How do you know when you need to go the hospital?

Okay so my psychiatrist told me and someone who's a strong part of my support system to use both of our judgment about whether or not I need to be in the hospital...

Context: I saw my psychiatrist on Friday and she said I am full blown manic with psychosis. She put me on another AP in hopes of leveling me out, but said if I'm not down to earth by today ish to go to the hospital.

I'm still way up, which makes it hard for me to believe there's anything wrong with me much less needing to go to the hospital. My psychiatrist's words really shocked me. She said if I'm not sleeping by Sunday to go in, I'm sleeping more than I was but let's face it that's not saying much because I've been averaging three hours of sleep or less than that every night for the past several weeks.

I don't know if I'm still psychotic. I don't know if I'm a danger to myself or other people. In other words, I don't know if I'm in crisis and need to go to the hospital to get stabilized. I really don't want to go, I'll be talking to my support person about it and see what she thinks because she was at my appointment. I would call my doctor and ask her but she's out on medical leave right now.

I'm not sure what to do. I feel fantastic and well according to my psychiatrist that is the problem because my judgment is "severely compromised"... She knows how much I hate the hospital so she's given me a chance to see if I can come down out of the hospital but **** I don't think it's happening. I'm not walking out of the house and into the bad part of my neighborhood and having sex with strangers anymore but I don't know if that's a good yardstick for knowing if I need the hospital or not.

I'm ****ing irritable as **** too when someone points out that I'm still not "stable"... Like **** that you don't ****ing know me or **** about my ****ing life so **** OFF!!! I was throwing **** last night because therapy kicked my *** yesterday and it's like if you could see my rage you would totally see volcanic ash coming out of my head LOLOLOLOLOL.

But I'm fine, that's what I think. Sure I have lots of energy, I'm bouncing off the walls, I can't stop talking, I'm still exhausted... I don't know if I'm psychotic though. I'm still euphoric and what's so bad about that I still don't get it. It's hard for me to even post in this forum because it's so hard for me to see that I'm not well as I mostly struggle with mania/hypomania and not depression so I don't know...

If I feel fine then why would I need the hospital? My psychiatrist was pretty blunt about it though... I just don't know and that pisses me the **** off too.

I've been hospitalized five times because of manic episodes like this and it's like... am I at the point to where I need the hospital? I don't know, I don't think so but I thought I may as well ask because why not and I can't stop talking anyways so HI if you have any thoughts you don't mind sharing about this please do!

Regards!

You sound pretty manic and very on edge. Do you see how much language had to be censored out of your post? Not a good sign of stability. Sounds like your pdoc may be right. Perhaps it is time to go in and let them get you stabilized.

Yes. It always feels ok given the alternative but I know a fellow manic when I see one and you my dear need too get some extra help. You don't want to wait until psychosis sets in because then it may be even more difficult to recover. Let them help you get better. It takes less time and support is available.

Okay, your Psychiatrist seems to be recommending you check yourself in, but what about the people around you? Even if they aren't outright commenting on your current personality and behaviour has their behaviour changed around you? Are they reacting at all to your mania and psychosis?

What is preventing you from checking yourself in? How would that impact your life? (ie. work, finances family, etc)

I have questions about your previous hospitalizations: how long were you a patient? did you discharge yourself? Were you stable on transition out? What kind of supports did you have in place on discharge? (ie. outpatient programs)

mania 80% time lands me in the hospital. I would suggest staying around positive minded people and family/friends who can support you. Stay away from alcohol and drugs. Take your pills. Don't do anything irrational. If you have to stay in the house all day, do that. Deep breaths. Try your hardest to sleep. Even just laying down with your eyes shut, is better then bouncing off the walls. Stay away from anything that might cause sensory overload. Staying off the internet, no television. Calming music might help, but don't listen to too much music. if it gets too overwhelming, maybe the hospital might be your best option. I know it's hell, I've been there far too many times. Well good luck!

Thank you all for the input. I appreciate it.

rcat you asked some good questions...

Everyone around me is concerned, they've stopped commenting about things because I'm "hostile" apparently. They do seem to be like they're walking on eggshells around me and watching me very closely. One of my strongest support people keeps pointing out that I seem psychotic though not as much today.

This is my main problem, I have a lot of things to do this week that really only I can do that are also time sensitive, like it can't just wait while I'm in the hospital for who knows how long. The consequences of missing all my obligations this week would be really messy and that could just destabilize me even MORE if I don't meet my obligations like I have to. I do not want to go in unless there is no other option.

Anywhere from five days to almost a month to answer the first question. The second, yes I was stable when I transitioned out, I haven't been in the hospital since early 2014. My outside support has mostly been limited to seeing my psychiatrist and going to therapy. I've never done an outpatient program though several people in my life have suggested I try it before...

Sleep is a good indicator. Even if you just lay down for 8 hrs it lets your body rest.

I have been manic and psychotic and stayed out of the hospital. My pdoc tries to avoid it unless it is absolutely necessary. Knowing if you are a danger to yourself or others is key. Is your support team saying anything in regards to that? What is the antipsychotic they have given you? Can you try haldol or something very strong that might knock you out while outpatient? Sleep would help you greatly and haldol always knocks me the crap out. Anyway, I agree that you would likely become well faster if you go inpatient so it may be the best route. I hope you have an easy and fast landing.

Nobody has said that I or anyone else is in immediate danger as of Friday through today. I'm taking haldol as another AP ha funny you mentioned that, I'm taking that twice a day and I do feel significantly less wound up right now so that's good... I just hope I sleep tonight, if I don't I'm going to the hospital because **** that.

Thanks for sharing your thoughts/experiences everyone.