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What to Expect From a Mental Health Partial Hospitalization Program

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I wasn’t quite feeling myself for about eight months. So I hid. So I did whatever it took to conceal my true self. I hid to protect my family and friends. I hid to protect my own façade. I hid from mental illness stigma. Until I couldn’t hide anymore.

After spending three days in a psychiatric center — for depression, anxiety and suicidal ideation — my husband was told I could be released if I agreed to enter the Partial Hospitalization Program (PHP). If I didn’t agree, they would have admitted me for an additional five days. The medical bills were adding up quickly and the psych ward was the most intimidating place I’ve ever been. I agreed to attend the program simply to flee the cold hospital walls and to get my pajama-strings back.

PHP is intensive treatment that runs eight hours a day in a highly structured environment that includes mental health education, group and individual therapy and care coordination. At the time, I had no idea it would forever change my life.

Your first couple days will be the hardest, but it’ll get easier. My first day was brutal. Between intrusive mental assessments and treatment planning, I was thrown in and out of group therapy in a room full of strangers pouring their hearts onto the round table. Arms crossed, I sat there thinking, “These people have real problems. They’re probably wondering what I have to cry about.” I have a decent job, a husband, a home and a lot more to be grateful for, so I didn’t believe I “deserved” to be there. I didn’t speak once during my first two days of treatment. As an extremely reserved person, I definitely didn’t understand how opening up to strangers about my struggles, trauma and feelings would help me recover. The truth is, however, anyone struggling with symptoms of PTSD, anxiety and/or depression can benefit from attending the program if s/he works hard and is open to changing.

You must walk into the program with an open mind. During the first two days, listening to my peers, I experienced a sense of relief in knowing I was not alone in grappling with mental health issues. In a society in which you are expected to always say, “I’m well” when asked how you are doing, I couldn’t believe how open these people were in discussing their personal struggles and darkest emotions. My peers offered examples of the effective skills they used to overcome their fears. This helped me want to overcome my own fears and struggles. They each helped me be brave enough to even try. This is the day I decided to trust the process, throw myself into the work and shared my very personal story with the group. The support and feedback I received was astonishing. One woman made me a bracelet the next day and said my story made her feel less alone. (I wore that “just breathe” bracelet for the remainder of treatment.) This is what group therapy is about — realizing that we are in this together. This insight helped me find my voice again and I began building upon these small victories I was experiencing.

You will face your secrets and fears head on—publicly and privately. I became far more anxious before I began to feel any better. Sounds counterproductive, but now I reflect that it is necessary to move forward. Each therapist’s approach was different. From focusing on meditation to facing trauma to openly sharing your negative self-talk, each technique brought interesting and difficult perspectives and emotions to the surface. Some days you will be triggered and will shut down in therapy, sitting in silence—this is OK, as long as you try again the next day. Other days you will feel good and proud of yourself. Keep showing up. This will get easier and will be worthwhile.

You will be given a lot of homework—be sure to do it. In group, we learned and discussed a plethora of Cognitive Behavioral Therapy (CBT) theories and connected them to our daily experiences. Simply knowing that what you are experiencing is a highly researched topic (i.e. lots of other people go through it!) and being cognizant of the term when it is taking place, is extremely helpful.

Whether the homework is practicing opposite action, evaluating your values and goals, practicing assertive communication and/or meditating, it is important that you complete each assignment thoughtfully. This isn’t an easy task, I know. It will make you re-evaluate your entire life and everyone in it, but this is an important part of the process of fully understanding what you are experiencing and who you want to become.

Before PHP, I thought of myself as generally self-aware; however, the activities we completed acted as a wake-up call — I wasn’t as self-aware as I had thought. Digging deep helped me realize I was just a girl who had been twisting and bending myself for everyone to love me louder than I could hate myself. The education, peer and professional support and homework PHP provided me with gave me the awareness and power to change the things I was unhappy with.

Today I smile because I’ve finally come to accept that it’s OK to be an average person in a quiet and honest way. More than OK actually. I’m not close to perfect or exceptional or exactly where I envisioned myself to be, but PHP helped me realize I am worthy and I’m doing what I can with what I have. You see, we don’t have to slay the dragons of the world every single day. We don’t have to do and crush all the things. Taking time for ourselves is OK and necessary, too. I smile because I haven’t felt this good in weeks, months — maybe even years. I smile because of the wonderful people who told me I’m good enough when I didn’t believe it to be true and wanted to give up on myself last year. I smile because I know I will never return to the hospital for mental health issues again because of the coping skills I learned in PHP.

If you struggle with depression, anxiety and/or any other mental illness, I see you. I love you. We might lose some days, but we’ll never lose the fight if we wake up. Survive. Half-smile until it’s real. We’ll get better one day at a time with the help of others. Keep fighting the good fight.

Unsplash photo via Samuel Scalzo

Originally published: July 5, 2019
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