SELF PORTRAIT - Male Holding Head in hands with stressful look

“I don’t care if you’re 3 percent or 99 percent, that’s too much,” said my brother, the emotion heavy in his voice. We were talking about the differences in the way I look at being suicidal, which I do somewhat regularly, suffering from depression and anxiety.

The sharpness in his voice really hit me hard and it drew my attention to the fact that my brother’s disturbed by the idea that I think about killing myself at all.

It’s black and white with him. Nothing but shades of grey to me.

We were having a conversation about the treatment I’m undergoing and I was trying to explain to him how my care works, which goes something like this:

I see a psychiatrist regularly, once a month when I’m not good, every three months when everything is under control. Right now, I’m at once a month.

My last visit with her, we decided to increase the dosages of two of the five medications I’m on. I take two anti-depressants, two anxiety medicines and a mood stabilizer. We increased the mood stabilizer and one of the anxiety meds.

It’s an ongoing process, medicating me for the mental illness I have. The human mind is one of the least understood parts of the body and from my perspective as a patient, treating my brain is nothing more than a game of educated guesses and trial and error.

I’ve been seeing this psychiatrist for more than two years, and I’m happy with her. I understand that she’s making informed decisions based on her diagnosis, yet I can’t shake the feeling that some of what goes on is just playing darts.

We’ve been working on my cocktail of medication for more than two years, tweaking it as I have ups and downs. I think it’s the reactivity of the whole situation that gets to me. We’re never getting ahead of my mental illness – it’s always a game of catch-up.

I have a therapist who I see every week or two. I’m also pretty satisfied with him. We have a good rapport, and he has taught me things that have proven useful.

The frustrating part about therapy is that it tends to progress and regress along with me. When I’m feeling good, we can delve into some pretty intricate and subtle things about depression and anxiety. But when I’m bad, the therapy becomes remedial and repetitive. I always know I’m there because my therapist will say something like, “Man, this is really difficult for you, isn’t it?”

Difficult, yes. But good for me? Yes, again. My therapy has opened my eyes into the way my mind works and has given methods that work for managing my depression and anxiety.

The trick is remembering and practising what I need at the times when I need it. It’s awfully hard to try to step back from ourselves and gain some perspective when we’re in the middle of a panic attack.

The psychiatrist and the therapist are my day-to-day help in dealing with my mental illness. But what happens when that’s not enough? Where do I turn when I’m having suicidal impulses, when I’m in a deep depression or when my anxiety’s so bad that it’s disrupting my functioning in everyday life?

Then it’s the hospital. A psychiatric facility. And there are two options when it comes to the hospital – inpatient and outpatient. Both are intensive programs, both involve multiple therapeutic sessions a day. The biggest difference is where you sleep.

More recently, just eight months ago, I spent a week as an inpatient at the Pennsylvania Psychiatric Institute. I was having suicidal impulses that were rapidly intensifying and I was afraid I couldn’t keep myself safe from myself.

In that case, being an inpatient was what I needed. A place where I could feel safe, the hospital provided me with a place where I could concentrate on getting better. Three to five therapy sessions or groups a day, and a daily visit with a psychiatrist. My time at the hospital gave me a chance to reset myself and gain some much needed perspective.

To me, the hospital seemed to be an appropriate solution for the problems I was having at the time. But what about now?

My anxiety is disruptive to my daily life. I recently left my third job in sixteen months due to mental illness. So I’m not making any money. Life is pretty terrifying to me right now. I get through my days managing how I feel, so as to not make myself any worse. I’m suicidal at times, but nothing like I was before. So do I need the hospital?

My psychiatrist suggested it as an option for me if the tweaks we made to my medications don’t work. But it seems like such a drastic step to me.

This is where our mental health system fails me. There is no in-between. You’re either in or you’re not. Psychiatrist appointments and therapy sessions just don’t become available when you need them. It’s not like your family doctor where you can call in and get an appointment in the same day if you wake up feeling bad. That just doesn’t happen in mental health. There’s no urgency to the system.

Maybe that’s what got my brother so upset when I was talking to him about my treatment. He recognized that I needed urgent and intensive health care, but it’s just not available like that.

I can’t always get what I need when I need it. And that makes my otherwise good mental health care seem awfully inadequate.

Jason Large,

Daily Zen.

Author Bio – Jason has suffered from depression and anxiety for over twenty years. He writes to bring light to mental illness and the ways that those who suffer from mental illness can work to improve their lives. You can reach Jason via Facebook or at