Acute Psychotic Break : Mommy of 3

This post can reach all mothers out there. This is something I was ignorant to before I met this next patient.  I will call her Sarah for the sake of her privacy. Sarah is a mother of three, all under the age of 8.  She was a working mother, an Accountant, an extremely intelligent woman. She had been married for 12 years. Sarah was brought into our hospital because she had a psychotic break. She had no history of mental illness beforehand, but had been triggered by something traumatic that had happened 1 year before. 1 year before Sarah’s husband had cheated on her, at the same time as Tax Season, which is an extremely stressful time for her at work. So a year later at that exact time, along with being stressed out with work, taking care of 3 kids, remembering the affair along with not eating or sleeping well, she had a psychotic break. When she came to us she required a lot of attention. She was extremely manic, talking constantly, repeating the same things over and over again. Being that she was psychotic she was not aware of what she was doing at all. She wasn’t aware that she hadn’t eaten, slept or showered in days. She would follow me around everywhere, holding onto my arm talking non-stop. She quickly became a 1:1 because she required so much attention. A 1:1 is where 1 staff member must stay with 1 patient at all times and never leave their sight. I would grab food from the kitchen and sit with her as she’s talking non-stop to me and force feed her yogurt, pudding, string cheese, graham crackers. I would undress her, put her in the shower and coax her into bathing herself and then have to redress her afterwards. Getting her to fall asleep was almost impossible. Her brain was on overload, running faster than she could speak and the most interesting thing about her was the phrases that she would repeat over and over and over again. She called me Ashley. Here are some things she repeated hundreds of times, ” Can you call my husband and tell him that were both competitive? Make sure you tell him your name is Ashley.” ” Can you call my husband and tell him it’s a generation gap?” ” Your a great mom” ” When was the last time I told you I was sorry?” ” When’s the last time you took my ring?” “How much am I worth?” ” You are worth more than $70,000.” ” I feel guilt for my dad.” ” My mom, I need to know he cares about my mom.” ” I feel like I need to impress you.” ” How much is your hourly rate?” ” Did you tell him he has 3 years to shit or get off the pot?” ” God! say God!!” She would repeat this until you finally said the word. She would also walk up to you and say “B***” randomly. These phrases would all run together, NEVER stopping. There was NEVER a break in her talking unless she was asleep. When it was time for her to go to sleep, I would literally sit on the bed with her and every time she would sit up and start talking I would literally push her lightly back down and say ” It is time to go to bed.” This could go on for hours. Us staff members would switch out at hour intervals because it could be so mentally draining.  She would sleep for maybe an hour and be awake again, coming out into the hallway talking non-stop again.

The scary part about a psychotic break is that if your brain stays there for too long, you are at risk for never coming out of it. And sleep is VITAL. Your brain needs the sleep to recover, so getting her to sleep was extremely important. We were all worried there for a little bit, but after a week of sleep and medications she came out of it! We were all so happy! One day I came into work and saw her sitting in the dayroom and she looked at me and gave me a little smile. I could tell she that she was better but that she could not remember me. It was kind of sad. We had spent countless hours together. I had dressed her, brushed her hair for her and fed her. I had truly grown to love her. I went over to her and said ” Hi Sarah, how are you doing? ” She looked at me and said , ” I feel like I remember you a little.” I felt so good to hear that! We had bonded after all. I want to scream and jump for joy and tell her what a miraculous recovery that she had made, that we had all been so worried, but I couldn’t. She just simply couldn’t remember the last week and a half of her life. She only remembered what happened right before coming in.  As I went about the rest of that shift, I would catch her looking at me with a smile, it was as though she felt that we had spent a lot of time together and she later left me a note saying simply, ” Thank you for taking care of me in my moment of need.” That meant the world to me. It was truly rewarding seeing her recover so well and be able to go back to her life.

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