Red Flags List / Planning

I'm trying to put together a plan for myself and some of my loved ones, as far as what specifically constitutes the need to be hospitalized / taken to the hospital. My loved ones tend to be extremely indecisive in emergencies and also tend to 'freeze up' easily. Then this has always combined with my strong fear of going to the hospital. I'm worried that if I have an especially bad episode or a bad reaction when I start medication, that I will be too frightened and confused to decide to go to the hospital, and that any loved ones around me will be too nervous and 'frozen' to make a judgement call. I think maybe it could be helpful for us to have a list of basically "if this ____" then "go to the hospital". Some of these things would only be for me if they include thoughts, I guess, since nobody can read my mind. I want my loved ones to be safe and also feel empowered with a plan should anything ever get really crazy. We've had problems in the past of me having very bad episodes and them not knowing what to do and just sort of freezing up / disassociating / ignoring major red flags.

Do any of you have your own lists that you rely on or try to stick to, for when your perception has been compromised? Or family crisis plans? Does anyone have link(s) to standard lists of like, red flags that it's time to go to the hospital, that you think are good?

Found this: http://www.dbsalliance.org/pdfs/pati...talization.pdf

I don't have a plan or any guidelines in place for myself but I can relate to having indecisive family members who freeze up in emergency situations. There have been times when I really should have been hospitalized but wasn't because family didn't know what to do or didn't believe I was bad enough to be hospitalized.

Times when I have been hospitalized were when I was feeling urgently suicidal or homicidal, feeling out of control and not trusting myself to make good decisions, having severe hallucinations. I would be interested to know what would constitute the need for hospitalization when depressed as I have always been IP when manic or mixed.

Wow thank you for that DBSA list but according to that I should be in the hospital at all times!

I feel like it's so hard to tell the difference between "being a drama queen/king" and "being in denial". I was hoping to find some professionally-guided, clear-cut lists to help me out, but my internet searches are not going so great. That link above is the best I have found so far.

Like for example, it is not unusual when I am winding up into a mixed state / dysphoric mania to have intrusive and overwhelming homicidal ideation. It's very difficult to talk about, let alone admit to, but it happens. I will do everything in my power to distract and distance myself, try to self-soothe, try to hold it together. When a sub-episode is over, I usually break down hysterically bawling because it feels like I have demons in my head, and I'm horrified and ashamed that I could ever have such thoughts and feelings. But, I've never actually attacked anyone. They've never amounted to anything more than horrible feelings and thoughts.

That is just one of several examples that make me feel extremely conflicted. Not to mention the sheer terror of trying to tell someone something like, "I felt completely crazy last night and wanted to murder you. Please help me."

It's also hard being so mercurial, feelings are changing constantly so one minute I might feel one way that would constitute a hospitalization but a few hours later I may feel differently. Each time I've been in the hospital at one point I've always been like WHY AM I HERE I'M FINE...so that's a tough part of this. At what point does it get bad enough to say ok, it's time.

Some more links:

When Do You Need Inpatient Treatment For Bipolar Disorder? | Mental Health Treatment Circle - HealthyPlace

Treatment-Resistant Depression: When Hospitalization is Needed

See this is where I get flustered. Danger to self and/or danger to others is commonly listed, but how do you know when that is the case? What about people who frequently experience such thoughts, but do not act? Are they still considered a danger to self/others? That seems overboard. Yet, is waiting until you're actually trying to attack yourself or others, pretty stupid? Seems so. So how do you judge the situation?

Definitely this, as well. The other night I was worked up into an absolute enraged frenzy and was having mild hallucinations, with horrible intrusive thoughts. A couple hours later, though, it changed to a very heavy melancholy and my body hurt. I felt like I might burst into tears at any moment for no apparent reason. Then I sat outside smoking, finally had one of those deep, not-breathing cries, but it only last about 30 seconds. Then I felt blank and aloof. Then I freaked out again like half an hour later. Endlessly looping until I self-harmed and passed out. Woke up a few hours later and felt completely normal/fine. Made some decaf coffee and listened to some music for a while. Same old, same old.

Then, lats night I actually got about 8 hours of sleep out of nowhere. So it is over? I never know what to expect. Or what to do.

My wife is under standing orders from my psychiatrist to shoot me down with an antipsychotic dart gun if I show any reliable harbingers of mania, including failure to sleep or eat, compulsive speculation in precious metals, or repeated use of red-flag manic catchphrases, i.e. 'black op', 'false flag', and 'hide in plain sight'.

Have you had the government paranoia themes, too? I mean don't get me wrong, the government is corrupt as all hell, and it makes sense to be vigilant and skeptical. But, I've had some pretty intense and out-there paranoid delusions in my life. To this day it only takes a couple conspiracy theory videos on YouTube and I can feel my entire mind changing.

I don't have a "list", no, because my episodes tend to be different.

The underlying reason for hospital for me would be:

When I'm a danger to myself

(suicidal, or lost contact with reality and want to hop on a train to xyz because I think someone's chasing me)

But of course, my friend. The fact that we're both crazy doesn't prove that 9/11 wasn't an inside job, but it does mean that nobody will listen to either of us.

If I'm a danger to myself, that's when I seek hospitalization.

I haven't had psychotic features ��(kick on wood), however I've had intrusive thoughts. They were awful! I had a great therapist at the time that explained the difference between you actually acting on those thoughts or not. In her practice, she said the ones she worried about were the ones that weren't worried they would do something. The ones that were scared about doing something were fine. Her experience is that when you are worried about it it's totally different. When someone is in a full on psychosis and doesn't seem concerned....that's when hospolization is needed. My two cents and I'm not a doctor. HUGS

Haha, truth.

Oh man I have had some serious issues with government conspiracy paranoia...whether it is warranted or not is another topic

For me I think it's because a lot of the conspiracy theory materials out there are very similar to my own delusions. 99% facts and then one little assumption and the whole thing goes haywire. It's not even about the theories themselves, but how they are often presented. There is some respectable material out there, calm, mature and informative, but it's mixed in with a sea of sensationalist stuff. Just trying to wade through it can be very difficult for someone with a mind like my own. Everything starts to blur together, and I won't know what to think anymore, but I will know that I feel very strongly and want what's best and safest for my species, for my nation's people, for my family. I will know that there are lies and conspiracies, because well, humans, but I won't be able to sort it out. Then it's like that fine line between feeling like a selfish coward if I just back out and ignore it all and focus on my own happiness, and feeling like an egotistical nutter for thinking that I could make a difference anyway. Oh gosh it sucks something serious.

this is what is so tough right. even deciding if u need to go ip or not. at least for. because i will be totally not well one minute and then by the time the doc calls me back I am like well that was yesterday i'm fine now. but yeah. fine doesn't mean everything is fine now. hard to remember

love it........

oh this makes a lot of sense. so i guess the freaking out about the freaking out is a good thing ha

this is a great topic/idea copperstar. i made a sui plan back when or i guess after i was so bad. it isn't really about when to go though more like what to do i guess or yeah.

i wasn't that into it. like others have said it changes all the time. i feel like i am prepared for the next time and then it kicks my *** again with some new kind of hell ****.

so yeah

a related question/issue i have is that i really need a middle option in between going to the hospital and having to do my whole life jobs and everything with no real break or support. i know that IP should be saved for when someone is in danger but i often feel like maybe i should go because i just can't function anymore. i don't know really what that answer is.

it seems weird to get a nanny so you can lie in bed all day and i don't want to out myself to family...

i don't know.

It might depend a lot, too, on whether or not someone has reliable, supportive people in their life. I know some of us, including myself, don't really have that. My mother is a situational parent, and has been since the day I was born, meaning that whether or not she acts like a parent is entirely dependent on her mood and whether or not she feels like it. She has allowed me to go running off into society completely psychotic multiple times, because she was in a snit over something I said while I was completely losing my mind and extremely emotional. The way she thinks is that if I have a psychotic episode that includes being paranoid of her, then she'll be damned if she's going to help me and I might as well go die in a fire. So even trying to decide whether or not to include her in an emergency plan is a major dilemma in itself.

I hear ya. It is hard when you can't consistently rely on somebody and you need people u can consistently rely on. My mom doesn't know much for the same reasons.

I have an insane (in a different way) mom too, just saying. She means well but ultimately she just makes things worse for me. She is definitely not included in any emergency plans of mine unless it becomes absolutely necessary. I think sometimes people who are TOO invested can be way more of a problem than they are a help. I'm glad that my fiance is understanding and intelligent enough not to take my bipolarness personally. My mom always takes my **** personally.

I have been working on putting together an emergency plan for my family recently. I put some basic info on BP in the front and am "working" (when I have the motivation, that is) on typing up typical symptoms that relate to my personal experience as well as information on my more out there symptoms (psychosis, etc.) so they know what to watch for, as well as information on how to handle various types of situations/symptoms. It's nowhere near being done, but at least it's started.