This is a story about rehab...
What's the difference between detox, rehab and inpatient treatment for mental health disorders? Very little actually. Here's my little exposé into being a patient of the UK's most notorious private drug and alcohol abuse treatment provider.
As far as my medical records show, I was admitted to The Priory for treatment for Type II Bipolar Disorder, during an episode of acute illness. My private health insurance picked up the bill and JPMorgan gave me the time and the space to get better. They're a great employer actually.
I had found a local private psychiatrist, as I was running out of ideas for how to deal with my Dual Diagnosis (Bipolar & substance abuse) and I knew that the stats weren't good. Not many people recover from such a death sentence of a diagnosis.
I was very lucky to find the psychiatrist that I did. I had been trying to get in contact with a number of specialists directly, but things were very slow going during the Xmas/New Year period, when a lot of people suffer a big decline due to the bad weather and family pressure to put a jolly face on everything during the holiday season.
I contacted a general psychiatrist at the local private hospital, and he turned out to be one of the nicest, kindest people I could ever have hoped to meet. It was pure relief to meet somebody nonjudgemental who would hear my story without leaping to immediate conclusions. The first time I met him, he simply said "we can only play the cards we are dealt" which had me in floods of tears, as it was the first time that anybody had ever said something so kind to me.
I had been taking quite a kicking from my supposed loved ones - but I'm not going to go into that anymore - and been made to feel very guilty and a total failure for having gotten sick. It should be noted that I became clinically depressed and suicidal before any substance abuse entered the picture. Bipolar symptoms had always been present in my life, but it took a further 2 years to get diagnosed. Then, finally, substance abuse reared its ugly head and became the most pressing issue.
From my point of view, I had struggled for years and years with recurrent suicidal ideation, suicide plans. I have struggled all my life with mood instability. To be simply dumped in a bucket labelled 'lost cause addict' was a bit s**t to be honest, after 30 odd years of reliable good service, despite fairly debilitating mental health problems.
Perhaps I'm complaining too much, making too much of a big thing of my struggles? Yes, yes, yes, there are people who've had it so much harder than me, blah, blah, blah. Ok, unless you've sliced your forearms multiple times, lengthways along your veins, with a razor blade, do me a favour and shut up? Some of my friends are wonderfully supportive and have gone out of their way to learn about mental health problems. Perhaps you could follow their example?
So you think this is attention seeking? Save it for the funeral.
It's true that it's taking me a while to work up the bravery to take the Final Exit. Ending your life is a big deal, and you've got to do it right, otherwise you're just going to end up in hospital in pain.
I've had cans of inert gas to suffocate myself, 2 grams of Potassium Cyanide, enough barbiturates to slip into a coma and drown in my hot tub while unconscious, travelled to the top of tall buildings, cliffs and peered over the edge of high bridges. The most serious attempt I made was trying to open my veins with a razor blade. I must admit though, I was just testing the water. You want to make sure that you open some major veins, like the jugular, if you want to die quickly.
Stupidly, I still have hope and some faith in myself. I should write myself off for dead, like those-who-shall-not-be-named have done.
So it came to pass that I went into The Priory, with a referral to one of the country's leading experts on Bipolar Disorder and Dual Diagnosis. JPMorgan were told that I was experiencing mental health problems (true) but the main objective was for me to detox for 28 days, so that there was a clearer clinical picture, and the treatment of my Bipolar and depression could begin.
That makes me an addict right? Don't need to read the rest of the story. Skip to the end. Case closed.
Well, actually, The Priory and my psychiatrists were concerned with my mental health, and saving my life, not just labelling me as an addict and sticking me into the revolving doors of mistreatment and stigma that those suffering individuals endure. The Priory is actually a private hospital, and cares primarily for those suffering with various mental health disorders that are less controversial and stigmatised than substance abuse. There were ten times as many patients who were there because of depression, anxiety, schizophrenia, borderline personality disorder, eating disorders etc. etc.
It's actually all part and parcel of the same group of problems. One fellow patient had been admitted with mental health issues, but out of some drive to self-destruct, she started filling up a mug with alcohol-based hand sanitising gel and flavouring it with orange squash, and drinking it to get drunk.
One of my fellow patients tried to commit suicide by climbing a high wall and hurling herself off, while I was there. Does it matter if she was being treated for depression, or for substance abuse? The fact of the matter is that she was suicidal at that moment. Mental illness of some kind had driven her to try and take her own life.
There was a game we used to play, when a car used to roll up to the house, and out would step the worried looking family members, dragging some dishevelled son, daughter or partner out of the back seat and into a meeting about admission. We used to try and guess what they would be admitted for. Sometimes it was obvious - if they had red wine all spilt down their clothes for example - but often it was nearly impossible.
But what's it actually like, in private hospital? Are there rock stars and stuff? Well, my doctors had treated a number of high-profile sportsmen and women, but when I was there, there weren't any rock stars. Couple of millionaires but no rock stars.
Really, it's much like an NHS mental hospital, except a little more well appointed. Everything is bolted down and the windows don't open and the doors don't lock. The lights don't dangle down and there are no curtains. Mirror glass is made of plastic, and pictures are screwed to the wall, not hung. Yes, there is quite a lot of anti-hanging thought that has gone into things.
When you arrive, you will hand over your razor, scissors, tweezers, solvent containing toiletries, shoelaces, belt etc. to the nurses to keep at their station. If you want to have a shave you'll have to ask for permission, and you'll only get a short amount of time to attack your face with something sharp.
Plus, it's still a hospital, and people are very sick. One woman said to me "it's OK, your secret is safe with me" and tapped her nose with a knowing wink. It later emerged that she thought I was a royal prince, and that my presence in hospital was a state secret. She also came into my room and stole all my underwear and my books, before the nurses tracked down her hiding place.
The rooms are actually as good as any 3-star hotel, with a writing desk, nice view of the gardens, an OK single bed and an ensuite with no shower curtain or plug (drowning is frowned upon). Once you're off suicide watch, you might get to move to one of the double bedrooms that are further away from the nurse's station.
Other than the slight refinement of having a TV and a telephone in your bedroom, there is little different from NHS mental health treatment. The food was very good, I have to say, but your days are generally structured around morning and afternoon trips to the dispensary hatch for your medications, and being regularly checked on by nurses if you're not in some group activity.
Between art therapy, yoga, mindfulness, music therapy, table tennis, TV, movie night and generally socialising with the other patients, it all sounds like a thoroughly lovely spa break. There was a gym and quite big grounds that one could roam in, provided you told the nurses where you were going and how long you'd be gone for. Leaving the compound within my 28 days was forbidden.
Your partner can come and visit you, and you can give a knowing wink at the nurses station before you have sex, so that nobody barges in on you unannounced. Just don't take too long. Visiting is only on a Sunday, so you'll probably have a sack like Santa anyway. You have to hand over your mobile phone and laptop, and digitally detox, so pornography is hard to come by. Probably because sex addiction is also treated at the hospital.
We should remember that although people talk about 'rehab' we need to be quite clear about the treatment route of substance abuse. There is first a detox. It's necessary to break the body's dependence on substances, and treat the withdrawal. If you are an alcohol or a benzodiazepine abuser, there's a good chance that withdrawal could kill you, so the hospital will put you on tapered medication to get you off those substances. If you are an opiate abuser, you will get very sick from withdrawal symptoms, and these can be attenuated with substitute prescribing or by putting the patient into induced sleep. If you are a stimulant abuser, you will suffer cognitive impairment, exhaustion and suicidal depression.
After detox, which could take the whole 28 days, then comes rehabilitation. Depending on how dysfunctional a person has been, they could need 3 to 6 months of rebuilding their damaged life in a safe environment. Just breaking the cycle of chemical dependency is not enough. There's a reason why a person entered that cycle in the first place. There's a reason why that person stayed in that cycle.
We know that gambling addicts don't inject packs of cards into their veins, so addiction can't just be about chemical substances, can it?
So it was, as my time at The Priory drew to a close, the staff gave me the bad news that my treatment was incomplete. I would need another 3 months of rehab if I wanted to make the changes permanent. I flipped out. I discharged myself, went home for a day. Then I spoke to one of the staff on the phone and decided to go back for the remaining few days of treatment. She-who-shall-not-be-named decided that I had "failed" in my commitment to getting better. That's simply a lack of understanding about the commitment that is needed to support somebody in recovery.
Recovery is not about abstinence, it's about having people who love you trying to support you. Support does not mean hectoring, bullying, nitpicking and generally being obnoxious to a person. Your holier-than-thou drinking and smoking and generally behaving like it's OK to do whatever you want and laughing in the face of the abstainer is not helpful, OK?
Abstinence doesn't even work anyway. It's just a continual reminder of what people want to believe: that you're somehow a bad person, that you're faulty, defective. People want to treat you differently, want to label you. Teetotallers are ridiculed, treated with contempt. Why bother being teetotal?
Certainly, not being a smoker was a problem in hospital. There would be long periods where I was left all on my own, because everybody was outside smoking. There is no real abstinence in the world. I found the nurse's stash of caffeinated coffee in one of the more remote kitchens, and in some hospitals you are even allowed to have caffeinated drinks. 'Addicts' are encouraged to not give up smoking and tea/coffee, because they will need those things as a crutch, during those early days of abstinence.
If you look a little more closely at human behaviour, you will see that people are self medicating in one way or another. You'll see the hypocrites, dosing themselves up with stimulants in the form of caffeine. You'll hear the hypocrites, being hypocritical about addiction inbetween puffs on their cigarette. You'll suffer the hypocrites, swallowing their pills and liquids they have as government sanctioned, medically approved substitute addictions.
I could go to my doctor and get a prescription - called a script in addict parlance - for something to salve my addiction and turn it into something seemingly acceptable in society. It's OK if my pills come in boxes from the pharmacy, with my name printed on them and with a prescription from my GP or psychiatrist?
If I had to go to work at the moment I would probably need some Dexamphetamine, or at least a gallon of super strong black coffee. Because I've used so many stimulants, I can drink heaps of coffee without having the anxiety, palpitations and sweats that you would get, but it's a poor substitute for genuine amphetamines, even if the caffeine molecule is virtually identical.
There's no magic in treatment. There's no magic to recovery. It's just time & space and being treated nicely by people, being respected as a human being.
It's important to respect people.
Just respect people.
Tags: #addiction #alcohol #drugs #suicide #mentalhealth #nhs #bipolar #depression
