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.”


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

13 Reasons Why ..

..and what I think about it


13 Reasons Why

What is it?

13 Reasons Why is an american drama-mystery television series based on the novel “Thirteen Reasons Why” by Jay Asher. It was adapted by Brian Yorkey for Netflix.

The series revolves around this girl, Hannah Baker, who committed suicide and left behind a box of 13 cassette tapes on which she recorded the reasons that made her take her own life.

Each tape is dedicated to one person that had an impact on Hannah’s suicide, those people will receive the package of tapes, in the same order in which the girl recorded their stories, and have to pass it on to the next person. If they refuse to do so, a seperate set of records will be released to the public.

Watching the show we follow a high school student, Clay Jensen, as he listens to the tapes.

What can I say about it?

I watched the show twice and after thinking about it for quiet a long time I think I’ve formed my opinion on the show.

First of all, I disagree with so many things they did there, BUT I have to admit that watching it for the first time I actually thought that I liked the show a lot. I was literally in love with it.
But after watching it for the second time and thinking a lot about it, I figured I didn’t like the show itself, I liked that I found something I could use to trigger myself and make myself feel even more depressed.

And that’s the first and most disturbing thing about Thirteen Reasons Why, it’s honestly so triggering. There are like three or more episodes that show rape and sexual assault VERY GRAPHICALLY, as well as the suicide episode which shows Hannah’s suicide in a very unappropriate and dangerous way.
If you look up the guidelines on how to safely portray suicide on TV, you’ll recognize that they did absolutely everything they were warned not to do.

Second, I absolutely hate that they made Hannah’s suicide some sort of revenge and made it seem like there’s always a specific reason as to why someone takes their own life. (That’s not how it is!!!)
They also made all those people in Hannah’s life responsible for her actions. Yes, a lot of them have done her wrong in so many ways, but STILL suicide is always the decision of a single person! Nobody but Hannah herself took her life!

What – for me – probably seems like the most unbelievable thing is, that they didn’t talk about mental health A SINGLE TIME. Yes, we’ve heard Clay’s mother talk about him having night terrors and that he had to go to therapy, but they’ve never ever talked about Hannah’s depression or possible PTSD.
I simply can’t understand why a show that claims to educate on mental health issues doesn’t even mention this topic in its progress.

This is also what the next point is about. Hannah reached out, she asked for help, she went out and talked to the school counselor.
He kinda played down her problems, which probably happened because he didn’t know her and her story. As Hannah says that she’s been raped the counselor tells her that, in order to report this, he needs to know the name of the offender and a few more details, just as it has to be done in real life.
After hearing this Hannah walks out like “Well, I gave life one last chance, but they’re not gonna help me, now I’m definitely gonna kill myself.”
So basically the school counselor did his job and everything he could do in this certain moment. Yes, he could have been a bit warmer and may could’ve asked more about how safe or unsafe his student really is, but Hannah blaming the school counselor on not helping her is not okay.
For the producers, this point could’ ve been a really great time to bring in the support of others or at least the possibility of Hannah getting help. But it didn’t happen.
The reason why I think this is really bad is, that it actually discourages the viewers to reach out and seek help. For me it feels like they wanted to say that it’s a waste of time, and nobody’s gonna help you anyways. Somehow that’s exactly the opposite of the intention they had with this show.

In the process of the series a student dies in a car crash, which affects a lot of the other students in a negative way. The thing that bothers me about this episode is, that the school doesn’t do anything at all. They do not make sure their students are okay and able to deal with this on their own.
This is not how it is in real life. Most schools have suicide or crisis protocols and offer psychiatric or therapeutic help when things like this happen. Actually a school is obliged to make sure their students get help and the opportunity to talk to professionals after events like this.

Another thing that just doesn’t make sense to me is that after Hannah’s death Clay also shows symptoms of depression, but still, he doesn’t get any help. Even such a short time after already losing a student to suicide, they still don’t see the signs and offer the help they need. Wouldn’t the logical conclusion here be to educate the teachers and also the students on how to recognize when others are feeling depressed or suicidal?

What I also didn’t like was that there were sooo many issues shoved into one show, like, yes, this is a high school drama and high schoolers have a lot of issues, but Netflix seemed to want all of these at once just to get enough reasons for Hannah to kill herself in the end. And, for me, it’s really overwhelming and we tend to lose the storyline and the main topic it’s all about.

So, to sum it up..

In my opinion the show has a good intention and is based on a very good idea, but the realization has a ton of flaws.
I, personally, wouldn’t recommend watching this show unless you are feeling really stable and distanced from the topic.
Even if you feel like you do not get triggered easily, you will probably end up getting triggered.
If you still want to watch the show I would recommend to not watch it on your own or alone. You don’t know how you will react and you really shouldn’t risk being unsafe because of it.

For me, it’s NOT a show that raises awareness on mental illness, depression, bullying or suicide, nor does it EDUCATE its viewers on these topics.

I’m glad that there is a show about sensitive topics like mental health issues and suicide on traditional television and I think it’s really good to get these topics out of the taboo-zone.

The things I also liked about this show was that I could relate to a lot of things on a personal base. I really liked the way of filming it and the cinematography behind it.

But all in all, I think, it’s a show that isn’t suitable for a lot of viewers and should only be watched with care and background information on how to handle possible reactions.

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