Inside Bipolar Podcast: In-Patient Hospitalizations: How to Stay Prepared

Meet Your Inside Bipolar Podcast Hosts

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

He is also the host of Healthline Media’s Inside Mental Health podcast available on your favorite podcast player. To learn more about Gabe, or book him for your next event, please visit his website, gabehoward.com.

Dr. Nicole Washington is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions.

Find out more at DrNicolePsych.com.

Episode Transcript:

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Bipolar, a Healthline Media Podcast, where we tackle bipolar disorder using real-world examples and the latest research.

Gabe: Hey everyone. My name is Gabe Howard and I live with bipolar disorder.

Dr. Nicole: And I’m Dr. Nicole Washington, a board-certified psychiatrist.

Gabe: So today we’re going to talk about being admitted or committed to a psychiatric hospital, basically staying in a psychiatric facility overnight. Whether you admit yourself, whether you’re committed in a crisis. Whatever it is, if you find yourself in a psychiatric hospital, we’re going to talk about ways to make that experience better. Now, I want to let you know, Dr. Nicole, I talked to a lot of people with bipolar disorder, and they and I asked them, I’m like, do you have a plan for this? And they say, no. And I was like, have you done any preparation whatsoever? No. And even people who have been admitted before who have stayed in a psychiatric facility before, even have even been committed in crisis, I’m like, do you have a plan for if it happens again? No, no, no, no, spending no time on this. So, I’ve got to tell you, as a podcaster, this this worries me because if people aren’t willing to discuss this or think about this ahead of time, they may not be willing to listen to this episode. So, I sincerely hope that people will tune in and give it a chance because my grandmother, who is the wisest woman that I know, she has this saying that an ounce of prevention is worth a pound of cure.

Dr. Nicole: Yeah, I guess my version of your grandma’s saying is if you stay ready, you don’t have to get ready. Right. Um, so we know the hospitalization is a possibility, so why not prepare for it when things are stable and calm? Because if you wait until you’re in a severe depressive state, wait until you’re manic. Are you really going to have a good experience or are you really going to have the capacity to pull up enough energy and cognitive ability to be able to have a successful admission? Sometimes the answer is no.

Gabe: Dr. Nicole, I’m curious your opinion, should people with bipolar disorder have a psychiatric hospital go bag?

Dr. Nicole: Of sorts. You know, in some states there is what’s called a mental health advance directive. So, think about when you go to the physical health hospital, you go have a procedure, they ask you, do you have an advance directive? Do you have an advance directive on file? That’s that form where you say, okay, in the event that I’m incapacitated, this is who I want to make decisions for me in the event, you know, I’m not able to make these decisions for myself, these are the things I want. These are my desires. You can do a similar thing for your mental health. And really, even if where you live, you can’t file them and they can’t become part of the system if there is no system because it’s hard to create a system, you have to have a system where any hospital could access it at any time because it’s not like you just show up at the mental health hospital. 8 to 5 Monday through Friday. So, it has to be in a place where anybody can access it 24/7. And from what I’ve seen, that’s some of the barrier for a lot of places. I think they’d like to do this for the populations they serve. It’s just logistically hard to make happen. So, but you have this form and even if you don’t have this legal like these are my legal wishes, it’s still not a bad idea to have the conversation with somebody who you’re very close with.

Dr. Nicole: So, you have the conversation, if I am manic, I would like to go to this hospital. If I end up in the psych hospital, here is where I keep my spare key. Please go feed my dog. If I end up just the things that stress people out when they get into a hospital. Like you can identify all these things that you’d like to see happen. And I think that kind of planning is very helpful.

Gabe: This is why I love working with a psychiatrist. If I asked that exact same questions to 50 people living with bipolar disorder, they’d be like, I want my iPhone. I’m going to need earbuds. I don’t want to forget my charger. And you were like, okay, we’re bringing legal paperwork into this to make sure that you get the care that you want from your doctors.

Dr. Nicole: Yeah.

Gabe: And I love it because my brain wasn’t going to advance directive at all. And I like what you said about how you need to decide what kind of care is best for you when things are going well.

Dr. Nicole: Well, I mean, this is the thing. Things can happen very quickly on an inpatient unit very, very quickly. So, we have to have that form. And that’s what I said earlier, if you’re in a place where it’s a legal document, once it’s a legal document, then then the doctor has to do everything they can to abide by that everything within reason or there may be consequences to that person. So, I mean, we try our best, but it’s not always cut and dry very easy because things happen so quickly. And our systems, as much as we have some states who say, oh, yes, we respect the mental health advance directive, but they still don’t have a great system in place.

Gabe: Before we move on, I want to let everybody know you should Google psychiatric advance directive in your state and find out information. You can get information from local charities, your mental health board or of course, you can contact a lawyer. I recommend looking it up for your state. The nice thing about this podcast being nationwide is that we can reach a lot of people. The downside is it can be state specific, but in a way, Dr. Nicole, I think we put the cart before the horse. We’ve got this great document and I do believe in these and I think a lot of people are unaware that they exist, which is why we started off the show with them. But I think we put the cart before the horse because somebody’s got to hang on to that document. So, for example, I have many copies of my psychiatric advance directive and I have given it to my wife. So, I know that if right now, literally just right now, I could pick up the phone right now and say, hey, honey, call my wife. Right. I don’t want you to think I’m calling randos honey. I said, hey, honey, I’ve been admitted to the psychiatric hospital. She would know exactly what to do and she knows exactly what to do because we’ve discussed it. I don’t need to be in my right mind for her to do her part. Because we had the fire drill before the house was on fire.

Gabe: So, let’s talk about practical information. See, I’ve got it easy, right? I love my wife and I trust my wife. I’ve signed all the forms. She’s my health care power of attorney. She’s she’s my everything. I hope she’s listening. She. She’s my everything. She’s my Wonderwall. She’s going to be the one who saves me, right? I just. I want, you know, holidays are coming up. I want to want to make sure I get a good present. But it’s not so easy for everyone, right? If I didn’t have my wife, I would trust my mother. I would trust my father. But not everybody has an obvious choice. So, from your perspective, if you don’t have that, that wife or parent or sibling who you just immediately trust, right. If somebody’s listening to this and they’re thinking to themselves, I don’t know who I’d pick, obviously, if you know who you’d pick, then then this is easy, pick them. But what about the people that are just like, I don’t I don’t know. I don’t know who I’d want to give this to. I don’t know who I’d want to sign the HIPAA waivers for. Who should I pick? Who should I pick, Gabe? And, Dr. Nicole, who should they pick?

Dr. Nicole: Yeah, well, I mean, the reality is for some people there is nobody there is not that person who they can say, oh, this is my person, and they’re going to be the one who feeds my dog or they’re going to be the one, you know, who makes sure my cats and my dogs are taken care of. It is. It’s really unfortunate for people who don’t have a support system. And we know that sometimes when people are actively in that active symptom phase of their illness, they may not have a lot of people around and that becomes very tricky to manage. So, I think to me that’s more of a reason why. You need to be the one that’s so in charge of your mental health care and being really on top of how do I recognize those signs that I need to go into the hospital? You are going to be so much better off having voluntary admissions, staying stable, as stable as you can on your meds and recognizing when you’re not stable so that you can make the decision to go in, hopefully to be able to get these things out. You can probably create the document. If there’s a hospital in your area you go to on a regular basis like it’s the one that you go to in your area. You can always have the hospital keep one of those on file in your chart and make note that you have such wishes or such a document. Because you have a medical record and most of us have an electronic medical record at this point. So just like they keep your regular advanced directive wishes, you can create something, you know, that they know what your wishes are and you can have it written out, have someone help you type it out to keep on file so that you can kind of advocate for yourself when you’re stable so that when you’re not stable, especially if you know that, oh, I go to that one same hospital every time.

Gabe: I really like self-advocacy and I agree with everything that you just said, that the goal is to not get so sick that you can’t advocate for yourself. And I really like what you said about making sure that it’s in your Dr. Nicole’s file. Make sure that it’s in your therapist file. Make sure it’s on record with your hospital. Give it to your general practitioner. I think these are all really, really good things. But at the same time, it sort of smacks a little bit of, well, just make more money. Like I’m having a financial problem and I’m listening to a podcast to get some ideas and, and to get out of debt. And you’re like, here’s what you need to do. Get a job that pays better. All right. That’s a wrap. Everybody, I, I, I really think that that, that working to find somebody is a goal and then decide where they fit. I don’t know how to do that. I don’t want anybody listening to this to, you know, grab the person they met at the support group two weeks ago that they feel really close to that they’ve been texting a lot with lately and start signing over HIPAA documents.

Gabe: But at the same time, I don’t want people to dismiss maybe people who they do trust. But the relationship has been strained. And I think about in my own family, you know, I have aunts and uncles, I have cousins. I do trust them. Maybe the relationship is a little strained, but sincerely, I know that I can count on them in an emergency. I know that I can count on them in a funeral. I know that I can count on them. If something happens, it might be worth exploring those relationships if you have them in your family.

Dr. Nicole: You know, I do think for you, some of this is coming from a place of having a great family that you’re close to. Because I will tell you, I see a lot of people who have nobody they have no family. Their family isn’t talking to them. They aren’t talking to their family. They have no support system. They are largely doing this alone. And we do talk a lot about building support systems, and I think they’re important. I think that reconciling with relatives, if you can, is always a good idea. We’ve talked about how people need people. No man is an island, all the stuff. Right. But there are probably, I’m guessing a lot of people listening who say, I don’t have anybody gay, I don’t have your great family. And if that’s the case, that’s why. You should lean on these. These people who are in your support system. You’re the hospital people. Because if you don’t think of it that way, I mean, the reality is they are part of your system because when you’re at your lowest, that’s where you go. So that you may not like that they are your biggest support. But that hospital system and that team who knows you and sees you, they are your support system during those times.

Gabe: I always appreciate you giving me that push back, because the reality is, is I don’t know how to manage bipolar disorder without a great support system. It’s not my lived experience and not my wheelhouse. Now, I want to talk about something fun, right? I want to get to fun stuff, right? I want to go all the way back to my original question and talk about the go bag. I just want to know what we can put in the go bag, because all of the stuff that I want to put in the go bag, I guarantee that at least half of it, they’re not going to let in because in my mind, it’s like, first off, I got to pack like a whole bunch of Diet Coke. I got to put a whole bunch of Diet Coke in that go bag, right? I’m going to have chargers, a computer, a gaming system. I’m going to have lots of books. I just I want to make sure that I just, I’m maybe my drum set. I’m just I’m thinking and I remember once I said to somebody, well, I would put all that stuff in. And she looked at me and said, I’m not even allowed to have an underwire bra. And you think that you’re going to walk in with all of that. And again,

Dr. Nicole: Uh.

Gabe: I’m a man. I don’t I don’t wear a bra. But I was like, really? You can’t have an underwire bra? Dr. Nicole, you can’t bring an underwire bra in? So obviously, one of the things that needs to go in your to go bag is a non-underwire bra.

Dr. Nicole: That is very true. And I will tell you, there are very few things that frustrate me more than working in a hospital when I have to give an order for a sports bra for a lady, because that that rule had to be created by some man who was there before me who said, we can’t even have sports bras without a without an order. That is ridiculous. But yes, ladies, leave your underwire bra at home. Leave a pants with drawstrings. Right. If you have those cute little pants that you like from Gap, those little sweats and they’re so cute on you. But if they have a drawstring, you probably don’t want to bring them because what’s going to happen is they’re going to say, well, we can take the string out. And I don’t know about you, but I don’t want anybody removing my drawstring from my sweats. So that’s a deal breaker. And then you end up having to wear the hospital’s clothes, which all bets are off. Who knows what you’ll end up wearing. So, if you can pack your bag with things that you do not think will end up being confiscated or taken and altered. So, drawstrings, shoes with shoelaces, some places won’t let you wear shoes at all. They make you wear those little socks with the grippy things under the bottom. Some places will let you wear shoes as long as they’re not like steel toe boots. And trust me, I have had people bring steel toe boots to wear in the hospital.

Dr. Nicole: And we don’t for safety reasons, a lot of things like that. So, making sure that the things you bring are things that you can wear. I think it’s important for you to have your things, have your clothes, to feel as comfortable as possible. And it’s hard to do that when you’re wearing generic hospital clothes that may even have the hospital’s name written on it in a Sharpie so that you don’t, you know, take it when you leave accidentally. They know it’s theirs that can’t be comfortable. You’re already in an uncomfortable position and now you can’t even have your clothes on. So, I think those things are very important. The clothes that you bring. You need to know the hospital’s policy about outside things gate. Some hospitals will let you bring your Diet Coke. Absolutely. They’ll let you bring them as long as they’ve never been opened, as long as it’s a plastic bottle. They label it. You can have them. Some places will not let you bring anything from the outside. So, it is good to know. Oh, I normally go here. Every time I’m there, I see people with their cute little bottles of Sprite and I don’t have one because nobody brought me one. Absolutely. Bring it with you. Have it in your bag. Have a have a couple in there. If you know that this is a place that allows smoking, for example, let’s say you’re a smoker, maybe there are still hospitals that allow smoking.

Dr. Nicole: I can think of one that I’ve worked at in the last two years that still has an opportunity for people to take smoke breaks, but for the most part, that’s not allowed. So, you can leave your cigarettes at home and leave your vape at home because you will not be using it. Leave your cell phone. Well, I take that back. Don’t leave your cell phone. Bring it with you. But recognize you won’t be able to take it with you on the unit. The reason I say bring it with you is because a lot of times people come into the hospital and I say, hey, can I talk to your fill in the blank sister or mom, brother, whoever? And they say, Oh, yeah, sure. Well, what’s their number? Oh, I don’t know. It’s in my cell phone because nobody knows anybody’s number anymore. So, you may need to have your phone with you just for the purposes of having the nurse or the tech assist you with charging it up, turning it on, getting numbers out of it so you can call people if we need collateral information and things like that. So, I’d say bring it, but just know that you will not have the ability to use it. Probably you won’t be able to use it when you’re on the unit. Most units I work in don’t allow people to have cell phones and tablets and things like that.

Gabe: So, I want to rage. I am ready. This is. This is BS. How can I not have my phone? What am I supposed to do? I want to be on my Internet. I want to be looking stuff up. I want to be on social media. I want to be hanging out. How could you take my phone? How could you take my phone? On one hand, I understand that like even as I’m miming the argument and I’m doing it for effect, I want everybody to know I don’t actually feel this way. There’s a part of me that believes it, right? There’s a part of me that’s like, you know, I’ve got to be in here and you want me to be without my device. Like this is the device is what keeps me sane. It’s it has become my coping skill. It is. It is the thing that I do in the corner. We did an episode of this show where Dr. Nicole said, if you are feeling overwhelmed, fake a phone call. And then Dr. Nicole said, just now that we don’t even remember numbers, this is how important our devices are. And then in the next breath, she’s like, but we won’t let you have it right? And it sounds a certain way. I get it. But I want to pause for just a moment and ask people this question.

Sponsor Break

Dr. Nicole: And we’re back discussing how you can prepare for an inpatient hospitalization.

Gabe: When you are in a psychiatric hospital, do you want your picture on social media? Do you want somebody to take a picture of you and tag you and say, look at this dad bod who hasn’t had a shower in two weeks and he’s babbling about how much he misses the 60s. And do you want that picture on social media? Because if people are allowed to wander around with their devices, you can’t stop them from videotaping you, taking your picture, putting you on social media.

Gabe: And if your erratic behavior goes viral and it costs you your relationship, your job, your standing in the community, etcetera, the first words out of all of our mouths are going to be, how could the hospital let this happen? I thought this was a safe place and like, well, it was a safe place. But you also wanted to have your phone, which means we had to let everybody else have their phones. I get it. I don’t like giving up my phone either. Truly. And honestly, I don’t. I don’t. It is a comfort item for me. And that’s one of the hardest parts about being inpatient, I think, is that we have to leave one of our comfort items behind. But it truly and honestly is in fact for our own good because I don’t want my behavior filmed and put on TikTok with an upbeat music behind it. Et cetera. And I have to believe that that’s the reason for this rule. It’s not to deny us our comfort item. It’s to protect our privacy.

Dr. Nicole: That is one reason. And the other reason is it can be a huge distraction. I mean, if your phone were that great of a coping skill, then why are you in the hospital? Something’s going wrong. So, we have something we need to work on while you’re there. And the cell phone is not going to help anybody in that moment. If you are so depressed that you are experiencing a loss of functioning or you’re in danger of hurting yourself in some way, or if you are so manic that we feel like you need to be in the hospital to protect you from your symptoms at that moment, your cell phone can do nothing for you in that moment, and it can be a distraction from the activities on the unit, the groups, the just resetting and recharging that we hope happens in the hospital.

Gabe: All right. I’m still planning my go bag. We’ve talked about what we can put in there. We’ve talked about what we can’t put in there a little bit. One of the things that I think about is I don’t want to I don’t want to panic if something gets taken out of the go bag. So, some practical advice for me when I talk about like the clothes that I pack and the things that are mine, I don’t want to put in there that things are like super special, right? I don’t I don’t want to put in there the t shirt that my grandmother gave me, you know, when I graduated high school, that while it feels really good and I love it and it is in fact one of my comfort items, it may not be the thing that you want to take on to the inpatient unit because a lot of things could happen. It could get misplaced, it could accidentally get taken, it could get stained. And you don’t have access to stain stick right away ensuring that that stain set. So, there’s sort of this sweet spot between you don’t want to just go out and buy all brand-new stuff because then you could just wear the hospital clothes, right? But you also don’t want to grab your, your, your most important and treasured items because if anything happens to them, including you’re not allowed to bring them in. So, they say they will keep them safe. Well, I don’t know about you, but even though I 100% believe that the hospital will keep it safe, I’m still anxious about it. That that thing that I care about, that I love the thing that is meaningful to me, even again, a potential comfort item is now stored away from my control. So, there’s like this sweet spot in the middle, not

Dr. Nicole: Yeah.

Gabe: Too personal, but also has some it has some love to it. So, Dr. Nicole, to your point, I’m not sure that I would bring my favorite sweats. I would bring my second favorite sweats.

Dr. Nicole: Yeah. I also wouldn’t bring things that are of large monetary value to you if there’s jewelry or things like that. Most of the time you’re not going to be able to wear jewelry on the unit. And those are things that I just don’t know that I would trust anybody to say, oh, we’re going to put it with your things. It’ll be here when you check out. 9.9 times out of ten. That is probably accurate. Your things are there. But what about that 0.1? What about that time? And just my luck, I’d be in that 0.1 and then I’d be mad forever just being mad about my special pair of earrings that I never recovered.

Gabe: Now, packing a go bag is a big deal. And for many people who are listening, they’re like, look, Gabe, I’m not going out and buying a duffle bag. I’m not putting stuff in that duffel bag. I’m not keeping it in my bedroom. And people when we talk about this in support groups, they say that they don’t want to do it for two reasons. One, laziness. I want to I want to be fair. People are really, really honest in support groups. Like I’m too lazy to do that. I’m not that organized. But there’s a second reason that people don’t want to do this that I actually think is really, really valid. They don’t want to walk into their apartment, their house, their bedroom and see that go bag and be reminded of the idea that they could get so sick that they would need to be admitted. Check themselves in committed in crisis. They don’t want a reminder of previous experiences and they want to stay positive. And every time they see this go bag sitting there, they believe that not only does it represent failure, but it represents sort of a, oh, I know failure is going to happen. So that’s why I did it. First, I want to challenge that. That first one. One, I think being prepared for something doesn’t mean that you believe that it’s going to happen. I wear a seatbelt. I don’t believe I’m going to get in a car accident. I have smoke detectors. I don’t believe that my house is going to burn down. I go get a physical every year. I don’t think that it means that when I go to that physical, something bad is going to happen.

Gabe: It’s preventative, and I find that very empowering. I’m taking control of the reins to ensure that I get the best outcome possible. So, I want to be very, very clear. I think that there are all kinds of reasons to do it. But that said, hey, I got a secondary plan. I’ve got another idea for you. Make a list. Make a list of all of the stuff that you want to bring. And if you do have that support system, if you do have, you know, a wife, mother, cousin, brother, bestie, make a list and give it to them and be like, Hey, if I ever call you up and say that I’ve been admitted to a psychiatric hospital, go to my house, apartment, bedroom, find me this stuff, find me this stuff right now, put it in a bag and bring it to me immediately. And this this I think, I’m trying not to say this can be a fun thing to do, but, you know, I have to admit, in the early days of my marriage and when we’re going back 12 years, when I when I told my wife, hey, if I’m admitted, I want you to bring me this stuff, she started asking questions. She was like, why? Why do you want this? And she started, like, offering suggestions. She’s like, oh, well, if you’re going to be there for five days, you’re going to need a charger. I told her about the cell phone and, you know, it did open up this this real big conversation. And I got to tell you, I, I still reflect back on that.

Gabe: And I just I feel so empowered because I just I knew something she didn’t. I had an experience that she didn’t. And again, I was well, I was not in crisis. I was doing all of the planning and I had all of the knowledge. How often in dealing with bipolar disorder are other people in charge? Are other people telling us what to do? Are other people leading the charge? And we just have to follow to get healthy for our own good, to save our lives. And this this sort of flipped the script on this. I was like, I got all the knowledge and you honey, have none of it. And it wasn’t in a negative way, but it, I want to admit it felt very empowering and I still remember it all these years later. And I have to believe, for what it’s worth, that all of these little empowering things and making all of these plans and telling people about the plans, I can’t help but think that they led to me staying stable because these were all really positive and empowering things that I could put in the bank. So, when the when the dark times came, when the depression came, when the symptoms came, I was like, no, I’m ready, bring it on. And I had these things to fall back on.

Dr. Nicole: Uh huh. And you’re right. It’s about control, I think, too, when you’re in that in that state of whether it’s severe depression or severe mania and you’re going into the hospital, everyone has control. But you. They tell you when to wake up, when to go to bed, when to eat, when to go to group, when you can watch TV, what you can watch on TV. So, it’s nice to know that you had some control over something like you at least get to have your favorite comfortable pants or you get to bring your Diet Cokes in. You know, toiletries are another thing. I work at some places that will allow you to bring in your home toiletries. I work in some places that will not let you bring in home toiletries because we’ve had people smuggle things in in toiletry bottles. There are some places that will let you bring unopened. So maybe you get travel sizes of your favorites and keep those in your bag, especially if you, you know, are a black person and your hair is a little bit different. A lot of times the shampoos and conditioners that the hospital have will kill our black hair because they just weren’t made for us.

Dr. Nicole: So, you want to have little samples of the things that you use that are going to work better for you. So, if you have certain lotions or toothpaste or things like that, I do recommend you keep a little unopened sample size bottles in your bag because those are the little comforts that can just kind of help you keep it together while you work on improving and can make things so much more frustrating and seem so much bigger when you’re like, I can’t wash my hair with this, or this comb does not work on my hair. I recently looked at a comb at a facility that they gave a lady and she had a ton of hair and this comb was not going to put a dent in her hair. And she was very frustrated and angry. So, I had to go buy this lady a comb because that was completely not going to work. And I do think sometimes hospitals are just like, deal with it. You’re in a psych hospital, you just get whatever comb you get, even if it won’t go through your hair. So being prepared on those fronts are things that I think you can do to help you.

Gabe: You’ve mentioned a couple of times when making your plan that it’s smart to know the policy of the hospital because not all psychiatric hospitals have the same policies. What flies at one won’t fly at the other and that that it’s good to know what that is so that you are prepared. Now, the first caveat that I want to put in is you might not get into that psychiatric hospital for a couple of reasons. One, it’s certainly possible that wherever the crisis happens is closer to a different hospital and you will be taken there. That’s number one. If you’re admitting yourself, it’s possible that the beds will be filled and they will send you to a different hospital for that reason. So even the best laid plans I want to point that out. But I got to tell you, thinking as a patient, I you please correct me if I’m wrong, but honestly, I’ve got my dude living with bipolar hat on. I am positive that if I call any psychiatric hospital and ask them what their policy is, that they’re going to hang up on me, I don’t think I’m going to be able to figure out their policy ahead of time. I’m going to be stuck in some press one, press five, press seven. And if I get a person on the phone, I’m like, hey, I’m concerned that I might be admitted to a psychiatric hospital and I want to know what I’m allowed to bring. I’m going to get hung up on how does anyone figure out what these policies are ahead of time to make these plans.

Dr. Nicole: Yeah, they’re probably going to be afraid that you’re going to show up with your large rolling suitcase with all of your home comforts with you, which we know never, never turns out well. It really may be that you don’t figure these things out until you’ve been there once. Mean that. That may be the honest answer. It may be that I went to this one hospital this one time, and now when I get ready, if I know I have to go back, I’m going to be ready. You could call, though. I mean, you could call and say, hey, I have bipolar disorder. Sometimes I end up in the hospital. I’m not planning to come in, but I’d like to know, do you all allow outside food? Do you allow outside drinks? Can I wear my own clothes? Can I bring my own toiletries? The person at the front should be able to tell you those things. You should be able to get that information and we’ll hope it’s accurate so that, you know, if and when you end up there, you can have the things that you need. But it may be tricky. You’re right. Some people may say, oh, I don’t I don’t know why you need to know that information. And they just may not be very helpful. I can’t even lie to you and tell you that I think everyone who answers the phone is going to answer your question.

Gabe: I always recommend applying for the lowest common denominator, the strictest place there is, and then make adjustments as you as you learn. And I recommend that because again, even if you figure out the exact policy of the hospital that you are most likely to go to, it doesn’t guarantee that that’s the hospital that you end up in, as we’ve already discussed. So, I go for the strictest of the strictest of the strictest. I don’t bring my Diet Cokes because a lot of hospitals have no outside food or drink policies. I drink Diet Coke, which has caffeine in it. Many hospitals have a no caffeine policy. Obviously I don’t bring electronic devices, chargers. Et cetera. I’d be careful about things like. Like belts and drawstrings. I bring flip flops and. And everything that I bring has enough comfort in me that I know that it will it will provide me some comfort. But if I lose it and never see it again, I’m okay with it. I’m just, hey, that’s a bummer. I lost that and that is how I plan now.

Dr. Nicole: And if you do have that support system, having someone you can call and just say, hey, can you pick this up for me? They’ll let me have it is huge. It’s huge. I would also say keep a current medication list. That’s the one thing I think I forgot. Keep a current medication list in your bag, which requires you to keep it updated and to change it as things change. But I cannot tell you how many times people come in and they say, oh yeah, I’ve been taking A, B, C and D. Do you know how much you’re taking? No. And it’s like Friday at 10:00 at night. Their doctor’s office isn’t open. The pharmacy may not be open, depending on where we are, I’m stuck, you know. Oh, I take ABC and D, you know the doses. No, I used to take F and G and they made me feel horrible. Please don’t give me those. Oh, what were they. I can’t remember. But don’t give them to me. So, I think having a list and keeping an ongoing list of things that you’ve taken before your reactions to them, I think that is a very valuable thing. And the rare, rare chance that somebody comes into a psych hospital with such a list. I am giddy. I am literally giddy because it just doesn’t happen that often.

Gabe: If you want to make your Dr. Nicole’s Day. [Laughter]

Dr. Nicole: Yeah. Yeah.

Gabe: Keep this list.

Dr. Nicole: Yeah, for real.

Gabe: Here’s a hack your bipolar tip, keep it on your phone. Right? Whatever phone you have, open up notepad or whatever, and keep it in real time. Keep it updated over the years. And remember, while you can’t bring your cell phone in, Dr. Nicole and I agree recommended bringing it because that’s where your contacts are, your phone numbers, and you want to be able to call these people and let them know where you are. And I don’t have my wife’s number memorized, but in that phone will be that sheet that you’ve updated in real time. And again, you can make your Dr. Nicole’s day, but sincerely, you will also get what you want. You won’t get that drug that you tried five years ago that you don’t like. You’ll get better, faster. Care to get on with your life quicker?

Dr. Nicole: And to me, the most empowering part about a hospitalization is a voluntary hospitalization. Nobody wants to come in kicking and screaming, getting to the point where the police, you know, are having a cuff you because you’re fighting everybody or, you know, before you end up doing something to yourself that’s dangerous, make the decision on your own. There’s to me, for the people I see, the most empowering thing is coming in on your own and saying, these are my symptoms. I need to be here. You just have so much more say over your treatment. When you come in voluntarily, you have a lot more say over when you feel like you’re ready to go from the hospital. You just have so much more power in your hands than you do if you wait until it has to be an involuntary admission. So, to me, the preparing for it and recognizing it early like that’s the that’s the powerful piece the you making the decision to go in and not having someone else make it for you.

Gabe: Obviously we would all agree that the best outcome is to not need to be impatient. It’s not to need to go to the psychiatric hospital. It’s not to need to be in crisis. But I really, really, really, really, really do think that it is way more empowering to be prepared than to be caught off guard. Listen, I have never needed my smoke detector except when my wife cooks. I have never needed a fire extinguisher, but every five years it expires and I buy a new one. I am prepared for a house fire that has never happened and statistically is unlikely to happen. But I got to tell you, if you’re living with bipolar disorder, the chances of you needing inpatient hospitalization are higher than the chances of your house burning down. But I would venture to guess that everyone listening has smoke detectors. I’m just asking you to consider to do the smoke detector equivalent for managing bipolar disorder for your own good, for the good of the people around you. And because I believe as someone living with bipolar disorder, that it is super empowering to be ready and prepared and to make your wishes known to get the best care that you can.

Dr. Nicole: What I find on my end is that when patients come in on their own, they’re able to come in with the reality that this place isn’t perfect. It’s not going to be perfect. They’re going to be some things I don’t like, but right now it’s the best thing for me to do. And just in general, they have a better experience because they aren’t just looking for every little thing to rip everybody apart. They just are a little bit calmer because it was their decision. And even if we do things that make us uncomfortable, if it’s our decision and we are in a space where we can talk through what the potential benefits can be, it just makes it such a better experience for everybody.

Gabe: All right, everybody. My name is Gabe Howard and I’m an award-winning public speaker, and I could be available for your next event. I also wrote the book “Mental Illness Is an Asshole and Other Observations,” which you can get on Amazon. However, you can grab a signed copy with free swag or learn more about me just by heading over to my website gabehoward.com.

Dr. Nicole: And I’m Dr. Nicole. You can find me on all social media platforms @DrNicolePsych to see all the things I’m typically doing all around the world at any given moment.

Gabe: And hey, can you do us a favor? Wherever you downloaded this episode, please follow or subscribe to the show. It’s absolutely free and you don’t want to miss anything that Gabe and Dr. Nicole discuss. And we need another favor. I know it’s a twofer. Recommend the show to people. Bring it up in a support group, bring it up on social media, bring it up in bipolar forums. Because sharing the show is how we grow. We will see everybody next time on Inside Bipolar.

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