The morning everything would change was clear and bright. It was mid-summer, and everyone was glad of the nice weather. Most people were out making plans, but one person remained closed in the small guest house he lived in. Jayden Wilcox woke this day with a bit of a headache and feeling inexplicably sad. Of course, that sadness was an old companion, and he was used to it; today was different, though.
Immediately upon waking, he was struck by how fake the world around him felt. It was almost like he was outside the world watching. The sensation was surreal in the extreme, and scary. He struggled daily with the monster that slept beneath his skin, but today, it felt like that monster would consume him from the inside out. For years, this had been a part of his life. He had never been without this inextricable sadness that sat in his chest every day. He had gotten used to it and even counted on it being there. Still, this morning was different than every other morning, and he was struggling to deal with that.
His eyes settled on a DVD as he left his room. His mind, unbidden, decided that if he broke that DVD in half, he could use it to cut open his wrists. He furiously shook that thought away. Where did that come from? He didn't usually think of killing himself, well, not all the time.
It was true, on occasion, thoughts of death, or really, just the idea of not existing anymore, came to mind. It wasn't really a desire to kill himself so much as a desire to not be. He couldn't even say he wished he was never born; it wasn't like that. He'd never made a plan before, though the thought of harming himself had come up many times. Sometimes he wondered what it would be like to do things that would hurt, just so he could stop feeling numb. Those days were hard, but this strange sensation of actually seeing ways to end his life was even harder.
He found himself in the kitchen, holding one of the knives from the butcher's block and staring at it. His mind again wandered into that place where he didn't want it to go. How easy it would be just to cut... No, he thought as he sheathed the knife back in the block. This wasn't good; he couldn't stop these thoughts today. He shook it away again and sat down on the sofa, his brain shutting down for a little while and spacing out. Today was terrible; he hadn't had a day where he disassociated so severely in a very long time. That, combined with his mind finding ways to kill himself, made him worry.
He skipped breakfast altogether, not wanting to go back in the kitchen out of fear of the easy access to the knives that were in there. He glanced at his phone lying on the table and wondered if he should call his adopted mother. He would be seeing her soon, so he rejected the idea. He could handle this. He was sure he could because he'd always handled these moments before.
He found himself in the garden and felt like he was watching his body move independently with no thought. He was holding the small rake and staring at the points on the prongs. It would be so easy to fall... He put it down and swallowed against the building ball in his throat. It wasn't stopping, and he would do something to make his adopted parents sad; he couldn't do that. He went back inside and changed into something comfortable. He had an idea of how this day was going to go now, and he figured that he should take steps to ensure his safety.
He went to the main house to find Ella and Bradley, his adopted parents, in the kitchen.
"Sweetie, what's wrong?" Ella asked immediately, seeing the distraught look on Jayden's face.
"I think I need to check myself into the hospital. I'm having a hard day and I don't think I can handle it on my own anymore," he answered and smiled sadly at her.
She looked at him curiously. "What do you mean by a 'hard day?'" she asked, frowning.
Jayden knew she meant well, but he didn't know how to answer that. "The sadness is eating me alive, Ella," he decided to say finally. "I've been seeing ways to stop living, and it's scaring me."
She nodded and looked at Bradley. "Will you drive him?"
"Of course," the other man answered. "Come, son, I'll take you there."
"Thank you," Jayden answered flatly. He was feeling that unreal sensation again. It was so strong today for some reason. He guessed it wasn't being weak to ask for help when needed; he needed it today. "Please take care of the plants while I'm gone."
"Of course, dear," Ella said before she gave him a tight hug and let him go.
Jayden quietly followed Bradley to their car and got into the passenger seat. He buckled himself in mechanically and then stared out the window as his adopted father drove him to the main hospital in their town. He didn't notice the passage of time or the passage of the world around him. He was jolted out of his headspace when Bradley shook his shoulder.
"We're here. Do you want me to go in with you?" Bradley asked.
"No, I'm fine from here. I'll go in the ER and tell them what's wrong. I'll call you when I know what they will do with me. I guess if you want to wait here, you can, but really, I think they'll admit me." He felt strange talking about himself. It was as if he didn't exist and was talking about someone else.
He got out of the car and waved as Bradley drove off. For a moment, he rethought what he was doing. Would checking himself into a psych ward really do something to help stop these intrusive thoughts he kept having? They would put him on medicine, which he had long avoided. He needed help, though. Maybe it was time to take that step that he'd always feared. He knew it wasn't true, but he had this idea in his head that taking medicine meant he was weak and couldn't handle things on his own.
He didn't want to make Ella cry. She had been so kind to take him in when he was in such a bad place with his mother and stepfather. He rubbed his jaw in remembered pain and shuddered. He hated to imagine where he'd be if it weren't for Ella and Bradley. He swallowed hard and walked through the doors.
He approached the front desk and saw several nurses sitting there. He hadn't thought about what he was supposed to say to them. What sort of thing did one tell someone when they came in like this? After all, he was willingly putting himself here, but he knew they had to have a reason to admit him. If he didn't tell them what was going on, they'd just send him on his way. He didn't want that to happen.
"What can we do for you?" one of the nurses, a woman with gray hair tied in a bun and clear bright blue eyes behind wire framed glasses, asked him.
"Um, I think I need to be checked into the psychiatric ward. I've been struggling with depression, and today, all I can think about is ways to kill myself," he said with a detachment to the statement. Again, it was like he was talking about a different person.
"Okay, fill out this triage form, and we'll get you in line to see someone," she said and handed a paper to him.
He carefully filled out his name, address, phone, and emergency contact, and he paused when he got to the reason for the visit. He swallowed and put "suicidal thoughts" down and left it at that. He handed her the paper and sat in the waiting area. He felt that same sensation of being outside his body and the world seeming fake. He crossed his arms and tried to concentrate on the people around him. There was a little boy with an earache screaming off and on. Thankfully, he was called back quickly. He saw someone with their arm cradled to their chest and someone holding an icepack to his head. He lost track of time then and felt himself detach from the world again. He had no idea how much time passed, but the others came and went around him, and he tried to watch them but found himself staring into the distance again, feeling like he was outside his body watching it move on its own.
"Wilcox," he heard and stood up automatically. Another nurse was standing at the door to the ER area. He took in the fact she was wearing scrubs that had spring flowers on them. He thought it a little late in the season since it was already into summer, but he realized it didn't matter.
He approached her and felt strange, as though he were walking outside his body again. He watched as he was weighed and led to a room with nothing except a bed and a built-in TV. The nurse showed him the control to operate the bed and the TV and told him that someone would be in to see him shortly. He watched her leave and realized this must be the room specifically for people like him. The front had all windows, and the door was also slide to open. He found himself going through the channels on the TV several times, never stopping on a show. Finally, he just turned it off with a sigh. He leaned back in the bed and closed his eyes.
"Mr. Wilcox?" he heard after a while. He lifted his head to see a woman in a doctor's coat.
"Yeah?" he said with a sigh.
"I'm Dr. Manchester. I'm the ER psychiatric consultant. I hear you've been having a tough time. Tell me what's going on." She was taller with long brown hair and piercing hazel eyes. She wore a tan pantsuit with a white doctor's coat over it.
"I'm feeling like the world isn't real," he started, sitting up in the bed a little straighter. "Like things are just imaginary, and I keep spacing out. Which that's not all that unusual; I've had that happen before. The reason I came in today is because I kept thinking of how to kill myself with different things. I knew it was wrong, but I couldn't help the thoughts."
"Have you had these thoughts before?" she asked, jotting down something on her clipboard.
"Not like this. I mean, I've struggled with depression since I was a child, so I'm used to that; this was different and scary."
"You said you wanted to be in the psychiatric ward when you talked to the nurse," she pointed out.
"It is the only thing I can think of to keep myself safe. I don't want to hurt my parents by doing something to myself. I just can't be sure I won't listen to these thoughts and do something drastic," he explained.
"So, you have a support network?" she asked, still making notes.
"Yeah, I have my parents. Well, grandparents, really, but they adopted me so I'm legally their child. My father dropped me off here today," he said and looked away from her, already feeling the sensation of being distanced from himself. He swallowed hard and brought himself back to the interaction with her. It was a struggle though, to get his mind to cooperate with him.
"Does your depression seem to affect the way you interact with them?" she asked.
"Ella worries about me, but I spend a lot of time alone even so. I don't want to be around anyone. I live on their property in the guest house."
She nodded. "Tell me, how old are you?"
"Twenty-two," he said.
"And did you go to college at all?" she asked.
This question made him slightly uncomfortable, so he shifted on the bed. "Well, I would have, but I just couldn't bring myself to sit through classes. My mind in high school had a tendency to wander a lot and I found it hard to concentrate. I managed to make it through high school classes, but it was rough from time to time. It wasn't a sure thing that I'd graduate, but I did finally do so. I could go to the local college, but I just don't know that I could handle it with the way I struggle with keeping my mind on one thing."
She made a couple notes. "I notice your discomfort at the question. Is school something you want to do?"
"Well, yeah, it is, for sure. I really want to study botany and learn to care for plants, but I just can't seem to do anything right, you know? I just don't think I'd do a very good job." He frowned a bit because that really did bother him.
"Do you work?" she asked.
He shook his head. "Ella and Bradley take care of everything."
The doctor looked up. "What do you mean? They pay for your bills?"
"Ah yeah, see, Bradley is an inventor. Well, he used to be. He still tinkers around in his shop now and then, but he invented a piece of farm equipment when he was younger. He gets money from that patent and is able to pay for anything, really. We have the big main house, with the guesthouse that I live in, and the only thing he never got was the pool, though he could afford it. My guesthouse would have to go, though, to have room to put in a pool." He swallowed as he thought of how he was stopping his adopted parents from doing something they wanted to do just by existing in their life. He shook his head. "Ah, sorry, my mind wandered for a moment. But he can pay for me to be here, if that's what you're worried about."
She smiled. "No, I don't deal with the financial side of the hospital, so that's not an issue here. I just deal with intakes. Can you tell me what you expect to happen today?"
Jayden swallowed, thinking on that question. "I was hoping to start some kind of medicine. I've never taken any, really I've avoided going to the doctor because I didn't want medicine, but I guess I need to do something because this is getting to me more than I've admitted before." He paused to take a deep breath. "I'm just ready to feel normal, even though I have no idea what normal feels like."
She made a few more notes and stood up from the stool she was sitting on. Jayden watched her curiously, wondering what exactly she was writing on that notepad of hers.
"I think you qualify to be admitted and are willing to seek help. That's a good thing. I'll send someone from the psychiatric floor to take you to a room. It shouldn't be long. Then I'll be up to visit with you some more and get to know you." She smiled at him and turned to leave.
"Thank you," Jayden said with a half-hearted smile himself.
He settled into the bed and looked through the TV shows again, finding nothing he was even remotely interested in. He never watched TV very often, even though his parents paid for all the channels through the cable company as well as good internet service. He put down the remote and rested his head on the pillows to wait and see how long it took for someone to come get him and take him to the psychiatric ward. He had almost fallen asleep when he heard someone in the room. He opened his eyes to see a male nurse standing by the bed. He noticed he wore pale yellow scrubs.
"Mr. Wilcox, I'm here to take you to a room," he said. This guy was shorter than the doctor, with dark hair and eyes. "I'm Charles."
Jayden got up and followed the nurse, walking close behind him to avoid getting lost. They went to the elevator and up to the second floor. He turned into a locked door, punched a code, and led Jayden inside. Once inside, the nurse got a set of clothes and handed them to Jayden.
"Go ahead and change in this room here, and we'll put everything you have with you in a locker. You can't have any electronics, so your phone has to stay locked up. There are some activities inside the ward that you can do."
Jayden nodded, stopping to send a quick text to Ella saying he'd been admitted, and he'd call when he could. He went into the bathroom, changed into the scrubs-looking outfit, and handed over all his possessions. He only had his wallet and phone, so there wasn't much to put away aside from his clothes. Once he was changed, the nurse led him through another set of locked doors and down past a nurse's station into a hallway to a room with the number 234 on it.
"Is there anything you need now?" he asked.
"No, I'm fine like this," Jayden said with a soft smile.
"Dr. Manchester will be down to see you soon," the nurse said, turning and leaving.
Jayden was now alone with his thoughts as he sat on the plain bed. There was a TV behind plexiglass and another remote like the one in the ER. He again tried to find something to watch but was disappointed again. It wasn't like much had changed in the last couple of hours. He heard a knock and looked up to see Dr. Manchester in the doorway.
"Hi, doctor," he said as she came in and sat down on a stool that was in the corner.
"Shall we get to know each other?" she said and held the same clipboard as before.
"What do you want me to talk about?" he asked, sitting up and turning the TV off. He thought they'd had a good talk in the ER, so he wasn't sure what else she was going to want to know.
"Why don't you start with when you started having depression problems. You said it started when you were a child."
"Um, yeah. My mother and stepfather raised me until I was ten. My mom didn't do much with me, and my stepdad was abusive. He liked to hit both my mom and me, but she never did anything about it."
"How did you come to live with your grandparents?" she continued when he stopped.
"I was adopted when I was ten by them. They were the parents of my birth father. My birth father never acknowledged me, choosing his other son, Michael, as his heir. I have other half-brothers through him, including the one I talk to named Corey. He stays in his house because he has severe social anxiety." He paused to gauge whether he should continue or not. He swallowed and went ahead. "I think I was eight or nine when I started to feel lost and disconnected from the world now and then."
"When do you remember the abuse starting?" Dr. Manchester asked, looking at him instead of her clipboard.
Jayden thought. "As long as I can remember, really. My stepfather married my mother when I was a baby, mostly because she divorced my birth father right after I was born. He was cheating on her, and she left him with me. He didn't care and left her with nothing. He had to pay child support, of course, which was why she never worked. From then on, my stepfather was in my life. I guess she married him to help with me, but he was the type that hated me for not being his. He also drank, but so did my mom."
"So, she was neglecting you?" she said.
Jayden nodded. "Yeah, I mean, I would go to school on the bus each day, but I had to get myself up and try to find something to eat. We were pretty poor because my stepfather was always between jobs. He worked construction, and he never seemed to keep a steady job for long. I got food at school, but sometimes there just was nothing in the house to eat and I didn't know how to do anything yet. And when there was no money to be had, things were always worse. Though, there seemed to always be money enough for alcohol and cigarettes. I don't know how that worked," he said, looking at his arms where the round scars were somewhat visible.
"How did your grandparents find out about your situation?" she asked, jotting down a couple notes.
Now, Jayden did grow a bit more uncomfortable. "Ah, there was a bad incident. My stepfather broke my arm. I don't remember what triggered it, but he'd been drunk, and just had a violent reaction to me. I had a broken arm, along with bruises and burns, and my mom figured I needed to see a doctor. She wouldn't take me to the ER, but she did take me to the doctor, I remember that. It took two days, and I was in so much pain I just cried all the time. Which led to me getting yelled at and hit again." He licked his lips dryly. "And, uh, it ended up the doctor called the authorities on me because of the condition I was in. I guess I was way underweight, and with all the physical damage, he could tell what was happening."
Jayden paused. "Ah, do you have any water?" he asked.
"Sure, hold on," she said, stepping out in the hallway for a moment, calling to a nurse. A few moments later she came back in holding a foam cup and handed it to Jayden. He sipped it, soothing his throat for a moment, and giving him some time to settle his racing heart. He hated talking about that time in his life. It made him sadder than he already was.
"Um, so after that, I went to a house with a lot of other kids. I remember a woman came and talked to me, asked me a bunch of questions. I wouldn't talk at first because I was scared of what my stepfather would do when I got back home. The woman, though, managed to convince me I was safe, so I told her everything. I told her about the abuse, about the neglect, all of it. Then, some time passed, and one day after a couple weeks, this older couple came to visit me. It was Ella and Bradley, and they told me they wanted me to come live with them. I was happy, but I couldn't show it. It was weird, but they didn't seem to mind."
"So, when your grandparents adopted you, your life improved?"
"Tons. Ella and Bradley are good people. They were in their fifties when I was adopted; I'm actually close in age to their other grandson Caleb. It was about twelve years ago now since I started living with them. I didn't want to move out when I got out of high school, so they offered to let me stay in their guest house. That way, I can have my privacy, but I'm nearby." Jayden stopped again and sighed. "I try not to be sad or depressed because it worries them."
The doctor nodded, still making notes. "It sounds like they love you very much to care so much. But you need to know that it is beyond your control to be depressed like this. Do you know what neurotransmitters are?" she asked, as she made some more notes.
Jayden shook his head. "No, what's that?"
"They're the chemical messengers in your brain. When people are depressed, one of these neurotransmitters, serotonin, is out of sync with what the brain needs. So, we prescribe medications called SSRIs. That stands for Selective Serotonin Reuptake Inhibitors. They make it so that you have the right amount of serotonin available to your brain, which keeps you from being depresses." She smiled and laid the clipboard down in her lap.
"I will prescribe an anti-depressant, one of those SSRI medications. I want you to start while you're here. It won't really take effect for several weeks, but the sooner you start, the better. I'm also going to put you on another medication that boosts the effectiveness of the other one. It will work pretty fast, but you might not notice much of a difference at first." She stood up and smiled at him. "I also want you to attend groups each day. I'll see you every other day to see how you are doing. Expect to be here at least a week."
"Can I call my family to tell them how long I'll be in here?" he asked, suddenly worried because he knew Ella wouldn't relax until she knew what was going on.
"There's a community phone in the common room. You can use that one anytime you wish. You don't have to stay in here; in fact, we recommend you go out and meet some of the other patients. You'll have your meals brought to you. It won't be long until lunch. If you need anything, ask one of the nurses."
Jayden nodded, feeling like he was making so much imposition on so many people. "Alright, thank you."
He watched her leave and lay on the bed to stare at the ceiling. He thought a lot about what she said, especially about the medications. Maybe it wasn't all his fault after all, if there was something off in his brain. He certainly liked that idea a lot better than just thinking he was messed up from everything that happened to him as a child. He looked around the room again and smiled a little bit because nothing made him think bad thoughts. At least here, there was nothing he could hurt himself with.