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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by glennb on December 9, 2008, at 18:43:13
My psychiatrist is recommending I enter a hospital for inpatient treatment. I'm suffering from major depression, in my 30s. I'm not suicidal, don't harm myself, and have no history of psychosis so I presume the recommendation is being made on the basis that it will be therapeutic for me. I'm in new york and I looked at the web sites for columbia presbyterian and Cornell and on the one hand it seems like it could be useful but on the other hand I can't see how a few weeks of intensive treatment will flip my depression. I've been in this episode for about a year and a half and it has proved to be refractory, if not very treatment-resistant. I posted on a different thread about my latest nortriptyline trial. I'm wondering if any of you have done inpatient treatment and could share your experiences. They seem to me to be more like psychiatric rehab than hospitalization. Please let me know your thoughts on that as well.
Posted by SLS on December 9, 2008, at 19:15:43
In reply to Pdoc recommending inpatient treatment, posted by glennb on December 9, 2008, at 18:43:13
You should check to see if NY Presbyterian still has its depression evaluation service. If you meet their criteria, they will treat you as an outpatient. If you are treatment resistant and end up needing a combination of drugs to respond adequately, that might take many months. I don't think it makes sense to do this inpatient. There are many things to consider when making the decision to go inpatient. What is your doctor's rationale for suggesting this course of action?
- Scott
Posted by SLS on December 9, 2008, at 19:19:25
In reply to Re: Pdoc recommending inpatient treatment, posted by SLS on December 9, 2008, at 19:15:43
> You should check to see if NY Presbyterian still has its depression evaluation service. If you meet their criteria, they will treat you as an outpatient for free.
http://www.depression-nyc.org/
- Scott
Posted by JadeKelly on December 9, 2008, at 21:02:36
In reply to Pdoc recommending inpatient treatment, posted by glennb on December 9, 2008, at 18:43:13
> My psychiatrist is recommending I enter a hospital for inpatient treatment. I'm suffering from major depression, in my 30s. I'm not suicidal, don't harm myself, and have no history of psychosis so I presume the recommendation is being made on the basis that it will be therapeutic for me. I'm in new york and I looked at the web sites for columbia presbyterian and Cornell and on the one hand it seems like it could be useful but on the other hand I can't see how a few weeks of intensive treatment will flip my depression. I've been in this episode for about a year and a half and it has proved to be refractory, if not very treatment-resistant. I posted on a different thread about my latest nortriptyline trial. I'm wondering if any of you have done inpatient treatment and could share your experiences. They seem to me to be more like psychiatric rehab than hospitalization. Please let me know your thoughts on that as well.
Glenn,
I,ve only heard a small part of your story, but you don't sound like someone who needs inpatient. Too much time is lost, and you could be doing your own research and trying meds during that time. Unless of course, getting away from it all sounds good! I can relate. I'd ask your Doc point blank what he hopes you will gain. Btw-what is he telling the insurance company? Just curious.
I posted at your other thread re:STAR*D update, check it out when you get a chance.
~Jade
Posted by raisinb on December 9, 2008, at 22:10:17
In reply to Pdoc recommending inpatient treatment, posted by glennb on December 9, 2008, at 18:43:13
My dad has been hospitalized for depression a few times. He lives in the midwest, not NYC, so ymmv.
But as far as I can see, the main reason to check yourself into an inpatient unit is a serious (maybe imminent) threat of suicide. They don't really *do* anything in the hospital different than what your therapist/pdoc will do outside the hospital, except ensure that you are safe. They observe you, assess you, and keep out anyone you don't want to see. They ensure you get good referrals and quick appointments with therapists/pdocs, but follow-up is up to you. But the basic care--meds and therapy--is the same.
It sounds odd to me that your pdoc is recommending that, but perhaps s/he has good reasons. After all, your pdoc knows you best.
Posted by Bob on December 9, 2008, at 22:17:10
In reply to Pdoc recommending inpatient treatment, posted by glennb on December 9, 2008, at 18:43:13
> My psychiatrist is recommending I enter a hospital for inpatient treatment. I'm suffering from major depression, in my 30s. I'm not suicidal, don't harm myself, and have no history of psychosis so I presume the recommendation is being made on the basis that it will be therapeutic for me. I'm in new york and I looked at the web sites for columbia presbyterian and Cornell and on the one hand it seems like it could be useful but on the other hand I can't see how a few weeks of intensive treatment will flip my depression. I've been in this episode for about a year and a half and it has proved to be refractory, if not very treatment-resistant. I posted on a different thread about my latest nortriptyline trial. I'm wondering if any of you have done inpatient treatment and could share your experiences. They seem to me to be more like psychiatric rehab than hospitalization. Please let me know your thoughts on that as well.
I'd have to wonder how you'd ok this with your insurance. From what I've heard, they don't put up with in patient stays when the patient isn't actively suicidal. I'd be interested to hear how your doctor is handling that aspect of it.
Posted by Phillipa on December 10, 2008, at 0:55:59
In reply to Re: Pdoc recommending inpatient treatment » glennb, posted by Bob on December 9, 2008, at 22:17:10
That's true actively suicidal, blatantly psychotic, very manic and threat to self or others. The referral Scott suggested sounds like a good idea. Love Phillipa ps do you live alone? Could that be a reason?
Posted by Phillipa on December 10, 2008, at 0:57:03
In reply to Re: Pdoc recommending inpatient treatment » Bob, posted by Phillipa on December 10, 2008, at 0:55:59
That was a combo to Bob and glenn. Sorry. Phillipa
Posted by no rose garden on December 10, 2008, at 10:46:41
In reply to Pdoc recommending inpatient treatment, posted by glennb on December 9, 2008, at 18:43:13
I would love to be an inpatient...I want more than anything to be cared for/taken care of...but that's another story.
T says that it's better to stay in the "real world" if you can, b/c it's what we have to do...might be too much of a shock to go to nice inpatient (depending on program) and then be thrown back into the big sad world. :(
Posted by SLS on December 10, 2008, at 11:01:34
In reply to Re: Pdoc recommending inpatient treatment » glennb, posted by no rose garden on December 10, 2008, at 10:46:41
> I would love to be an inpatient...I want more than anything to be cared for/taken care of...but that's another story.
>
> T says that it's better to stay in the "real world" if you can, b/c it's what we have to do...might be too much of a shock to go to nice inpatient (depending on program) and then be thrown back into the big sad world. :(It doesn't take long for a person to become institutionalized in a hospital. Many come to rely on the hospital to supply services that allow one's own survival skills to deteriorate. Reentering the outside world without them can be incredibly difficult, especially without a support system.
- Scott
Posted by glennb on December 10, 2008, at 15:28:52
In reply to Pdoc recommending inpatient treatment, posted by glennb on December 9, 2008, at 18:43:13
Thanks for all the thoughts. My pdoc's raionale was that you get intensive therapy and it's therapeutic to spend some time with other people in similar circumstances. I decided to hold off and to go back on the only med that has ever helped me, fluoxetine and go off the nortriptyline I was on. I considered going to another TCA (anafranil) but opted to avoid further experimentation for the time being. Hopefully I will improve in a few weeks and be able to get back to some level of functioning and then can try and fight upwards from there. Maybe lithium augmentation on the prozac is worth a shot. I've learned experimenting with full 6+ week trials of meds to seek remission can be quite risky though I started this slide on fluoxetine and may have spiraled if I hadn't been switched (to effexor) anyway. I guess there is no way of knowing, it's so hard to tease out what's meds and what's life. With regards to insurance, I don't know what would have happened with regards to coverage, etc. I am staying with family so I'm not alone.
Posted by Phillipa on December 10, 2008, at 19:15:14
In reply to Re: Pdoc recommending inpatient treatment, posted by SLS on December 10, 2008, at 11:01:34
Definitely agree with that. It's up early in am breakfast and groups begin . Rest for an hour or so afternoon then groups til bedtime. I was exhausted when discharged. Love Phillipa
Posted by Phillipa on December 10, 2008, at 19:18:00
In reply to Re: Pdoc recommending inpatient treatment, posted by glennb on December 10, 2008, at 15:28:52
Great that you have family to stay with to help you feel safe. Good luck with return to other med. Love Phillipa
Posted by desolationrower on December 10, 2008, at 19:57:44
In reply to Re: Pdoc recommending inpatient treatment » glennb, posted by Phillipa on December 10, 2008, at 19:18:00
For the cost of a hospital, couldn't you rent a room on the coast and a small sailboat, and still see pdoc & therapist frequently? That would be much better than be socialized into thinking you're part of a group who needs extreme treatment.
-d/r
Posted by bleauberry on December 10, 2008, at 20:51:31
In reply to Pdoc recommending inpatient treatment, posted by glennb on December 9, 2008, at 18:43:13
I have been inpatient. Not exactly the kind of place for healing, but then the place you are considering could be different. The main priority of most psych units is to "stabilize" the patient, usually when they are psychotic or suicidal. You'll be locked up in a ward with some frieky ones.
Anyway, all that aside, there is no way you can get someone well in a couple weeks.
But it is a good opportunity for yet another opinion, another doctor, to make some creative pharmaceutical strategy with you. And enough time to get started on those meds and be in a safe place during the worst of the side effects, or the worst of the withdrawals of the old ones, or both.
I wish they had a hospital where people could go for a few weeks just to change meds. Ya know, no working, no laundry, no cooking, no worry, no responsibility, just survive the change and then go from there. It would be nice if you could wear regular clothes, get some sunshine, and see something other than a hospital hallway and hospital rooms as scenery. But, locked doors, no sunshine, no scenery, no friends, no family, pajamas instead of clothes, ya know, it just doesn't have healing built into it.
Posted by Roslynn on December 11, 2008, at 16:40:12
In reply to Pdoc recommending inpatient treatment, posted by glennb on December 9, 2008, at 18:43:13
Hi,
Also is there a good partial hospital program in your area? That's more like a day program. You still get the group therapy and lunch, I think. You go home in the late afternoon.
It's also for people "stepping down" from full inpatient.
Not sure how they handle meds in partial hospital.
Posted by Phillipa on December 11, 2008, at 18:57:04
In reply to Re: Pdoc recommending inpatient treatment, posted by bleauberry on December 10, 2008, at 20:51:31
BB we had to dress daily before breakfast and had outdoor secure patios and even planted flowers as part of theraphy . Never let us stay in pajamas wasn't allowed?? Love Phillipa
This is the end of the thread.
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