This young man's medications were gradually reduced and, when he finally discontinued all medications, he recovered.http://www.kansan.com/stories/2008/may/05/hell_and_back/?news
Editor’s note: Kansan reporter Thor Nystrom was diagnosed with Attention Deficit Hyperactivity Disorder his senior year of high school in Minnesota and prescribed the drug Adderall. When he developed anxiety, a side effect of Adderall, he was prescribed Paxil. The two drugs, mixed with the beer he consumed as a KU freshman, led to behavior that culminated in a fight in a KU parking lot, his arrest and his entry into the mental health system. Using his own medical records, police records, his own diaries, interviews with family and his own recollections, he wrote this account of what he calls his descent into the “depths of hell,” a journey with an ending that neither he nor his parents saw coming. This is his graduation story.
Seven and a half months before the day I should have died I am in the parking lot of Naismith Hall. I am a 19-year-old freshman. I have just gotten a ride home from the bar, and I am drunk. I have again ignored the red sticker on my orange bottle of Paxil warning against drinking alcohol with the medication. My head throbs, and my thoughts race.
A group of students across the parking lot yell and swear. I walk over and tell them to shut up. They curse me. I curse back. I take a swing at the tall one, and I miss wildly. His friend lands a blow to the left side of my forehead that knocks me to my knees. I rise and put my hands behind my back and tell them to take their best shot.
A tall guy with dark hair hits a glancing shot across my jaw, and I stagger. I scream: HIT ME. HIT ME. They close in.
His friend lands a shot directly into my right eye socket, and I drop heavily. I stay on the ground. They laugh, and they kick. One lands in my diaphragm. My wind is gone, and it feels like I am breathing out of a straw. I’m drooling blood that pools with dirt on the concrete near my face.
Soon I hear the sirens. An officer puts me in handcuffs and drives me to the hospital. We’re at the counter, and I am disoriented and sad and as drunk as I have ever been. I nod toward his holstered gun and ask him to kill me.
“Shoot me in the head. No one has to know.”
The officer puts his hands on my shoulder and looks me in the eye.
“We’re going to get you help, OK?”
I’m transported to Stormont Vail Regional Medical Center in Topeka via squad car in the early morning hours of October 10, 2003.
I meet with the psychiatrist on a Sunday morning. We are alone in a sparsely decorated room. I take the empty chair across the table from him.
“Why did you ask the police officer to kill you?”
“My mind was kind of racing. I guess it is just what I felt at the time. It was like a voice inside my head was telling me to say that. Telling me I should die; that I deserved to die; that I should hurt myself.”
“Did you want to die?”
“At that moment, yes.”
“What about right now?”
“You mentioned voices. Do you often hear voices in your head telling you to do stuff?”
“It’s hard to explain. I feel like I have two tracks of thought. Like, you know how you see people with an Angel and a Devil on their shoulder in movies?”
“So one of the voices sounds like the Devil?”
“I guess in a matter of speaking, yes.”
The young doctor’s brow is furrowed as he scribbles notes.
“What you are describing sounds to me like schizophrenia. Have you heard of it?”
“The auditory hallucinations you have been experiencing are symptoms of schizophrenia. This may have changed your sense of reality, and it explains the delusions and suspiciousness. You have a chemical imbalance in your brain, and I can prescribe you medication that will make you better.”
There isn’t much time to discuss the diagnosis. This on-call psychiatrist had other patients to see. He rises and shakes my hand. I’ve given him the right answers to get me discharged.
I had no way of knowing then that this doctor’s diagnosis would start a year-long journey into the mental health system and the depths of hell. It would feature seven different diagnoses, 13 different mind-altering drugs, more than a dozen psychiatrists and psychologists, hundreds of hours of therapy, drug overdoses, self-mutilation, a suicide attempt, a weight gain of 140 pounds and being committed by the state of Minnesota for four months into three separate mental institutions.
It will end with one last-ditch attempt at a self-imposed cure.
I return to my room in Naismith Sunday evening with a black eye and handful of prescription bottles. With the drugs coursing through my body the rest of the semester, I am sluggish and lazy. My mind is cloudy, and my thoughts come in fragments. I am profoundly sad. I brood when I have the dorm room to myself, and I cry. The anxiety that caused me to be put on Paxil just before I left for college is a distant memory. Now I can’t stand being awake, which is a jail inside cloudy and hateful thoughts.
I become despondent over the failure of the new medication. I begin to drink more. Sometimes when my roommate leaves, I turn off the lights, flick on the TV without the volume, sit on the futon and drink beer by myself in the dim gray light.
I go home for Thanksgiving, and I am miserable. I am withdrawn and depressed. I don’t want to interact with my family. They act like everything is fine, but I’m different, and we all know it. My mom notices that I am constantly twitching. My legs and arms sporadically spasm. My head twitches to each side. My face is expressionless, but I am in a constant state of agitation. Although I often feel tired, I am at the same time restless, and I lie awake in bed staring at the ceiling until exhaustion finally takes me away.
When my mom takes me back to the airport to return to school, I can only talk about Her. I shouldn’t have broken up with Her. I should get back with Her. I can’t stop thinking about Her. The negative thoughts have found an unlikely resting place, a former girlfriend. It is the last time I remember true happiness, and I latch onto it.
I finish the semester and move back in with my family in Baxter, Minn. My friends are away at college, and I have no one to hang out with. I sleep 15 hours a day, but I have stopped dreaming; I haven’t had one in months. I tack a beach towel over my window to block sunlight entering my bedroom.
I have difficulty keeping grasp of my thoughts-my mind is in a perpetual haze. I sign up for classes at the local community college, but have lost my capacity to think creatively. I hire a friend to write the assigned papers for me; it helps me pass the course.
I don’t work out. I inhale junk food, and my medication lives up to its warning label by slowing my metabolism. I’m growing fat. I go outside only when I have to. I hole up in the basement. I don’t care about my appearance. I don’t brush my teeth, shower or wear deodorant. I stink.
In March, Bryce, my best friend, visits and drives me 15 miles to a cabin party. I drink until I vomit in the snow. I rinse out my mouth and start drinking again.
I ask Bryce to drive me home. He laughs as he talks. I think he is making fun of me.
I throw punches before I know what I am doing. He hides behind his arms to block the onslaught. I don’t stop until I am pulled off him by three guys. I am laughing.
I lose many friends that night.
At home, I take out the sleeping pills. Half the bottle is left, and I swallow them all. I tell my 18-year-old sister, Quinn, what I have done, and she tells my mom, who helps me to the bathroom. I vomit for the second time that night, heaving out the small white pills. They float in the toilet bowl.
The next day, I call Bryce. He refuses my apology. I don’t blame him. I hate me, too.
I become increasingly testy and combative around the house. One day, my 12-year-old brother, Will, won’t clean up after the dog, and I push him into the wall. Sometimes I ignore my stay-at-home mom and pharmacist father. Other times I yell and argue.
I have more free time than I have ever had. I have no job, and I don’t do my schoolwork. The time I spend awake I think about the past. I think of Her. Obsessively. Blonde and smiling. She is still in town, a year younger than me, going to high school. I want Her to save me. I call Her. She’s dating someone else, and she doesn’t want to talk. It infuriates me. I become enraged when she hangs up. I throw my phone and smash my fist into the wall.
I have lost faith in the therapy, which I suffer through twice weekly. They remain convinced that I have schizophrenia. I am convinced. I say I have many voices in my head, including Satan’s. I descend further into darkness when they increase the doses of my medication. I have made up my own reality. I no longer remember the person I was just six months ago, going off to Kansas. I am a miserable schizophrenic, and I am convinced I do not deserve to live.
Every night I pray: “God, take me tonight.”
I will find out later that one side effect of the Geodon I’m now taking is “depression, suicidal thoughts.” In the not-yet-developed mind of a teenager, especially one who has become an abuser of alcohol, these side effects are exacerbated.
One day my psychiatrist changes the diagnoses. Now I have Bipolar Disorder. I am put on Risperdal and the antidepressant Prozac. I will find out later that Prozac has a warning stating: “Before using this medication tell your doctor or pharmacist of any prescription drug (such as Risperdal) that is specially removed from your body by certain liver enzymes.” The psychiatrist doesn’t heed this warning. There is only so much the liver can handle, and the excess goes back into the bloodstream, effectively multiplying the stated dose. I am also on Trazodone, an antidepressant used to induce sleep.
I don’t understand the clinical jargon, but I take every medication they prescribe and go to every therapy session they require. How could I not? As the son of a pharmacist, it is only natural to accept the diagnosis of medical professionals and believe the prescribed medications will make me better.
My behavior becomes increasingly irrational. I start shoplifting. It gives me a much-needed thrill. I steal sports trading cards from Target and Wal-Mart. One day, at a Target in St. Cloud, I carry two boxes past the security guard into the bathroom. I lock a stall and put the seat down. I open the packages and drop the cards onto the floor.
The security guard comes in, and the cops are called. I am arrested.
Late May arrives, the night of my sister’s high school graduation and just when I should be finishing up my freshman year at KU. I tell my mom good night, but not goodbye. She will tell me later through tears that this hurt her deeply.
As she walks down the hallway to her bedroom, she has no idea that her oldest son is about to ingest 10 times the maximum recommended dose of prescription sleeping pills. She has no idea that he decided earlier in the evening that things would never get better. She has no idea that a suicide note has been typed onto a downstairs laptop. It begins and ends “I’m sorry.”
I walk to the garage and place the rags in the exhaust pipe of the Jeep. I seal it with layers of duct tape.
I start the Jeep then walk back around to check that the tape has held.
I climb into the back, curl into a ball on the leather seat and pull the hood of my sweatshirt over my head.
I lie alone on the cool grey leather in the dark garage. I shut my eyes tightly. I concentrate on my slowing heart beat. thump….. thump…. thump.… thump….
I am content. I’ve made a decision for myself, and I find it hard not to respect that…
Quinn, my sister, finds me in the garage at 5:15 a.m., groggy but alive, the car still running. The high school held a Grad Blast for all seniors, and they were released at five. Sometime during the night the tape broke. The rags dislodged.
Quinn remains convinced that her presence in the garage that morning was a miracle from God.
An emergency session is scheduled with the psychiatrist. It takes an odd twist when she turns on my parents. She is outraged they didn’t call an ambulance and have me hospitalized. She threatens to report them to social services if it happens again. She offers me two choices: be hospitalized or attend an out-patient program for depression at a hospital in St. Cloud, four days a week. She insists on an extensive neuropsychological evaluation.
The neuropsychological testing also takes place in St. Cloud. I am administered an extensive two-day battery of tests. They give me a questionnaire. It has hundreds of yes/no questions. I resent it, but I am honest.
I am depressed.
I blame my problems on others.
I hate myself.
I think others are out to get me.
I have frequent suicidal ideations.
I feel like I am alone.
After I am done, the middle-aged doctor talks to me. He speaks very slowly. I show him the cuts on my wrist. I show him the scab on my left hand from where I recently put out a lit cigarette. I tell him I am returning to the University of Kansas in the fall.
The doctor shares his results with my parents and me one week later.
“Thor will look very much like a social introvert, have high levels of anxiety, and probably has a social anxiety or social phobia. His scores on the MCMI-III would strongly suggest a borderline personality disorder with tendencies to be dependent, avoidant, depressed and self-centered.”
I am smirking. I won the “Class Clown” award in high school.
“I recommend that Thor not return to a highly competitive university, which will overwhelm him emotionally and subsequently affect his ability to function cognitively. He will tend to lose touch with reality when placed under periods of stress. My results show that Thor’s academic skills were generally average, but he has a slowed processing speed.”
Now I am livid.
My mom looks puzzled. I was editor of my high school newspaper, always had respectable grades and did well on the ACT.
“Assume that your mind is like a meat grinder,” the doctor says. “For Thor, it does grind, but it comes out a little slower. The way he processes information is just slower.”
The rage builds up in me. I ball my hands into fists. My face is red. My heart is pounding, and I can hear it.
I stand and snarl, “You’re wrong.” I’m out the door, and it slams behind me.
Three weeks later, on a bright sunny early July day, we have a family session with the psychiatrist. On this day, like most, I am agitated. I don’t want to be here.
“Thor, if you have suicidal thoughts, will you alert your father?” she asks.
I stare at her and don’t respond.
“If you have suicidal thoughts, will you tell your father?”
“Then I have no choice; you must be hospitalized.”
Like hell I do, I think, as I run from the room and then the building. It is the last act of freedom I will have for four months.
My dad catches me down the road. He urges me to go back, but I refuse. As we talk, a squad car pulls up beside us, and two armed officers jump out. One grabs my arm and puts me in the back of the car. I see my mom staring at me as we drive past the psychiatrist’s office.
Because there are no beds available in Brainerd, the town next to my hometown, I am transported via a police van to St. Cloud.
I am put in a white, tiled room with two beds. The beds have metal bars on the side. I refuse to talk to anyone that day. All doors going out are locked.
When mom comes the next day, I don’t acknowledge her presence. We sit in silence.
“I’m leaving,” she says and stands.
Then I start talking, but I am still seething. I’m furious at the psychiatrist, furious at my parents.
On day three I get a roommate. Jonathan is in his 30s and has spent time in prison. He holds eye contact incessantly. He has a look in his eye I have never seen before; I will come to know it is the look a man gets when he no longer has any connection with reality. Jonathan occupies his own world, stars in his own daily movie. He scares me.
“Do you smoke?” he asks. Eye contact.
I look away. “Some.”
Eye contact. “I have something to show you.”
He breaks eye contact to pull a cigarette from his pocket.
“Snuck it in. In my armpit. They never look there.”
He produces a paper clip and a foil gum wrapper.
“Come here.” He is at the electrical outlet between the beds.
He hands me the cigarette.
“Now just hold this until I say so.”
He jams the paper clip into the outlet and jerks it around. I can’t believe what I am seeing. He has a spark. The foil wrapper smolders with embers on one side.
“Cigarette,” he says hurriedly.
I hand it to him. To my amazement, he gets it lit. He offers me a puff, but I decline. He hasn’t taken four or five puffs before we hear footsteps. Jonathan puts the cigarette out on his tongue. It sizzles. He rushes to the closet and puts the butt beneath a stack of shirts. Two attendants walk in. They pull Jonathan from the room.
When it is time for bed an hour later, I can’t fall asleep. Jonathan is in the bed next to me, and I can’t bear the thought of closing my eyes. He falls asleep as I lie in the darkness. His snores are throaty and loud. I grab my pillow and blanket and head to the front desk.
“I can’t sleep in there. He snores.”
The attendant tells me I can sleep in the seclusion room. It is just like the moviesa white padded room.
“This’ll be fine.”
After a week, a bed opens up in Brainerd, and I am transferred back. The dozen low-slung brick buildings strewn across green manicured lawns were built in the l960s; a self-contained city for the damaged. The thousands of residents, insane, addicted, indigent and retarded, have moved to smaller group homes. The state had decided that institutionalization was not the best form of treatment. Just a few buildings are still open. The mentally ill in Building No. 6 are among the last residents in this ghost town that would shut down completely soon after my release. I join them in the middle of July when the grass is just beginning to brown.
Although I insist to the hospital psychiatrist that I have no suicidal ideas, he puts me in the suicide watch unit. They take my shoelaces and belt. I wear slippers, a T-shirt and flannel pants.
The bathroom stays locked, and I must ask for permission to go. Once inside, the attendant waits outside the door. Suicide watch patients must be observed taking a shower. I have no intention of letting a stranger see my naked body, anyway, because I have gained almost 100 pounds in a year. Fat hangs over my waist band. My torso is streaked with stretch marks.
We have no planned activities. We read old magazines and fight for control of the TV all day. After a week, I graduate to the next unit on the other side of the building. The bathrooms are not locked, and I am grateful.
I can also receive visitors. My family is diligent. I receive multiple visitors a day. Mom, Dad, Quinn, Will, aunts, uncles, grandparents from both sides. The few friends who have stuck with me come, too. This is a major inconvenience for the staff, because they must check each one in and out after locking up keys and wallets. Their ideal resident is utterly alone and under complete control.
For the first week, I refuse to go the mandatory group therapy session. Instead I read books in my bed. My routine: wake up, breakfast, take pills, return to bed and read, lunch, read in bed, dinner, read, watch TV, meds, bed. Repeat. One day I read “One Flew over the Cuckoo’s Nest.” It gives me an amusing perspective on my situation. I begin referring to a condescending and tyrannical staffer who wears too much eyeliner as Nurse Ratched. I meet a giant Native American with a long ponytail who has frequent seizures and anger problems. I call him Chief to everyone but not to his face. I am told to get out of bed and attend groups or my visitor privileges will be revoked. From then on, I just carry the books with me.
Unlike my three previous stops, I make an attempt to get to know people. My roommate, Paul, is college-aged. He is nice, but he always talks about the evils of sex and says he has too much respect to do it. He talks in his sleep, but he doesn’t snore.
Archie is in his mid-20s. I like him until one day in the common room he is sitting next to me and shouts: “I’m gonna fucking kill myself, man! I CAN’T TAKE THIS SHIT ANYMORE. I don’t want to live anymore.” His eyes roll back in his head, and he shouts words that are not words. One staffer runs to the med room and returns with a syringe while another locks Archie in a bear hug. When they inject him in the arm, the words taper off, his eyelids droop, and his body goes limp.
I enjoy talking to an older woman. She has white hair and wears cardigan sweaters. I call her Grandma. She is delusional and talks down to everyone. She frequently tells a story about how she once got offered $100 for sex from a black man but declined. Whenever a new person is admitted, I tell her to go tell them the story, and she does. She frequently states, “This place is evil,” and “This place makes you sicker than you are.” I don’t disagree.
Sheena is a 19-year-old meth and coke addict. Her fiancé is in prison. She cheats on him often and brags about it. She says her mom hired the neighbor to tape her having sex in the family truck. After it was done, Sheena beat her momma’s ass. She says she will have sex with me for $800.
“How could I possibly get that kind of money, Sheena?”
I say I’ll think about it, but I don’t.
With the closing of the facility now planned and the job eliminations that followed, it was clear the staff had one foot out the door. We were supervised, and so long as we didn’t act up, we were ignored. If we caused a problem, they confined us and took privileges.
While I see other patients allowed to go outside, inside a fenced area, I am never on the list. I spend six consecutive weeks in the dark, tiled, sterile, flickering fluorescent-lit building before my mom complains.
“He could have gone outside, but he never requested it,” she’s told. This is a lie.
I am rebellious. I mouth off to staffers, especially Nurse Ratched. I don’t clean my portion of the room. I leave books, magazines and newspapers on the floor. I get into confrontations with fellow patients. One night, I instigate a confrontation with David, a homophobic patient in his 40s, after he angers me. I use Grandma as my go-between to send messages to him about how we should kiss and make up. Then I wink at him. David is on his feet ready to “whip my ass” when staffers are upon us and send us to our rooms.
The next day, I’m called to a meeting with the psychologist.
“I can’t remember in my history a patient who managed to alienate an entire unit. You do know what I am talking about, correct? Is something the matter?”
“No, I feel fine.”
“I have just gotten done talking to a group of about, oh, 15 patients outside, all of whom have serious qualms with your behavior.”
“I can’t imagine about what.”
“Well to name a few, I was told you have been antagonizing several patients, almost instigated fisticuffs last evening, inappropriately called one patient Grandma, whipped a patient with your towel, snuck a cell phone with a camera onto the unit, and have made several lewd comments to the staff. Mr. Nystrom, is this how you act at home?”
I stop acting up when I’m informed good behavior will allow me to receive night passes. My mom picks me up on my birthday, Aug. 28. As we drive into town, she says I am acting like an alien from another planet. I see a McDonald’s. We could pull over and eat if we wanted. There is a movie store. We could pick out a movie if we wanted. We are in a car, and we could drive anywhere. The idea of freedom is much better than the cake and presents I will soon receive. But those are good, too.
While in therapy, the psychiatrist changes my diagnosis. I am so used to this that I don’t even pay attention to the new illness. This doctor says I don’t have schizophrenia or Schizoeffective Disorder, or Bipolar Disorder or any other psychotic illness. Now I have Borderline Personality Disorder, an emotional dysregulation featuring extreme sensitivity and a short fuse.
The doctor says most people with BPD were abused. Were you abused?
“I already told you. No.”
The doctor says the diagnosis is unusual for a young man and calls me unique. By way of explanation, he tells me I have built an “invalidated environment” where I have not learned to care for myself emotionally. Then he drones on about my emotions.
He is mildly surprised that I have no interest in his pontifications on my illness and his perceptions on my life. I’m done humoring these people. I want to go back to my room and read.
A few days later, I have a court date for a commitment hearing. They give me an attorney. I tell him I’ll do the talking. Inside the courtroom, in the basement of a campus building, I tell the judge: “I understand I was put here because people thought I was a danger to myself. I don’t dispute this. But I am no longer. I’d really like to get on with my life. I don’t see how anyone is served by me being locked up out here.”
The judge tells me I have articulated myself better than any patient in his history of coming to the institution. He commits me anyway, citing the strong recommendations to do so from my psychiatrists.
They send me to the Regional Treatment Center in Willmar, Minn. They treat BPD with Dialectical Behavior Therapy, or DBT.
When I first get to Willmar, I hate it. The campus looks much like Brainerd’s, with brick buildings, tiled floors and fluorescent lights. My unit, for those diagnosed with BPD, is full of middle-aged women. They are all emotionally fragile and can be easily set off. I try to be nice and not cause problems, because when they get upset, they burst into tears and talk about their sad lives. For the first week I rebel and refuse to go to group while requesting a transfer back to Brainerd.
In the second week, they tell me if I complete the eight-week program, I can leave. They say they cannot force me to go to groups, but when I do, the clock will start ticking. This is all I need to hear.
Willmar has structure. We are required to go to DBT groups. The leaders in group speak of “Interpersonal Effectiveness” and “Emotional Regulation” and using our “Wise Mind.” Some of it is bunk, some makes sense. The group leaders seem to care about us, the older women and me. I am no longer taking anti-psychotic meds, and they have lowered the doses of my anti-depression pills. I start to feel better. The fog is lifting from my brain, and I think more clearly.
They allow me a cell phone and an iPod. They give me free time to play PlayStation. They give me weekend passes to go home. We have nightly group outings to McDonald’s or Burger King. I savor being out.
The patients are starkly different from my previous stops. Everyone is friendly. No one yells or has seizures or talks about killing themselves or has vacant looks in their eyes. Many come from abuse and do not open up, but they still want to talk. Because I am the anomaly, the 20-year-old male who talks quickly and doesn’t get easily offended, some gravitate to me. I enjoy their presence. They know I am a sports fanatic, and they let me have control of the TV when the World Series starts in October, even though they hate baseball.
The weeks go by much quicker than in Brainerd. They release me in early November. I walk hurriedly from the building to the car and lock the doors once inside. I am afraid they will call me back in.
Upon returning home, I inform my parents I will be returning to Kansas. They call it a “terrible, terrible decision.” I have enrolled in spring classes at Johnson County Community College, and I have agreed to sublease a place from a student in Lawrence. They attempt to talk me out of it.
“This is what I’ve decided to do,” I say. There is a conviction in my voice that I haven’t felt in more than a year.
They agree to support me financially only if I continue taking my medications and seeing a ther