Spotlight on mental health: Trish's story
Editor's note: This story is part of a RiverTown Multimedia spotlight on mental health. Find the rest of the series here.
On a good day, Trish Nolan never would have met the man.
It began as a group of four. They would sit around and talk regularly, usually until around 2 a.m., as music from the employee lounge permeated the halls.
He kissed her behind the scenes when he thought no one was looking. He lied to her about his alcoholism. He lied to her about his marriage. He got her phone number. Then he showed up at her apartment and raped her.
"It was like," Nolan paused, "going into hell."
Days earlier, Nolan had sat handcuffed and shivering in the back of a squad car parked outside a Twin Cities hospital.
She didn't commit a crime and she suffered no physical ailment.
READ MORE: Mental health glossary
"You get thrown in the back seat, that plastic seat in the back, which is hard and you are, in essence, treated like you've done something wrong. And I was freezing, it was cold, it was in winter and I was just freezing to death because I just had my home clothes on. I didn't even have a coat, because they just take you, they don't —," Nolan stopped, sat back momentarily, her eyes focused loosely on the picture window directly across from her. "It's really shaming and degrading. At least for me it was."
All of this happened because Trish Nolan is bipolar.
— "It doesn't distinguish between good memories and bad memories"
Nolan was born and raised in Stillwater, Minn. She graduated from the University of Minnesota with a degree in art history and French. She got married and moved to Albert Lea, Minn., where her husband taught, to begin what would be a 16-year marriage.
She took trips to Europe with a girlfriend. She struggled through her dysfunctional marriage. She cut herself. She saw a therapist. She lived through many unsuccessful suicide attempts. She laid curled up in a ball on her bedroom floor, unable to move, her dog the sole companion by her side.
Eventually, she sought psychiatric care in Owatonna in the late 1990s, where doctors initially diagnosed her with depression. She was given electroconvulsive therapy, a modernized version of shock treatment.
As a result, she no longer remembers some of the darkest moments of her marriage. She also no longer remembers her trips to Europe.
The majority of those diagnosed with bipolar disorder begin to show symptoms in their teens. Nolan started early.
"For me, it was when I was about 8 years old," she said. "I started having mood disorders and I even had suicidal ideations at that age — which is not normal."
After years of uncertainty — of which the final two were spent effectively, albeit unintentionally erasing memories through electroconvulsive therapy — Nolan's doctor diagnosed her with bipolar.
Along with her bipolar disorder, Nolan has symptoms of rapid cycling.
According to the Treatment Advocacy Center, rapid cycling is defined as four or more manic, hypomanic or depressive episodes in any 12-month period and can develop in as many as half the people with bipolar disorder during their illness.
Nolan said she has cycled multiple times within a day.
Even more rare within the bipolar spectrum is mixed mania or mixed states, where an individual simultaneously suffers mania and depression.
In 2016, Nolan experienced mixed mania for the first time. She was hospitalized for a total of 11 weeks that year.
— "We forget that the brain is an organ and it's a part of our body and doesn't always run properly"
Once a week, a nurse comes to help Nolan organize her pill box. She makes two trips to the pharmacy each week to order and pick up pills.
She takes roughly five different medications each day for symptoms of anxiety, depression, mania, mixed mania and Rheumatoid arthritis.
A new drug, alongside the rest, Nolan said, has allowed her to remain in her home since her mixed mania manifested.
"And I've been on practically every medication in this book for bipolar disorder," Nolan said, the nuanced complexity of her diagnosis regularly revealing new layers. "It's not just finding the right med, it's finding the right dosage with that."
Each day, on a calendar next to the couch, Nolan charts her mood, 1 (depressed) through 10 (manic). If she feels stable, anywhere between a 4 and 6. A preventative call to her doctor is placed at 7 as well as 3.
Each part of Nolan's crisis plan was carefully crafted, with the hope of keeping her at home, her own life lessons lending their weight. For example, she refuses treatment at Twin Cities hospitals and will be treated only at the 10-bed Owatonna facility.
— "There's just so much ignorance about all addiction and mental health"
Nearly a decade ago, new to the world of her own diagnosis, manic and suicidal, Nolan found herself on the phone with a crisis line worker who called 911.
Minutes later, a police officer was at her door.
She was handcuffed, put in the backseat of a squad car and driven to a Twin Cities hospital, where she sat cold and confused, no choice but to wait for the officer to finish his phone call.
"And I remember waiting and waiting and it seemed like an eternity before he finally hung up," Nolan said. "We are not criminals. We are not criminals and yet, when I was taken to (the hospital) that time by the police officer, I was treated like a criminal."
Her admittance to the mental health unit was through the emergency room, a procedure perpetually stressed as more and more individuals have nowhere to turn for treatment.
On average, according to Minnesota Hospitals Association, Minnesota hospitals treat 1,077 mental health patients each day.
From 2007 to 2014, MHA reported, emergency department visits rose 20 percent for all age groups, while mental health emergency department visits increased 49 percent over the same period, which includes substance abuse.
Increased need paired with whittled down resources has resulted in overcrowding of facilities, causing those in mental health crisis to wait days, sometimes weeks, for an open bed.
"Waiting is very degrading and it's very shaming," Nolan said, her tone turning sour. "That stigma — within your family, within your friend system, within the people you work with that they know about it. All of those things I've had to run up against, and I still run up against."
And that was just the waiting.
— "You shouldn't be having relationships with people in the hospital"
A term of endearment coined by those who require its services, "The Zoo" comprised multiple floors, lax structure, varying oversight, little discipline, no curfew and nightly music provided to those within earshot of the employee lounge.
Nolan entered "The Zoo" after a wait in the emergency room, after the officer finished his phone call, after a ride in a squad car, after being handcuffed and taken from her home without even the chance to grab a coat.
Once inside, the pace quickened.
"We would be up 'til like 2 in the morning in the lounge area and the staff was playing their music as loud as it could be and they didn't care what we were doing or anything," Nolan explained.
A man in the group of four took interest in Nolan. She was manic and, as a result, impulsive.
"I didn't know him from Adam, I didn't know what his diagnosis was, what his criminal record was," she said. "And I'm a very chaste person and he started to kiss me behind the scenes and things like that. There were no guidelines, no curfews, there were no — people watching us could see that we were having this romantic liaison."
He was a married alcoholic with his own mental health issues.
With little knowledge of her condition, the doctors released Nolan while still manic.
The man from the hospital, released around the same time to an alcohol treatment center, showed up at her apartment.
"We got involved, which again, is against my faith and against my own choice. I was," Nolan paused for a few seconds. "I hate to use this word — it was basically — I was raped in my own home. And I had to get him out of here somehow. It was one of the worst, traumatic experiences I've had."
Nolan contends her release was premature, the lack of oversight setting her up for the ensuing disaster.
"It was horrendous, it was horrible, it was disgusting," Nolan fumed. "I should have been safe there and I wasn't. I was not safe. They teach you how to make keychains and I don't need to make keychains when I'm manic."
It wasn't long after her release she was admitted to the 10-bed facility in Owatonna, never to return to a Twin Cities hospital for mental health treatment.
Nolan never told her family.
— "No one visited me. I mean, no one called, not my family"
Nolan lifted the paperback copy of "Team of Rivals" from her coffee table and turned it over to look at the cover. Opposite the couch, a bayonet hangs on the wall. She loves history.
A few years back, Nolan rode along with two of her brothers on a trip out East, the majority of the time spent around Gettysburg. She saw the Atlantic Ocean for the first time.
Not too far from the battlefields, in a mennonite house that served as their home for the trip's duration, Nolan's brother abruptly informed her it was time to quit being a victim.
Her two-word response was biting and filled with the hurt of betrayal.
That night, before they all went to bed, her brother came up to her and, for the first time in her life told her he loved her.
"We are not victims, we are warriors," she said. "We work and we do the best we can. Yes, there's times when things are really rough and we are not perfect. The expectations for us are beyond the bar."
Nolan said while her brother still doesn't fully understand, the trip to Gettysburg was a turning point in their relationship.
About four years ago, Nolan was diagnosed with rheumatoid arthritis. Before her diagnosis, she explained, she went to the "regular" hospital where she noticed a stark contrast to her time spent in a different part of the hospital just a few years prior.
"All of a sudden, friends, family, they all came to visit, sent flowers," Nolan said.
She was there for three days of testing.
"So for 20 years, while I'm dealing with my bipolar and all of this, and I'm in and out of the hospital and none of that happens. You're abandoned."
Nolan said her story is not unique. Even getting a return phone call while she's in the hospital has proven a chore, to the point where she no longer tries to call family or friends.
— "I hope I live a long life and I hope things will change as I live longer"
In fall 2014, Nolan said goodbye to her part-time teaching job. For years, she said, her boss gave her the time when she needed to focus on her health.
Then, she was told the district didn't have the money to keep her employed. After she was let go, she said someone was hired in her place.
She missed a lot of work in the year leading up to the school board's decision to let her go. With the nature of her disorder, she has no way of knowing exactly how or when something will manifest.
Again, Nolan emphasized that this aspect of her story is not unique. She's talked to others who experienced similar discrimination with little hope of recourse.
When stable, Nolan writes letters to legislators, and others, advocating for improved mental health care. She volunteers through her church, visits hospitals and senior centers to lend an ear to those in need.
In January, she began a new role as co-facilitator of a support group through Washington County NAMI.
"What I want to do — so much of having my bipolar is taking care of myself — is wanting to give back something to the community."
Now on disability, the severity of her illness requiring the majority of her time and efforts, Nolan typically ends up at the facility in Owatonna a couple times each year. She said she knows the staff there and, more importantly, they know her.
Nolan is thankful to have a facility she's familiar with, a place she knows she's safe. Both are far from guaranteed.
"There's a crisis in that there's not enough beds," Nolan said, pointing to a shortage of doctors, fewer facilities and the general effectiveness of the treatment as contributing factors. "They push you in and they push you out and they expect you to stand on your feet. Again, it's a chronic disease, all of this. It's something we deal with for the rest of our lives."
Which is one reason Nolan doesn't use the term recovery when it comes to her mental health issues.
"There's no recovery," she insisted. "There's learning to deal with it."
It took Nolan years of work to get to a point where she can start to identify some of her triggers, what she's feeling and what it means.
Nolan insists without her professional network, crisis plan and faith she has no hope of living any semblance of a stable life.
"Your life is at stake every day," she said. "It's that simple, it's about life and death."
Nolan has hope, ultimately, that she'll see a day when mental health issues receive equal attention with other health-related causes.
"I guess I can say that I'm glad that I was unsuccessful," Nolan said of her suicide attempts. "I tried many times and I'm grateful that I was not successful. And I do believe that part of giving back is being able to talk about it. It shouldn't be a secret."