Partially hospitalized... at home (and it helped!)

The pandemic turned our lives upside-down. And for many like me that lead to massive increases in mental health symptoms. When I lost my connection to friends, teammates, baristas, and bartenders who had been a part of my daily routine, it hit me hard. I gain energy from social interactions with the people I know and am comfortable with. I still had two partners at home but they work all day, and the void of losing everybody else was deeply felt. My depression went from a shadow over my shoulder—ever-present but often manageable—to a looming darkness overhead that threatened to swallow me whole. I had more and more days where nothing felt worth living for. The pain of existing was more than I felt equipped to bear. Self-harm and suicide were often on my mind. In short, it sucked hard. And it scared my partners.

Because they are wonderful, caring people, Kristin and Ethan worked to get me help beyond what my psychiatrist could give me—help in the form of a partial hospitalization program (PHP for short). In "regular life" PHP would have meant spending my days, 8-4, in the hospital and my evenings and nights at home. During a pandemic PHP meant spending that time in my room on zoom calls with therapists of every ilk, nurses, doctors, and most importantly other patients

Maybe it isn't the other patients that make the experience positive for others, but for me these people were my world. Tears are rolling down my cheeks as I try to write this post. I will write about the logistics, what I learned, and all that in the following paragraphs. Due to confidentiality I can't say very much about the amazing people who went through this journey with me. Nonetheless, I want to take a moment to say thank you to them. Thank you for your willingness to be venerable. Thank you for your words of encouragement and acceptance. Thank you for the little things—your puppies, kitties, artwork, hobbies, totally "off-topic" stories... All the things that made us more than pixels on a screen. I also want to say an extra special thank you those who've stayed in touch. Getting your texts, or even just seeing you on FB or Instagram, means so much to me. Thank, you thank you, thank you... for existing and being so honestly and wholly you. I was so goddamn lucky to have y'all in my PHP experience.

So what exactly did I do in PHP? I shared a lot. Every day would start with a check-in:

  • What is your goal for today? 
  • What might be a barrier to that goal? 
  • What is something you're proud of/grateful for? 
  • How can we support you? 
  • Would you like to take some processing time right now?

I think that it doing this sort of check-in every day in real life could be useful, if even only with yourself. I journal and through PHP I learned some tools that have helped make that journaling even more helpful to my mental health. GLAD (or the longer version, GO GLADLY) is one easy one to do and share. Basically you just write down something you're Grateful for, something you Learned, something you Accomplished, and something you Delighted in. A lot of the tools we learned were ways to be more introspective, to put words to our feelings and be aware of where we are and what we need to get where we want to be. And there were also skills—actions for self-soothing, calming, or otherwise bringing ourselves down from high anxiety. And actions for "activation," things to try and jump-start you out of that low place where depression lurks, waiting for a chance to pull you further down.

I can't say that it fixed me. It helped. It didn't cure my depression (or anxiety), but it gave me more ways to cope. One of my favorites is my deck of cards. Following the lead of one of the most amazing fellow patients, I now have a deck of cards. And on different cards are different activities. Some are calming some are activating. They include things like count your breaths for one minute, splash cold water on your face, go for a walk, take a shower, do the electric slide... Some are more useful than others and I've added to my deck since the end of PHP. It sits next to my bed and is one of the most tangible reminders of the fact that I have tools. When things feel hopeless, just holding that deck can be a comfort.

If all this sounds like hokey tricks and nonsense, I understand. I think a few years ago I would have rolled my eyes hard at some of the lessons. And I actually did nope out of a few things during the program. But I was desperate enough to try almost anything. And I'm glad I did. I wish I could go back. The program ended long ago but I still have the skills, worksheets, and friends I made there. Some days I wish I could go back so much it hurts. But missing what I had in PHP, as painful as that can be, is hell of a lot better than wishing I didn't exist at all.

I followed up PHP with an all-too-short stint in intensive outpatient therapy (basically PHP-light) until insurance got crabby ('Merica!) and now I have a personal therapist in addition to my psychiatrist. It's not perfect but it's something.

If you are depressed—especially if you think about hurting yourself—please reach out to somebody, even if it's a stranger on a helpline. People who can help you are out there. It doesn't have to be so bleak all the time. Really. 

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