Dissociating in hospital

Living with Dissociation is very lonely. You are constantly misunderstood and often unable to make yourself heard.

One way of thinking of about it is that it is in many ways the opposite to anxiety. I don’t mean we don’t feel anxious, of course we do! Excessively anxious at times; suffering depression and clinical anxiety are common accompanying conditions to DID. What I’m referring to are the visible symptoms of anxiety. Instead of visibly panicking, becoming distressed and frightened or jumpy and paranoid, a dissociative will withdraw. A sudden loud noise which would cause a person with anxiety to jump and become nervous, would cause a dissociative to instantly zone out, go into ourselves in an attempt to protect ourselves from things we can’t run from. That’s what it’s all about in the end; protection. A person with  extreme anxiety may feel compelled to run away, whereas a dissociative may feel internally run away and hide, leaving the body to go “auto” whilst our minds are safely tucked away.

That’s not to say we can’t panic and run with the best of them! DID is nothing if not complex and our mind’s responses to any situation are unpredictable at best. There many ways we can dissociate – some more common than others. The problem comes when I’m terrified, genuinely terrified, but the way I deal with that is to hide inside myself, go into autopilot and hide away, which means I appear perfectly calm and normal on the outside, while inside I’m screaming and crying in a corner for someone to come save me. If I don’t go into autopilot but still internally run and hide that’s when I become unresponsive and “zoned out”, other times it might trigger a switch and someone else will take over for a while. I find that unless I’m dangerously zoned out, most people don’t notice the sometimes too subtle transitions between normal me and autopilot me, which is the whole point.

There have been 3 separate occasions when this has happened at A&E. 2 of those occasion’s I was actually brought in due to my DID and once, the most recent, I panicked while in there for a physical problem. On each occasion no one had a clue what was wrong, or even considered my problem was a mental health problem assuming instead I had hit my head or taken drugs. Meanwhile I was unable to explain the situation, after all if I was in a position to calming explain the problem at hand there wouldn’t be a problem to explain!

The first time I was 17 or so, I forgot who I was, where I was, everything. Complete memory loss. If that had happened at home there wouldn’t have been such a drama, it’s happened plenty of other times without authorities getting involved. Unfortunately on this occasion I was in a town centre. Eventually I was noticed, acting strangely, and the police were called who in turn, assuming a drug overdose of some kind, called an ambulance. I don’t know how long the whole episode lasted, all I know is after checking my blood and limb reflexes they sent me home with my parents (having found ID in my purse). No consideration of mental health needs at all.

The second time I was older and in the middle of an intense psychotherapy course, I was walking down the street when I experienced my first body flashback or physical flashback. I’ll not go into details, just suffice to say there was pain involved and it was unpleasant. Again an ambulance was called, gas&air given and rushed off to A&E. When the flashback ended I immediately zoned out to extreme levels, I had no idea where I was and nothing was real to me. I walked out of hospital. My partner found me wandering down the road on his way to hospital from work, he picked me up and took me back to reassure any concerned staff but we found that no one had noticed I left, even my coat was in the same place I dropped it in the middle of the floor.

More recently I was taken to hospital with a physical problem, and whilst waiting to be seen I experienced a panic attack swiftly followed by complete memory loss. They assumed I’d fallen and hit my head when no one was looking and when I came back to myself and was able to explain a little better they were unconcerned and left me to it.

There have been many other times as an inpatient, in wards after surgery for example, where my dissociation went completely unnoticed. I would be zoned out, inside I was screaming, panicking, losing my grip on reality, but because outside I seemed calm and not at all distressed the nurses didn’t notice.

These are our front line healthcare workers, the people who are trained to spot the symptoms and either diagnose and treat or refer to the relevant department in the hospital yet they seem to be dangerously lacking in mental health training, unable to spot the symptoms of a potentially dangerous mental health condition and give the necessary care, or if you like “first aid” – its simple to do, you just need to calm and reassure, take away the threat and help to ground. Once the person is centred and more self-aware you can get to the bottom of what triggered the episode and if further steps need to be taken to ensure continued safety.

It’s not the fault of the staff, it’s the lack of training they are given. It’s left to those who specialise in mental health to have the mental health training but who will refer people in need if our primary care workers can’t recognise someone in need of help?