My brain has gotten me to the hospital emergency room more than the rest of my body. I’ve been twice, both in 2011. I read an article about people who had bad experiences in the ER with their mental health so I thought it might be good to share what’s happened to me. There is a range of experiences in emergency rooms for those with mental health issues. You never know what might happen, so it’s always good to go if you’re feeling as though you may harm yourself.

At the end of 2010 my psychiatrist and I changed up my medication and things weren’t going so well. I had intense suicidal ideation and didn’t feel safe so in February 2011 I went to the ER at a local hospital in Boston that also had a mental health ward. My insurance provider’s website directed me there. I had no context to know whether it would be a good fit so it was pretty much like throwing a dart at a list.
 
The content below is an excerpt from my memoir, Fiercely Lonely, which will be released at some future date.

The entry to the emergency room was smooth and the wait time non-existent. I felt calm and casual with my conversation with the nurse and intake worker. As I went through the check-in process and found my way into a bed in the emergency room, I actually felt pretty good, all things considered. I received my own room with my own bed within the ER. There was a nurse’s station outside that watched over all the rooms. Once ensconced I changed into a gown and received a blanket and lay down while Valerie (my girlfriend) sat in a chair next to me. A nurse came in and asked what I had planned to do to kill myself. At first I thought that was none of her business, but I realized that she was asking so that she could keep an eye on me.

There was a window where a woman sat and looked at me every few seconds but otherwise kept her head down in a book or crossword puzzle. I didn’t understand why she kept looking at me, as I thought she was a nurse. But I soon realized she was the person making sure I didn’t kill myself. That was her only job: making sure I stayed alive.

Throughout the evening a psych doctor came to ask me questions. She was very calm and gentle in her presentation and with the manner in which she queried about my condition. The typical questions were: Do you want to kill yourself? Do you have a history of mental illness? Have you tried to kill yourself before? She spoke without belying a sense of happiness or sadness. Her manner was direct. I felt uncomfortable with her because she appeared embarrassed to be around me. Was it because she wasn’t used to handling mentally ill patients? Or was I being too sensitive?

The psych doctor didn’t have many answers at that time; they were looking to see if there would be an opening in the ward for me the next day. If not, I would spend the day in the ER once again. I couldn’t imagine sleeping on that bed for more than one night. It wasn’t made for any sense of comfort, cushioned but without much depth, the vinyl feeling unnatural against my skin. I didn’t want to get up too much and worry the nurse and the woman watching me. I was, even at my worst, more concerned with others instead of my own sense of well-being.

With my future placement in question, I did the best I could to make myself comfortable. My clothes and other items went into a locker. My sense of suicide and depression was still hovering in the background. It was waiting for an opportunity to make itself known once the newness of my situation had worn off.

I tried to sleep as my guardian peered into my living space to make sure I still existed. I received water, and nurses checked my blood pressure and vitals throughout the night. I felt as comfortable as one could in that situation. It was the best they could do, all things considered. I wondered if everyone I had so far encountered deemed my rather cheery albeit somewhat tempered disposition confusing.

I woke up in the middle of the night a couple of times to go to the bathroom (located down the hall). Both times I exited my room I noticed that the woman set to watch me had fallen asleep. One time, as I left the room, she woke up, startled, and stared at me, mouth agape with a surprised look on her face. It was as though she was looking at an angelic apparition and yet at that moment I was far from any sense of perfection.

Outside my room, the nurse at the ER station looked up from reading her magazine and asked me, “Everything okay?”

“Yeah, I just need to go to the bathroom,” I replied with an upbeat tone in my voice.

“Okay honey,” she said and went back to her magazine.

When I got up the next morning, I turned on the TV encased behind Plexiglas. I kept track of what was occurring with the latest round of riots in the Middle East. My sense of self-destruction failed to silence my curiosity with what was going on in the world.

The same doctor from the previous evening was still on duty the following morning. After the routine blood pressure check by the nurse, staff told me there was a room for me in the psych ward. This hospital was a preferred provider by my insurance, a perk in my situation. I learned later that at other hospitals people often spent two or three days in the ER before receiving a transfer to a psych ward. People were falling apart all over the Commonwealth of Massachusetts. ​

I’ve been going through many changes in my life with not only a new job but also a redirection for my future. I’m desiring to do something that will have a bigger impact on those around me through mental health writing and speaking. These are all positive things and yet they stress me out a great deal. Change is never easy, but as someone who struggles with anxiety and depression, I learned a few things that are of some help during such times.

1. Keep your routine as much as possible
This isn’t always easy for everyone in times of change, especially if you have a longer commute or work a different shift. But, it’s important to establish a routine in that new schedule sooner rather than later. Many of us find a routine to be comforting as the general chaos of our lives can be stressful over long periods of time. We have heightened awareness and are on edge if we don’t have a regular schedule.
 
2. Exercise
Lifting weights, stretching, and doing yoga have all helped me with my stress. I try to build in time at the gym or at home to be physically fit. In doing so I can best fight off negative feelings and exert some of the stress that creeps up on me when I’m going through a transitional period.
 
3. Sleep
If you are starting a different work shift, make it a priority to establish a regular sleep schedule if you can. While not all jobs allow for that, do your best to find a time in the day when you can get 7-8 hours of uninterrupted sleep. While I tend to be okay with getting by on less sleep, it’s important we have that set period to rejuvenate and rest. Getting enough sleep is key in keeping us healthy.

4. Eating right
It’s so tempting when you’re in a rush and starting a big change in your life to rely on fast food options that are often unhealthy. Take the time to make yourself some meals that are nourishing for both the mind and the body. A simple internet search will pull up many options for recipes for such meals. I find that when I eat food that is high in sugar or heavily processed it can lead me to feel gross about myself and my body, which isn’t something I need.

5. Make time for yourself
After you’ve taken care of work, eating right, exercising, and sleep, set aside some time for you. Do the things that you know make you happy. For me this includes writing, watching movies, going on a walk or hike, and traveling. But whatever it is, make sure you schedule in an hour or two every so often to do the things that you enjoy. This is excellent for mental health and key to a healthy mind in a transitional state. 

There are some days I struggle with my hypocrisy. I try not to think about it too much, if at all, because it gets under my skin. I tell others to hang on when they’re feeling down in their lives. I want people to keep on living when they’re feeling suicidal and depressed.
 
Yet, the fact of the matter is that I don’t always want to keep on living. There are often times—usually once a month or so—when I want to throw in the towel and end it all. It’s a thought and sometimes it’s fleeting—gone in a minute. But I feel overwhelmed, tired, and trapped by responsibilities I don’t want such as work I don’t enjoy. Sometimes what I need to accomplish in a day—chores, errands, projects—seems too much. I’m unable to live in the moment and take pleasure in what I have.
 
I then think about the hypocrisy involved with that. There is a light that shines in us and I know that. To extinguish that light is tragic, as things can often turn around and get better. I’ve felt that in my own life.
 
Depression is a slog, though. It’s asking whether the glass is half-empty or half-full. Sometimes I look at it as a life-long struggle that never ends and that discourages me. I think about how depression will always be there and how much it tires me.

There’s another part of me, though, that recognizes the depression goes away. That my default state isn’t sadness, but kindness and helpfulness. Those times of feeling down are bumps along the way.

I think about people whom I know who seem mentally strong but at the same time hide their suicidal feelings. Sometimes they give in to them.. I never want to be that person. Past experiences have shown me I want to live when given the chance. Yet suicidal thoughts hang there, on the periphery and stare me down as I tell others, “Keep going.”

I know that for many people, their depression is fleeting. A message of encouragement is what they need in their darker hours. So, every little bit of help I can give to others is great. But it doesn’t mean I don’t struggle. And it feels hypocritical to tell others to keep going when I want to give in.
 
Regardless of what happens to me, I figure if I can get one person through a mentally rough patch, it’s worth spreading the word of staying with us. We need you, even if I may not always feel that way about myself. It doesn’t change that fact that you’re good and wanted and loved by so many others. And I know I am, too. If only that could always be enough.

Trigger warning: I get in the weeds in speaking about suicide in this entry. It may not be for everyone.

Suicidal ideation is a scary topic to talk about, both for the speaker and the listener. It's safe to say suicidal ideation is generally considered a bad thing. But there are parts of it that I’ve come to realize are worse than others. It’s one thing to think about throwing yourself in front of a train but knowing you’ll never act upon it. Yet suicidal ideation has many layers, some of which affect the individual more than others.

1. You never know what will set you over the edge
I can handle my thoughts most of the time but I live in fear of wondering what the thing will be that might set me over the edge. Will it be an unkind word from someone? A frustrating day at work? What helps is knowing coping skills that I can undertake when those difficulties occur in my life. I can try and adjust my thoughts and realize that things happen, but the important thing is my reaction to difficult situations. Things can change and that includes my feelings at that moment.

2. Other people don’t know what will set you over the edge
Once you share your thoughts of suicide with others, it’s possible they will fret about it. No one likes to hear someone they love is suffering, especially when it’s not treatable in an easy manner. I’ve come to learn that fine line between ideation and action. Thus I don’t always share when I’m feeling suicidal with others because I know there’s not a lot they can do about it. Yet, I must acknowledge friends and family can show emotional support which means I should share more often what’s going on in my brain. This support can go a long way to helping me recover from down times.

3. Wondering when it will go away
When suicidal ideation comes along, sometimes it hangs around for a few minutes, but other times it’s with me for days. It's not constant but it is consistent. Often times this is in passive ways that I don't register. This may include thinking about what it would be like to not exist when I have a difficult situation occur. Or it may mean thinking of how the impact of various vehicles would feel against my body if I jumped into traffic.
 
But I can’t help but wonder how long such feelings will stay with me. And that can be troublesome because in those moments I may believe I’ll never get better. I know I have to fight such feelings. They deny the reality that I do, deep down, want to be here on earth. But it can be hard if they’re going on for days at a time.
 
To combat this, I’ve learned that if these feelings go on for more than a day or two, I reach out to loved ones to let them know what I’m going through. Perhaps the ideation will pass away on its own, but when it comes to mental health, it’s always better to ask for support than not do so.

If you are feeling suicidal, or need someone to talk to, please call 1-800-273-8255.

I met with a man in a position of authority recently. “Kurt,” he told me, “I truly believes everything happens for a reason.” I nodded and smiled. He told me how he immigrated to America and achieved success.
 
I didn’t want to belittle his story, but while I put on a smiling face at his comment, inside I cringed. That’s because I used to believe that things happened for a reason. I thought that god had a plan for everyone and there was purpose and meaning for all my tragedies and successes.
 
Yet I always chafed under that idea because it didn’t line-up with my experiences with mental illness. Regardless of my belief in god--which is a different subject—as I got older it became harder for me to believe there was a reason for much of anything. Instead, I realized that experiences just are.

For a long time I wanted to believe that my depression, anxiety and suicidal thoughts were going to make me into a greater or better person than I am today. But mental illness doesn’t go away. There’s not a lesson to learn from it. It's not like I wasn’t paying attention while I was driving and got in a car accident and now I should pay more attention on the road. No, my mental health issues are on-going. They always will be a part of me.

Some might argue that there are lessons to learn from this on-going struggle, though. I can use my experiences to help others, as I’m doing right now, they may say.
 
While that may seem like an easy answer, I hope I could help others with mental health issues without having to go through what I have. The idea of having to deal with suicide and feeling a constant state of mental weight on my brain is something I’d love to avoid. I don’t think I’d still need to be going through what I’m going through to share my experiences about mental health.
 
I find that when people say, “Everything happens for a reason,” it minimizes what I have gone through. It makes it seem as though my experiences are a pawn in some sort of larger game of life that can get me someplace whereby I will have “won.”

Based on my experiences I find it far more likely that things in life just are. They happen and there’s no reason. And that’s okay. I don’t need my trials and tribulations to have some grand meaning to know it’s worthwhile for me to be alive and to continue to live.
 
Years ago I learned to be okay with ambiguity (as much as it’s possible, at least) and the weirdness of life. It makes things fun and gives life a sense of adventure.
 
I’ve learned to become okay with life having no universal purpose. It’s up to each of us to come up with it on our own. I’ve chosen to do my best to live a life of service to others, but what you find makes you happy may differ. I continue to experience life with its ups and downs, but what I choose to make of them is my own decision. Anything else deprives us of our autonomy as human beings and limits what we can do and what our struggles mean to us.