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    Thread: Tell me about PTSD and Mental Hospitals...

    1. #1
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      Tell me about PTSD and Mental Hospitals...

      Hey, hey.

      I've been away a little while, partly because of a few projects I'm working on. One of those projects might just happen to be a novel centered around lucid dreaming. In this (alleged) novel, the main character's sister was a witness to the horrific murder of their father, by some creature that could only be described as "not of this world". After the incident, the creature vanished, and there was nothing to prove that she saw what she says she saw, outside of the damage that was left to the corpse, which couldn't have been done by a human.

      A large portion of the story has to do with the main character visiting her in a mental hospital that she'd been kept in for the past couple of years - having not been able to truly get over what she saw that night, and her dealing with the fact that there is really no one who believes what she says she saw. So I'm trying to get a feel of what that might be like for someone; what life might be like, inside of that kind of facility. She's not a complete nutcase and all (like in the stereotypical 'looney bin' sense), but she's very withdrawn, and just has a heightened sense of fear, and always has recurring nightmares about the incident, bordering on hallucinations.

      Is there anyone who might have any experience with PTSD, or knowing someone that has it, that has any idea of what life might be like, inside of that kind of institution? I've been doing some reading and watching some videos, because the interaction between her and the main character will be very intense and important to the story, and I'd like to get the atmosphere down as much as I could.

      Any input is appreciated!
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      My uncle has PTSD.
      Some of this has translated to knowledge for me, and I will share what I know.

      My uncle attaches a date to his PTSD... He was in Vietnam on his birthday, and usually when it's a soldier's birthday they don't go to battle on that day... Another soldier had the same birthday as he did, and they drew straws to see who would go out that day. My uncle got the longer straw, and the other soldier went to battle that day. The team returned, all but the soldier who got the shorter straw.

      To this day, my uncle resents his birthday, preferring to shut it out of his memory. Whenever we try to have a birthday party for him or give him birthday gifts it only makes him irritable and sad...

      He's always been very reclusive, and introverted. I think that's a part of his PTSD....

      PTSD is characterized as posttraumatic stress that is so intense it becomes difficult to cope with and gets in the way of every day life.

      I would not say that I have any kind of PTSD, because I don't, but I have experienced post-traumatic reactions that have puzzled me.

      I witnessed a motorcycle being hit by a car from no less than 20 feet away. I was also one of the first to respond to my step-mother's car accident not two months ago. There have been a few other times when I have come up close and personal with accident wreckage and seen the aftermaths of car wrecks. Now, I find car wrecks to be common in my dreams, as well as my subconscious thoughts... Now I get a sort of anxiety about driving, and especially about being a passenger... It's to the point where I can be a real jerk to a crappy driver.

      Anyway... I think it's all about a thought that... You think about so much that it starts to become a bigger and bigger part of your mind... Until it begins to consume you.
      Last edited by DreiHundert; 05-12-2012 at 07:12 PM.
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    3. #3
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      Thanks very much, DreiHundert. That's very helpful - particularly the part about how your uncle attached the date to his PTSD. I would imagine something like that might be common, even if it didn't fall on his birthday. I definitely might incorporate that in the character's demeanor. Much appreciated!
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      Hmm...this seems like a somewhat interesting idea for a novel.

      I have met a small handful of individuals with Post-traumatic Stress Disorder, though their PTSD was developed mainly by emotional and/or physical abuse from parents, siblings, relatives, classmates, or teachers. I have not known anybody whom has witnessed a murder or death.

      Most of those I have met with PTSD were very closed-off and paranoid, and had a lot of trouble falling asleep most nights (or days)--and would often have dreams about people whom have hurt them in the past, or dreams about random people persecuting them. They also experienced strong, often unpredictable, surges of anger (induced by the bad memories), which were often followed by severe tantrums or emotional outbursts. In the victims I have met, these tantrums have almost always occurred when they were alone, usually in their rooms or any indoor location they were quite used to being in. In these moments, they did not take their anger out on their family or acquaintances (unless the individual was someone whom caused the trauma(s) he/she was at the moment reliving), but rather on themselves, their personal belongings, or any other present inanimate object. Although, there were some whom would repeatedly take it out on a single individual or anybody whom probably reminded him/her of the victimizer(s) in some way.

      I have never been in a mental hospital, at least not long enough to have a firm grasp on how everyday life is like in them, so I cannot offer much wisdom in that area.

      ...Anyhow, I just thought I would post what little knowledge I have on this subject, though I doubt this will be very helpful.
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      Thanks for the input, Aristaeus. Any little bit helps!
      Quote Originally Posted by Aristaeus
      Although, there were some whom would repeatedly take it out on a single individual or anybody whom probably reminded him/her of the victimizer(s) in some way.
      This is actually a very important part of her interaction with her brother (the main character). In fact, this part of her psyche manifests itself as a completely separate character (a sort of 'nightmare-ish' version of her, that plays a completely different role in the story).
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      How exactly does the PTSD interfere with her functioning? Does she need to be in a hospital that long?

      I've visited mental hospitals as well as a facility. The hospitals were full of old, decaying, depressed people, depressed young people, and a couple manic people. The food was good, they had therapy groups up to three times a day, had a television and computer with internet, and visitors were allowed from 9 to 9. Most people stayed for 3-5 days, but some were there significantly longer (10 days, for myself), some would leave for months and then stay for a month. If you weren't crazy enough to try and escape, they'd let you walk around outside for an hour at a time.

      The facility was dark. It's meant for aggressive folk and seriously confused schizophrenics. Though it confuses and angers me that they'd mix helpless, scared schizophrenics with murderers. Just found out my friend's in there. Again (he's one of the scared ones). Visiting hours are limited, two hours a day. Sometimes only one or two relatives are allowed in, and friends are sent away. Sometimes even a parent is prevented from visiting (a fucking divorce let's you do what? fuck). The food is terrible. There is no internet access or television, and the piano is locked in the visiting room (which they generally don't have access to). I have yet to have a visit there that isn't interrupted by someone else's outburst. Actual 'care' is limited, patients don't actually get to have conversations and therapy with their doctors, though they meet once a day, it's just a checkup. It's a prison.
      Abraxas

      Quote Originally Posted by OldSparta
      I murdered someone, there was bloody everywhere. On the walls, on my hands. The air smelled metallic, like iron. My mouth... tasted metallic, like iron. The floor was metallic, probably iron

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      Quote Originally Posted by Abra View Post
      How exactly does the PTSD interfere with her functioning? Does she need to be in a hospital that long?
      Hey there, Abra.

      Yeah, that's one thing I learned about while looking into 'State Hospitals' and PTSD. I've been thinking of making a few changes to where she ends up having a night terror about the ordeal that turns violent, and she is Baker Acted for her safety and the safety of others. She will also have developed chronic insomnia and, considering there was no hard proof of what she says she saw, she's still under the suspicion of being 100% crazy. For her to have been under the facility's care for about 3 years is all I need to make the whole thing work.

      Quote Originally Posted by Abra
      I've visited mental hospitals as well as a facility. The hospitals were full of old, decaying, depressed people, depressed young people, and a couple manic people. The food was good, they had therapy groups up to three times a day, had a television and computer with internet, and visitors were allowed from 9 to 9. Most people stayed for 3-5 days, but some were there significantly longer (10 days, for myself), some would leave for months and then stay for a month. If you weren't crazy enough to try and escape, they'd let you walk around outside for an hour at a time.

      The facility was dark. It's meant for aggressive folk and seriously confused schizophrenics. Though it confuses and angers me that they'd mix helpless, scared schizophrenics with murderers. Just found out my friend's in there. Again (he's one of the scared ones). Visiting hours are limited, two hours a day. Sometimes only one or two relatives are allowed in, and friends are sent away. Sometimes even a parent is prevented from visiting (a fucking divorce let's you do what? fuck). The food is terrible. There is no internet access or television, and the piano is locked in the visiting room (which they generally don't have access to). I have yet to have a visit there that isn't interrupted by someone else's outburst. Actual 'care' is limited, patients don't actually get to have conversations and therapy with their doctors, though they meet once a day, it's just a checkup. It's a prison.
      Thanks! Definitely gonna use some of the visitation information. This is the place I've pretty much decided on basing the hospital scenes around: Florida State Hospital - Wikipedia, the free encyclopedia 4

      The story is set in Florida, and that place seems to have an interesting and old-enough design, without looking too much like the stereotypical, Victorian, castle-like 'asylum'. I also wanted to make sure it wasn't like one of the newer State Hospitals that were boring, old 1-story, bank-like buildings. This one walks a fine line between the two. I'm still going to make sure it has a very uncomfortable atmosphere (and it will be worse, when visited in dreams/nightmares in the story).

      I appreciate the input!
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      Not had to deal with PTSD myself and I personally do not know anyone suffering from the condition, but I know how it works and maybe the knowledge could offer some insight?

      The amygdala is involved in PTSD. The amygdala is responsible for hormonal responses to external stimuli--it's responsible for more, but this is the part most relevant to PTSD. In short, the amygdala preps your body for whatever stress it needs to handle, and it does this before your conscious self realizes what exactly you even need to be prepared for. For example, you see a large animal moving in the dark, and your body is already getting prepped to run or to fight this thing off before you even realize that you've seen an animal because how quickly the amygdala provided a hormonal response.

      When people become overexposed to certain stresses or experience a particularly stressful situation (typically something someone will never forget unless the memory is repressed), this can lead the amygdala to be over responsive, even to stimuli that are only kind of similar to what usually triggers the stress. This is why it is so typical in war veterans--they hear the sounds of guns firing, bombs exploding, or screaming, or moving vehicles, and the amygdala responds with adrenaline. From then on, loud bangs, similar sounding vehicles, and angry commotion may now make them think they're in war time and need to be ready to kill or be killed. It has more to do with the brain trying to keep you alive and surviving than it does with mental fortitude or anything like that. The brain learns to respond this way because this is what keeps you alive. The person that responds to gun fire most quickly is more likely to survive. Some people can be more predisposed to PTSD than others. People who usually suffer from anxiety or people with low cortisol levels (a hormone that helps maintain homeostasis after the body experiences stress) are good examples. To put it simply, people with PTSD experience intense fear/emotional responses to stimuli that would otherwise cause very little or average stress.

      Hopefully I didn't just tell you things that you already know, and good luck with your novel.

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      Hey Oneironaut Zero. What age is this character of yours? At what age did this incident occur? I'm assuming she's over 18. If she's 18 or younger, keep in mind she'll be placed in a minor's institution. Anyone above 18 will likely meet anyone from 19-55.

      What year does this book take place in? If it's more recent, then some of the horror stories you've heard about state-run mental wards wouldn't apply anymore--they've gotten a little better over the years. They're still not great, but definitely not as terrible as what they used to be. As you could imagine, you would run into a lot of colorful people in such places--patients and staff alike. My mom worked at a geriatric psychiatric unit, and the sense of humor will naturally be a little dark. As my mother stated, "If you don't laugh, you'll cry." My mom's unit had a difficult time being fully staffed. Anti-psychotics are often prescribed as sedatives.

      My sister was depressed in high school, so she went to a behavioral health center for a week or two, and then two weeks of an out-patient program. It wasn't state-run, and it physically didn't look too bad. Very bland colors though. None of the patients were allowed to have strings in hoodies or on your shoes, they were only allowed to write with crayons, and the first night you had to be under 24 hour surveillance. You return to 24/7 surveillance if you might harm yourself/others. Also, the place my sister stayed at only had one visitor's room, so there'd be a couple of families there at once. There was no privacy. And as someone else mentioned, the visiting hours were limited.

      From my knowledge, most people don't stay inside a mental institution for years at a time, not nowadays. People will usually stay for 1-6 weeks, until their insurance won't let them stay anymore, or until the doctors/psychologists/psychiatrists decide that the patients have made enough progress to be released. Some people don't come back, others go in and out for months, potentially years.

      Sorry, I know this is a rambling mess. And this isn't even about state-run institutions. But these are just some facts about what I know from non-state-run institutions.
      Last edited by Caenis; 05-22-2012 at 02:07 PM.

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      Quote Originally Posted by snoop
      Hopefully I didn't just tell you things that you already know, and good luck with your novel.
      Took some of my impressions of the condition and added much more substance to it. Gave me a few more ideas, as well. So I thank you for that.


      Quote Originally Posted by Caenis
      Hey Oneironaut Zero. What age is this character of yours? At what age did this incident occur? I'm assuming she's over 18. If she's 18 or younger, keep in mind she'll be placed in a minor's institution. Anyone above 18 will likely meet anyone from 19-55.
      At the point where the story begins, she is about 24. She was 16 when the incident happen. I wanted to make sure she was in an adult institution, so that's kind of what made me think about making the episode that got her admitted come some years after the one that gave her the condition.

      Quote Originally Posted by Caenis
      What year does this book take place in? If it's more recent, then some of the horror stories you've heard about state-run mental wards wouldn't apply anymore--they've gotten a little better over the years. They're still not great, but definitely not as terrible as what they used to be. As you could imagine, you would run into a lot of colorful people in such places--patients and staff alike. My mom worked at a geriatric psychiatric unit, and the sense of humor will naturally be a little dark. As my mother stated, "If you don't laugh, you'll cry." My mom's unit had a difficult time being fully staffed. Anti-psychotics are often prescribed as sedatives.
      That's kind of what I'm going for. I don't want to write the hospital as one of the iconic old asylums of the past. The story is pretty recent. Within the last couple of years (haven't decided on the exact year yet within the last five or so). The main character, her brother, was affected by what happened during the incident as well, but not nearly to the degree that she was. So, with the story being centered mostly on him, his own perspective of the hospital will make it seem more sinister than it truly might be. I may need to look into some anti-psychotic effects as well.

      Quote Originally Posted by Caenis
      You return to 24/7 surveillance if you might harm yourself/others.
      I was thinking about that. That's the reason I wanted to change it to her getting Baker Act-ed for being a danger to herself and others. I'm really trying to get a good feel for how severly someone might have been affected by something like what she saw. I don't want her to be a completely unresponsive basket case, but a deeply troubled person who is suffering from severe PTSD, has almost killed someone during an episode (in perceived self-defense, of course) and (maybe) has tried to kill herself at least once, since no one really believes she saw what she saw that night. I'd like to nail her affliction in a way that shows that she's extremely traumatized - enough to be institutionalized for at least a couple of years - but still enough to show that she's a smart, somewhat normal (maybe even if only in spurts) person. Even if she only goes in and out over a number of years, that would be workable.

      Thanks again!
      Last edited by Oneironaut Zero; 05-22-2012 at 04:06 PM.
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      So, an update:

      I'm starting to write out the first actual (waking life) visitation of the 'state hospital' (aka mental institution). I've pegged Jocelyn's (the sister) condition as pretty severe PTSD, along with bipolar disorder. The two, I've read, often go hand-in-hand. She also has insomnia due to nightmares and a general fear of what could happen while she is asleep. For some time after the incident which killed her father, they tried to do home treatment. She was in and out of the hospital, but at a minimum. It was tough for the family to manage, but seemed to be going alright for awhile. Then, years later, she had something of a 'night terror' episode, in which she relived going to her parents' room with a knife, to fight the monster that was killing her father. When she awoke, she found out that she was actively trying to kill her mother's new (old) boyfriend with said knife, her dream having made him out to be the monster...

      After that, she was placed back in the hospital, under tighter security. Since, she has been on suicide watch after a few attempts, but now (as the story really begins) she is getting a little better, and is no longer under 24/7 surveillance. This is pretty much the point of her treatment where the first visitation in the book takes place.

      Now, what I'm tryin to do is set up the visitation where, in the beginning, the main character, his sister and their mother get a chance to talk all together, and then both the brother and sister get a moment to walk off with each other and talk in private (I know some of these hospitals have games and things. Is the patient and visitor having a moment to play any games together even a possibility in these sorts of situations?). If that's not possible, I can resort to just a walk through the courtyard or something, but having them playing a game while having a very, very intense and (at times) heated conversation about their past might make for an interesting dynamic.

      Anybody with hospital experience know if this is a plausible scenario? Surprisingly, it's pretty difficult to find any good examples of a state hospital visit, online.
      Last edited by Oneironaut Zero; 06-11-2012 at 08:03 AM.
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      My mom has worked for about 30 years as a psychiatric nurse in the psyc ward of a regular hospital. I don't know how similar they are to entire mental institutions, but I imagine there must be some similarities, if they aren't the same thing. They have long-term patients, as well as short-term ones.

      She's come home with many stories over the years. Episodes in which the cops have had to be called, murder threats, men hitting on her, delusional people of all sorts. Some school-aged people are put there because they only got 90% on a math test or something. One girl around my age was admitted there for being suicidal (this isn't even publicly known but I don't think anyone would make the connection). She was released because she'd talked her way into making them believe she was okay, and then the next day she killed herself. I believe they've had a few escapes and at least one suicide. They let the patients out on walks sometimes, supervised by nurses. If the patient seems to be recovering well and is not acting completely insane anymore, they'll let them out on their own for short periods of time. On one of the nurse-supervised walks, one of the patients escaped somehow, made her way to a bridge and jumped off of it. Later witnesses said that a few people in cars driving by were cheering her on, insulting her and telling her to jump.

      I don't know if that's helpful or not, since it's only a psyc ward, not a psyc hospital, and they deal not only with severe cases but mild ones too, so the supervision might not be as strict.

      The thing my mom hates about her job is having to load people up with pills or shots when they don't want to take them. She and other nurses will literally have to hold patients down sometimes to inject them with a needle or force-feed them pills. She's explained to me that some of the pills make them feel horrible and dead, even though they reduce the insanity, so she understands why they don't want to take them, but she has to anyway, and the patients likely have no idea she cares.

      The parents of a female patient were meeting with my mom once about reducing her medication, since it seemed only to be making her worse. My mom just said what she was expected to, that the girl needed to stay on it, etc. The parents' anger escellated until they were yelling and crying and my mom finally started telling them about a psychiatrist that our family has been seeing. They listened and finally calmed down.

      This is a little late and I'm not sure if he it helps or not. I'm wondering now what the difference is between a psyc ward and hospital, so I think I'll ask my mom about that next time I talk to her. If they turn out to be similar enough, I'll be sure to ask her your question or any others you might have.

      Afterthought: Have you seen or read the book Girl, Interrupted? It's an okay movie about a girl who's admitted to the women's ward of a mental hospital with BPD. She's the least insane person there, reserved and quiet and intelligent, and she seems misdiagnosed. The only problem is that it takes place in the 60's (although it was filmed in 1999).
      Last edited by Dianeva; 06-11-2012 at 08:13 PM.

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      Great stuff, Dianeva! Thanks! Some of that will help me form some of her opinions about the facility (lapses in security; suicides; sexual advances; etc.)

      Quote Originally Posted by Dianeva
      The thing my mom hates about her job is having to load people up with pills or shots when they don't want to take them. She and other nurses will literally have to hold patients down sometimes to inject them with a needle or force-feed them pills.
      I've got a pretty good scene in, already, involving this.

      Quote Originally Posted by Dianeva
      Afterthought: Have you seen or read the book Girl, Interrupted? It's an okay movie about a girl who's admitted to the women's ward of a mental hospital with BPD. She's the least insane person there, reserved and quiet and intelligent, and she seems misdiagnosed. The only problem is that it takes place in the 60's (although it was filmed in 1999).
      I've seen (and enjoyed) the movie, but it's been a while. I'd like to check it out again.

      Thanks!
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      Well, when I was little, my mom was in a mental institution and I remember getting to visit her a few times with my family. We had to go through all sorts of security, and we were supervised, but I do remember going out on short walks in the court yard (I got to meet and talk to a couple of other patience there as well) with her before we left. I can’t remember if it was a psych ward or hospital (though I want to say it was a psych hospital), but I’m pretty sure that the amount of supervision and security depended on the threat level of the individual patient. I remember the building was brown and they had the types of windows that had metal wire kind of inlaid inside the glass (keep in mind that this was about ten years ago, so I’m not entirely sure how things have changed).

      I know this is a little late, but I’ve got a little PTSD story for you. When I was in Iraq a few years ago, we were mortared clockwork twice a day, every day for the first two or three months after I got there. I got really sensitive to ground vibrations because the vibrations would let you know when something got hit long before the sirens went off, and usually the stronger the vibrations, the closer the explosion, etc …. Anyway, I got good at telling when we were mortared or attacked based off the vibrations, so every time I felt even the slightest vibration, I’d get ready to have to get up, grab my riffle and do the army thing.

      I made it through the deployment and got back home, thinking that everything is fine and behind me with no lasting PTSD that I could possibly think of. So, first night home, my family is watching Inception and my dad turns the volume up loud, to include the bass, and as the intro was going on, the bass caused such intense vibrations throughout the house that I freaked out on everyone and nearly started screaming at them to turn the bass off. Even though I wasn’t in a war zone anymore, I’d unconsciously conditioned myself to feel vibrations and relate them to getting ready to react to an attack. It was stupid, because I logically knew I was fine, but my body automatically defaulted to ‘get ready for an attack’ mode, and I had to leave the room. I had no control over my reaction at all.

      I thought it would go away after a month or so, but it hasn’t. I can’t listen to music loud or with a whole lot of bass, I can’t be in a gym that doesn’t have a lot of shock absorbing matting because the feel of weights being dropped feels the same as the mortars, etc… they agitate me and make me feel angry almost instantly. It’s annoying. Can’t even go to a concert without wigging out a little. It’s a pretty mild case of PTSD, but PTSD isn’t always overt and in your face. It can be subtle too.

      Anyway, I hope this helps. Good luck with your story! I’d be more than happy to provide you with other experiences of PTSD, if you’d like. I have a huge pool of people I work with that have been in similar/worse positions.
      Oneironaut Zero likes this.

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      Quote Originally Posted by kaze
      Anyway, I hope this helps.
      It absolutely does. Makes me want to be sure to focus on those smaller, more subtle triggers - sounds or gestures that no one else would react to, but would have a definite effect on her. Thanks so much for the input (and your service ).

      I may just call on you again, in the future!
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