Bi-Polar Disorder: Mania

This patient is awesome. I love her so much and its so funny because when I first met her I was terrified of her, afraid to leave the nurses station in fear that she would attack me. I will call her Jessica.

Before I met Jessica I was told that she had thrown a chair into the wall earlier that day. And they told me that she was sleeping and to be careful not to wake her. I went ahead and started doing my rounds and when I went to check on her she woke up, looked at me and with a cheerful tone said, ” Good Morning!” I said hello back and walked away confused because it was 6:30pm but I didn’t think much of it because I hear stranger things all the time. As it neared time to go out to the patients smoke break I went and asked her if she wanted to go out and smoke, she told me she didn’t want to go out. I went out for smoke break with the other patients and when I returned she was in a full on yelling match with my co-worker. She was yelling that she wanted to go out to smoke break. We told her that she should have gone when we told her about it. This fight went on for over 3 hours. She yelled at us, called us profane names, threw chairs, turned over tables, punched walls and banged her head against the wall. Nothing worked. If we tried talking to her calmly she escalated, if we yelled back, she only got worse. She was scaring the other patients and so eventually my co-worker took her outside to the patio to smoke. She stayed calm for like 20 minutes and then she was back at it again. We finally drew up a shot and I called our male co-workers to come down in case we had to hold her down for it. She surprisingly took it willingly but it didn’t help for awhile.

Even after all the other patients had gone to bed she was up pacing back and forth in the hallways yelling at us. I eventually just said to her, “If you’re not going to go to your room you’re not allowed to talk.” and then when she would try to talk to me I would say, ” No talking, I’m not having this conversation anymore.” When I said that to her she began banging her head against wall. Nothing worked. Nothing.

She was like this for a few days. Then one day I came into work and she was a completely different person. She was still manic but a “nice” manic. It was out of a movie hilarious. She paced up and down hall and instead of yelling obscenities she was yelling positive nice things, such as , ” I am inspired to be a better person.” and a lot of religious things too like, ” My Heavenly Father loves me!” She would follow me around asking for a fist bump as well as smiling at me and giving me a thumbs up and when I would do something for her she would unnecessarily thank me. One time we had a new patient come onto the unit and she ran over to her, hugged her and broke down into tears and began trying to speak in Spanish to them because she thought they were a different country. She was extremely concerned about this person feeling comfortable and welcomed. I had to go and pull her away from her because she was making her uncomfortable. Within minutes Jessica had gone from smiling, being overly happy to crying to then screaming. Being that Jessica has a lot of psychosis she suddenly became angry at me because she thought that I had poisoned the cheese squares that I just given her. I attempted to talk to her but she just screamed for me to get away from her. She didn’t trust me suddenly.

Long story short Jessica was let out shortly after this because they didn’t believe she was a “danger” to herself or others. Somebody had picked her up and on the drive home she escaped from the car, ran away and ended up in a neighboring town. She was found underneath somebody’s porch screaming and when the police asked her what she was doing she reported that she was hiding in a fox hole and that she was a navy seal. This all happened within 1 hour of letting her go. Needless to say she was brought right back to us. We welcomed her back with open arms and when she crawled around on all fours as a navy seal I just smiled.

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Multiple Personality Disorder

This is also known as Dissociative identity disorder. It’s sad, especially when you find out why someone comes to have this saddening disorder. I will call this patient, Sarah.

When I came into work that day I received a brief report that among our 15 patients one of them had Multiple Personality Disorder. It was a busy day and we didn’t have a lot of time so my co-worker quickly told me that Sarah had a couple other people that she “became” and told me their names, Elizabeth and Becky. I was quickly pushed out onto the Unit and I began walking around doing the 15 minute rounds while I introduced myself to everyone. I couldn’t tell you anybody else that was there that day, Sarah was the only one I can remember. When I finally came to her room I looked in and saw a woman in her mid thirties with only a hospital gown on sitting up in her bed. She had her head slumped over staring down at the bed. I called her by name saying, ” Sarah?” She continued to stare down at her bed. At first I thought she was just ignoring me as I tried calling her a couple more times. Then I realized that she could be in her other personality. I tried “Elizabeth” and when she still didn’t respond I said ” Becky” and she immediately jerked her head up and looked at me. She quickly coiled into a ball bringing her body inwards and a look of fear spread over her face as she retreated to staring down at the bed again. My gut feeling was that “Becky” was most likely a young child. I sat down on the bed so that I would meet her eyes. I began by asking her how old she was, she responded with a child’s voice, ” Seven.” Then I asked her if she knew why she was with us, Becky responded, ” Mommy says it will help the bad dreams go away.” She began telling me how she wanted to go home to her Mommy and that she was scared. I told her that she would have to stay with us for a little while and asked her if she was hungry. She said she was and so I left to go find her some food. When I left the room I felt conflicted because I wanted to spend a lot of time with her but I knew I had 14 other patients who were going to be also needing my attention. I began helping the other patients, taking their vitals, checking their rooms, ext…but I would run back to her room every chance I could get so that I could see if she was ok. One of the times I went back she had finished eating the food I had brought her and fallen asleep. When I walked in she jerked up from her sleep in fear. I knelt down next to her and asked her what was wrong. She said, ” I had a bad dream.” Then I asked her what it was about and she said, ” Daddy was hurting me.” It broke my heart. I wished that I could stay with her and tell her everything was going to be ok, and I hated that I couldn’t. I knew I couldn’t stay long so I asked her what her favorite song was so that she could distract herself with something. She was quiet for awhile but finally said, ” The bubble gum song.” I got up to leave and I had made it all the way down the hall when I heard someone calling my name, ” Are you going to come back??” I assured her I would eventually.

The next time I saw her was a couple days later and she was standing in the patio smoking a cigarette. I called her by name and she didn’t respond. She had switched back to her mid thirties self. I then called her by her other name and she looked up at me. She walked over and said, ” You must have met Becky huh?” I replied that I had and she went on to tell me that when she switched to the seven year old Becky that it was as though she blacked out. When she would return to her regular self she had absolutely no memory of it. She talked about how upset it made her that this would happen. She also had a 6 year old son who she couldn’t take care of and was worried that he would be taken away from her. She wanted so badly to be cured from this disorder. We talked for a little while longer, she went back inside and then I never saw her again after that.

It was so humbling to see somebody go through something like this and sad to realize that she had experienced so much abuse. She had as a young child been so severely sexually abused her brain had to split up, compartmentalizing the abuse in order to survive. The brain is in essence protecting itself. It makes me so angry that people can hurt the ones the very people they are supposed to protect.