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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Ilene on March 4, 2004, at 12:26:31
I'm going to be talking with my pdoc tomorrow about being treated as an inpatient. I don't know what to think about this. The only time I was in a psych ward was to see one of the few psychiatrists that accepted my former medical insurance. I *hated* being there and seeing him.
I don't know what I can get from being hospitalized. I long to have someone take care of me and make me better, but I realize that there are no guarantees here.
My husband thinks I should move to California right away. I'm in D.C. until our son finishes 8th grade. The plan has been for us to sell the house and move in June. I think my husband's idea is not practical, but I have no support system out here.
What's it like being hospitalized? How long do they keep you? Does it help?
I.
Posted by fallsfall on March 4, 2004, at 17:14:19
In reply to Hospitalization, posted by Ilene on March 4, 2004, at 12:26:31
Yes, it really can help.
In my hospital they have a lot of group sessions where they teach coping skills and ways of recognizing problems that you have. There was a heavily educational focus. It was also possible to talk to staff members (but you had to ask - be sure to ask) one on one, and that was helpful, too.
Lots of times people do med changes in the hospital (because if their meds were working well they probably wouldn't need to be there...). In the hospital environment they can keep an eye on you and so can do the changes faster.
They keep you from nothing to a couple of weeks - I think the average now is 3 to 5 days. I'm a firm believe in the couple of weeks. I think a lot of people are discharged just when they stop being in crisis and they haven't had the mental energy to learn anything to keep the out the next time. I always try to encourage people to stay in as long as they can - but most people want "out" right away.
The hospital also helps you understand that you aren't so different from a bunch of other people. That can help, too.
Good luck.
Posted by Ilene on March 4, 2004, at 17:56:05
In reply to Re: Hospitalization » Ilene, posted by fallsfall on March 4, 2004, at 17:14:19
> Yes, it really can help.
>
> In my hospital they have a lot of group sessions where they teach coping skills and ways of recognizing problems that you have. There was a heavily educational focus. It was also possible to talk to staff members (but you had to ask - be sure to ask) one on one, and that was helpful, too.
>
> Lots of times people do med changes in the hospital (because if their meds were working well they probably wouldn't need to be there...). In the hospital environment they can keep an eye on you and so can do the changes faster.
>
> They keep you from nothing to a couple of weeks - I think the average now is 3 to 5 days. I'm a firm believe in the couple of weeks. I think a lot of people are discharged just when they stop being in crisis and they haven't had the mental energy to learn anything to keep the out the next time. I always try to encourage people to stay in as long as they can - but most people want "out" right away.
>
> The hospital also helps you understand that you aren't so different from a bunch of other people. That can help, too.
>
> Good luck.I need meds that work before I can utilize coping skills. I don't know what skills I can use that I'm not using. I feel like a zombie a good deal of the time. I think I'm aware of my problems, but I'm too depressed to do anything about them.
I'm taking an MAOI, which doesn't seem to be working. We've talked about adding lithium, and occasionally talked about ECT. ECT seems so risky.
I also have my son to think about.
Thanks for responding.
I.
Posted by Racer on March 4, 2004, at 20:39:02
In reply to Re: Hospitalization, posted by Ilene on March 4, 2004, at 17:56:05
Um, not to put too fine a point on it, but if you're taking an MAOI, and it's not working, how about trying a drug from another class of anti-depressant before going into lithium and ECT? ECT can be a life saver, but it comes with a lot of risks. Scares the hell out of me, so I can only imagine your reaction to hearing about it.
MAOIs, tricyclic antidepressants, and the newer drugs like SSRIs are all about equally effective. That is to say, they help about the same proportion of people who take them. The main differences are in side effects. MAOIs, for instance, require dietary changes which the other drugs don't. There are a lot of drugs out there, one or more of which might help you.
Going from MAOIs to any other drug requires a period of at least two weeks to get the MAOI out of your system before starting the new drug. It may be that your doctor is suggesting inpatient treatment to keep you safe during that time. It may not be that, but that would be a reasonable reason to do it.
As for help in hospitalization, it's a mixed bag along with anything else about mental illness. You have your son to think about, your husband across the country, lots of major real life stressors to complicate your illness. I've got a similar stressor right now, a cat with kidney failure. If I didn't know that I needed to give him subQ fluids, I would ask to be hospitalized myself. Those are very valid concerns. Anyone who tells you otherwise is exhibiting disrespect.
What's the best thing to do? Well, I'm a reactionary sort of person, so I'd say "find a doctor who knows that someone's come out with alternatives to MAOIs, first..." That probably isn't the right answer for you, since you're also feeling unsupported with your husband away from you and sole responsibility for your son. What would my advice to you be? Interview yourself. Is there someone whom you trust who could take care of your son while you were hospitalized? If not, there's your answer: hospitalization at this time under these conditions is contraindicated. What other options do you have? Well, you're staying in DC until your son finishes the school year, right? He'll have consequences no matter what you do right now, so which would be worse: moving to California before the end of this grade? Or feeling confused about what you're going through without someone who can help him resolve those fears? It might just turn out that moving him mid year isn't the worst thing that can happen to him.
My heart goes out to you, dear, and I wish you all the best.
Posted by socialdeviantjeff on March 5, 2004, at 1:13:42
In reply to Re: Hospitalization » Ilene, posted by Racer on March 4, 2004, at 20:39:02
Never been hospitalized, but being that my pdoc is a Director of Inpatient and ECT Services, I have some kind of perspective.
ECT is good for catatonics subtypes of depression and acute episodes where sedation for some reason is contradicted. It is actually relatively safe, the big issue being short term memory prblems just after treatment and about 1-2 weeks. It's far from the picture of dark basements and evil docs. There are certain mood disorders it is bad for and lots of depressions it's inneffective for.
In Utah(tard) you wouldn't get hospitalized until you were an acute danger. Lots of civil commitment here. I've been close a couple of times but never admitted.
I wish I could say more, but good luck lady and I'm rooting for you.
Posted by judy1 on March 5, 2004, at 12:02:04
In reply to Re: Hospitalization, posted by Ilene on March 4, 2004, at 17:56:05
i've been repeatedly hospitalized and quite honestly i don't feel it helped. if you are at immediate risk for suicide, then by all means go- you need to be in a secure environment. but if you're expecting some kind of 'miracle' to happen, it won't. what did help me was the outpatient services i used when released. that's where i learned coping skills. i also have children and a husband who travels and i literally cannot be in the hospital. what is your support system like- family, friends, church? it is important to have that in place to help you get through this period. as far as ECT, that really is a last-ditch therapy- type in a search on this site and look at the discussions on ECT. you have my prayers- judy
Posted by kid47 on March 5, 2004, at 12:58:40
In reply to Hospitalization, posted by Ilene on March 4, 2004, at 12:26:31
This may sound wacked, but I LOVED being in the hospital. I was fortunate that I had decent insurance, a VERY flexible work situation, and a good support system at home. I had been feeling so bad for so long, it was like this unimaginable weight was lifted from me when I was committed. The only responsibility I had was to get better. It was a good hospital with good staff & lots of interaction with docs & therps. After two days & complete physical & mental evaluation, my meds were completely changed (I know. Not always a good thing) After two weeks I was put on a day patient program & was feeling better than I had in two years. Unfortunately I have had some setbacks since then, but have not needed further hospitalization. For me, I would not hesitate to go back if it was necessary. best of luck. I hope you are feeling better soon.
kid
Posted by fallsfall on March 5, 2004, at 13:18:46
In reply to Re: Hospitalization, posted by Ilene on March 4, 2004, at 17:56:05
Ilene,
I can certainly relate to the meds issue. I've been on different meds (including an MAOI) for 9 years now. Sometimes they help, sometimes they don't. Switching meds can be a very unsettling thing - and then it still takes a long time to decide if the new med is helping, or if you need to try something else. If your current meds don't seem to be helping, then I would encourage you to be pretty vocal with your pdoc and try something else (I loved Lithium - I took it for 8 years - my longest med).
I understand your zombie feeling - all too well. If some of your depression is worsened by your home environment (or your work environment etc.) then a hospitalization can give you enough of a break from that stress so that you can regroup - and return stronger and more able to deal with the outside world you live in. I have also seen the hospital help people in zombie states because they are a place where people do focus on you and how you are feeling and encourage you to do a little more while understanding that you do have real limits.
The other posters are so right about looking at the logistics, too. If your son has a best friend whose parents could take care of you son for a while, then you would feel more free to focus on you in the hospital. Or if there were relatives who could help.
Do consider moving to be with your husband. You need to weigh the cost to YOU of not having your husband's local support, the cost to your son of having you depressed - against the cost to your son of moving during the school year. It is appropriate to factor YOUR needs into this decision. Your happiness and stability do matter (to both you and your son, as well as your husband). The decision on whether to move or not is not ONLY based on your son's needs. Then again, I can't imagine moving while being as depressed as you sound. Moving when you are feeling good is hard enough!!! Would you have enough money to hire someone to pack your stuff for you (or enough really good friends)? This may be one of those times when you will need to say "If I was feeling good, I would pack it all and have a yard sale etc. etc. BUT I'm not feeling good, and I still need to move, so the MINIMUM that has to happen is stuff has to get into boxes (maybe your local Girl Scout troop would help as a service project), utilities have to be shut off etc. I wish I could do it the "right" way, but at this point I have to accept that I'll have to do it any way I can." Then you can sort out the mess after you have moved with help from your husband.
Posted by Ilene on March 5, 2004, at 13:32:40
In reply to Hospitalization, posted by Ilene on March 4, 2004, at 12:26:31
I had a meltdown this morning when I saw the pdoc. She wants me admitted right away. She called my husband, and my husband and daughter are flying out today and should be here tonight.
I feel strangely calm. I feel like someone is going to take care of me. I've actually been doing a few things around the house--paid some bills, starting dinner early.
Or maybe it's just random mood variation.
Here's the sticky part: my insurance will pay for either 80% or 90%, less deductible, depending on whether the hospital is in network BUT my doctor has been unable to convince the case manager that admission is "medically necessary". The fact that I am less and less able to take care of myself and my 13-yr-old son is unconvincing, or that I have taken a dozen ADs with no response. I get the sense I would have to make a suicide attempt to get admitted. Is this crazy or what?
I'm supposed to go to the ER tomorrow morning.
Posted by Fallen4myT on March 5, 2004, at 18:26:52
In reply to Hospitalization tomorrow, or maybe not, posted by Ilene on March 5, 2004, at 13:32:40
This may sounds crazy but can you ask your PDOC if you can FAKE you are suicidal???? That would get you in and covered by insurance for sure...BUT ONLY FAKE IT PLEASE.
MANY PRAYERS FOR YOU
Posted by Ilene on March 5, 2004, at 20:50:17
In reply to Hospitalization tomorrow, or maybe not, posted by Ilene on March 5, 2004, at 13:32:40
Thanks to everyone who responded. I really appreciate the input.
If I don't post here tomorrow, or add to my diary over on Babble, it means I'm in and maybe some good will come of it.
I have no need to fake suicidal ideation, or a plan. If I tell them I'm going to put my plan into action, then I think I'm in danger of involuntary commitment, which changes the ground rules considerable.
Posted by fallsfall on March 5, 2004, at 22:42:02
In reply to Re: Hospitalization tomorrow, or maybe not, posted by Ilene on March 5, 2004, at 20:50:17
Tell them that you are *afraid* that you will soon want to put your plan into action. If you can give them an example of how you are closer to wanting this than you were in the past (i.e. "I feel more and more hopeless because I don't feel that I can adequately take care of my son - these days I can't even [fill in the blank]").
Tell them that you don't have a plan with date/place/time for executing your plan, but that you are afraid that you aren't too far away from that.
I'm assuming that what I have suggested here is true for you. I'm NOT suggesting that you lie. I have never made an attempt, but I have been hospitalized twice - both because I was afraid that I would do something.
Best of luck to you.
Posted by Fallen4myT on March 5, 2004, at 23:48:01
In reply to Re: Hospitalization tomorrow, or maybe not, posted by Ilene on March 5, 2004, at 20:50:17
Oh OK we don't want you unable to sign yourself out..I pray you get in. I didnt know they have a journal area too wow I am semi new and still learning the site.. MANY PRAYERS and let us know please
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