Depression and anxiety. Depression and anxiety. Some days it seems that those are all the problems I see. Run of the mill stuff, really, when working in a prison. You expect people to be depressed here.
Except it’s not quite as simple as that. Three inmates come in, one after another. They’re all being treated for depression and anxiety. And they couldn’t be more different than morning, noon, and night. The first is pretty routine; from what I’m reading in his records, the only time he ever complains about mental health stuff is when he’s in jail or prison. Diagnosis: “jail-itis.” A habitual thief, he’s been in a few times before and knows the routine; he’ll be all right once he quits wasting time on feeling sorry for himself. (He certainly hasn’t any sympathy to spare for his victims.) Won’t hurt to keep an eye on him and give him a safe place to get things off his chest, but chances are he’ll be fine in a few weeks, and he admits as much.
The second has different problems. He has high blood pressure and has started having chest pains recently. He’s middle-aged, a bit overweight. He’s been in prison before and can handle that; it’s his health that’s got him scared, legitimately so. The question is whether his depression and anxiety are reactions to his health problems or is a direct result of them, since heart disease appears to have a physiological tie to both. The psychiatrist has already put him on antidepressant medication to help take the edge off his emotions, but he’ll definitely need some supportive therapy. If the medical department can help him get his blood pressure under control and work with him on losing some weight, that will probably help too. The less helpless he feels about his health and the more he feels that he has some control over his condition, the better. Since he’s indicated a religious preference, I suggest that he talk to a chaplain or volunteer from his faith as well; the more lines of support he has, the better.
The last of the trio is a 19-year-old, first time in prison. That’s reason enough to be upset and scared, but there’s more going on with this youth than that. He’s alleging that he was molested by his cellmate while in the county jail; the record indicates that his claim is being investigated. If his story is true, there’s a serious lawsuit in the making — how could anyone have been so stupid as to pair a youthful offender (so designated by court order) with a 60-year-old with a previous history of sex offenses against younger males? The teenager is now reporting symptoms consistent with posttraumatic stress disorder: not just depression and anxiety, but nightmares, intrusive memories, and inability to relax anywhere, any time. The one bright spot in all this is that the molestation apparently happened only once and wasn’t all that long ago; it’s a lot easier to intervene under these circumstances than when there’s a long history of repeated traumas. Fortunately, we have a counselor on staff who’s taken special training in the treatment of trauma; I refer this young man to him, hoping that if we can lay the groundwork now, the inmate will recover with relatively little long-term damage.
Whew. And that’s just the morning’s schedule. Wonder what the afternoon will bring?
Tags: anxiety, depression, mental health, posttraumatic stress, prison
