‘I Felt I Was Not Worthy of Having Survived’

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

Out of the blue recently, a reader emailed hello@ with a simple note: “I would really love it if The Atlantic did an article or collected reader experiences of stays in psychiatric hospitals.” I asked Eva if she’s ever been to one herself, and she replied:

Yes, I am in a psychiatric hospital even now. Not crazy, but in a severe depression for a year and a half now, with bad anxiety. Bad stuff in life a couple of years ago triggered this, plus a certain amount of genetic predisposition, plus not the right meds. In a year and a half, it’s been three psychiatric stays in the States, one in Norway, and three in Germany. I’m joking sometimes now that I should write about international comparisons of mental facilities :)

I do have the feeling that I’m finally better—knock on wood. I do often think about the everyday routines in these type of hospitals: the many biographies and patients with various illnesses you encounter, the humiliating events that happen, the bleak hopeless days where you merely hang in there, the struggle to maintain a measure of dignity for yourself, or the small unexpected comforts one finds.

I can think of many things to write about. And I would just love to hear from other people who have these types of experience. It is more common than one thinks.

If you’ve had a memorable experience in a mental hospital, either as a patient or staff member, please send us a note: hello@theatlantic.com. In a followup note, Eva elaborates on her experiences in poignant detail:

Humiliating events

There are many small things about psychiatric hospital life that can cause tear and wear on your personality and dignity—the whole sum of it, really: the meal times; the bed times; medications you may not want to take; having to be back on the ward by certain times; having to ring bells and wait for doors to be unlocked; staff going through your underwear and personal things whenever; having to step out of the shower to show you really are present when presence is checked; having to strip down completely upon admission to get searched for scars, wounds, injection marks, drugs ... between your toes and fingers, underneath your breasts. Just all of it as a whole, and keeping a measure of dignity, adult self-determination, and personality—and I guess, sass.

Personally I found it very humiliating to return to the same hospital a second and then a third time—both after an overdose of pills—and for prolonged stays. I felt like shrinking into the ground, like not meeting anyone’s eyes for the first few days. Here’s Eva AGAIN, still depressed, still not cured, with yet another overdose.

Although there is wonderful staff, there really are quite a few Nurse Ratcheds everywhere, and the encounters with them can wither your pride and not let you keep your chin up and head held high.

My absolute lowest low, and greatest sense of humiliation ever, was just after my most serious suicide attempt and closest call. I did this—and I am truly ashamed of this—on the ward itself.

I woke up in intensive care. Apart from that close-to-death feeling getting under your skin, and the actual overdose itself making you feel awfully sick for days, it is the behavior of those around you that alienates and humiliates. I really do know what I did was wrong, and that suicidal people need a strict environment—but strict does not equal bone-chillingly-cold people who avoid you, are mad at you, or think you have deserved this misery.

For days after the suicide attempt, I received not a single smile, not a single kind word—no encouragement at all. Lots scolded me harshly, and each seemed to think they were the first and only people to do that. I started to not feel like a human being. I felt I was not worthy of having survived. My mom didn’t speak to me for one week and that was terrifying.

Memorable patients

I first recall a woman whom I had initially seen as not that smart (shameful for me), judging by her spelling errors and reading skills. It turned out she had been kept home throughout her childhood and teenage years—she was the oldest of many children—and she had to run the household and look after the younger children while the parents randomly took off. She had never been allowed to go to school and no authorities had kept an eye on that. So she did not learn to read and write into her thirties. The abuse at home took a toll on her, but she was so warm-hearted and determined.

***

Really, it’s very hard to pick among patients. To me, about two-thirds seem very remarkable. I have simply never encountered such a high concentration of extraordinary life stories as in a psychiatric hospitals. Very few seem “crazy” by the conventional ideas that many have of the mentally ill. Patients are from both genders, all ages and professions. They’re just beaten up by life events, and some by genetic predispositions.

The addicts often really impressed me, the people who tried for the gazillionth time to get off alcohol and/or drugs. It takes so much trying to stop substance abuse. Also, it is pretty obvious to me that staffers treats addicts worse than other patients.

Anyone who keeps suffering from truly severe depression and keeps trying is perhaps the most impressive to me. That is only being one small step away from the dead, and to tolerate that state for months or years and not know if one can ever expect true improvement … there is simply nothing harder I can imagine. I was in that state for a year and a half. It is my biggest fear to ever ever be in such a state ever again.

However, I gave up on myself three times during that length of time and tried to commit suicide. There are people so much stronger than myself who managed to hang in there without resorting to that. I think the ability to hang in, out of sheer endurance, is so much more important than trying to achieve immediate dramatic changes.

***

The years 2015 and 2016 in German psychiatric hospitals also meant getting to know many refugees, who are now a noticeable presence not just in everyday life, but as patients in hospitals. Many of them were Syrian, probably 80 percent of them, but also Kurds from various regions (right now there is an African lady on my ward, as well as a Christian man from Iran). The refugees here have really enriched my life over the past year. They’ve had hardships and traumas I can barely imagine.

Losses, to me, were one of the hardest things to tolerate. I thought I had lost pretty much everything—my job, my marriage, my apartment, life as I knew it in the States. But many of the refugees have lost more. I still have my parents, my citizenship to a country willing to look after me medically for free, a good education, and an environment whose language I speak. Here are some individuals completely on their own, without German or English skills, who have recently not only lost homes and possessions, but loved ones. Many have experienced rape, war, cold, hunger. You really can start over from nothing, with just the clothes on your back.

I know now that I may have lost most things that most people consider the essentials of an adult life—but I have everything really important inside myself; the rest was mostly just stuff or things that time can heal. If I get and remain well, I can deal with the rest. Even if I didn’t get really well, my life is worth something.

Small comforts

Showers and soap—they make you clean and a little new and shiny when nothing else does. Locks on bathrooms—once you are well enough to have a regular room.

The movies and songs from the 1930s and ’40s. Fred Astaire. Putting a shine on your shoes and a crease in your pants. Art therapy—not because it was cathartic or anything, no such cliché, but just rediscovering I was actually good at painting and accomplishing paintings I am still fond of.

Jennifer Michael Hecht’s book Stay: A History of Suicide and the Philosophies Against It. Books books books in general. Perhaps predictably. But despite a severe depression, I was always still able to read. I basically read a book a day. I would not exist without books. How would the time have passed, especially in intensive rooms, when you are hardly allowed anything? What worlds could I have escaped to? Many people are not able to read while severely depressed. Thank God I was.

Speaking of Jennifer Michael Hecht, a few years ago I did a reader-based “Ask Anything” video series with her. A Dish reader called the following video “the most useful encouragement I’ve heard to keep your life.” In it, Hecht describes the suicide contagion effect that spreads to the family, friends, and even strangers of people who kill themselves, making it much more likely that others will follow suit. As she puts it, “If you don’t kill yourself, you’re saving someone else’s life”:

If you at any point need emergency help along these lines, the National Suicide Prevention Lifeline is 1-800-273-8255.