having to go to school gives all of us a lot of free time, but that doesn’t mean that we’ll be able to do things all day. We still get stressed and overwhelmed, we still fear the stuff we fear when we’re going to school and we still struggle with daily tasks.

Being on summer break doesn’t make us able to do fun things with our friends all the time. Often we don’t get to enjoy the stuff mentally healthy people enjoy, we might get exhausted or upset very easy and still need to plan our activities.

If you or someone you know struggles with mental health problems, please remember: Holidays or breaks don’t magically cure our illnesses, we’re still struggling and that’s totally normal and okay. Healing takes time.

Fear vs Phobia

 

People often tend to use the word ‘Phobia’ when they’re actually talking about fears.
Well, not trying to talk down your fears, but telling someone you’re suffering from a mental illness called “Agoraphobia” or “Emetophobia” and having someone say “Oh yeah, I have that too, I’m afraid of this and that, too.” is literally the worst.

Being afraid of something doesn’t equal having a phobia of something.

When you fear spiders you might not want to go downstairs because there might be spiders or you might go a bit crazy when there’s a spider in your house.
But having a phobia is something completely different.


Let’s just say someone has a phobia of headaches.

They’re waking up and the first thing that comes to their mind is “How does my head feel? Am I having a headache? Is there any chance I’ll get a headache today? What if I get a headache today? Maybe I should just stay in bed, maybe I won’t get a headache then.”

They probably still start their day just like you, but whilst getting ready they’re most likely to think things like “What clothes should I wear today? Not these, I got a headache the last time I wore them, if I wear them today, I’ll probably get a headache again. Should I wear these? No, they’re to pretty; if I get a headache today I won’t be able to wear them ever again. Maybe I should wear this, but if I look like that people will think that I have a headache.”

When they finally found something to wear and sit down for breakfast, usual toughts might be “Can I eat this or am I gonna get a headache from it? I need my coffee, so I won’t get a headache, but if I drink too much of it, I’m gonna get a headache. Am I having a headache already? I don’t know if that’s the beginning of a headache, maybe I should stay at home today. I need to drink something or else I’m gonna get a headache, but I can’t drink this water, because my brother touched the same bottle when he had a headache and if I’m gonna touch it I’ll get a headache, too. Oh god I already feel it coming.”

Finally out of the house shit is getting real. “Does anyone around here look like they have a headache? Oh no, this boy just touched his head, probably because it hurt, I need to get away from here or I’m gonna get a headache, too. Look at that womans face, she looks like she’s in pain, probably a headache, everyone around here has a headache, maybe there’s something in the air causing it, I need to get out of here.”

And on the bus. “Why are there only a few people in here? Did everyone else stay at home because they had a headache? What if there’s some kind of disease going around that’s causing headaches? I should probably take an aspirin now, oh my god, where are they, did I forget them, no, I have an extra package. Oh no, I have no water, I need water, I need to take these pills now or I’m gonna get a headache and die. I need to get some water, now.”

At work / school. “What if taking aspirin when you’re not having a headache causes headaches? What if I get a headache in class and can’t get out. What if I’m not allowed to drink something in this class, I’m gonna get a headache. Where’s the teacher, isn’t he here today, did he get a headache and am I gonna get it, too?”

In the evening. “I need to go to bed now, staying awake for that long is causing headaches. No phone, no laptop, no light. Darkness is better for the head. Why are there so many cars outside? Are they all on their way to the hospital because some peoples headaches didn’t go away? I hope I won’t have a headache tomorrow. What do I do if I have one? Please, I don’t want to get a headache ever again.

Sleeping at night. *NIGHTMARES OF HEADACHES*