Quiet Confessions, Episode 40: Psychiatric Hospitalization Part 3

In this "Quiet Confession," I’m taking us back to my second day of perinatal psychiatric hospitalization at UNC Chapel Hill. 

After recently finding the journal I’d kept during my treatment, I reflect on the stark difference between my clinical, "robot-like" recorded entries and the emotional turmoil I was actually experiencing at the time. 

I describe the rigid routines of the unit, the weight of a potential psychosis diagnosis, and the powerful moment a doctor offered to "hold hope" for me when I had none left.

Key Takeaways

• The Clinical Perspective: Chelsea’s journal reads like a "Captain’s Log," focusing on medication, meals, and sleep rather than their internal feelings.
• Morning Routines: Days began at 7:00 a.m. with breakfast and mandatory vitals checks, which remains a sensory trigger for them today.
• Psychiatric Consultations: On their first Monday, they met a team of specialists who initially discussed a potential psychosis diagnosis due to their extreme paranoia and delusions.
• The "Scaffolding" Struggle: In Occupational Therapy (OT), they practiced "scaffolding"—breaking down basic tasks like brushing teeth into minute steps—though they felt physically unable to perform them at the time.
• Holding Hope: A pivotal moment occurred when a doctor offered to "hold hope" for them until they were ready to take it back.

Relevant Links

• Quiet Confessions Substack: For deep dives into the clinical journal entries.
• Postpartum Support International (PSI): Information on support groups, the Alma program, and peer mentoring.
• Instagram: Follow for updates

This episode discusses topics that may be triggering for some individuals. Please check the show notes for more information and be mindful of your own mental health and comfort levels.

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Transcript

Chelsea Myers (00:01.294)
Hey, welcome back to another Quiet Confession, a little mini episode where you and I get to share some space. And lately I have been doing a series that was requested by many of you about my perinatal psychiatric inpatient hospitalizations. And I keep saying, I don't know how I'm going to...

release these or what order I'm going to go in or if I'm going to take breaks. But here I am back again. And I'm just going to keep going because I feel like I can. I just had therapy and that was helpful. And last night I found the journal that I was looking for, that I've been looking for, that I mentioned in my previous episodes. So I kept this journal.

from my very first day at my first hospitalization. And I maintained it through almost every day of that experience and even like in between hospitalizations and a little bit after my last one. There are, have, so I haven't.

finished reading it. I opened it last night for the first time in a year and a half. And the last time that I had opened it, it was in therapy. And it was just an exercise in tolerance because at that point I was still pretty deep in my PTSD. So we worked on like touching the journal and

holding the journal and opening the journal and I didn't even necessarily need to read it. And at that point, I think I only read the first page and then I put it down again and I had not looked at it since then. And so it got lost. I couldn't find it. But I had an inkling of where it might be and I found it yesterday. And while my husband was

Chelsea Myers (02:22.38)
playing D &D with his group. So he was out of the house and my kids were with my in-laws, so they were out of the house. I opened it up and I read through it and I got through a good chunk of it. When things started to feel uncomfortable, I stopped and I put in a bookmark and I haven't continued since then. But I will. I just not ready yet.

But when I last spoke with you, I gave my best recollection of my first 24 hours at UNC Chapel Hill, as well as some other little tidbits. And so today I'm gonna kind of continue down that timeline, but I also just wanted to note, I...

I had this vision of what this notebook was. I was really hoping that when I found it, it would give me more insight into like the people that I was meeting and the activities that I was doing in terms of like therapies or projects that I had worked on. And it reads like

I'm a Trekkie, so excuse the reference, but it reads like a captain's log. Like, this is not my writing style. If you follow my blog or my sub stack, this is not how I write at all. Everything is pretty clinical. And it really just reads like, this is how I slept.

This is what I ate or what I wasn't able to eat. This is what the psychiatrist said. This is what we're doing with my meds today. This is the therapy that I had. Okay, I'm going to bed now. So it's not exactly what I thought it would be, but I'm still really glad that I found it because it does help me with the timeline a little bit. And I'm happy to report that my

Chelsea Myers (04:43.084)
My recollection of the first 24 hours was pretty much spot on. So at least I can remember that. So I will take you to day two at UNC.

Chelsea Myers (05:02.7)
I had apparently, when I woke up the next morning, I had slept a little bit. But like I mentioned, the heat was broken in my room. So was really, really cold. So I woke up a lot of times shivering, but like I said, you can't have multiple blankets in units like this.

And you can put the puzzle pieces together as to why that is, but it's a safety concern. so you kind of just have to make do. So I think I slept, I'm assuming I must've slept in like a sweatshirt or something to make up for that. But, that was the first morning that I met with the psychiatrist because I, I.

came in on a Sunday, so they weren't there. But Monday they were. And what that would look like is you would wait to be called. So you'd have your breakfast and while you're eating breakfast, there's a little conference room and you kind of get called in one at a time. Actually, before any of that, this is what mornings look like at this particular facility.

If you're not up before the sun, like many of us were just because you couldn't sleep, they do make an announcement. I think like 7 a.m. that breakfast is here and that it's time to get up. So you can hear it in all the rooms. And then a nurse will come around with a portable blood pressure machine, which I still have, I still get triggered.

when I see those, when I hear those, when I have to have those used on me at doctor's appointments, because it was three times a day, every day. So first thing in the morning, you wake up, you wait for your turn for them to come get your vitals, and then you eat breakfast. And for me, one of the biggest symptoms was the nausea from the anxiety. So

Chelsea Myers (07:25.157)
Eating was really hard. But while everyone's eating breakfast, you wait for your turn to be called in to this little conference room to meet with the doctors and the psychiatrists. And this was my first time meeting with them. I can see one of their faces like right now. And we all had to wear masks because again, COVID times. But I don't.

I know there was a team of them, but I only remember one of them. And I can't remember her name, but she was the one who I kind of spoke directly to. But I spent most of that first meeting just crying. And this is their first time meeting me, so they're really trying to get like the full picture, like why I'm there, what's been going on, what am I experiencing. My journal tells me...

I have a completely different recollection of how this played out, but in my journal I wrote down that we talked about my symptoms and that they discussed several diagnoses with me. They had mentioned OCD or the possibility of psychosis. My memory is that my husband told me about that later.

like much later that they had called him and talked to him and mentioned psychosis. I don't have any memory of them telling me that, but it's in my journal on that date. and it lines up too, because the, the plan of action was that they were going to put me back on anti-psychotics and keep me on

antidepressant for now. So I mean that does align with a psychosis diagnosis. mean spoiler alert, when they got to know me more and observed me more, they said that it was more likely that it was postpartum OCD and PTSD and anxiety. So I was never formally diagnosed with psychosis and

Chelsea Myers (09:47.817)
I never had auditory or visual hallucinations. Delusions? Yes. Hyperfixations? Yes. Like, I was incredibly paranoid. I was incredibly, like, convinced of catastrophic things happening to me or my baby. But because...

My response to those things was constant reassurance seeking as well as like rituals. Some people call it like, well, we've talked about magical thinking, but like the rituals sort of are things that you do to almost make sure that the bad things won't happen. So I, when I was younger, I just said I was superstitious. Now I realize.

And we realized, my therapist realized, my psychiatrist realized that for most of my life I had OCD, but I had a generalized anxiety disorder since I was 12, but it has likely been OCD. Because I've been doing all these things, but they were amplified during this time. yeah, so I guess meeting with the psychiatrist that morning, they put psychosis on the table, but it didn't register.

enough for me to recall it that way. I just remember this woman's face and me just crying and ask again, reassurance, reassurance seeking, like asking over and over and over again, are you sure this is going to stop? Like, are you sure you can fix me? That was my biggest thing.

with anyone I talked to is like, is this forever? Is this forever? So from there, you meet with them, they talk about medication management. The difference with this place is that I knew that I would be meeting with them every weekday and that this was a specialized perinatal team of psychiatrists and MDs and

Chelsea Myers (12:07.385)
I would meet with a therapist, like a psychologist as well, but I think I only met with her twice during my time there. And that was more like a therapy session. But I saw the psychiatrist every day, except for on weekends. So when you're done with that, you kind of like get dismissed and we all kind of check in with each other. Like, how did yours go? How did yours go? But it was only day two there.

I again, I just went back to the day room and did a lot more crying. think a lot of us were crying that day. Again, according to the journal, I had a one-on-one session with occupational therapy, which is another thing that they offer. There were so many therapies that they offered that were not even a thing at my first hospitalization.

And what's really interesting is that the skills that they were working on with me, they focused on one skill in particular on this day. And it was like scaffolding tasks. And because of everything that I have gone through, I ultimately, and we'll get there, I did partial hospitalization outpatient treatment where I learned dialectical behavioral therapy. And now,

as a PSI trained peer mentor through the Alma program, where I will be mentoring perinatal people and teaching them behavioral activation skills. Both of those things are incredibly, they're so similar, it's just the same thing with a different name. And so I can look back now at what OT was doing with me with scaffolding these tasks and realize that it was a DBT skill.

like structuring scheduling and i can't remember what the third s is right now there's three s's but i was so frustrated like these two these two ot's were so sweet and so nice and they were so patient with me but again i cried through the whole session because

Chelsea Myers (14:30.574)
The task that we chose for me, because I was trying to tell them how physically sick I felt from all of this and how like I can't even get out of bed. And it's not because I'm so depressed I can't get out of bed. It's because I'll like, I'm going to throw up or I feel so sick. So the task was getting out of bed and brushing my teeth.

And so we're going through every, like we're scaffolding what that means and literally breaking it down to the most minute actions. So like, what's the first thing you have to do? You have to put your feet on the floor. Well, you have to sit up first, then you have to put your feet on the floor. And then you have to stand up and then you have to walk to the bathroom. And then you have to get your toothbrush and put toothpaste on the toothbrush.

I could go through the whole thing, but that's literally how tiny the details were. And I'm going through this whole thing with them and I'm doing it, but I keep telling them, I literally cannot do this. I'm not telling you that I'm so depressed that I don't have the motivation to do this. I physically can't do this. And they...

I don't know that they knew how to react to that because they were like, okay, well, let's just keep trying. Let's keep, let's just keep trying. Let's go through the worksheet together. And I think at that point, I just was like, okay, whatever. We have a limited time together and I'm going to do whatever it takes to like do the treatment here. So I did, I did it with them.

I have it somewhere. kept everything. Everything's in a box. But it's somewhere. And I did it. I did the worksheet, but I did not feel any sense of accomplishment when I finished it because I was like, cool, great, we did this, but I can't do this. So I left that feeling pretty defeated. I even remember saying like,

Chelsea Myers (16:49.669)
I don't know, like am I asking too much? I don't understand. I just don't wanna feel like this. And on this particular day, my hope was at a bare minimum.

Chelsea Myers (17:11.161)
Like I don't want to read directly from my journal, but I essentially said I don't know what to say or do anymore. I think I'm too far gone. I'm lost and I don't see a future for myself. So even though I met with the psychiatrist and met with OT and everyone was so calm and so gentle with me.

And I don't know if it was this day or a different day because it doesn't say it in my journal. Cause again, I was writing like a robot, not like me. I do remember that one doctor telling me like, know you don't have hope right now, so I'm going to hold it for you until you're ready to take it back. I use that same line with peer support group members. I use it with mom's.

on Quiet Connection because that kind of jolted me back into the present, even if it was just for a millisecond. I was like, okay, someone else is going to hold hope for me because I literally can't. I have none. I have none to hold onto. But if she can hold it for me, then it's safe. So I offer that as

as something that was really helpful for me at the time. But yeah, like, I don't, I don't know, I didn't write anything else about that day. Again, Captain's Log, woke up, was cold, met with doctors, had OT, have no hope.

So I don't remember super specifics about the rest of that day, but I do know because of the repetitiveness of what the days looked like is that I would have had lunch at that point, which would be in the day room, the small day room with the other moms. If I ate anything that would have been good. And it was really cool because the other moms would always celebrate with me if I could eat something.

Chelsea Myers (19:35.78)
and that felt really, really nice. I don't know, I just felt supported even though it didn't feel like a big win for me. But anytime I would eat anything, they would like cheer me on. From there, we would either walk the halls. I did so many, I probably walked.

So many miles in those hallways. And funny story, my crocs, whatever they cleaned the floors with at this facility, my crocs did not mix well with it and they were so squeaky. And I knew I was driving everyone crazy. I even asked them one day, like, I'm like, you guys hate when I do my laps, don't you? And one of...

the other patients from the gentle crisis side was like, yup. I don't know if I laughed or if I cried. I don't know. But I started walking in the grippy socks, which is why I have a very big reaction when people say that they want to take a grippy sock vacation. And I understand people don't get what that means. And I understand that they mean that they just want to break. Babe, you do not want a grippy sock vacation.

You don't. You want a vacation at the spa or you want a night at a hotel or an Airbnb. You want to be pampered, okay? You don't want a grippy sock vacation. Trust me, unless you need it. And it's not a vacation. But I get the sentiment. I get it. No shame. Just that one hits me. Ugh. Hits me in a way that gives me the ick.

But yeah, so yeah, that night I was wearing my Crocs. Eventually I would switch to just wearing the grippy socks because I was pissing everybody off with my squeaky shoes. But we'd walk the halls. I did a lot of coloring and sticker by number. I would do anything to keep my mind occupied so that I wasn't thinking about all of the like,

Chelsea Myers (21:59.394)
Perseveration and like the endless thought cycle in my head as long as I kept my fingers busy. I could kind of keep the noise in my head quiet. And again, like midday, get my vitals taken, stop at the nurses station. We always had to set a goal in the morning. Usually mine was to take a shower and to FaceTime my family. So at some point, usually around dinner time or after dinner time, I don't know.

I would FaceTime my husband and my kids and that was hard and I'll get into that in future episodes because I don't even think I had done that at this point. yeah, I'd do walks. I would color. I would read. And then by the end of the day, we would have dinner. And then this is where we started my ritual of watching game shows.

We would watch Jeopardy and I think it's Wheel of Fortune. And then we would read for a little bit, take our nighttime meds and go to bed. And that really, that was just like the routine for almost every day. Some days had different things and we'll get to that.

But that was day two, as best as I can remember it with this bleak journal entry. And I'm going to be sharing some of these journal entries over on Substack and maybe here and there on Instagram. But I just think it's important. It gives you a little bit of insight into my state of mind and

Because it's so clinical, gives you kind of an insight into what this particular program was set up like. So if you're interested, you can check that out. But that's where I'm going to leave you today because I'm feeling safe. I'm feeling okay. I'm going to go take care of me for a little bit and move on with my day. And I hope that you take care of you. And I hope

Chelsea Myers (24:26.379)
that this is helpful. I hope that this is somehow validating for those who have been there and informative for those who have never experienced it, but may have someone that they know and love who has experienced it and can give you some insight into what our world may have looked like at the time. So I will catch you back here next week. Go drink some water.

and be kind to yourself.