"I'm Okay. You're Okay": Dealing with self-esteem and psychiatric hospitalization

Being hospitalized is usually a demoralizing experience. Something has gone wrong, terrible enough for you to be considered a danger to yourself and/or others. Often, as a patient, you may not be aware upon admittance that there is anything wrong with you. You may feel bewildered, angry, and insecure.

Being hospitalized means giving up all control over your life. It requires an inordinate and sometimes impossible patience with the slow wheels of the staff and doctors. It may mean interminable boredom. In short, you may feel crushed and overwhelmed. Often, doctors talk to the family or friends about your behavior and conditions, leaving you in the dark. Often, it means being locked up. How can this not damage the self-esteem, damage the ego?

It is important to remember that in all but totally debilitating circumstances, it is temporary. One day, depending on how well you can cope and adjust to your environment, you will see the trees again, breath fresh air. One day, you will be free again.

Involuntary commitment is terminated after a commitment hearing before a judge. Sometimes you will have a lawyer. Sometimes you will not. It may take a week or more for a hearing to take place and you may not be informed about when it will take place or what will happen. It is all part of learning to cope with a total loss of control for a time. If hospitalization is voluntary, it may be determined that your status needs to be changed to involuntary. If not, the duration of your stay will be determined by both you and your doctor. Either way, the conditions are difficult at best. At worst, they are almost intolerable.

What is left when you are finally released back into the real world is a damaged ego and insecurity. But, it is possible to recover with time. How much time it takes depends on what you do with your hospitalization and the crucial time thereafter.

Usually, after you are transferred from the closed ward where there is more severe restriction, you will enjoy a little bit of freedom in the "open" ward. There may be groups where you can learn or remember coping skills. You may or may not see your psychiatrist regularly. During one of my hospitalizations, I saw my psychiatrist once only to have him tell me he didn't know what to do with me. During my last hospitalization, I saw my psychiatrist every day. There are no therapists available to help process your experience. They leave that to be accomplished after your release. Your medication will begin or be adjusted.

The groups may be your salvation. There is usually some form of recreational therapy. The hobbies you may find interesting and enjoyable can be continued after your release. Having a hobby or other enjoyable past time helps create a more meaningful life. You may also learn how to use music as therapy, set goals, learn a modified form of exercise or yoga. In one hospital, I was exposed to creative visualization. You may attend lectures or groups. You may be able to watch movies or some kind of television. Further, the privilege of walking in the fresh air can be earned. This was the most important thing for me of all.

Also key is learning to set goals or setting them for yourself if no goal setting therapy occurs in the hospital where you stay. The programs vary widely from hospital to hospital. It has been my own experience that no two are alike and by the time you learn all the rules, it is time to be released.

What happens in the hospital, to a large extent, is up to you. Regaining your self esteem is up to you and to some degree your therapist. It is important to seek therapy as soon as possible after your release. Processing what has happened will take time and help. You may have to answer questions about your condition before and currently again and again. You may be asked questions during your hospital stay that seem absolutely ridiculous. However, like everything else during your hospitalization, it must be endured. Often, the hospital staff seems less well adjusted than I am. Other patients are hard to cope with.

In most hospitals, you will be placed among people who are seriously, even hopelessly ill. Interacting with them may also require patience. But, after your release you will be a more understanding patient person than you were before. You may have new skills or have learned new ones. Keep a journal, if possible, while in the hospital. It can be a place to reflect or vent not available to you otherwise. I wrote a lot of depressing poetry while in was in there. It helped to get my feelings on paper, helped me to express my feelings to an extent I had no opportunity for otherwise.

Remember it's not your fault you were hospitalized. Don't feel obligated to answer prying questions of people who may mean well, but do not respect your privacy. Privacy is one thing you are guaranteed during your hospital stay. No one can talk to you, you don't want to talk to you. No one will be informed you are there unless you grant them permission to know or contact them yourself. Guard that privacy jealously. There is no reason to announce widely that you have an illness at all, let alone that you were hospitalized.

And most of all, allow yourself time to heal and exercise that hard learned patience with yourself. Take walks. Talk to the people you trust the most. Get out of the house as often as you feel comfortable with. Pursue the hobbies that interested you most in the hospital. Pick up new ones. Keep on writing in a journal and follow your medication regimen religiously.

I saw my psychiatrist more frequently than usual after I was released. I saw my therapist more often as well. I discontinued the pace that got me hospitalized in the first place and followed the after care program I had designed myself.

Do not keep in touch with the people you met in the hospital. It doesn't help to be supportive as you may have been in the hospital to others. You probably do not have any more energy than you need for yourself for awhile.

It is not necessary to be totally insecure with yourself after you are released. Trust yourself and those who truly care about you to do the best possible things for your welfare. Give yourself positive reinforcement for every step of progress you achieve and put it behind you as soon as possible. It can take as little as a few days to become a better self than you were before you went in. It may take longer. It takes what it takes and you must give yourself permission to let it. In all, you can turn your hospitalization into a positive experience - a time you spent learning or being reminded what you have to do to take care of yourself.