How did I end up self admitting into a psychiatric institution for the first time? I can still clearly see myself signing my rights away. I remember the ilegible scrawl that scratched from the pen, which represented my signature, as I signed the official documents. I remember how at that moment in the emergency room, I felt surprised and oddly interested that for someone with beautiful penmanship, my messy signature was unrecognizable. I was losing control of my mind and my body, and I was slowly losing the will to combat this insipid side effect called Akathisia.
To give some background, I had unknowingly lived with untreated bipolar for quite a number of years. I barely sought medical treatment in September 2015 because the mania was swallowing me up one day at a time. I was medically diagnosed and entered the realm of antipsychotic medication and therapy. When I was prescribed 80mg of Geodon — 40mg in day and 40mg at night, I refused the prescription because I wanted to start at the lowest dose possible before moving on. It is the way I think. I wanted to titrate up and watch all the changes. I wanted control. So I refused the day med and only took 40mg at night. I continued on 40mg at night for two and a half months. This dosing only at night caused my side effect. Apparently, some doctors believe Geodon should be taken two times a day; otherwise, one dose is spiking your brain.
Taking Geodon one time at night caused a side effect called Akathisia which caused me to end up in a psychiatric institution. The horror of it all still lingers. A memory that has yet to fade. I watched myself lose a grip on reality over a three day period. It was not like experiencing psychosis. It was different because it did not hit me like a ton of bricks like psychosis where you cross a line and cannot see where you came from. When I experienced Akathisia I could see my mind crossing a sanity versus insanity line that I could not control and then return back to me. Each time was more powerful, and the restlessness, that it is known for, occurs in waves. It rolls through your body. You cannot stop the urge to move, to fidget, to walk, walk faster and then to run. You cannot settle your mind. You just want to move faster than your mind is capable of doing. The mind and body are disconnected.
At the time, I did not know what was happening to me and this occurred over a three day period. I survived three days of Akathisia and two minor episodes before this. When I experienced it before, I called it “The Hurt” and I wrote about it in my blog in a short story titled, “The Hurt.” The episodes that occurred on the first two days started two hours after I took Geodon and lasted one hour. I dealt with it by putting myself to sleep with Benadryl. I did not know it was Akathisia until the third day of my episodes when it started at 8:00 in the morning during work. I googled my symptoms and came to the conclusion that this was what I was feeling in addition to the wretched anxiety that presented mortality to me in ways that I never thought of before. In ways only those who are terminal or in the gallows probably feel. The anxiety was smothering me a little at a time and left me gasping for air. For mercy. It lasted a few minute but then returned for longer and longer periods. It dragged me through a dark, chasm of helplessness. I wanted to jump out of my skin and run full speed down the street away from it. I realized that I could possibly end up running down the street – screaming. I was convinced this would be my outcome if I did not get help. These three days were no longer ‘The Hurt.’ They had become ‘The Wicked.’
Akathisia causes a distressful restlessness of the mind and body. In the third day, as it progressively got worse, it made me walk circles around my office, around my building and then outside the building. I got up and walked every 30 minutes for 15 minutes for eight hours on the third day. I was worried that the security guards would notice me and this caused me to change my pattern of walking so that I was not so obviously and oddly walking the building.
So you see, I could still think things through. I even read my crises plan that I had in my phone. My doctor asked me to photograph the crises plan we wrote together, and it was in my iphone. The photo was a list of things to do in crises and one item read “go to the emergency room if in psychosis.” Although I was not in psychosis, the words “emergency room” jumped out at me. I just knew then… I just knew this was my safe haven.
After work, my boyfriend was driving me home and as calmly and as rationally as I could through the waves of Akathisia rolling through my body, I told him that I was not well. At the same time, I was willing myself not to jump out of the moving car. Like in a major way. He said we would go home, and he would take care of me. I came to the conclusion in front of him that this episode was bigger then the both of us. We were entering unchartered territory – the emergency room for a mental health crises. When the ER Psych doctor asked me why I was admitting myself, I told him because I knew that when I started running out the door screaming, they would stop me. With that, my first formal admission to a psychiatric institution was complete.
*I stayed in a psychiatric ward for six days while adjusting my medication. My final treatment plan was Geodon 20mg day and 20mg night. In order to stop the acute Akathisia, I was given Cogentin 1 mg which worked. I titrated off Cogentin after one month and the Akathisia stopped. I am still take Geodon.