Hospitalization

At what point does one become a candidate for hospitalization for thier Bipolar Disorder..my depression is getting worse..suppose to see pdoc the 18..hangin in there tho the best I can...and BTW, where the heck are you guys on the chat rooms?? I can never find you!

ok thanks anyway

My T always says I'll know but I have a list of things that if I can't or wont do I'll call T or psych. Usually it causes a med change, more frequent appointments but not hospitalization.

ETA my list

• being unable to recognize or correctly identify family members and friends immediately
• Agitation 4 days
• neglecting personal hygiene (for how many days?) 4 days
• not cooking or doing any housework (for how many days?) 4 days
• not understanding what people are saying 4 days
• thinking I am someone I am not 2 days
• thinking I have the ability to do something I don’t 2 days
• displaying abusive, destructive, or violent behavior, toward self, others, or property 4 days / 2 self destructive acts.
• abusing alcohol and/or drugs ANY excluding pot
• not getting out of bed (for how long?) 4 day
• refusing to eat or drink anything 2 days

Thank you again that is very helpful I can identify was some of those things. I will keep that in mind

Will somebody please tell me what is done in hospitalzation to improve a patient's
mental condition? Is it primarily isolation and rest or is it intravenous feeding or
a combination? Or is it something to clear the system of current medications and
the application of a new prescription to improve the mental condition?

I mean hospitalization that does not require electric shock treatments.

Thanks for any information on that.

1. Safety!
2. Rest!
3. Medication management/titration can be handled much faster with 24/7 supervision and daily visits with doctors. Sleep regulation and getting a handle on severe depression, anxiety, psychosis, etc. are priorities for med management generally.
4. Therapy/skills/education groups -- sometimes individual
5. Intervention/assistance through social workers to set up services, therapists, pdocs etc. once discharged.
6. Detox is often part of the plan as many psych patients are also dealing with issues with substance abuse.
7. ECT, by the way, is only started (generally) inpatient, but moves to being an outpatient treatment fairly quickly.

Thank you, Farmer Girl,

I was most interested in the Detox portion of your article. I'd really give a pretty
to know what that consists of, because I have an inkling that it may be needed to reduce strongly the ill effects of a few prescribed medications--not only the other things a patient might be doing that was detrimental to his health.

Is that part an intravenous procedure, as well?

Thanks again.

detox in my experience with other people consisted of taking meds to lessen side effects of alcohol or drugs and theyd watch the patients so they dont get sick or pass out stuff like that. make sure they are ok. you know.

There is absolutely NO intravenous meds on the psych unit I have been in of any kind (not sure why you think there would be). A patient needing that kind of medical care would be on a regular medical floor.

I had a lot of IV done while on the psych unit, because I needed electrolytes due to orthostatic hypotension on Risperdal. Orthostatic hypotension is a common reaction to various AP's and it would require IV fluids.

Do not know about other reasons for IV work.

My psych unit would consider IV's to be a safety risk due to the number of suicidal patients, etc. Patients needing that kind of medical intervention would be treated on a regular hospital floor until they are medically stable enough to be on the psych unit. The only time I ever had IV's was during ECT which was done on a different floor (outpatient surgery). IV was administered just prior to ECT and removed just following it and before returning to the psych unit.

IV was administered with patients sitting next to the IV unites next to the nursing station and not in the rooms - that took care of the sui risk.

What does this mean exactly?

Usually patients lie in beds with the IV unit positioned next to the bed. Of course, the beds are in the rooms. That creates a suicide risk. Therefore, on psych units, a patient needs to sit in a chair, for hours, right next to the nursing station, in full view of the nurses, to remove the suicide risk. And the IV unit is next to the chair. It is a very tiring experience.

Thanks for this.

Farmer Girl, I wondered because I had the feeling that detox might mean that a
patient had, as Hamster did, a reaction to drugs that caused problems. I wondered if, perhaps, a patient might be given one or more IVs during the stay to restore
a much-needed alkaline state to fluids and tissues. That was my only reason for
asking.

The answer is that a patient like that would be treated on another floor. I see.

Thank you again.

Not in my experience at the hospital. The unit I use is a dual diagnosis unit which means they treat both chemical dependency and psychiatric patients (often there is overlap of course). Most detox patients are detoxing from alcohol, illegal meds, or prescription meds they have abused/become addicted to such as opiates, benzos, etc.

Wildchild I would guess most people go when they are in danger, are at risk of harming others or are low functioning that they are no longer able to take care of basic needs such as eating. I have never gone on the chats here. Im sorry you were not able to find someone to comnect with there. Have you reached out for extra help in real life to help get you through this time right now?

Genetic, when I was hospitalized it was for mania. I was manic for about 5 months with no relief. Numerous med changes and adjustments in that time. I was not taken off any of my meds but my meds were increased all in the first day. I was given seroquel, risperdal, zyprexa, ativan, lithium and tegretol all at once. They continued to increase the dosages everyday unill the zyprexa was at 35 mg a day which is over the max dose. I fainted three times the first day in the halls. They couldn't understand why, but I already have low blood pressure. They increased the meds for almost two weeks that I was there, and when I could no longer tell if I was manic still or had any psychosis I was released. I'm not sure how they didn't kill me with so many meds. When is three AP's ever needed? I'm a pretty small person. Needless to say when I went home I could barely walk or talk from being so drugged. I was not offered any programs or anything like that. I would meet with the Pdoc for about 10 min each day to access how I was doing, that's about it. No one I saw had IV's. I think they did have groups for people with depression. This ward also dealt with detoxing from drug addiction. They probably also had groups to attend .

When my old pdoc retired I was reffered to the pdoc who treated me in the hospital to replace my old one. Might explain why I never see him. I am not sure this is the common experience, but not rare either I doubt. I think it should be impotant to have someone looking out for your interests and advocating for you while in the psych unit. After I was released for a few weeks broke it off with my long term bf because I could not feel anything and was conviced I was not in love with him. We had a few problems but nothing to break up over, we wern't arguing or anything either. Got off some of the meds, realized what a mistake I made and luckily he understood even tho he was heartbroken. That forsure was a result of being over medicated.

Ahh anyways that is my experience. I know many people have been truly helped in the hospital.

Anika, I think I was orthostatic so much also because my normal blood pressure is already low. It does not take much to make us orthostatic.

35 mg Zyprexa is an impossible dose for anyone, but especially for someone with your small frame! I mean, you have to be a bipolar elephant to receive that much Zyprexa!

The psych unit I go to will not allow you to be admitted on that unit if you need any kind of IV or tube feeding. For that matter most physical ailments can't be in an acute state.

I receive excellent care there which includes, Medication management( which could be a med chg or not), group therapy, art therapy, music therapy, each shift you have a contact person you can talk to about anything, Psyc nursing care, a social worker and more. This unit has private rooms, which is great for rest and reflection. Some of the best help comes from the other patients.
Because of the nature of my individual illness, over the last 13 years I have been there multiple times. Some of the most compassionate people I have ever met have been here.
The criteria with my insurance for inpatient treatment is basically a danger to yourself or others. For me it has been either a suicide attempt or suicidal feelings with an actual plan.

What great help! Thanks so much for these.

hang in there, you don't need to be hospitalized unless you're a danger to yourself or others. tough it out sweetheart its not gonna be easy but you can do it i do it every day i have 12 approximated metal disorders that i deal with on the daily with no therapy. You'll be alright

That has been my experience. The hospital I use is an acute care, crisis stabilization unit where most patients stay, on average, about 4 days. My shortest stay was 3 days; my longest was 3 weeks. Patients enter there for a variety of reasons but all are in need of immediate intervention and care.

The security is pretty tight since it is a dual diagnosis unit, so all belongings are checked carefully. You are not allowed electronic devises, clothing with strings, shoelaces, belts, glass containers, alcohol-containing self-care products, wire-bound notebooks, etc. All safety precautions. The rooms are not fancy, but are clean and safe. You are supervised constantly; they log where you are and what you are doing every ten minutes. Patients who are truly a threat to themselves even on the unit are supervised one-to-one at all times until the doctor feels they are safe (that may last a few hours to a few days depending on the patient). Food is decent, perhaps a step better than most hospital fare.

Groups are held every hour throughout the day: one process group, the rest are skills or educational groups. You see your pdoc every single day. You meet with your social worker every couple of days. A nurse meets with your at every shift. Your sleep patterns, food intake, activities, etc. are noted and monitored as they are indicators of your condition and readiness for discharge. You are assigned a nurse who dispenses your meds; she/he is your go-to person for whatever you may need help with.

Most importantly, the staff is amazingly supportive and kind and funny. I've used this hospital many times in the past 8 years, and while there are always a few new faces, many of the same nurses and psych techs and most of the pdocs are exactly the same people who were there the first time I was admitted. They remember me immediately and are always so kind.

You have no idea how beneficial this is. I was always a little wary of the hospital
in case I needed it, but all this is very calming and reassuring about be hospitalized if it is ever necessary.

I think there might be many out there who read this who would take steps based on these testimonies to get help for themselves.

Thanks again.

As in all things, not all psych units are created equal, but by that token they aren't all the nightmares you hear about either.

The only time I was scared on the unit was the first time simply because I had no idea what to expect, but I soon learned it was a very safe place and the other patients were pretty much just like me--people in need of help. On occasion there is a patient I am wary of, but trust me, the staff is already aware of that kind of patient and keeps a close eye on them.

I've never been intentionally over-medicated in the hospital. That's why you see your pdoc daily, so he/she can make quick adjustments if things aren't working right. In fact, if during the course of the day you are having problems, your nurse contacts your pdoc for instructions for anything that might need to be adjusted even between his/her visits.

Those both sound like how all psych wards should be.

Farmergirl, I am guessing they do not have a lot of staff turnover because it is a good place to work and probably a lot of satifaction from really helping people.

I think I was the only manic person on the ward at the time. It's a small hospital. But pretty old fashioned. The treatment the people got who were a threat to themselves, like a serious threat or to others is a room with no windows except a small one on the door, a cot on the floor, no sheets or blankets, a metal toilet and the door is always locked. Kinda like a jail cell. If the person was severly depressed I suppose they would be safe, but I can't see how that treatment would help depression.

When we had one code red patient come onto the ward they gathered us all in the lunch area and locked the door untill it was "safe" to come out. You can imagine the anxiety that created for the patients. The person did get viloent and damge the walls and ripped the patient phone off the wall. There were many more incidents with this patient. I was really out of my element there.

We had a tv, an old exercise bike and a puzzle on the table in the hall to occupy time. Thats about it, i had so many hours for two weeks to try to fill while being very physically aggitated, I tried the puzzle many times but couldn't sit long enough. Basically you just spent time wandering the hall trying to avoid some of the patients that would try to intimidate you. It wasn't a very healing experience. The staff was nice to me, tho maybe not so nice to some of the other patients. But the staff almost always stayed behind the desk in their office area unless to hand out medication. There were tv moniters and cameras on everyones bed and throughout the ward for safety. And you were not allowed anything that could be used as a weapon. No cell phones or anything like that.