I don't think I am "low acuity."

I think out-patient should always be the first choice. The hospital's role is to keep you and others safe and to stabilize you enough to treat you in the community. Ideally it will provide therapy as well, but if you are depressed going into the hospital you will probably still be a little depressed coming out. The hospitals are getting better at providing partial hospitalization and intensive out-patient programs though, and I would definitely consider doing one again if I relapsed.

there is a problem in the mental health system wordwide!!
...and ironic as this will sound it is true and correct...(only according to me...I might be in my own orbit here)

the mental health system is mentally ill.
the collective minds of the mental health system are involuntarily incompetent.
and before I sound like I am attacking! I believe it is not the fault of the very dedicated people of the medical world while they attempt to address the increasing incidence of mental health issues....it
is simply that there is a general lack of understanding and an overwhelming workload...and outdated procedure....(unlucky)
the world has changed...and it changes by the second...
how professionals were instructed to deal with people like me does not apply now.
years of mental illness has taught me to be vigilant and not to trust the system completely because it is outdated...an example of natural progression is this forum. it is a superb way for people to connect and treat themselves, each other and ourselves.

I relate to the low acuity situation and alarms went off in my head...mental illness does not mean low functioning!!
for me it means emotionally compromised functioning!...I am a veteran at delivering myself to 'the system' during times of crisis and they simply do not know what to do??
guidelines...protocol...policy...user bloody manual....I end up telling them what to do..
and I do love them for being there for me but there is a shift coming in the world of mental health wher pills aren't passed out like lollies and the persons at the front line will be like you and me ...we have experienced the struggle first hand and can really make a difference.

I apologise if I have offended anyone beyond what I didn't intend.
and if I am out of my mind feel free to tell me..

I think you absolutely need to get treatment for your depression. I defiantly think you need outpatient though.

I don't know how to put this without sounding horrible, because by no means am I trying to be mean and inconsiderate.

basically I think that the reason you have not been put as high priority is because in the eyes of mental health professionals you are doing well. I'm not saying you don't need help, I'm just saying you need to find help from your GP who can get you a therapist or something rather than actually going to somewhere people go when they are in crisis and cannot stay safe themselves.

so for a lot of people you seem to be doing well because you are functioning, even though you are REALLY struggling and do need support and not functioning well, you are still functioning.

I guess I'm saying this because when I had a team meeting last week my psychiatrist said that what I should see as possible in terms of recovery is not to be 'better' but to be able to function. basically to be able to get through the days without SH and suicide attempts and that all the thoughts and feelings would still be there and I wouldn't 'feel better' but I'd be able to function. because me or my family thinking I'll be 'better' and able to live 'normally' is not realistic.

so I absolutely can see that you are really struggling and I really hope that you can get some support. I just don't think going to somewhere that deals with crisis' is the best way for you to get help because they staff there will see you as not needing emergency intervention and therefore will make you wait and wait.

I hope this hasn't upset you.

and I hope you are managing to find some support to help you feel better.

...can you see QuietOne?...can you see how important you are?

I know that wasn't for me, your post...but I was so encouraged by it just the same.

there are reasons QuietOne!...I am a madboy and crazyman but I know there are reasons.....and they keep me alive

thats the best thing what you wrote there.
J

I thank those who posted today. What you say about how someone like me gets looked at when I go for help shows a lot of insight. You understand how the system is set up to work and I believe that you do understand that I am in need.

Those of you who live in highly progressed countries, outside of the United States, might not quite realize how backward the U.S.A. is in some respects. I know that very rich people (and even some not so rich people) in Canada sometimes will go and cross their southern border just to get to some of the very fine medical treatment that is available in the United States. I had a cousin in England who used to cross "the pond" in order to get medical treatment here that she could not get in the U.K. I understand about the "rationing" that goes on in places like the UK and Ireland. Australia, I'm not so familiar with. What I've read is that Australia does rank high in quality of care on a number of fronts. (I'm sure it has it's problems. I read that delivery of services to aboriginal peoples is not so great, as is the case here in the U.S. I read that psych services, Down Under, are not keeping up with demand.)

So I appreciate that none of you are living in Utopia.

At the same time, you may not quite grasp how the best of the best in care goes on right next to care that is deplorable here in the USA. I am glad Merlin that you "would definitely consider" accessing a PHP, or other "intensive out-patient programs" again, if you relapsed.

I was told yesterday that there is no PHP program anymore. As far as intensive out-patient programs go, there isn't much of that. I got put on a waiting list to get a therapist. The social worker told me I can expect to be on the list for 8 months, before they will have an opening. Since October, I've had virtually no care at all. One clinic discharged me to another clinic. The second clinic keeps canceling my intake appointment and pushing it further into the future. ("Come in next month . . . no the month after that . . . no the month after that.")

Maybe I am going out on a limb, but I believe that no one in a modern industrialized country faces the level of complete disorganization of mental health services that Americans in the poorer of the 50 states face.

I will admit that, if I needed my appendix taken out tomorrow , I would get excellent care. If complications set in from that, my country would literally spend hundreds of thousands of dollars on me without blinking . . . millions even, maybe. I'll bet I could get open heart surgery next week, if it seemed what was best for me. America absolutely excels at certain things. What goes on in my country is bound to confuse those who live elsewhere in the modern countries of the world.

I understand that, for me, recovery is not going to mean feeling happy. I have been acclimated to recurrent major depression for a very long time. I don't expect that to change. I expect that I have a chronic problem that is not going to get cured, but, rather, needs for me to "manage" it. I prefer to be as self-directed as possible. When I had a good income, because most of my life I did, I got the psychiatric and therapeutic help I needed. Either I had insurance, or I paid out of pocket for whatever was appropriate to have in place.

The hospital was terrible and being there was not bringing me closer to better out-patient care, which the admitting doctor hoped would be the case. I left there in despair.

My mind is all wound up now. I guess one might expect that anyone who can type up these coherent sentences can't be all that much in crisis. Maybe I'm whining about nothing. Maybe I'm a total fraud.

Maybe this bad spell will pass, and I'll be okay for awhile, like usually happens.

I went into the hospital because I was in crisis - just as real as what many go into the hospital for. This place doesn't take you in just for being in a funk. Were a lot of people in there way sicker than I am? Yes, on my ward, all were extremely low functioning. It was truly pitiable.

I will go make my bed and see if doing one thing doesn't lead to doing another. That's how I have gotten better in the past. That's how most people get through their lives . . . doing something that needs doing and then moving on to doing something else. That's how I have gotten through before. The last time I went inpatient to this place was over 7 years ago. That led to me attending getting some very good out-patient care. It didn't work out that way this time. At least, now, I won't waste time debating between going in or not going in. It was dreadful and I would not go back there.

I am severely depressed, but somehow I don't think this is beyond enduring. Before Christmas and for awhile after, I was doing pretty okay and thought I was really gettin' it together.

It hurts awful bad to have fallen off my path up. If I can do the dishes that will be something. Time to stop talking about it and go do it.

I did the dishes. It wasn't too hard. Maybe that is the Neurontin kicking in. I am listening to some of my favorite music. I've been crying and missing the past.

The song on now says: "There is a balm in Gilead . . . to heal the sin-sick soul." And Paul Robeson's voice sounds so strong and reassuring. He, too, knew so much pain. Why are we put here to feel like this? I ask my God above. It is my fault, I know.

Next, I might clean up - shower. Make myself presentable. I feel so deformed. I'm so afraid of going to a job site.

This has come and passed before. Should it not happen that way again?

yes...

you are an inspiration!

I live in Australia and the mental health system here sucks big time. You can't even get INTO the psych ward unless you are either acutely psychotic or you have attempted to kill yourself and failed (or succeeded, come to think of it). Otherwise no help for you. If you are suicidal but havent attempted, they don't really give a rats.

On the one occasion I DID get in there - they have nothing to offer except medication changes. You sit on a couch in front of the TV all day long. The nurses treat you like garbage. It took me like 4ish days to get to see the psychiatrist (there are no psychologists in there for some reason) and that was only because I camped outside his door continuously. Then they changed my medication, told me i had a bad attitude and then discharged me. How dare I go in there to seek help! The audacity!

The irony is this: everywhere they tell you that if you are feeling suicidal or whatever, to go directly to your local ER without hesitation. They tell you this on TV, on advertisements, on fliers, in brochures, everywhere. Yet they forget to mention that you will be turned away from the hospital 99% of the time.

Kazza...I am from Adelaide I know what you mean

KazzaX - I'm sorry you had such a rotten experience going in-patient. That sounds worse than mine, and I thought Australia was more enlightened than that. I'm a nurse, and I see mention of Australia here and there when I read medical articles - about how your general health system is ahead of ours in the U.S. - in various respects. Isn't it something how Psych can be at such a lower level than other areas of health care.

I was able to get in, I think, because I live in a state where firearms are very easy to obtain. I'ld say the majority of us are gun owners.

Once I did get in, though, the scenario was not too different than what you describe. Everyone on the unit where I was placed were either psychotic or had dementia. I was put on on a ward for older people. I was much younger than everyone else in the unit. They told me there were more violent patients on other wards. That's a thing they look for here - potential for being a danger to other people. It's sometimes like the psych facility is an extension of the correctional system. I felt like I was treated more like an inmate, than a patient. When I got to the unit, they really didn't tell me about anything going on. They did talk to me about the potential of being restrained or put in "seclusion." It's routine for them to tell you that.

The psychiatrist spent minimal time with me. No real interview or assessment. Like you say, it's just about medication.changes. I stayed in my room because mainly it was that, or be parked in front of the TV. Similar atmosphere to what you describe. Nothing therapeutic going on. It seems they mainly monitor for violence. Staff stays away from patients and just sort of monitors. Absolutely no one asks what is going on in the patient's life. It is a very cold, almost mechanical environment. And there is that attitude on the part of Doctors that you are something low, if you are in there.

A social worker was nice to me. Even he told me that the system was bad. He thought he could get me some decent follow-up for when I left. He tried and came back and told me he was "shocked" when he was told I could go on a waiting list for 8 months.

I will admit I DID have a bad attitude once I saw how bad the place was - well, mainly just toward the doctor. He was like a robot. I would never go there again, if I felt suicidal. Some individuals were nice, if I took the initiative and talked to them. I felt sorry for patients who were too out of it to make any initiative. Some staff remained cold and condescending. That's how the pdoc was. The place was dirty. The food - much of it inedible. I lied to get out by saying I had improved and would be fine.

Today I'm not anywhere near as disturbed in my mind as I was. I've been taking Gabqapentine (Neurontin), but it is hard to know if that is what changed things. These miserable "tailspins," as I call them, come in and then move out, like a weather front.

In between, I can feel, and seem, pretty normal. I look back on how I was, and I feel like I acted like a baby. Right now, I say to myself: I'm never going to get that way again. I feel convinced that, this time, I really mean it. However, I've said that so many times before.

I don't know if anyone can relate to that. I can not believe that this changeableness is unique to me. Sometimes, I wonder if this could be a sign of bipolar disorder. Once a doctor told me that it was.

The last two days were terrible, but today I am NOT horribly depressed. I wish I understood better how this misery comes and goes.

Hi Rose-do you think it might be food triggered? Have you considered keeping a food diary?

My short answer would be no.

Still, when depressed, I tend to skip meals, which I do believe exacerbates feeling low. Sometimes, when I feel low, if I happen to eat a pretty full meal, I notice I can feel better after eating. I keep high protein nutritional shakes around, so that I can easily get some nutrition when I am too depressed to put together a meal. They are not as mood-improving as real food.

If my apartment becomes disorganized - that provokes anxiety, which provokes depression. If I can somehow get the ambition to put things in order, then I am apt to improve a lot. It's just so hard to do that, once I become depressed. It sure sounds - even to me - like laziness. Yet, I've always been considered a diligent worker on any job I've ever had. I tend to be very thorough about how I do things.

My chart at the facility where I get care has something down about some kind of OCD type thing. I really don't know exactly what, but a pdoc mentioned seeing it to me, and I was only half paying attention due to being upset at the time.

My apartment tends to be either very neat or rather a disgrace. Either I'm fussing over keeping things real tidy, or I'm just tossing stuff around to land wherever it happens to land. This is cyclical and has gone on all my life. I'm not one to just habitually do things in an organized fashion. Basically, I don't have good habits.

I know that got off the food subject. I'm just trying to see what I can correlate with the ups and downs.

I woke up feeling bad. Nauseated. Don't care. Not trying. Afraid of upcoming job assignment.

Me too - I think this is proof these are two separate genes, a neat gene and a messy gene. I got my messy gene from my mom and my neat gene from my dad. So it must be a dominant, not recessive, copy of both. Or they are both recessive? hmm, I have to figure this out...

Rose76

I am so sorry to read about the situation you are in. I hope this will help somehow. I am new to the forum but have had many hospitalizations for severe depression and in my experience all the replies I read are very accurate. So my advice to is to voice your suicidal feelings and the fact that you have no outside support I know where I am from they cannot turn you away for these reasons. As for pulling yourself up by your bootstraps sometimes we all need a little help getting started with that plan.

I know you are anxious about the assignment (totally understandable) but I am so happy for you that you have work!

Thank you all for posting here. I can't tell you how much I don't want to leave my apartment to go anywhere, least of all to this job assignment. It is awful to feel this way.

It's okay to be afraid and not want to leave the house. We've all been there at one time or another. Your depression just makes it feel so much worse. Will you be able to muster up the courage to go to the job anyway? Maybe being at work will give you a respite from being alone, inside your head all the time. When does the job start?

Thanks so much, Buggs. I go tomorrow for some orientation. This morning, I thought that I would not even go, but would go jump off a high cliff instead. My medication helped me to calm down, and I found the ability to try and take it one day at a time.

I managed to color my hair and shower and have decided to get out of my pajamas tomorrow morning, dress appropriately and leave the safety of my house. If I get through that, maybe I'll even show up for the job next week. But I can't think beyond tomorrow, or I get too scared.

And, yes, it could be just the respite I need - but I won't think too much on that cause, then, I might jinx it.

My hair came out how I wanted it to, so that is a start. I'm glad I did something right today. It's given me a little confidence.

I got told yesterday that I am probably Bipolar and need to be on anti-psychotic medication. I think where I get my care is awful and I am afraid to go back there.

First of all, how did the job go?
Second, there are a lot of anti-psychotic meds that they use for bipolar. It doesn't mean you are psychotic (my first reaction to being told the pdoc wanted to put me on abilify).
Third, it's not the end of the world, and may actually even out some of your low lows. Hang in there and let us know how it goes!

It was training I went for yesterday. The person training me spoke of how she has had to work with so many "idiots." She seemed to sort of hope that I wouldn't be another one. I don't think that is a good way to talk to someone new at something.

Maybe I'll actually go to the job, do okay, and be glad to have the experience.

I've become very despondent. But there is nothing new in my saying that.

Thanks for encouragement.