They Called It Seclusion, I Called It Solitary Confinement
An excerpt from Mental, Jaime Lowe's new memoir on lithium and bipolar disorder.
BY Jaime Lowe | Sep 28, 2017 | Fitness & Health
I was sixteen, young, at that time, to receive a bipolar diagnosis. The morning after I was driven to the hospital, I was volatile and irritated. The nurses said I was disturbing other patients. So I got a private room with four beds. There were about seven other teenagers in the ward, mostly girls with eating disorders and one boy. There were automatic double-locked doors next to the on‑call nurses’ terminal. Doctors could pass through; we could not. Immediately, I paged through my patient handbook, a small stapled brochure that outlined rights . . . very few, there were very few rights afforded to me. I explained that I was sixteen, old enough to drive, old enough to file to become an emancipated minor, old enough to know when certain nurses were trying to kill me. I demanded to be released; I would be seventeen in two months and I was too old not to make my own decisions, too old not to exercise free will. I already had too much responsibility to be stripped of choice. I had a part-time job wrapping gifts at a boutique owned by pothead lesbians, I was a Red Cross certified babysitter, I had a driver’s license, I had been a camp counselor, a volunteer at a shelter for runaway teens, I’d campaigned for three Democratic presidential nominees and attended political rallies to protect a woman’s right to choose. I was an autonomous latchkey kid. Here in the ward, I was a danger. I argued aggressively, pushing the point that my residency at this facility was a violation of my constitutional rights, my human rights. “I have been to Amnesty International concerts; this doesn’t happen in this country,” I said. A nurse politely pointed out, “A minor has no constitutional rights, no amnesty.”
HERE IN THE WARD, I WAS A DANGER. I ARGUED AGGRESSIVELY, PUSHING THE POINT THAT MY RESIDENCY AT THIS FACILITY WAS A VIOLATION OF MY CONSTITUTIONAL RIGHTS, MY HUMAN RIGHTS.
I eyed the double doors. I thought of escape.
NPI was a jail. The building was an imposing postwar brick behemoth shaped like a plus sign with wings extending in each geographical direction. The adolescent ward was in the west wing. Looking out the north-side windows I could see a power generator three stories tall and equally wide. If I looked past the metal grates, past the generator, I could see the bucolic hills of UCLA’s campus and imagine the expansive green lawns with freshman students and stacks of books and backpacks full of purpose. Those rolling grass hills were not for us; we were locked in, double-locked in—no, triple. Those hills were not real to me anyway, just another movie set, a form of make-believe to mask an apocalyptic landscape—cratered earth swallowed by thick nefarious lava, a war-torn battlefield burning on the west side, an army of degenerate zombie serial killers thirsty for brain. Nothing good was happening on the outside. I was fixated on the generator—the pipes intertwined and shined, they were big and boisterous and volatile. It was a maze of metal, menacing and alive. I watched those pipes like something was going to hatch—a plan, a spirit, a baby, a monster, a baby monster, a zombie serial killer, the Night Stalker, Richard Ramirez himself. The south side of the ward faced an equally awful image: a fenced‑in asphalt volleyball court and recreation area that was wrapped in double-sided barbed wire. What kind of MacGyver move would it take to escape and save the world? Tuck and roll? A hysterical diversion? Sure. Maybe.
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I tried to keep my head in the game by resisting meds, an obvious instrument of mind control. I would spit them out and run. I never made it far. Several nurses would tackle me in the hallway and pin me to the floor. They held my arms and my legs against the antiseptic linoleum. One nurse would peel back the waistband of my pants and stick a hypodermic needle into my left hip. In the needle was a cocktail of sedatives and antipsychotics. Nothing worked immediately. Those meds were appetizers to the medication that they would eventually give me in capsule form. Lithium.
But before the lithium, I was still a savior, a messiah, a renegade. I would stand outside the rec room door, whispering to another patient (TeeVee Dude) about the evils of TV, like a ghost speaking in tongues: Back away, the rays, they are toxic, turn it off, it’s not worth it, the TV, the fiber optics they will suck you in and spit you out, zombie, commercial, an evil corporate plan for brain hijacking. Stop letting them hijack your brain. They will take your soul. They will turn you into a sitcom character. They will turn you into a watch, a bomb, a drone. Step away, step away. I am here to help you. Don’t be gassed, turn it off. Those rays, don’t you see them? They are colorful and there is a laugh track but they are still noxious, the fumes will poison you. You see them. Don’t breathe, don’t move, I will save you.
I was a doomsday preacher, I believed in my telepathic and all-knowing predictions. I believed I could save TeeVee Dude and that I could save me. I needed to save the world and I needed to save him. That was made even more clear in the visitors’ lounge one afternoon when his stepmom sat in one folding chair and my aunt Carrie in another; they were old friends. The connection seemed uncanny to me, too coincidental. The boy was clearly sent to me as an ally, an inside support for revolution. Of course. I continued whispering in doorways about pipes and apocalypse. He continued not to hear. It was dark and crowded and chaotic. I was forced to go to group therapy, to appointments with people who grinned and said they could help.
THOSE MEDS WERE APPETIZERS TO THE MEDICATION THAT THEY WOULD EVENTUALLY GIVE ME IN CAPSULE FORM. LITHIUM.
I explained to Dr. DeAntonio that those pipes, those pipes outside were actually a vessel for death. He nodded, curious, but replied calmly: “Jaime, they are the generator for the building.” Undeterred, a little exasperated, I repeated myself. There is a planned massacre in place, I explained, and it needs to be stopped. It would be the Holocaust all over again, teens and doctors gassed to death in the night. An asphalt volleyball court full of corpses. Gas seeping through Westwood village poisoning professors and tourists and crystal vendors alike. Could he not see it? Could he not feel it? It was imminent, it could be now! Those bodies would be on his hands. He had to let me go, I had to . . . stop it. Tuck and roll, escape, I explained. He could help me, I could sneak out through the volleyball courts. It was fate that my room faced north to the pipes; I could hear them breathing and sighing and steaming. I could stop it, I told Dr. DeAntonio confidently. It was up to me and I was up to the task. I left his office shouting loudly about the coming apocalypse, about the gas. If I was nuisance enough, maybe someone would let me go. That led to more tackling, more needles.
“Don’t open the windows, don’t turn on the TV,” I told TeeVee Dude and the other patients and nurses, enacting my own emergency evacuation. When I talked to Dr. DeAntonio years later, he remembered me being aggravated and annoyed, on edge and obsessed with Nicaragua, that I was hysterical about the apocalypse. He said I was particularly interested in disrupting other patients’ routines, to tell them about the end of the world. But I was convinced I knew the truth; I was trying to save them. I refused medication. I would not take the Dixie cup full of pills that would sedate me—I needed to be sharp, aware, and ready. Once I raced away from some nurses. They followed. I thought it would be another hip check; I was ready to be tackled.
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Instead, they took me to a room. Dr. DeAntonio called it seclusion, I remember it as solitary confinement. The difference was nomenclature—it was a four-by-four-foot room with no door handles on the inside and brown marbled padded walls. The pattern was streaked—khaki, poop brown, orange brown, brown brown—all muddled together in stripes that looked more like a swirl. A kind of ikat, using J. Crew catalogue terminology. There was a double-paneled glass square window in the handleless door; I could not make out anything that was happening in the hall. I panicked. I hyperventilated. I clawed at the walls and threw myself against the door. I exhausted myself with hysteria. There was nothing left to do, no one to see. I sat down in a corner. I touched the soft walls. I imagined them absorbing my screams, and screams before mine. But then I was quiet. I could hear my older brother, Matt, whose sitcom catchphrase with me was “Jaime, calm down.” His emphasis was slow and pointed. I hated when he said that. I collapsed on the floor. With no one to whisper to, no pipes to fear, no tunnels, no TV, no doctors, no teens, no hallucinations of Muppets, just me crumpled on the floor, tired in this variegated brown room, fetal and deflated.
It felt safe in there, like space. I was floating, tethered to a toxic world but letting go. I felt far away and secluded and deserted. I could sense a shift, I was alone, I needed to be alone. It was quiet in the soft, brown room with no doorknobs, and then it was quiet in my brain and quiet in my body. I just sat still for the first time in a long time. I could feel the padded walls. I knew what padded walls meant—I was dangerous, to myself and to others. In solitary, there was nothing I could do but fold. I was curled up in a ball, alone but attached to support, forming and developing all over again—like the early moments of life. Recalibrating, adjusting my brain, adjusting my place in the world. I was in so much trouble, the world was in trouble, everything was trouble. Not too long ago, I was a small, normal teenager who made earrings, bought overdyed jeans from Jet Rag, gossiped about first kisses that were never mine, hoped for a first kiss of my own, and stressed about chemistry tests.
I WAS CURLED UP IN A BALL, ALONE BUT ATTACHED TO SUPPORT, FORMING AND DEVELOPING ALL OVER AGAIN—LIKE THE EARLY MOMENTS OF LIFE.
My parents knew my behaviour was not the norm. But adolescent psychosis raises the question: What is normal for a teenager? How do you distinguish between a kid encountering surging hormones and continuing physical and emotional development from one who is mentally ill? Adolescence has no logic, there is no norm. John Hughes’s canon of teenage angst and dystopia barely scratches the surface of adolescent issues that have cropped up in the decades since. A child’s brain was once thought to be structurally complete by age five or six, but more recent research shows that while 95 percent of the structure of the brain has been formed by then, the remaining 5 percent—including the prefrontal cortex, the area that controls mood, reason, and impulses—continues to develop. The teenage brain can “imprint” experiences. Certain triggers and experiences can change the way the brain works later in life. It’s a period of time when “nurture” can modify “nature.”
Image by Kathy Ryan
The irony of mental illness in adolescence—when many mental illnesses first emerge—is that the brain, according to Frances E. Jensen and Amy Ellis Nutt’s The Teenage Brain, has to be mature enough to “do mental illness.” Jensen and Nutt ask, “How, for instance, can you have adult-like schizophrenia that stems at least in part from abnormal frontal lobe activity if your frontal lobes aren’t hooked up to the rest of your brain yet?”
My mind and body were incubating in solitary confinement. I had very recently been close to Jesus and carrying on idle conversation with Michael Jackson. But a new version of me was emerging—I was floating through a black hole, I was a supernova, eating and exploding and forming and circulating. I sat in solitary for hours; it felt like days. My brain, simmering and cooking and settling and emerging. Eventually I sat with limited awareness of my actual surroundings. I could see that there was no Michael Jackson, no secret tunnels, I couldn’t hear voices anymore. I could just see the repeating pattern of the soft brown ikat walls.
I melted into the corner, my knees splayed, my body taking on a languid state. I waited. Waiting I learned is a big part of mental illness recovery. So is a kind of breaking—like breaking a wild horse or a baby elephant. I had to be restrained and I had to learn to operate within certain societal structures. I had to accept them. A day of seclusion broke me. One study that compared physical restraints to a seclusion room found that 82 percent of participants thought seclusion was less frightening than bed restraints, that they were able to reach a state of calm in a shorter period of time. I wasn’t really into either, but solitary was good for one thing: I decided that the end of the world could wait. I stopped clawing at the door. And they let me out.
I was presented with a simple solution. Lithium, a mood stabilizer that can help stop and prevent manic cycles. It’s usually the first medication tried with bipolar patients. It’s effective for most of them. Including me. Dr. DeAntonio compared it to insulin, the hormone used to treat diabetes. Once it was explained that this was an element in everyone’s body and that I just needed more, the three pink pills in the Dixie cup didn’t seem so bad.
This is an excerpt from Jaime Lowe's new memoir, Mental: Lithium, Love, and Losing My Mind, available October 3 from Penguin Random House.