Mania: It’s Not Just What Happens on Black Friday

Inside the Mind of Mania

…continued from yesterday.

St. Helena Hospital Behavioral Health Center

Admission Inventory

Valuable Name:

Clothing: at bedside
Clothing, other
Suitcase with other misc. clothing items.

Monetary: in safe
Gift Cards—1 Target, 2 Barns & Noble, 1 Home Depot, 1 Driver’s License
Money—16 cents

Misc.: held at nurse’s station
Micellaneous—One Tums box with wire, strings, scissors and fork
Toilet articles—1 Bar of soap, shower gel, shampoo, conditioner, lotion

Prosthetic Device
Contact lens, left—med room
Contact lens, right—med room


St. Helena Hospital Center for Behavioral Health—Day One

Unsent letter to my parents:
Towards you
my wrath is like
lighting fire
hell raining down
You threw me, dragged me to HELL
Fell it in your soul
Your ugly heart
Experience my fury complete
violent, bloody, shaking, perverted
You sent me to that shrink
Yeah, the b**ch w**re backstabbing
mother f*** psychologist
I f***ing hate her guts
She, too must feel my pain
know the hrut she caused me
the irreversible scars on my
bleeding heart
mended only by love.
Love alone can stop the
torrential flow of crimson
My heart and soul will forever
bear the marks of all your
tortuous words and deeds
You have all done me so wrong
You say it’s “in the name of love”
To hell with that.
Not one phone call, not one word did
you speak to me
to ask me how I felt.
That may have saved ME this
F***ing s**t.
Maybe I would still be living
my life like a normal human at
this moment
Thanks for NOTHING.


Two days after Sarah’s admission to the psych ward, Laura and her husband, Louis, drove over from California and joined Pedro and I for a spring vacation trip to Oklahoma. While there, we would help them hunt for houses in the area where they would be moving to in the summer to start Louis’s first teaching job.

We found it difficult to celebrate and travel with the same enthusiasm whilst under the pall of Sarah’s hospitalization. How does one celebrate life as usual when life has suddenly acquired a dark menace of a diagnosis no one wants to receive?

We knew nothing about bi-polar affective disorder. On our long drive to Oklahoma, Laura and I started looking for answers on the Internet. After all, I knew how to do cancer caregiving, but I had no idea how to do bipolar caregiving. Laura found the first really helpful resource. (

As we traveled and researched, the puzzles started falling into place. I wondered how so many counselors, psychiatrists, and psychologists could have missed the diagnosis. How has our insurance system and healthcare system managed to bungle something so important as mental health care? What would have happened had someone at Alta Bates invited us in for a session and asked us leading questions about Sarah’s depression, behavior and history? Would they have seen something earlier?

Once again, the HIPPA laws frustrated me. While I understood that Sarah’s rights needed protecting, I felt that more communication with the center would have been nice.

I guess I expected things to work like a cancer diagnosis. I wanted a psychiatrist call us up and verbally ‘sit us down’ and break the news to us that, yes, indeed, our daughter suffered from bi-polar affective disorder. Than I wanted him to explain exactly what that meant and exactly what we could do to help her recover, along with the center’s proposed treatment protocol for treating severe mania.

I wanted the doctors to treat my daughter's #bipolar diagnosis they way they treated a #cancer diagnosis. Click To Tweet

It didn’t happen that way at all. My first call to the unit involved asking if I could speak to Sarah, identifying myself and then having the nurse put me on hold while she checked to see if Sarah existed and whether or not she had given permission for the center to acknowledge that she was a patient.

Once we accomplished that, Sarah had to give permission for me to call and talk to her. She willingly did this, although she expressed great anger at Pedro, me, and her aunt and uncle for forcing her into the hospital. Her rapid speech and mercurial moods continued. She couldn’t understand how we could treat her in such a hateful manner.

Because we had done some initial research, we had something to fall back on. The article we had read suggested staying neutral and voicing concern, commitment to the affected person, and love. So, that’s what we did. We listened. We listened when she told us how angry she felt. We listened when she said that the second the doctor’s released her that she would quit taking her medicine. We listened as she chattered about the wonderful friends she had made (other patients). We listened when she shared her plans for her immediate future (return to college in Washington).

We tried to avoid verbal sparring of any kind. We didn’t point out that she had no cash, no car and no debit card. We didn’t point out that springtime weather in California could be nice, but that she had packed for Puerto Rico. We didn’t point out how frustrated and hurt and confused we felt.

When she paused to breathe, we tried to tell her about our trip to Oklahoma. We related funny incidents of travel, house hunting and the minutia of everyday life. We told her that we loved her and that we missed her.

The weekend loomed, and we discovered that just like any other medical facility, the behavioral health center seemed understaffed on the weekend. One of the nurses I spoke with explained that Sarah’s 72-hour-mandatory hold would end Friday morning, but since it was the weekend, insurance would probably approve holding her until at least Monday, when they would assign a caseworker to her.

I questioned the sanity of their decision. According to another nurse I spoke with, Sarah was still “flying high.” For those of us who knew her well, she had not approached anything near normal yet. The nurse suggested that I call our insurance company and explain that Sarah needed more time.

By this time, I had suffered through countless conversations with insurance agents over the course of the past year. In addition I had spent several hours on the phone with the hospital billing personnel who couldn’t figure out our insurance coverage.

Since vacation had started and I didn’t feel emotionally stable enough to tackle advocacy once again, I turned the problem over to Pedro. “Could you call insurance this time?” I asked. I explained that they would probably not approve a stay past Monday, but if we called and made a case for Sarah’s instability, they might approve a few more days. I started praying.

I don’t know what Pedro said to the insurance people when he finally got ahold of them—I only know that they agreed to cover her stay longer—as long as it would take for her to stabilize. We had no idea how long that would be.


St. Helena Hospital Center for Behavioral Health—Day Three


Hands lifted my body onto a gurney from the hospital bed and into a body bag. Confused, I looked up at the looming shadows that pushed me away to God-knows-where.

“I’m not dead,” I screamed, scratching, clawing at the zipper and trying in vain to tear the fabric. “I’m alive! I’m—“ I stopped when I looked down at my chest in the dim light. Where my heart used to be I saw a gaping hole, red and sticky, ribs protruding.

“Where is my heart? What have you done to me? Give it back!” Suddenly, I couldn’t breathe. Choking, gasping for air, my arms fell to my sides. I yearned for somebody, anybody to hear my cries. I felt nothing. No pain. No fear. My body now rigid, I let my heavy eyes close and felt myself falling, down, down, down into endless darkness.

…to be continued.

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