In 1982, when I was 29, I got into a situation where I didn't sleep for days. I tried to do too much. I went psychotic. When I heard someone coming down the hall, I thought the devil was after me and jumped out of my father's second-floor window in the wee hours in my underwear (since I knew how to do a parachute landing fall, I really didn't think I would get hurt, and I didn't). After I was captured, I was taken to Alaska Psychiatric Institute (API) in a straight-jacket, and pumped full of a whole lot of Mellaril.
Prior to this, I was a practicing attorney. I had gone through college in three years at the University of Oregon by averaging 21 hours a term, rather than the normal 15 hours. After graduating from college I was admitted to Harvard Law School. Since graduating from law school, I had been practicing law in Anchorage. Before my episode I had never run into a situation where I couldn't do all the work that "needed to get done."
When I woke up in the hospital, still groggy from the medication that forced me (finally) to sleep, a young man was sitting in a chair at the foot of my bed with a clipboard. He asked me what day it was. I asked him how long I had been asleep. He wrote down that I didn't know what day it was. Things didn't get better from there. I was somewhat belligerent since I was used to being free and being able to make my own decisions. Sometimes I would just go limp to make them catch me. One time, they didn't catch me before my head hit the floor and I decided that that really wasn't such a good idea. I was slow to learn that until I did the things that they wanted me to, things were going to go poorly for me. When I told members of the staff that I was an attorney, some didn't believe me and the others said I would never do that again. I refused to believe them. According to them, I was in "denial."
At the end of 3 days, I was given the choice of signing a "voluntary commitment" or they would take me to court for a court ordered commitment. Well, I had the presence of mind to recognize that I didn't really want to be dragged into court in the condition I was in so I signed. It was hardly voluntary, though.
There is no doubt that I was confused. It didn't help that when I noticed that my hospital shirt was inside out (there was a pocket on the inside) and changed it, that it was still inside out (there was still a pocket on the inside). At that time those who were on "Suicide Watch" or "AWOL Alert" could not wear their own clothes and were given surgical scrub clothes which could be put on either way. It also didn't help that in some of the elevators, the button for the ground floor was a "B" and in others it was "G" (I mentioned that this was confusing to patients to every Director of API since 1985 (there were many), but it was not until 1995 or 1996, when Randall Burns took over that this was changed).
I mainly needed sleep, but API was so scary and noisy that I didn't sleep well. The Mellaril added to my confusion and to this day, after the first few days there, I don't know how much of my confusion was the Mellaril and how much of it was the sleep deprivation. Well, in spite of the heavy medication and the poor sleeping conditions, I gradually learned that I had to behave. I ceased being uncooperative at the stupid daily "group therapy" sessions that was only humiliating to the patients. I went to the asinine "occupational therapy" where we literally had to weave pot holders for god's sake. Since I was a private pilot, I knew that I couldn't keep flying if I was on medication, but they insisted that I should be on Lithium. Fortunately, my creatin clearance test didn't pan out and they didn't put me on it (I was also sent to a kidney doctor to have a biopsy, but he couldn't find my kidney -- honest).
Anyway, I was let out after a month, still being told that I would never again lead a normal life. My official diagnosis at discharge was "atypical psychosis," which at least meant that they weren't sure about me. My family had a lot of financial resources to get me the best help, but they didn't know what to do either. I was even sent to New Rochelle, New York, to see a psychiatrist there. He was a very nice guy, but really didn't do anything for me. He diagnosed me as bi-polar. When I got back, sure enough, I went into a major depression. I couldn't get off the couch for months. However, I finally found a psychiatrist, Robert Alberts, who said, there was no reason why I couldn't manage the situation and recover. After about six months, my father arranged for me to get a job with a law firm, which I appreciated, and I dragged myself there and forced myself to go to work and get my work done. However, it wasn't a good fit and in less than a year I became an in-house counsel for my father's company. That was better.
However, by that time I had gotten involved in the Mental Health Trust Lands Litigation and in 1985, I allowed myself to get into a sleep deprivation situation again. Sometimes when I have a project with a lot of moving parts that need to be sorted out, usually on a time deadline, I can have a hard time getting to sleep. I am working on solving the problems, working things through my head and I have trouble "turning it off" so that I can go to sleep. In 1985, even though I recognized that I was getting into trouble and tried to stop it, I didn't act fast enough, nor strong enough and ended up back in the hospital. This time, however, I had Dr. Alberts who admitted me into Providence Hospital's psychiatric unit. The difference between it and API are like night and day (or heaven and hell?). Instead of psychotropic drugs, to make me sleep, he gave me Seconol. He said it took an incredible amount to get me to sleep. This time I was in the hospital for only a week. I took Navane for awhile to settle my brain down. I went into another depression.
My father said I would have to either give up the Mental Health Trust Case or work somewhere else. I decided to open my own law office. This was only three months after my second episode. I really never felt fully recovered until after my second episode and I haven't had another one. I have learned to recognize the warning signs and take action before anything serious happens. The first thing, of course, is if I'm not getting proper sleep. But more than that, I recognize certain thought patterns. This will be the first thing. Next, my speech patterns will change. I will start making really quick, sharp remarks. This can get to the point where other people notice. But, before things get out of control, I now know to take medication to get some sleep. Personally, I like the much-maligned Halcyon. It works great for me, particularly because I don't use it long term. Another option I have is a Restoril/Xanax combination. This is particularly useful when I don't think the Halcyon will get me to sleep long enough. Also, the Halcyon takes at least an hour to work, while the Xanax kicks in very quickly. When I see that I am going down the road towards trouble, I make sure that I take my medication.. I only need a small dose, and usually just for one night. Then, I've gotten a good night's sleep and the vicious cycle is broken.
During the Mental Health Trust Case, when things really heated up, particularly the incredibly short time-frame in 1994 when they jammed the settlement through, I had to take my medication more than I ever had (basically during the hearings and when we were writing briefs). During the hearings, my normal medication regime was not enough to stop the wheels from turning in my brain. So, I called Dr. Alberts and we adjusted my dosage. I got through this extremely difficult time without any problems. I mismanaged our time for the opening appeal brief before the Alaska Supreme Court for the Mental Health Trust Case and ended up working too many hours at the end and had to use medication then too. Now, I normally go about six months between uses. But, I do take it in an instant when I need it.
To me the main thing is that I have learned to recognize the warning signs and have been able to work out things that work for me. I could just quit taking assignments that lead me into the situation where I need to take the medication. But that wouldn't be a full life for me.
Now, some people will say, "But Jim is not really mentally ill. He's not like the rest of them." First, I was lucky not to have been made permanently mentally ill by The System. I could have very easily become "chronically mentally ill." It was pure luck that I didn't. Second, when I have listened to other people who have recovered from serious mental illness, they uniformly say that is what people say about them too. I do think that my problem is easier to manage than a lot of other consumers. But I have heard other recovery stories from people who were much worse off than I. As far as I know, there are some things that are true for everyone that recovers from serious mental illness:
1. You have to take responsibility for your own mental health and behavior
2. You have to learn to recognize your symptoms.
3. You have to learn what works for you.
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last modified 8/27/1999