N.N.

A photo of N.N. on a hike near her home.

Photo by N.N.’s mother

I’m a social but studious 20-year-old studying health sciences in Toronto. I’m the oldest of 3 siblings. I was a competitive figure skater and I loved to coach other kids.

I was 9 when I was first formally diagnosed with anxiety. I think I had anxiety much earlier, but I was too young to understand what I was experiencing.

My first admission to hospital was in grade 12. I hadn’t been sleeping. I ditched all my classes, was very impulsive and would do things like run to the CN Tower from midtown and back in the middle of the day. But I also had severe depression with suicidal ideation. It’s a dangerous combination when you have the impulsiveness to act on your thoughts. My family was nervous to leave me alone. My mom slept in bed with me at night. I eventually went to the emergency department and it was a long wait. I was told I couldn’t be admitted because I had gone to the wrong hospital. I was under 18 and they didn’t have adolescent care. But they also said I did not need admission and was safe to go home with some adjustments to my medication. I tried to manage at home but ended up in a different emergency department 2 days later, from which I was admitted to hospital. My discharge diagnosis was a mixed episode of hypomania and depression caused by antidepressants.

My second admission was last fall semester. It started with not being able to focus. Then came the lack of sleep, the 10 km runs and the walks in the middle of the night. This time I also had thoughts that people were conspiring against me, including my family and friends. That I was being watched. I emailed my psychiatrist, who immediately responded to tell me to go to the emergency department. We waited 12 hours. When the psychiatry team saw me, they said I was safe to be discharged. I felt abandoned.

I don’t remember much from when we got home, but I have an email chain between my mom, myself and my psychiatrist. My perception of reality deteriorated. I started hearing voices. I tried to run away, and I refused to take my medication. My psychiatrist was trying to give me inpatient-level care over Zoom. I remember phone calls at midnight with her trying to bring me back to reality from my delusions. Within a week, I returned to the emergency department and was admitted to hospital. I now have a diagnosis of bipolar disorder.

My journey to wellness might have been easier had I been admitted to hospital within a few days of the start of my psychosis, rather than after a week. I don’t think the strategy of waiting for people with mental illness to be at the peak of their crisis to receive care is the right approach. I think early intervention is key to success.