SMILE (Part 4) – Or Read my Official Psych Report


Name: Sundance, Jennifer Lennon
DOB: 06/30/75
Admit Date: 12/31/2000

IDENTIFICATION: The patient is a 25 year old female who is admitted to the inpatient psychiatric until for a 72-hour hold.

HISTORY OF PRESENT ILLNESS: Patients states she has been increasingly depressed and under stress, having increased mood swings as well as decreased need for sleep and increased nightmares. She reports anxiety, hopeless feelings, angry feelings. She had a fight with her husband of 5 ½ years with whom she is currently separated from. She states after the fight her husband took her children (Daughter 5, Son 2) and left and while she was at home she impulsively overdosed on bottle of Trazadone. Patient describes constant suicidal ideation, but states, “I’d never acted on anything since I was a teenager. Before now.”

FAMILY, PSYCHIATRIC, AND CD HISTORY: Patient wonders if her mother had a history of bipolar affective disease. She reports rampant chemical dependency through her entire family.

MENTAL STATUS EXAMINATION: Mood is both hyper and depressed. Affect is anxious. There is no behavior evident at the time of interview of acute suicidal or homicidal ideation or acute psychotic delusional or paranoid symptoms. Thought process, however, appears quite accelerated. Patient appears hypo-manic overall. Judgment and insight appear impaired secondary to patient’s extreme mood lability.

1) Bipolar affective disease.
2) Anxiety disorder.
3) Rule out major depressive disorder.
4) Cocaine abuse.


PLAN: 1) Continue patient on hold for close, further observation.
2) Code I Privileges.
3) Initiate Topamax for mood lability.
4) Initiate Seroquel for patient’s racing thoughts and mood symptoms.


It’s Saturday morning. The curly-haired girl thrusts her hand out at me to shake. “Names Miranda, and trust me, weekends suck. We only have groups during the week, so the weekends are all about old VHS movies and visitors. If you’re lucky enough to have some.”

Instead of visitors, knuckles constantly rap against my bedroom door. There are nurses with carts and blood draws, physicals and stethoscopes listening to my lungs, poking my abdomen, asking me if it hurts, where it hurts. They take my blood pressure, make me pee in a cup with the door open. I feel like I’m in a fish tank, everyone watching me swim around, nowhere to hide, not even a mossy, sunken toy ship anchored to the bottom of pink and blue stones.

Dr. Lopez finally comes in. He looks like he belongs on the cover of a cheap romance novel, long flowing hair, a fitted lab coat and pressed dress pants. He wears a shiny watch, has shinier, white teeth. He’s a soap opera doctor, with a deep, rich voice.

“Hey there,” he says and pulls out a file folder. “I have your chart here. Dr. Coolidge told me what happened. The ER doctor. I don’t think I need to ask you the same questions. I’m certain you’ve already answered them over and over again. But I’m here to see how I can help you.”

I feel like I’m in a movie, some low-budget after school special about a crazy, suicidal girl who is saved by a handsome, understanding doctor with a sexy last name: LOPEZ.

“I want to help you. No one comes in here unless they need to. I understand that. But I see you have a couple of kids, and I am sure they need their mother. That’s my job. To get you back home.”

I start to cry. I don’t know where home is, a place I’ve been trying to find my whole life. And I remember I’m a mother, a fact I’d forgotten over the past few months between nightmares and hateful thoughts and drugs. All I’d do is shuffle them around, waiting for Shen to take them on his nights so I could run out and drink too much at bars that all looked the same, with people who all looked the same. Sometimes, I’d walk home alone at night through deserted streets with passed out bums and shady crack heads who always said, “hey, hey, hey, got a light?” And no one tried to fuck with me because I must have looked crazy, wild eyes and tensed muscles that felt like they could snap at any moment. I walked back to my house in the hood, counted my steps, anything to  keep the looping thoughts from being too loud: you’re a failure. A loser. You’re crazy. Too crazy. Just end it all, why don’t ya? No one loves you. No one would miss you.

“It says here that you’ve been given a potential diagnosis of Bipolar I. When was that?” He flips through the chart and uses his finger to trace the paragraphs that describe earlier incidents.

“Yea, some shrink in the burbs thought it might be that. I don’t know. She didn’t seem to really care, just threw me on some pills that made me sleepy and fat. It was a year and a half ago,” I say. I remember the meeting – I wore a floppy black hat, a black and white formal dress, and bright red lipstick. I thought dressing up would somehow get my point across, somehow make the shrink see that what was happening to my head wasn’t “situational” or “normal shifts in mood.”

“Let’s talk mania. You ever feel like you’re on top of the world, as if everything is presented for your viewing, for your pleasure?”

“You mean, do I think at times I’m brilliant and ideas are exploding in my head like fireworks? Do I start to see patterns in people and situations? Sometimes, life seems to unfold right in front of me, and I think, wow, this living is so fucking easy and fun and I can’t believe a few weeks ago I couldn’t get out of bed,” I say. I think of mad moments of repainting the house in bright colors, buying new furniture at garage sales, hanging curtains until two in the morning, trying to change the unsettled feeling that came over the house. I think of writing letters late into the night to old friends and my x-boyfriend who went to prison when we were in high school. For nine months, I wrote him ten page letters almost daily, revealing what I could not reveal to the rest of the world in cursive, in pretty words that painted pictures of ugliness: I was losing my mind.

“And I see a history of depression and past suicide attempts when you were a teen. When did that start?” He has a pen in his hand and it’s scratching the paper furiously. Maybe he’s manic, too.

“Ever since I can remember,” I say. I see myself with curled hair and white buckle shoes, wearing a green and white checked dress. I’m small, still in training underwear, and I’m in my brother’s room with a toy record player. It has six plastic records, thick and in solid, pastel colors with deep grooves. It plays short instrumental songs and nursery rhymes.  The record is purple and chipped and every time it ends I lift the tonearm and drop it at the beginning. I don’t know the words of the song, don’t know even where it’s from, but this feeling wells up in my throat that stings and starts to choke me, and my body shakes. And all I remember is how the curtains were drawn but the sun struggled to shine in anyway as I told my small self that I wished I would die.

“Increased compulsion for pleasurable activities despite consequences? Overspending? Hypersexuality? I see you had an affair a few years back, presumably during a manic phase. Do I have that correct? And drug use that started, what, six months ago? Cocaine? Tell me about that.” He’s listing my indiscretions, my mistakes but the look in his brown eyes is so gentle and soft I don’t mind.

“I don’t know. It all started to slide. Was fun at first, ya know? I’d go to parties and had new friends and people would laugh at my stupid stories and antics. I mean, I was off the wall, but people seemed to enjoy it. But then, I felt like a puppet putting on a show, someone pulling my strings and I’d dance and sing and perform. But, really, the whole time….” I am searching for words, looking at the blank walls as if they’ll appear, explain the complicated thoughts racing inside my head.

“The whole time you’re smiling, you want to blow your brains out?”

“Exactly! Exactly!” I jump up from my chair. I’m smiling so big I think my face will split. Dr. Lopez might save me after all. Maybe.


10 Responses to “SMILE (Part 4) – Or Read my Official Psych Report”

  1. You’re killing me, you’re so good. Don’t you dare kill yourself.

  2. Another great section. You’ve got the balance just right – the truth of sadness, and shadow, but then lighter moments like that description of the doctor when he comes in. And that line: “The whole time you’re smiling, you want to blow your brains out?” You’ve built up to it so well that I feel the same powerful relief.

  3. 6 Rebecca

    I really struggle to find good books that interest me, that being said……
    Instantly, I was captivated, connected, and wanting more.
    I’d like to see the other parts to your story, how do I find them? I’m also excited to here further writings. You really have a good thing started.

  4. 9 pinklightsabre

    I really enjoyed – rare, that I’m left speechless (and rarer still that I don’t think I have something witty to say in response), but for now I just want to say thanks for sharing. You go, girl!

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