by Naomi Judd
I tried to keep my distance from him since I had a strong intuitive feeling that there was much more to his story than depression or anxiety.
Every resident was allowed two and a half hours of free time on Saturday nights to leave the premises. It was the only time I felt a semblance of being myself again. Larry would pick me up and we’d drive into Santa Monica. I’d sit close to him and we’d sing along with the radio. We would always go to the famous restaurant, the Ivy at the Shore. I’ve been dozens of times and could call the waiters by name. Being near the ocean was restorative and eating dinner in a restaurant full of happy locals or vacationers reminded me that the real world was still happening outside my own personal turmoil. I wanted to be done with rehabilitation, and would plead for Larry to drive me back to Tennessee. Every time he visited me at Promises or dropped me off after our Saturday date, he would have tears in his eyes. If I wasn’t motivated to get better for myself, I certainly wanted to recover for the love of my life.
There was a curfew on Saturday nights, and as soon as you returned you had to give a urine sample and blow into a Breathalyzer as proof that you had not cheated. I felt like a criminal. On the second Saturday, the young man from New York returned on time but got into trouble when he offered a sum of money and begged one of the other clients to take his urine test for him because he was drunk. The “testing” room was very close to my bedroom and I could overhear every word of his escalating argument that he was being treated unfairly.
There were no internal locks on any of the rooms and I was feeling unsafe and on edge and expressed my concern to the staff. I noticed right away that they couldn’t reassure me that everything was fine. In fact, they seemed harried and distracted. Suddenly, out of nowhere, police cars came ripping up the driveway with sirens wailing and lights flashing.
I hollered to everyone, who were startled by the appearance of law enforcement, “I bet I know who they’re here to get. Come on! We need to get to the front windows.”
Minutes later we saw the police quickly escort the belligerent young man from New York City out of the building in handcuffs and shove him in the back of a squad car.
Of course, it was a mystery I couldn’t leave unsolved. One of the techs informed me that the young man had bludgeoned his psychiatrist to death in New York with a hammer the previous month and had flown to Los Angeles hoping to hide in the rehab facility. He was on the FBI’s “Most Wanted” list. And this violent murderer had been in the room directly across from mine! I had hugged him and put up with his weirdness. This made me look around the room at the rest of the clients and wonder what their secrets were.
Almost every night, as I got ready for bed, I would feel increasing fear about having another panic attack. Nighttime was when it seemed almost impossible to quiet my frantic mind. To each worry I had I would attach the worst-case scenario of an outcome. My mind would replay the threat over and over. If I managed to fall asleep, I would often awaken with a feeling of dread from some past toxic memory that was once again creeping to the surface. If there was no specific memory, the thought of “Will I suffer from this for the rest of my life?” was enough to provoke a full-on panic attack. I longed to be home, where I could pace the hallways until morning.
* * *
Promises was the first place to give me the practical skills to deal with my panic attacks. I met with a therapist who specialized in panic disorder. She told me that the most important thing to remember is that the panic attack will pass. It was important to feel the fear and then remind myself that I would not die. No one has died from a panic attack, though it feels like you might. One in three people who go to the emergency room thinking they are having a heart attack are actually having a panic attack.
The therapist even taught me about the neuroscience of a panic attack. The limbic system of the body is overactive, causing the amygdala to go into “fight or flight” mode. The amygdala was one of the first parts of the primitive human brain to develop and had great importance when man had to outrun a charging animal out to kill. It’s located deep in the brain’s temporal lobes. Even though we rarely have to outrun a ravenous bear coming out of hibernation, the amygdala has a default operation that can kick in for things that are not life threatening, such as a verbal argument or an emotional memory of a difficult time. I was taught that the best way to get through a panic attack was to convince my hypersensitive limbic mind that it was fine. One method was to force myself into the current moment by noticing my surroundings.
When I could feel a panic attack mounting inside me, I was encouraged to practice a deep breathing technique and channel my mind into focusing on something completely mundane that kept me busy in the present moment, such as counting the slats in the window blinds, and then counting the tiles in the floor at my feet. I could notice the colors in the art on the wall. Guess how many inches the chair was from the bed. I was to focus on any material thing that would keep my mind in the here and now. If I woke up with a panic attack, I was to remain in bed until it passed; I was advised that this would train my mind to believe I was safe.
At Promises, they try to replace your dependency on a strong drug, like Klonopin, with safe and effective nonaddictive medications that help the withdrawal process to be less painful. Still, the replacement drugs have far less potency and it was very noticeable for someone like me, who had been taking three or four Klonopin to make it through a night. I had become hooked on it over the past four months and the withdrawal symptoms were severe. My anxiety increased, my leg and arm muscles felt constantly clenched in spasms, and I had an omnipresent headache and nightly insomnia. If I was lucky enough to fall asleep, the nightmares would soon have me awake and jumping out of bed, my heart racing.
The sleeping medication given to me was mild and would only help me to feel a bit more relaxed, but not at all sleepy. After three sleepless nights in a row, I felt desperate to have a night of rest. I discussed this with the RNs who oversaw the medications, but they were unwilling to up the dosage. The next day, out of sheer desperation, I devised my own plan.
I had made friends with a nighttime staff person, a young, impressionable man with a great sense of humor who could be easily embarrassed. I had chosen him for my scheme. He would dispense medications from his small desk each night, as I sat next to him. He would lay my medications out on the desk as a way to count them and then put them into a container. I wore a bathrobe into the medication room to pick up my nightly distribution and tucked my hands in the pockets. On my left hand, I rolled up a piece of Scotch tape across my palm. I waited until he had laid out a number of medications and then surprised him with this question: “So exactly how big is your penis?”
His eyes opened wide in surprise and then he tipped his head back to laugh. In that split second, I placed my hand, palm down, on the desk and the tape picked up five pills in one quick motion. When he was done laughing, he wiped his eyes and tried to continue counting pills. I could see that he had been thrown off in the process of dispensing. He would have to start over.
That night I was able to take two sleeping pills, instead of the one prescribed. I was finally able to sleep for six hours in a row. It was heaven. The pull of finding relief through taking another pill is so strong with addiction that you set aside any moral conflict, thinking that you’re not hurting anyone else. My scheme worked perfectly—until one of the nurses entered my room unexpectedly and caught me counting the pills I had scored the night before.
“Oh my goodness,” the nurse gasped. “What do you have here?” She moved me aside and swept the pills into her hand and took them away. Then she searched the rest of my room for hidden pills. Later that day, she put out a bulletin to the other staff members that I wasn’t to be trusted. It hurt my feelings, even though my actions deserved the alert notice. I had earlier bonded with this nurse over our similar experiences working in emergency rooms. Now the bond was broken and my nights of good sleep would be over, too.
She looked at me the n
ext day and asked, “Do you want to get better or not? We’re here for you. But it’s your choice.”
At that time it didn’t feel like my choice. When you’re depressed you feel debilitated. Your judgment is off because your mind is in distress, which short-circuits your ability to reason. I would have surges of motivation to get better for Larry and my girls, but soon the hopeful feelings would be blotted out with a black cloud of despair. I looked at everything that was happening through a negative filter because my ability to see the bigger picture was warped. I wasn’t certain how I would live to see the next week.
At the end of my third week at Promises, I was irritable and feeling caged in. The therapists were already suggesting that I stay for additional time, as they were concerned I would find a way to go back on Klonopin to deal with my chronic anxiety. It seemed like all my energy was going into trying to control myself, instead of recovering and going home.
One night, as I lay in bed, I could feel my heart starting to pound in a frighteningly fast rhythm. I tried sitting on the edge of my bed and counting the tiles across the edge of the floor, but soon my eyesight blurred and I felt dizzy. One of the nurses tried to calm me down and talk me through it, but I was convinced I would never be able to catch my breath, as I couldn’t seem to inhale deeply at all. The nurse conferred with other staff members and decided to call Larry at his hotel. They advised him to take me to the emergency room at UCLA Medical Center, since an hour had passed and my symptoms had not subsided.
Larry and another staff member supported me between them as I stumbled toward the car. My breathing slowed somewhat as we drove along the coast into Santa Monica, but my heart was still pounding. Once in the emergency room, I began to cry from fear and humiliation. The female doctor was very sympathetic and assured me I wasn’t the first person to come into the ER in a full-fledged panic attack. She also informed that I was the third patient to come to the hospital that evening fearing they were having a heart attack when they were actually experiencing panic. She ordered a strong shot of Ativan, which is also a benzodiazepine like Klonopin, only not as long lasting. It was enough to take the edge off the panic and I could finally feel like I could cope. Ironically, before I left, the doctor wrote me a prescription for my anxiety and had it filled at the hospital pharmacy. When I got in the car with Larry, I opened the small white bag to see what I had been given. It was a packet of Klonopin. Larry shook his head and gently took the bag from my hand and tucked it into his pocket.
I was in a sleepless, dazed state all the next day, through the group therapies and my individual therapy. I didn’t want to be around people at all and craved the privacy of my own home and the safety of my cozy kitchen couch. My happier life as a wife, mother, and a performer seemed like a faraway dream, one I had never lived. I couldn’t concentrate on the smallest task. When Larry came to visit in the late afternoon, I sat motionless in a lawn chair in the sun as he did his best to cheer me up. His faith in my ability to recover was the one thread to which I desperately clung, though I feared seeing that committed faith missing from his eyes one day. There is more than a modicum of comfort in knowing that someone keeps praying for you, even when your own faith has collapsed under the weight of months and months of depressive darkness and emotional pain.
That night, expecting to be able to fall asleep from sheer exhaustion, I had what I would call the “grand mal” of panic attacks. It hit me like being electrocuted. I broke out in a drenching sweat from my scalp to my toes. My heart raced at such a high speed I was certain it would create an aneurysm. I wasn’t able to form words and when I tried to stand up to walk, my knees wouldn’t let me. My muscles twitched and jerked. I couldn’t catch my breath and began to hyperventilate. This time the staff didn’t try to calm me down; they summoned 911 paramedics immediately.
We raced down the driveway of Promises with lights and siren blaring. The paramedic who had transferred me to the gurney recognized me. I felt so ashamed and out of control. In the back of the ambulance, the EMT looked down at me with pity in his eyes and to assure me whispered, “Don’t worry. We’re going to take good care of you. You’re going to be okay.”
The emergency room doctor went through the necessary protocol while I lay on the narrow bed with my teeth still chattering and my heart racing. When Larry arrived, I held on to his shirtsleeve and told him I was sure I was going crazy and that I didn’t think I could take it anymore. The doctor must have overheard what I said, because he convened with his staff and came back with the decision that Larry shouldn’t drive me back to Malibu. They must have interpreted my thoughts as a suicidal threat. The doctor administered a shot of Ativan, the same as the night before, but this time added a dose of Seroquel. I have no memory of the next ten hours. I wish I had no memory of the next ten days in the UCLA psych ward.
Chapter 15
When You Live in a Glass House
My car had ended up in a deep ditch. I had lost control over it driving to attend my first day of nurse’s training at Eastern Kentucky University. It was a brisk January morning when the accident happened. I had seen Wy and Ashley off on their school bus and now I was on my way to further my own education. I was elated to finally be pursuing a lifelong passion and a career I knew would support a whole new lifestyle for my daughters and me.
Halfway down the steep hill from where we lived in a tiny, unheated fishing cabin, a freak snowstorm began pummeling the windshield of my old car. I slowed to a crawl, being careful not to make any sudden moves with the steering wheel, but still my tires started skidding across the newly formed black ice. Everything went into slow motion as my huge raft of a car first slid sideways to the right, then backward, and then veered in the opposite direction across the road before sailing into the ditch and tipping over onto its side.
The force propelled me with a bruising thud onto the passenger door, flat on my back. It only took a few minutes for the blizzard to completely cover my car. Standing on the passenger door, I used all the strength I had to push open the driver’s side door and crawl out. I screamed for help, but the dense snow falling all around me muffled my cry. I would have to find help on my own, because no one knew where I was and no one cared, either.
This was the memory dream I was having when I first came to consciousness in the psychiatric ward at UCLA Medical Center. When the accident had actually occurred thirty-five years before, I didn’t perish in the storm. I took action, trudging through six inches of snow across a farmer’s field and persuading him to tow me from the ditch with his tractor. He was busy and reluctant to help, but I used my power of persuasion topped off with some charm, and soon the giant-wheeled tractor yanked my old car back on to the road. I still made it to my first day of class. Nothing could stop me then. My fighting spirit had pulled me through thirty-six years of emotional and financial challenges. Where was that spirit now?
When I awoke in a barren room, I struggled to keep my eyes open, to distinguish the dream from a harsh new reality. It all felt like slow motion again. I only had a vague recollection of being brought here on a gurney and then transferred to this sterile-looking room. The bed I lay on with side rails and one small dresser were the only objects in the room. I noticed that the rails on the bed had holes in them, probably for tying down an out-of-control patient.
I felt like a fragile figurine in a terrarium because all four walls of my room were reinforced-glass windows. This is the type of room given to new patients so that they can be constantly observed from the nurses’ station and the hallways.
This is it, I thought. I have finally been committed as an insane person to a mental ward, thousands of miles from home, in an institution where I don’t know a soul. This is my real-life One Flew Over the Cuckoo’s Nest, no longer an amusing thought, as it was while in the group at Promises. Now I really was locked up.
I was suddenly overwhelmed by a sense of powerlessness and desperation at the thought of being involuntarily held in a psychiatric ward. I could feel a whale of a pani
c attack mounting as my heart rate increased. I weakly called out Larry’s name, praying he was there, just out of my line of vision. He wasn’t. I forced myself to breathe more deeply and tried to find something to count, as suggested by the therapist at Promises. I looked for window blinds, but there were none. There was no art on the walls, not even a hook for hanging a bathrobe.
Instead of finding an object to focus on, my attention was caught by a woman with wiry unkempt hair who was pacing in front of my window, brushing against the glass like a tiger in a zoo, her hollow and lifeless eyes locked on me as if she were sizing up her prey. I wanted to get up and find a bathroom, but I didn’t dare. I had no idea if this feral-appearing woman could burst through the door and attack me.
After what seemed like an hour, a nurse came in to check on me. She brought basic toiletries: a toothbrush, a plastic cup, and a small towel.
I did my best to keep my voice calm as I cautiously questioned her: “Have I been locked up?”
She answered that I hadn’t been committed, but I was admitted for intense observation because they thought I was very sick with panic disorder and severe depression. She checked my vital signs, drew blood, and gave me a pair of socks to wear on my feet. Anything with strings, like shoes or drawstring sweatpants, was not allowed. For now I had only generic hospital scrubs to replace my emergency room gown and the pair of socks. It was incredibly demeaning.
After she left, a tech wheeled in a tray containing some breakfast and stayed to watch me eat it. I could barely swallow a thing, but I didn’t want to appear defiant in any way. I was terrified that I would be put somewhere even worse. I couldn’t imagine where that would be, considering what was happening all around me.
The noise level, even sequestered away in my observation room, couldn’t be ignored. There was the loud sound of double sets of electronically locked and alarmed doors being buzzed open for staff and visitors, then clanging shut. Carts rattled through the hallways. I could hear patients yelling out incoherent things.