The mental load of life in Vancouver's Downtown Eastside

Erica Grant's home in a Downtown Eastside SRO hotel has many things you'd typically associate with a grandmother's home: photos of her grandkids, knick-knacks, even doilies on the coffee table.

But Grant, 57, also has naloxone kits, a stash of clean needles, and a struggle with mental illness, homelessness, and addiction to crack cocaine.

Erica is one of the many residents of Vancouver's Downtown Eastside who have struggled with depression and suicidal thoughts in the midst of what she describes as the "overwhelming" realities of East Hastings' opioid overdose crisis.

"I've lost so many friends down here, so many family members," Grant said. "It feels like we're in a war zone and the fight is against the drugs, alcohol, and the police."

Grant, who previously lived in Surrey, briefly used crack cocaine to numb the pain when she found out her ex-husband had remarried. That was 12 years ago. When her weight dropped to 110 pounds, she decided to kick her addiction cold turkey.

Later, she moved to the Downtown Eastside and was homeless for 19 months. She would sleep in Strathcona Park at night and tuck her belongings up into a tree during the day.

One cold February, when she had had enough, Grant marched into the Carnegie Centre and demanded someone help her find a place to live.

Local anti-poverty activist Jean Swanson, who is now a Vancouver city councillor, helped her get a room in the Savoy Hotel, where she's lived for two years.

Lure of crack

She left the neighbourhood recently to attend her four-year-old granddaughter's birthday party and it felt like an escape.

"I got to forget about things down here," she said. "It felt really good to live [for a few hours] like I wasn't living with everybody's stuff on my shoulders all the time."

She's glad she has a room, even if it's in an SRO Hotel, but the grind of East Hastings takes a toll.

"And there are a lot of times that I struggle to not get up and go get crack."

Grant is part of the roughly 75 per cent of Downtown Eastside residents who have struggled with major mental illness, according to the head of psychiatry at St. Paul's Hospital, Dr. Bill MacEwan.

MacEwan says the situation is worsened by the opioid crisis and the high rates of overdose and death.

"Someone who had some mild feelings of sadness now can move into a major depression or a real period of [suicidal thinking] and despair," said MacEwan during CBC's The Early Edition.

The cycle of watching people overdose, be resuscitated or die, only to overdose again, is hard on health professionals, said MacEwan. But it's even harder when they're your neighbours.

"It's that sense of unknowing, is it going to be safe, and who's going to help me?" said MacEwan.

He described how a potentially lethal batch of drugs can hit a single hallway in an SRO hotel, and suddenly multiple neighbours overdose.

Those who are resuscitated can have traumatic feelings and lasting cognitive difficulties. "It just makes their lives miserable," he said.

Cycles of sadness

Now, even off crack and with a room of her own, Grant still struggles with feelings of depression. A recent operation forced her to take bed rest for several weeks in her room at the Savoy Hotel, three floors above the noise of East Hastings.

Listening to the sirens, the yelling, and frenzy of people below, she says she felt so alone and so aware of her situation.

"I really didn't want to live anymore. I was at a point where [I asked], 'Is this going to be my existence for the rest of my life?'"

"I love all the people down here," she said. "Some of them kind of get on my nerves sometimes, but I still love them."

But she still cycles through waves of sadness a few times each day.

"There's so much that happens to everyone down here. I'm just one person among thousands. I just pray one day I open my eyes and realize it was all a dream."

With files from The Early Edition