Having a Nervous Breakdown

Miscellaneous and Personal Stuff I Must Share
1

My job is really crappy (CPS Investigator), and I’ve been sending out resumes, to no avail. The stress load is incredible, but the pay just got enough better that it makes it harder to find another job.

My marriage has also been really crappy, and at the advice of my bishop, I moved out last Thursday. I really love my husband and want to get back together. I’ve been diligently working on my issues, but he so far refuses he has any issues that he needs to work on. If that continues, I see no resort but divorce.

Almost 3 weeks ago, after spending an hour in my office staring at my computer and casefiles and crying, I called my doctor and made an appointment. That afternoon, I told him I was on the verge of a nervous breakdown. He said that no, I was actually having one. He encouraged me to check into a local psychiatric hospital, but I was averse at the time, due to having family from out of state visiting. He put me on sedatives and sleeping pills.

I’m due to start back to work on September 12th (I think–is that a Monday?). I have been thinking of going ahead and going to the hospital on Monday. I’m still not feeling ready to go back to work, but I have no choice.

Has anyone else ever been at this point? What should I expect if I go to the hospital? What would they want to do? I mean, I certainly can’t stay on the sedatives and do my job. And even with the sedatives, I do a lot of crying, major hiccupping, and feeling suicidal a lot. Please note this is not a threat of suicide–I don’t think I would ever commit suicide because of my religious beliefs; however, I do spend a lot of time thinking about it, and have even dreamed about it.

Should I go to the hospital? Should I just go back to my doctor and get my meds altered? I’d appreciate any advice at this point. I’m feeling very panicky.

2

I don’t have any advice but maybe you’ll get half a smile now that there’s “N Sane” and “TellMeI’mNotCrazy” in a nervous breakdown thread?

I can’t advise you one way or the other, but were I in the situation (and I’ve been close, but not quite there) I would probably go to the hospital. The added stress of going back to work could prove to be a very stressful addition to an already very stressful life, and getting meds altered probably will not change anything in the short term. That’s just my two cents and not meant in any way to influence you.

Good luck, and strength for what lies ahead.

3

The hospital will provide you with full-time, concentrated therapy, monitored medication, and a chance to review your issues without the other aspects of your life taking precedence. In short, it’s all about you. If you have a good hospital and good professionals, that is. There will probably be both individual and group therapy, sessions with a psychiatrist (who will be prescribing and monitoring medication), free time to read, write, visit with family, etc. They may even offer some sort of exercise (though my hospital didn’t have a gym…it was a lame calesthenics thing…just to keep us moving a bit). There was also an arts and crafts thing.

There are some people (even me, to some extent) who are cynical about mental health care. Going into it as fully informed as possible will certainly help. Your doctor can tell you what to expect from any medications he prescribes. There are possible side effects with most psych drugs. You can ask beforehand what the expected effect and usual side effects are and what other options you have if they don’t work out for you. You need to check with your insurance company to find out what’s covered and what will be out-of-pocket, as the charges for a two- to four-week stay can be extremely high.

Many states (going by conversations and information provided on these boards, as well as personal experience – ymmv) can decide to keep you if they determine you are a danger to yourself or others. They will probably encourage you to continue therapy and monitoring of medication after you are released.

You need to understand how your future ability to get government clearances, a gun license, and insurance (possibly other things as well) may be impacted because you’ve been treated for mental illness.

Mental health treatment can be very effective for many, many people. Ask your doctor as many questions as you want and be sure he answers them to your satisfaction. Check the internet for laws regarding mental health treatment, patients’ rights, etc. Best of luck to you.

4

I suppose something like this cannot be anonymous?

5

N. Sane, first off, let me say you have my sympathy and prayers.

Secondly, I think that you may benefit from some time in an inpatient facility.

Some background - I’ve been so depressed that I ended up not talking to anyone for about two months. After I surfaced from that I ended up inpatient on a psych ward for a couple of weeks.

I have a slightly different view of my inpatient time than Kalhoun described. While there was some therapy done every day while I was inpatient the real benefit of being inpatient to my mind was the ability of the doctors and nurses to monitor your responses to medications as they try to find the best set of drugs to work for you.

As for involuntary committing: in NY for someone to be involuntarily committed for more than 72 hours (96 over a weekend, IIRC) requires a court order. My experience was that for the most part judges are reluctant to commit people who don’t want to be treated. Now, part of that is that any mental health treatment works much better if the patient is willing to work with the caregivers. But, for the most part, the judge will be looking for very clear signs that a patient is a hazard to herself or the public before committing them. The fact that you are considering going in voluntarily (And it seems if you do go in, it will be of your own free will.) is going to negate most concerns that a judge will have. Unless you’ve tried poisoning everyone in the ward, or spent every night trying to find ways to commit suicide, I don’t think they will keep you against your will. Note, however, other dopers have had other experiences - in particular AHunter had a particularly ugly time, and is very negative towards the whole psychiatric branch of medicine, so, unfortunately YMMV.

One word of advice, there is no such thing as a side-effect that is too small to mention to your caregivers. When I first tried anti-depressants I went from my normal one dream a month to getting three to four a night. And since my dreams are normally vivid, surreal, violent and disturbing, this was more than enough to keep me from sleeping well. So I stopped taking the meds. I have since learned that, no, I wasn’t unique for having problems with sleeping when getting such medications adjusted because of the nightmares. Talk to your caregivers about anything related to your medications that concerns you. There is no concern too small for them to be willing to talk with you about.

I hope this can help you make up your mind how best to get treatment.

If you want to email for specific questions that you don’t want to share, here, feel free to contact me, please.

6

I think you can probably find the answers to a lot of this sort of thing on the internet, but I personally find it difficult to plod through all that shit. I dunno…maybe a call to a lawyer? I’m sure there’s a way to find out anonymously, but it would take some work.

7

I have also been through the psychiatric hospitalization route about ten years ago. I had been doing outpatient therapy and taking a combination of meds, and because I seemed to be doing well and my insurance didn’t want to approve another round of therapy, at that point my sessions were getting less frequent but hadn’t stopped yet. My issues were mostly to do with my parents, with whom I was living at the time (and am again, due to economic issues, but hopefully that will change soon). One day I was at work and my boss yelled at me for something stupid - he just did that, he was really only pissed off if he was smiling - and shortly after that I had to go on the road. While I was sitting in traffic waiting for an open bridge to close, I started having a panic attack. I didn’t so much feel an impulse to just drive the van off the bridge as have a vague feeling that I wasn’t sure I wouldn’t do it anyway. I don’t remember how I got through the rest of the day but I called my therapist when I got home that night. I had to leave a message and when she called a little while later she said she hadn’t gotten the message, but was just checking up because it’d been a couple of weeks and I wouldn’t see her for a couple more weeks. Thank Og for small favors.

We decided that I would go to a hospital for a three-day observation stay - my meds had been working pretty well up till that time and I was actually fairly upbeat about the future. I’m probably the most positive chronic depressive you could ever hope to meet. If I was judged to be a danger to myself they would be able to keep me longer; if it was felt I needed further treatment I would have the option of arranging a longer stay; if the panic attack passed and I was basically ok to continue as I had been, I could go home in three days. I had both group and individual therapy while I was there.

I’m not sure if the place I was at happened to specialize mostly in drug/alcohol treatment or if that’s just what most of the patients were there for at that time. I do remember when I checked in looking for an elastic to put my hair up before going to bed and the nurse flipping out because she thought I was going to shoot up, so I’m guessing the former. (I’ve never even smoked pot, not even in high school, for the record.) I honestly didn’t have much use for the nurses there at all. The doctors were mostly pretty good, though there was one who didn’t listen to me at all. He kept insisiting that the fact that I have tattoos proved that I was suicidal and refused to listen to anything I was saying. Fortunately another doctor, a much older gentleman, talked with me later and really listened to what I was saying - among other things, that getting tattooed was really one of the most positive things I had done for myself, because it made me feel like I finally belonged to myself, if you can understand that. I ended up being released after two days because they saw that I was really not even considering suicide, it was an isolated episode and as long as I kept up with treatment I’d probably be ok.

I’ve sought treatment and/or medication on other occasions since then but that was the only hospitalization experience I’ve had. A few years ago I did go through a situation at work where my boss was on a crusade to make everyone as miserable as she was, and I don’t just mean making it a generally unhappy place to work, she was literally targeting people. Two other people quit before me for the same reason. By the time I left, it had gotten to the point where I was missing at least a day every week because of severe dizzy spells and nausea. Ironically, I was denied on my disability claim because this only happened at, or on my way to, work. I wasn’t so sick I couldn’t work - I just couldn’t work there. The next job I took (a commission-based sales position) didn’t work out around the same time I moved in with a friend who had an elephant-sized prescription drug problem that I hadn’t known about before. I ended up having her committed - I was in the process of moving out, which she was pissed at me for but I had no choice, we were about to lose the apartment anyway thanks to her never getting out of bed long enough to look for a job, when I went back to get some of my stuff and found pills everywhere, broken glass everywhere, the dog cowering in the corner, and my friend passed out with a gash over her eye. The EMT’s brought her around and were explaining to me that even though she obviously needed to be hospitalized, they could only take her if she agreed or if they could prove her incompetent. She knew her name, where she was, who was president, etc., so they were having a hard time proving the incompetence thing. By the time she told them it was Thursday (it was Sunday), she had pretty much been talked into going anyway. She had a seizure and went into a coma in the hospital, and when she came out didn’t talk to me for two months. We finally ended up reconciling and she’s been clean for three years now.

So. I’ve seen it from both sides. It’s usually easy enough to get help, though it does very much depend on finding the right people to work with you. It’s not so much easy for someone to force something on you that you’re not willing to do. Even though my problems haven’t entirely gone away - I accept that I will probably suffer from depression most of my life, though how much it affects me is largely up to me in many ways - it hasn’t affected my ability to live my life as I want to. A couple of low-paying jobs later things are beginning to look up, and I’m working on a relationship though there’s a lot of stop and start there. I don’t discuss my issues with everyone right off the bat but I don’t deny them either. As far as having problems down the road because of having been though treatment, a therapist should be able to advise you on the laws in your state. The sales job that I had that didn’t work out was selling life insurance and while our questionnaire did ask if you were currently on any medication I don’t recall anything about past treatment for mental illness.

The fact that you’re able to come here and talk about what’s going on shows that you don’t really want to commit suicide, religious beliefs aside. People who talk about their problems are looking for support that will keep them alive and sane. That’s a good thing, and it seems like you came to the right place. I’ll be praying that all works out for you, though I know it can be hard getting there.

8

I would hope that mental illness records fall under HIPAA privacy standards, but from a security clearance standpoint here’s what happens: on the initial form you fill out, you are asked if you’ve ever been treated for mental illness (depression, etc.). I don’t think that a “yes” automatically means no clearance, but my guess is that they will ask for more information and determine whether they think the severity of your problems affects your ability to have access to classified information.

If you say “no,” but in the course of their investigation your investigator finds out that you lied, I get the feeling that’s much worse than if you’d just said “yes.” All of the advice I’ve ever gotten about clearances includes to simply tell the truth, no matter what that truth is – and you should not be keeping any significant secrets from your immediate family or friends, because you should not have the appearance of being bribable. For example, I know of one gay man who lost his clearance in the mid '80s, but not because he was gay: it was because he had lied about being gay, and at the time was still very much in the closet. I know people who admitted to using drugs in college (and even shortly afterwards) and still got clearances, while people who have never broken a law but have really bad finances were denied (they can be seen as bribable). (And by “really bad” I mean horrible, not just “no savings, living month-to-month.”)

So the anonymity thing gets challenged if you’re seeking a clearance, but only inasmuch as the investigator wants you to simply tell the truth. I think that anyone who thinks they will ever need a clearance has to understand that by requesting one, they are consenting to give up a little of their privacy and anonymity.
Disclaimer: I am not a security professional, I just have a little knowledge about clearances and the process of applying for one. Please do not take anything I have written as gospel. I am merely explaining my understanding of some things. If you have any questions about security clearances, please talk to your employer’s security officer.

9

I’d suggest checking your local Bar Association and asking for the local Mental Hygiene Law Services department. At least in N.Y., there are agencies that specialize in assisting people who have psychiatric problems with their legal problems. If there is something similar in your area, and you can manage to get a live person on the phone, they’d probably be a safer bet than an internet search.

10

n. sane,

i was worried about an official “record” of my therapy showing up later to haunt me, so i paid cash.

i paid out about 20k (100 per session, per week for 4 years), but i feel it was worth it.

also, you don’t have to tell the therapist your last name if you don’t want to.

11

(hastily pulling on psychiatrist hat)

There really isn’t anything a doctor or hospital can do to you if you give them a false name, or even simply refuse to sign releases of your treatment records to anybody. I’ve worked with a few patients who did that. I don’t know if they ever lied about it later. Insurance will want to see documentation before they agree to pay for
any of the treatment, though.

I am not your doctor and can not diagnose your problems or recommend treatment (Ethics 101), but psychiatry is what I do and I’ve been practicing it for more years than I like to admit to myself. So, some nonspecific thoughts here…

I think in general that hospitals may not always the best place to get treated. I would ask whether my patient was getting out of bed, washing, dressing, and eating regularly; if not, I’d strongly recommend inpatient treatment. If they have hallucinations or feel so anxious or terrified that they can’t think clearly, then I want them in a safe place, which may well be the hospital. If they are doing things that could kill them or anyone else, and can’t control the behavior, then I’m reaching for the involuntary admission certificate and a pen.

The home circumstances and the people close to my patient can be the decisive factor. Some families are supportive enough to provide a much more healing environment than any hospital. Some are terribly destructive.

If work is the only place my patient feels able to organize things, they should probably keep doing it. Many people seem to do better functioning as much as possible. If someone is sitting in a chair crying and not able to get any work done, I would advise at minimum a short leave from work until they feel better. Since every person is unique, there is really no standard set of rules to go by.

One thing to consider is the length of time a medication takes to kick in. Antidepressants may not make a noticeable difference for a week or more, and then sometimes take another month or two to help the brain normalize. Some family doctors are really good at treating depression, but if the situation is more complicated and the first-line meds aren’t helping, then it’s time for an assessment and management by a specialist. There are dozens of medication approaches we can try, and fitting one to the body and mind of a patient is what gets results.

Not sure how much of this info is relevant or helpful in your case, obviously. Therapy to help the person figure out what’s happening and decide where to go next is extremely helpful. Meds are tools; working with them and learning how to get results is what counts. Therapists are the folks who can focus on the learning process. There are lots of approaches to therapy and several academic paths to becoming a therapist, which means lots of opportunity for a person to connect with a good one. Most psychiatrists aren’t trained to do therapy these days (I was, but that was a back in the day and at a hospital that was founded well back in the 19th century.) Still, they should be able to make recommendations if needed. As a CPS staff person in the community, you can probably give the doc pointers. :slight_smile:
I’m hoping you soon feel healthy again and able to rebuild your life with no room in it for the influence of toxic people and circumstances.
:slight_smile:

12

Pardon me for asking, but how exactly does one do this?

Like so many of us, I’ve had issues with clinical depression myself, and while I hope that conventional therapy and medication will help, I want to be prepared in case they don’t. I often fear that the day may come when I can’t get out of bed and go to work any more–not because work is particularly bad, but because nothing seems worthwhile.

But how exactly does one check into a hospital? Do you just show up at the front desk and say, “I feel like shit?” I’m not feeling particularly destructive toward myself or others, perhaps more because of lethargy than anything else. Wouldn’t they just examine me, say I’m physically OK and not a danger to anybody, and send me home?

13

About 6 years ago I had an episode that resulted in me seeking psychiatric help. It was related to my job - I was working home health and for some reason I was the “on call” RN every friggin weekend. After working 10 hours on Saturday, I would be on-call from 5 PM Saturday to 8 AM Sunday, then be expected to do another 10 hours on Sunday. And on-call meant the beeper was going off all night. One late night, on my way to start an IV pump for a patient, I contemplated driving off the road because I thought it would be the “acceptable” way to not have to do this anymore. Scary. Luckily, I stopped and called for help. This all resulted in my various diagnoses - although I was not hospitalized, I began a very good relationship with a psychiatrist, whom I still see every 3 months. It took some med juggling and 2 years of SSDI (I was literally unable to leave the house for quite some time), before I was able to go back to being functional. I have moments of despair and depression, but they leave me quickly.
I work 2 part time jobs. I don’t feel great, the meds suck, but I can leave the house.

Your job is one of the toughest ones I can imagine. I hope you can get some help and start to see the light. Sounds so trite, but baby steps and one day at a time were helpful for me. I didn’t realized how sick I was until my psych MD said I needed to go on disability. I received SSDI first time around, which is apparently unusual. Due to my instability and also excellent documentation from my doc, I was granted SSDI without having to fight for it. My doctor has always discouraged
any in-patient hospitalization for me because he feels I can self-monitor and know when it is time to call for help. He has been wonderful to me.

Please let us know how you are doing. Hoping you can find your peaceful path.

14

I can relate: I had a job stress/harassment situation that had me come to work one day, sit down at my desk, and feel overwhelmed and unable to comprehend how to do the simplest task, and I just started to quietly weep. I recognized that it wasn’t going to pass, and called my husband to come get me. After calling a local hospital (sort of a phone triage), he took me to the ER to be checked out. They didn’t recommend that I be admitted, because I wasn’t feeling actively suicidal (just completely helpless & hopeless), but they did refer me to a psychiatric nurse practitioner, whom I saw for outpatient therapy while on a leave of absence from work. I started by seeing her several times the first week, then tapered off gradually, while starting on antidepressants, and eventually was referred to a specialized clinic which confirmed my diagnosis and put me in a group therapy.

While I still have struggles with mood now and again, I think the time off from work, the therapy, the meds, and the support were what I needed. I think you have to judge for yourself if being an inpatient is right for you, but I think it would have made me feel worse.

15

N. Sane, I cannot imagine being in a more difficult position. You have my sympathy. IANAD, IANAP, but from what I’ve read from others above, by all means check out the hospital route. I think it will help.

Meanwhile, you can thank your lucky stars that you don’t have it as bad as Hal Briston in this thread! :wink: