Shout Progress! Unique Progressive Designs

Tuesday, May 31, 2016

The (Profound) Difference Between Anxiety and Depression

I am fortunate enough to live with both anxiety and depression. They create different obstacles in life and those obstacles create myriad opportunities to be misdiagnosed and/or ignored. That is always lovely. Always.

On Mothers Day weekend this year I had terrible stomach pain. It started in my belly button area and I went to the pharmacy because I refused to go to the Urgent Care as the predominant feature of my anxiety is agoraphobia and being in places that are new to me or crowded or lack windows with clear views of escape are triggers I avoid like the plague. I might prefer plague, to be honest. Anyway, my pharmacy is in my grocery store and that is one of 3 places I've become comfortable being outside of my home or car. The pharmacist said I should go to the ER. I said that's not a choice and determined the ulcer I'd been treated for a couple of months earlier was probably the culprit. I explained my nausea and pain and she recommended Tums and Tylenol (the only pain killer I'm allowed to take because of previous surgery). I bought them and went home. The pain gradually moved lower and to the right and I could actually see a swollen area by my hip bone when I was laying down in the tub and thought whatever was there in my body was the problem. It looked like a sausage link. I just kept taking the Tylenol and hoped for the best.

The best happened. The pain was finally gone but the nausea persisted. I went to see my doctor that following week and she ordered a CT scan. I'd already googled and determined it was my appendix but figured if I wasn't dead I must be fine. I'd read that 'chronic appendicits' was a thing and felt sure this was my issue. My appointment for the CT scan was the following week on Wednesday. The doctor called me Thursday morning and said I have appendicitis and need to go get it taken out. Again rationalizing that if it had been an issue for 2 weeks now and I was not dead, it must not be a big deal and I told my doctor that my daughter's bachelorette party was this weekend and her sister was flying in from Florida especially for the event. I was not willing to ruin that with her having to worry about my having surgery. My doctor called a surgeon and an appointment was made for next Thursday to see him in his office.

On Memorial Day the nausea and vomiting into my plate whenever I tried to eat became more of a pain in the ass than I wanted to deal with any longer so I called the on call surgeon at the hospital who read my CT scan and she asked why no one did my blood work to count the white blood cells. I, of course, had no idea. Because I was so sick she determined I may very well have a blockage as the swollen appendix was putting pressure on other organs. Her encouragement that I go to the ER registered and I had my daughter drop me off.

Upon registration into the ER, I answered all of the usual questions. One of them was 'Are you suicidal?' to which I explained 'I have clinical depression and always want to be dead but I'm not doing anything about it'. She asked me several more questions about depression and I told her, 'Look, if I was trying to be dead today I wouldn't have come here for you to remove my appendix, I'd just let it go and not tell anyone.' That logic was lost on her and she informed me that she was going to flag my admission as needing to be watched by the Psychiatric department. Whatever. That's fine. Do what you want to do. Just get this stupid appendix out, thanks.

Of course, what she failed to explain to me was just what the 'watch' would entail. What it meant was that I was going to be taken to the ER ward specifically for psychiatric patients and, because I said I always want to be dead they would list my issue as being depression. My depression had nothing to do with my visit or my unwillingness to go to the hospital. My depression would not have had any problems in that space. My anxiety, however (which they knew all about as evidenced by the electronic record and instructions they gave me upon release shown below), was going to make my visit a complete and almost unexplainable nightmare.

When I left for the hospital I took 3 anxiety pills that don't actually do anything but are the only ones I had and took the maximum my doctor said I could take in one time. I also packed a bag with my iPad and headphones so I could avoid looking around and experiencing the uncomfortable and unfamiliar place that I was in. I brought my laptop so that I could write or design and keep my brain busy as I knew it would certainly be a long day and my anxiety was going to get the better of me if I didn't try to stay on top of it. I was as prepared as I could be to go to a regular ER and have the regular ER experience. I was woefully unprepared for the experience they would offer me, however.

When I was taken to the special ward I was not actually aware that it was no longer part of the ER. They gave me a purple gown to get into and told me I had to give them my clothes. They questioned whether or not I had any weapons or hard objects in my shorts. I said, 'just my cell phone'. The nurse said he needed me to give that to him. I was pretty uncomfortable with the idea and let him know it. He said I wasn't allowed to have electronic devices because of a hospital regulation about not having your 'treatment' recorded. I then told him that I also had my iPad and laptop and assured him that I was going to need to keep them. He told me that was not a choice. As I recall that moment to write it for you now the fear comes back and my anxiety and tears are just as real as they were in that moment. That is anxiety. But they didn't want to hear about my anxiety. I was there because the fucking woman at registration asked about the depression on my chart with no note or concern of the anxiety/agoraphobia listed directly below it.

After all of my tools to deal with my anxiety were taken away, I tried very hard to calm myself the only way that works for me. I count back from 73. I have no idea why 73 is my number, but that's what I do. Over and over. Sitting in front of a television that wasn't on, I put my ball cap down low and counted inside of my head. After a couple of hours of being in this room and having little attention aside from giving a urine sample and having my blood drawn, a very angry and large man was brought in by the police. He was very forceful and demanded that he was neither drunk nor on drugs and he refused to do the things all who entered that room were told to do. He was not going to change his clothes and he was not giving them his stuff. As he was screaming he used words and a tone that, as it turns out, were a trigger for me. They were reminiscent of the words my former abuser was screaming the day I got a police escort out of my home. I began having a panic attack. The police had left and this room was now, for this moment, occupied by the intimidating man and myself (a 43 year old woman with a shitty attitude but who honestly poses no threat to anyone), a 4 foot something 70ish year old woman who weighed 75 lbs (I know this because when a nurse came in to give her meds she questioned her weight for fear the dosage would be too much) and a 23 year old nurse who had a sweet heart but I doubt would be much of a counter to anything this man may want to unload.

My panic attack started slowly, as it always does. I couldn't count backward any longer. It was not working because my brain was too preoccupied with the memories of my former abuser and the worry that something might happen to my young nurse. I made my own anxiety worse by shaming myself because I was allowing this attack to create a limitation if I needed to take action to protect her. My breathing became more difficult and my body began shaking uncontrollably. This attack lasted about 20-30 minutes. Eventually the security guards took care of that man and another nurse who'd seen what I was dealing with asked if she could give me something for anxiety. 'Yes, please.' I don't really take anti-anxiety meds so when she asked if I had ever had the one she was going to give me I honestly replied, 'I don't know. I doubt it.' It started with an A. It worked. Eventually I fell asleep sitting up in the chair.

When I woke up that man was sitting next to me. I had had a panic attack that they witnessed and worked to cure. They told me they assessed that it was the loud and angry man that had set me off and I assured them that is what caused my anxiety and recounted my flashback of my abuser to them. They were good enough to set me to sleep and then allow me to wake to the same fucking man sitting next to me.

No worries... This story gets much worse.

At this point, several hours in, I still didn't quite understand why I was being given so much psychiatric attention and so little medical attention. I was sent for a new CT scan and after two more hours of waiting, I was told that the antibiotics I'd been given last week when the appendicitis was diagnosed were working and the infection was dying. They were concerned because there was a blockage due to the inflammation and they wanted to take care of that, as well.

After 6 hours of sitting in the psych waiting room they found a bed for me. At this time, I still believed I was there to get my appendix out. They put me in a room with no door, no windows, white walls and a television on Nick Jr showing some goddamned show I wouldn't have suffered well if my toddler was a fan (and I can take a lot - I still know every word to every Barney song), but I certainly couldn't watch it that night. The remote was broken and that show was my only choice. I turned off the TV.

When the TV was off I realized just where I was. I was in a mini version of the awful psych wards you see in movies. There was a catatonic woman walking up and down the hall. There was a faceless woman in another room moaning and crying and there was the angry man from earlier that afternoon who seemed to be well drugged up and harmless by this point but with a booming voice talking all nonsense echoing through the halls for actual hours. His nonsense was eventually countered, however, by an even louder and more offensive newcomer. Her name was Mary. I know this because I was out in the hall demanding for the *nth time that I be removed from this ward when three police officers came down the hall escorting a tall (at least 6 foot) and rather large woman to our happy group and she was cheering her own entrance with arms raised announcing, 'Mary's back. Is Curtis working tonight?'

Mary was good enough to rant for the remainder of my stay. She was a good Christian. And she hated gay people. And she shouldn't be expected to abide gay people. Apparently a man showed up at a Memorial Day cookout she was attending (who the fuck would invite Mary to their cookout, honestly!?) and she got in a fight with his new boyfriend. I imagine that is what precipitated this night's lodgings. I was beyond pissed about her homophobic rant and went to the hall to ask a nurse if they could just at least give her some drugs and put her to sleep. I said, 'You have no idea whether or not you have someone here who is depressed and gay and this is going to make it worse.' The woman who had been pacing the halls for hours looked at me with tears streaming down her face and said, 'Like me?' My heart broke for her. No one did anything to quiet Mary but they did escort the other young woman to the showers so she could get out of the area and cool down.

Once that young woman was taken care of I, again, went to the nurses station and said I needed to talk to my surgeon and figure out what was going on. I told them I would rather just be released and take care of this with my own surgeon on Thursday and reminded them I had an appointment. I was told that I did not have a choice to discharge myself because I was on suicide watch. Fabulous. Nevermind the fact that I never said I was going to kill myself and I came to the hospital today because a surgeon said I needed to get my appendix out. Finally a surgery student came in to tell me that my new CT scan showed that my appendix was going down and that I could get it out later. 'Great', I told her. 'Then I need discharged immediately.' She encouraged me to stay so they could work on the blockage. I asked how they did that and she told me that they would give me the meds I'd taken for the recent colonoscopy that found my ulcer. I showed her around my surroundings, explained my agoraphobia and anxiety and told her I should not be expected to stay there. They were literally perpetuating my own fears and making my mental health less stable with this 'treatment.' She agreed and went off to see what she could do for me.

An hour or so later the surgical student returned and said she had cleared it for me to be admitted into the regular part of the hospital but said they would need to have someone 'watch' me 24/7. This watch meant that someone was going to sit by my bed and watch me the entire time I was there to make sure I wasn't going to kill myself. I told her, again, that I had no intention of killing myself. She explained that she was bound by hospital liability policy. It appears their liability superseded my care. I told her that I was unwilling to stay and that I wanted to be discharged. I assured her that I was quite capable of taking the meds as I had several months earlier all by myself and make it to the bathroom without supervision whenever the meds kicked in. I demanded that I be released at once. This demand was as effective as all of the rest.

At midnight, it turns out, I was standing in the hallway being a bitch to the nurse at exactly the right time when a psych doc came down the hall and I explained my situation. He heard me. He said he would place a request to the doctor everyone else said I was waiting to see (I was there for 12 hours being promised to see the chief psych doctor who could clear me). Another hour or so later a young woman came in who was lovely. She asked me lots of questions. I answered her questions respectfully because she treated me with respect. She, too, agreed that I was not a danger to myself or anyone else (at this point, I'm not sure that I was not a danger to some of the nurses, not gonna lie). She called this phantom chief psych doc 'on call' and asked that I be allowed to be discharged. It turned out, after all of this, the man I was waiting to see was NEVER in the building. He was not tending to anyone. He was just 'on call' and, apparently, not taking his calls. I got to go home at 2am.

Upon release I was given all of the documents one would expect. I was informed that I should still get my appendix taken care of. I was given 'care' documents, as well. They literally gave me paperwork about depression even though they never witnessed or treated my depression. They did, however, witness and treat profound anxiety and agoraphobia. This fact was not even given a secondary nod on my way out.

These were my discharge instructions:

Dehydrated, you say? Interesting. It is important to note that the only way they could've determined I was dehydrated was the blood work done early in my visit. No one ever told me I was dehydrated. No IV was ever put in to hydrate me. Toward the end of the evening I asked them if they ever actually feed the patients and reminded them (what paperwork surely would have told them if my care were being documented properly) that I had not been given any food or water the entire day. I was given a plate of food and an 8oz solo cup of water.

My discharge did not mention my appendicitis. It had been (re)confirmed during my visit. At this point, however, I can not even confirm that it was noted in my chart. My online chart was updated to say I was seen and treated (treated? really?) for abdominal pain, nausea and vomiting on 5/30/16. I was given something that started with a Z for nausea. That is as far as I will support a single line of the bullshit in my chart.

I still should have my appendix tended to once the infection is gone. I can honestly say that there is little chance of my doing it. If I have been flagged as needing to be in a psych ward whenever I have a medical emergency, I feel confident that I will never seek medical attention again.

My anxiety makes situations like this more than a simple challenge. You would have to live inside my head to realize what a fucking rock star I was yesterday in getting through it at all. My anxiety is something a psych ward should be well equipped to handle. No one dealt with any depression. I wasn't given anti-depressants. I was, however, given anti-anxiety meds. Twice. My anxiety was the only thing that was treated yesterday. It was created and perpetuated by the psychiatric ‘care’ I was afforded when I went to get my appendix out. My appendix and I are still quite attached.

The truth is, after having lived with anxiety for a minute now, I’m not even surprised. I’m Just Pissed. Please share with anyone who has a voice in creating models meant to sincerely care for those who suffer with mental health issues.

Kiss Kiss ... Mean Progressive

Absolutely NEVER Again


  1. What a horrible experience that did absolutely nothing for your long-term well-being. I can imagine how you felt because I once had a different, yet similar experience that I will not detail, but your story brought it back to me. Please take care of yourself. Not every facility is that fucking stupid. I guess you know now that sarcasm is lost on those who get lost in the scientific, fact-based, fear-driven liability prone institutions. short answers - the less the better. OMG

  2. And we are going to release all the mentally ill people and the addicted people out on to the street and we really no nothing about mental health treatment. We cant tell the difference between anxiety and depression. That is the real problem we can not plug our selves into a computer to see what is wrong and they still tell us it is all in our heads when they know dang well there are many physical illnesses and fixable issues such as counseling and diet. Some problems are due to lack of vit and minerals such as low thyroid or high and vit d loss. Mine was down to a 9 and the Doctor could not figure out how I was still working, Well they know that over 80 percent of the population has low vitamins such as vit d then why dont they test for it.
    Because they ignore the fixes and concentrate on you coming back. They dont teach you how to do things to help yourself. That is why I see self help groups as much better places for the people share experiences and help each other with warnings about alot of the drugs. We have to study this more but not rely on one way fixes everything,

  3. So disorientating and they starved you in the process.

    How scary it's that - like being in different reality in another time. You poor love. Anything could have happened to you in that psych ward. Stay safe dear friend and stay out of trouble!!
    Big Hug, Susan