Punishment and Shame for Mental Illness: A Personal Story
Updated: May 31
In the fall of 2015, I suffered a psychotic break seemingly out of nowhere. At that time in my life, I thought I was doing well. I had started a law practice, my client load was increasing, and my future seemed relatively bright. Everything changed for me practically overnight. And the way that my situation was handled from a legal and medical perspective made my situation far worse for me than it ever had to be. To add to that, I was shunned by those who were supposed to be my friends. Essentially I was punished and shamed for something that was completely beyond my control- getting sick. This is unfortunately often the case for those with mental illness. And it was my experience that led me to working in mental health. Because I want to play some role in working to ensure that others don’t have similar damaging experiences.
When all this transpired, I had been working on a case I was emotionally invested in. I felt someone had been wronged, and I really wanted to make things right as best I could. I have no idea what led to my brain unraveling or fracturing. I was likely under a tremendous amount of stress and didn’t even realize it. Up until this point in my life, I had been in therapy and I did have a psychiatrist. I was seen mostly for struggles with anxiety and because I wanted to identify some of my maladaptive behavioral patterns that I felt were impacting my relationships. I was on very low does sertraline (an SSRI), and I was being seen weekly by a mindfulness based therapist.
Over the course of twenty-four hours, I went from a mild form of paranoia to extreme paranoia where I was convinced that others were trying to kill me as part of a conspiracy. My boyfriend at the time – who is now my husband – didn’t want me to go to the hospital for a couple reasons. First, he didn’t know how bad things actually were and thought I could just “sleep it off.” Next, he was concerned about the impact help seeking would have on my career. Unfortunately, I escalated enough to require serious intervention involving the police and fire department, and I physically attacked him due to the paranoia and misinterpretation. It was a very dangerous situation. Sadly, he wasn’t wrong about the professional impact.
I called 911 and told them to “send everyone!” because I thought I was in extreme danger. When they arrived, they had to break the door down because I would not come out of the closet where I hovered with two knives and my dog. During this time I made many posts on my Facebook and LinkedIn requesting help. I had just been in a physical altercation with my boyfriend, and fortunately he made it to safety while waiting for the police to show up. His face was scratched up pretty bad. They took photos, and filled out a report.
I was taken to the emergency room via ambulance. I was in restraints and still extremely fearful and paranoid. I didn’t believe anyone was safe. I remember thinking that if two staff were together with me I would be safe because it would be less likely that both of them would kill me. They ran tests, all of which were normal. I was evaluated by a psychologist and a recommendation was made for a temporary detention order (TDO). I would’t eat and I threw water on myself because I thought they handed me a cup of poison. When they took blood, I became incredibly dizzy because I believed they were injecting me with poison.
Eventually I was transferred to an inpatient unit at a hospital where I had previously done rotations as a clinical instructor. On that very psychiatric unit. To make matters worse, I had just completed training to represent folks in commitment hearings on that same unit via court appointment. My first day covering hearings would be that same week. The staff neither believed I had been a nurse, or that I was an attorney. Not until my boyfriend cleared it up for them. I was treated poorly for the most part. I eventually became what one would call a “difficult patient”. I was angry. Everything was met with some type of power struggle from staff from requests for food and drink, requests to do laundry, or a request for supervision to shave my legs. I tried to call someone to complain about what was happening, but the voicemail was full. During this admission, I was restrained and secluded twice. Neither time of which was sufficiently noted in my records as best I can tell. And at least one time, I did not deserve restraint and seclusion. I stand by that. They carried me through the air (don’t ever do this… it is unsafe for all) as I protested. Unfortunately, it resulted in my kicking someone in the face. This happened after I offered to walk to my room and take oral medication. I remember the face of the nurse, and the two security guards. I’m sorry to the person I kicked.
My court appointed lawyer turned out to be someone I shared office space with, and with whom I had worked on bits of cases here and there. He sat next to me in my hearing. I told him I didn’t want him representing me. The judge let me represent myself. Turns out I ended up with a terrible lawyer, and got myself committed. Truthfully, it was the right decision. I recall having offered to stay, but the judge told me he was concerned that I’d change my mind and request discharge. At this point, my psychosis had shifted and I decided that I needed to be there to help others. This may be the perception that leads to being labeled as “intrusive”…
I was out after 10 days. Still sick, but not unsafe. As was sitting at home, the police came and arrested me. I was walked downstairs, handcuffed, and put into a police car. I was charged with domestic violence. Over the next week, my colleagues (some of whom were friends) reported me to the bar. I needed a criminal attorney and a licensure defense attorney. I paid about 5K for the former, and 18K for the latter. All cash. And we paid an additional 4k for a psych evaluation for the criminal case. The end result of my criminal case was probation and dismissal of charges after “good behavior” or something to that effect. This is the exact same deal available for those who beat their partners on purpose for the first time. The relief I was given was that I didn’t have to take anger management classes like the others. Even the probation supervisor expressed confusion as to why I was there when I showed up at the jail for probation appointments. I had two other options to fight this, but I was scared of what would happen if I ever had a conviction…1) to use self defense as an explanation knowing my partner would not testify (hoping the judge would make the right call), or 2) to enter a plea of not guilty by reason of insanity (NGRI). I qualified for the latter, but at this point I was not psychotic and this plea would have swept me into a disorganized state hospital system where I may have ended up with a charge that would be even more difficult to climb back from. So I plead not guilty (you can do this in Virginia), and I did what needed to be done with charges eventually dismissed.
I am still sour over them proceeding with charges in the first place. I had good family support, and the victim- my boyfriend- wasn’t even going to testify. They agreed not to call him. The prosecution was used as an excuse to “get me help”…. Well, it was a garbage decision that ruined me for a good while. I had massive anxiety around applying for new jobs when I decided to leave law, and I still have to explain this situation with nearly every professional licensure application depending on how they ask the questions. I was extraordinarily depressed about all that was happening to me. Does this happen to someone with a medical condition? Let’s say they cause a massive accident during a medical crisis. Do they charge them with reckless driving just to “get them help”? No… They don’t. A prosecutor can choose to dismiss charges. And in a great many cases, they absolutely should. I’ve never been a prosecutor, but I think they have certain appearances to hold up, and sometimes that’s being “tough on crime”. I was told that the city was getting tough on domestic violence. So my emotional well being became a casualty of their efforts.
As for my bar process, I was sent for a psychiatric evaluation. In the end, I was deemed competent to practice law, and the case was dismissed. The stress of the whole situation was insurmountable. It seemed to take a lifetime to resolve. I know they have a job to do, but I had not once injured a client. Nor had any clients made any allegations against me.
The worst of it was how I was treated by peers and friends. They wrote in a bar complaint that I was never to be trusted again and that they could not work with me. I was also criticized for using an auto reply email for clients that said I had a medical emergency, which is unfortunately understandable given how stigmatized mental illness truly is. The real truth here is that I should be able to write psychiatric emergency or medical emergency and have them be understood as the same thing with one eliciting just as much compassion as the other:
October 5, 2015
I have communicated with Tara Candela on two occasions since her release from commitment. The first communication was a series of emails beginning on September 30, 2015. After receiving an email query from her, which was ostensibly about several cases on which I was working on for her, I replied and received the following reply:
Thank for you your email. I am tying up loose ends after a medical emergency. I expect to begin returning calls and addressing any concerns you may have after another week or so. If I need more time, I will keep this message updated.
Please know if you have a pending case, I will be doing some work on your case over the course of the next couple of weeks, but I cannot spend any time accepting non-emergent phone calls.
If you think you have a case deadline, please inform the receptionist. Also consider reaching out to another lawyer by calling the Virginia Bar referral service.
I find this auto-response email disturbing in several respects. First of all, Ms. Candela had not had a medical emergency; she has had a psychiatric emergency that has apparently caused her to be unable to communicate with her clients on any cases that are “non-emergent.”
A psychiatric emergency is a medical emergency- at least for those who understand psychiatry. I contacted all my clients, knew there were no deadlines, and do not feel this was an inappropriate email. My clients generally call and my answering service was communicating with them. My goal was not to take new clients immediately because I had been away at trial and then in the hospital.
In the end, I made a complete recovery and was even able to stop medication. But it was a very difficult road, mostly because of the poor response and misunderstanding of others surrounding anything having to do with mental illness. I also recognize the privilege I had to have the support needed and the funds to fight my battles.
The worst of it all honestly stemmed from mistreatment as a patient, as a professional peer, and as a friend. The therapist I found after this helped me climb back into the light. As it turns out, my psychiatrist and therapist at the time this occurred could not help me despite my having been a patient for two years. My symptoms simply were not part of their repertoire. I also engaged in peer support via NAMI, and I did volunteer work just as a means of getting back into the world, at one point pulling weeds. I also worked as a server because I was initially too uncomfortable with myself to work as a nurse, and I had decided that maybe law wasn’t the best for me. I finished up cases, and eventually returned to nursing full time. For obvious reasons, I chose psychiatric nursing.
When I look back, I feel the power in my experience. I have no shame whatsoever, and the clouds have lifted. But there are a great many others who suffer even greater levels of punishment, shame, and maltreatment on a regular basis simply because they have the misfortune of being ill. I hope to help change those experiences for as many people as I can.
May you all be well,