Can I afford the psych hospital?

What do you think: I am definitely hypomanic or manic not sure just which. Maybe hypo right now. Are any sort of hallucinations (auditory,tactile, visual) considered psychosis? I mean would a pdoc consider them psychosis? I am having auditory hallucinations. I am considering if I should tell my pdoc? I wouldn''t want him to say they are psychosis and put me in the psych hospital if he knew which is why I hesitate telling him. At other times, I think I should go to the psych hospital since I definitely am hypomanic and/or manic right now, not sure which. At other times, I think it's not so bad. I have energy to accomplish things, no desire to eat (good for my weight loss goals since I'm SO fat and half my wardrobe doesn't fit anymore). But I am having other symptoms of mania that I don't want my pdoc to know. I mean, if he sends me to the hospital, it costs buckets & buckets of money we cannot afford.

Can you afford to not go with safety in mind is more the question.

If you are a danger to yourself and/or others, you need to go. I wouldn't say more energy is a reason to go, and with decreased appetite I'd say as long as you are getting enough nutrients and calories to keep your body healthy that's not a major concern. It would be though if you're completely not eating or not eating enough. If the other symptoms are obviously safety risks, yes, go. If anyone you trust says they're concerned about your wellbeing, yes, go.

Definitely talk to your pdoc about it though. I've never been admitted for hallucinations as the sole psychotic symptom without also either showing disorganized/dangerous behavior or intent. Psychs really don't like admitting people if they don't have to.

Auditory hallucinations are a "psychotic symptom," and I don't know what the docs technically use as a definition, but I don't count my hallucinations as "official" psychosis if I can tell what's real and not and am in touch with reality (which I guess if you're in psychosis you don't know if that's the case which is why an outside perspective is needed).

Yes, other times I have been in full psychosis. At my worst, I could not communicate with anyone or follow directions and lost about 3-4 days at a time (most of it in the psych hospital before I came around again). I only remember flashes from those days and barely that. Mostly I remember talking with God and thinking & talking about all the "solutions" I had to save the world. I could NOT tell they were hallucinations. But with these auditory hallucinations, they are def. hallucinations & I know that even as they happen and am not losting touch with reality.

Right now is an ideal time then to talk to the good ole pdoc before things get worse. Med change could be the difference between inpatient and outpatient treatment.

@MuddyBoots is right. The sooner you get help the less intense the help has to be.

H called the pdoc yesterday. I left 2 messages for the pdoc and told him to call or text H. The pdoc did refill lamotrigine for me at the pharmacy, but the pharmacy status just reads "in process" right now and has since 10 AM though they said it would be ready at 2 PM and it's now after 3 PM and STILL not ready. Pdoc said I should (GOD, I had to look up how to spell "should"!) take a 2nd hydroxyzine, but it did not help.Do you think that might help? Pdoc has not called me back though it is probably for the best the good old pdoc is communicating with H right now. Pdoc is incredibly smart, MENSA, national intelligence competitions, trilingual (though he grow up in a Vietnamese family and speaks fluently, he has an American accent), but pdoc speaks very quickly, and with my lack of focus and forgetfulness, speaking to him might not be best because H remembers stuff (well, H has a Ph.D. from a Nobel laureate and teaches industrial engineering at the university level and has a shares & works with an international nanotube startup in India, so H is no slouch either. H tries his best to understand bipolar and mental illness, but only people WITH mental illness understand what it's really like living with it day after day. Anyway, I digress. Sorry. I get pressured writing (pressured speech too when manic). As you can tell.

Trying NOT to go psych hospital route. At this moment, I feel like not going. I felt like going earlier.

Heck, this post is supposed to be titled "Can I AVOID the psych hospital, not AFFOR, but I can't find to change it. Oh, well. It is also a good question if I can actually afford it moneywise!

From my experience and based on what other docs/NPs have insinuated, hydroxyzine isn't going to do jack for mania. It might be alright in early stages of elevation before it's even hypomania if it helps you sleep and decreases anxiety (if that's a problem), but personally I'll say it's never done anything for me especially after feeling what benzos (and other sedating medications and downers) do.

Is the lamotrigine a new med or something just increased because of this? Titrating to a therapeutic dose of lamictal takes a loooong time and increasing takes a bit to kick in too, and for a significant amount of people it's not effective at treating mania. You probably need something like a more hardcore mood stabilizer (think lithium, depakote, tegretol) or one of the APs that treat mania. Also (I'm sure you know this by now, but just as a friendly reminder), if you're on antidepressants or stimulants, those are going to fuel mania/mixed episodes/rapid cycling.

Don't be sorry about the long tangent lol. I get the pressured writing and speech too. My aunt loves it, most other people not so much :P

But keep calling pdoc until he gets back. How frequently for each of you I'm not exactly sure--with my old providers I'd call once a day and if they don't get back within two days I call the crisis line and tell them to get a hold of them so they know it's important.

Just as a suggestion that slows my mania progression, in the meantime you cand your days for harm reduction purposes. Schedule times to eat and drink water, making a list of self-care things you can't skip (showering, brushing teeth, taking meds, etc), find a way to rest that's tolerable for you and set a time you at least go through a bedtime routine even if you don't fall asleep and come up with some things you can do if you can't sleep that won't rev you up more, and whatever else you or others here can come up with just. If laying low doesn't really calm the storm, it at least doesn't fuel the mania like some other choices we tend to make/not make when flying high.

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TL;DR I'm sorry this turned out a lot and probably is a bit much for a racing brain, but basically keep calling the pdoc and stress you need something with a stronger sedating effect than hydroxyzine and think about planning your days out in a way that keeps you from making less than great decisions or fuel the mania.

Hydroxyzine sucks. How much seroquel do you take? Maybe you need a seroquel increase. That would probably help.

my pdoc nor my T send me IP when i have hallucinations unless i become suicidal. id talk to your pdoc. i just recentyl had to talk to a new pdoc how i was hearing the radio talking to me and feeing bugs all over me. shejsut changed my meds

@raspberrytorte

I am prescribed 300 mg of Seroquel, but I was cutting the pills in half so it wasn't so sedating in the morning and also to help me lose weight. But H called my pdoc and went over all my prescriptions with him. I told H and the pdoc I was cutting the Seroquel in half, and pdoc was NOT at all pleased. I got a lecture from him. H was adamant I get back on the 300 mg. I promised him I would. So I've been taking 300 mg again. It's more sedating, but after a cup or two of coffee, I do all right.