My Mental Health Emergency During the COVID-19 Pandemic

No one wants a mental health emergency at any time, but having a mental health emergency during the COVID-19 pandemic showed me how neither I nor the emergency room hospital staff was prepared to deal with a mental health crisis in this unsettling--and downright terrifying--time.

Before I go on to detail my trip to the emergency room, I think it's important to explain how my mental health crisis, in general, relates specifically to my writing here as a co-author for eating disorder recovery. In addition to a history of eating disorders, I also have obsessive-compulsive disorder (OCD). It might appear that having both eating disorders and OCD makes me the loser of the mental health lottery, the truth is eating disorders and OCD are anxiety disorders that exist on the same anxiety spectrum.¹ 

In other words, it is common for people with OCD to suffer from eating disorders, and vice-versa. 

I am not so uncommon. 

Understanding Mental Health Emergencies During the COVID-19 Pandemic

What is also not uncommon for someone suffering from an anxiety disorder is to have a severe reaction to the news of possibly having a benign condition like kidney cysts.

The afternoon before I went to the ER of my local hospital, I'd received a call from my doctor informing me that the severe abdominal pain I'd been having looked to be, according to an ultrasound, a kidney cyst. 

The call sent me into a severe anxiety attack. I was shaking. I could not focus. I threw up repeatedly. Even though I rationally told myself it was probably just cysts, which are ultimately treatable and harmless, my doctor also told me I was being sent for a computerized tomography (CT) scan, "to make sure." 

Those words set me off. I had cancer. I had some other horrible, fatal disease, I just knew it. Worst of all, I had it during a global pandemic: a time when my access to health care was compromised.

I could not calm myself down. My husband could not calm me down. I tried diffusing a relaxing essential oil and had a salt bath. I was tired but still ridden with anxiety. You can be both at once.

I don't remember how I managed to fall asleep that night, but when I woke up the next day, my anxiety was even worse. I told myself I would do anything not to feel this way anymore. I thought about cutting myself. I thought about suicide. I have a history of self-harm and at several low points in my life, I'd thought about ending my life. 

Still, I had not cut myself in over a decade and my mind has been free of suicidal thoughts for four years. 

The re-emergence of these dangerous thoughts scared me. I called my husband home from work to look after our four children and by 10 a.m., was on my way to the hospital.

My Mental Health Emergency Revealed a Broken System

When I got to the hospital, I was kindly but firmly hushed by the triage nurse for "going on" when I was trying to explain why I was there. Being told to essentially shut-up was hurtful, to be sure, but in retrospect, I understand that the triage nurse is there to quickly and accurately assess the level of a patient's emergency. 

By the same measure,  I realize how impossible it would have been for me to be to-the-point in the situation. It is difficult for someone suffering from anxiety to be clear. 

After four hours of sitting in the waiting room--which I understood, someone had respiratory failure--I was seen by a doctor.  I explained, as best I could, why I was there. I said that not knowing what was going on in my kidney was causing me severe distress, and I'd thought about hurting myself. I explained I'd been vomiting and could not eat anything. I told him how my family was concerned about my behavior. 

The emergency room doctor asked what my family doctor had said about my kidney cyst. I said that I was to go for a CT scan, but I didn't know when and wasn't sure how I was going to leave this hospital and live not knowing what was going on inside my body. 

I was shaking uncontrollably and sobbing. I was begging the doctor for help.

He told me he'd give me a prescription for sedatives. 

This is not what I'd wanted, and I told him so. I've spent years learning how to deal with my mental illnesses with positive lifestyle choices, like clean eating, regular exercise, quality sleep, spending time in nature and abstaining from any drugs, including alcohol. I was afraid taking a drug would through me back into my previous dependency on them.

"Please," I'd asked him, "I know this will be the hospital I come to for the scan anyway. Couldn't I just have it now? I can't go home not knowing." 

He curtly informed me that there were people with "real emergencies" who needed that equipment, and besides, he'd have to get approval to use the machine and no one would give it to him for my problem. 

I felt the air go out of my body. I felt like I'd been punched in the stomach. 

"My emergency is an emergency!" I blurted out, loudly at this point. The doctor backed up into the door, his hand on the handle, raring to leave. 

He informed me I could take the sedative prescription or not. I nodded yes and he left. I was totally defeated.

A few minutes later, a nurse came with the script and I left the hospital, passing the empty CT room on the way out. 

Mental Health Emergencies and COVID-19

I understand this is a difficult and dangerous time for all health care professionals and I can empathize with the stress they are under. I can empathize with extended, crippling stress more than a lot of people. As much as I know an immediate CT would have calmed my anxieties, I am not necessarily arguing that the decision of the emergency room doctor was wrong. The sedative prescription held me over until a couple of days later when I did have my CT.

What I am arguing is that the way people with mental health emergencies are dealt with is, for the most part, dehumanizing. This is not the first time I've had to advocate for myself in an emergency room due to a mental health crisis. I've been there due to alcohol overdose and self-harm. I've been there with other anxiety attacks that I thought would kill me.

Regardless, I reluctantly took the sedative when I got home and it did calm me down, but I felt small and insignificant. I still do, to be honest. 

I've since had the CT and it turns out I have hydronephrosis--an enlarged kidney caused by a back-up of urine. I have to have another more focussed CT to find out what is causing the blockage. It could be a stone, or a valve malfunction, or even endometriosis or an adhesion. I have had undiagnosed pain in my pelvis for years. Multiple ultrasounds and now a CT reveal nothing sinister.

But when you have an anxiety disorder and so much is out of your control, this loss of control is sinister enough. More than that, it can be life-threatening. I just wish more emergency medical professionals were trained to understand that, pandemic or not. 

Have you had a mental health emergency during the COVID-19 pandemic? What are your thoughts on emergent mental health care? Please share in the comments.

Source

1. Neziroglu, F., Ph.D. and Sandler, J., BA., "The Relationship Between Eating Disorders and OCD Part of the Spectrum." International OCD Foundation, Accessed March 31, 2020.