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

I went to the psych hospital last night. I am very seriously depressed. The nurse triaged me as "low acuity." After waiting in the lobby for hours, I left because it was bitter cold in there. The nurses were okay with me leaving. A nurse had said that she was wondering what I expected them to do for me.

I hate going over to that place very much for special reasons. The last time I was hospitalized there was in 2004. That did lead to me being put in a day program that helped me.

I take myself to the hospital because I have no family or close friends for thousands of miles. I am not close with my relatives. When they ask how did I get there and I tell them that I drove myself, then something gets said that implies there is not too much wrong with me.

It's not my nature to get dramatic at the hospital. I don't know what to do. I think maybe just keep going back as a way of saying that I can't cope well enough by myself right now. But I don't think I will do that. But maybe I should. I am afraid of them being annoyed with me.

I'm sorry to start another thread and I wouldn't blame PC members for being tired of me saying I am depressed. I am not getting the level of services that I know is available and gotten by others. I have no T. I don't see a pdoc until February. My appointment to see a pdoc in December was canceled. My appt. for January was canceled.

I always go there alone, whether it is for an appointment or to the crisis intake area. There is nobody to accompany me and advocate for me.

I see you doing the right things. Not sure why when you go to the hospital you do not get to see a doctor. Might be where you live. I know that when i've gone in a doctor has to release me. To make sure that I am safe. Hang in there you are doing what you can. Keep yourself safe.

Hello, Rose76! These statements from your post really stand out to me:

• "When they ask how did I get there and I tell them that I drove myself, then something gets said that implies there is not too much wrong with me."
• "I am not getting the level of services that I know is available and gotten by others."
• "There is nobody to accompany me and advocate for me."

An advocate is what you need. All the talk about advocating for oneself is great, but the seriously depressed are often (usually? almost always?) not up to that task. In my years of depression, I have only been able to effectively convey my state to the bureaucracy with the assistance of advocates of one form or another.

May you find the right advocate.

I went to the psych hospital last night. I am very seriously depressed. The nurse triaged me as "low acuity." After waiting in the lobby for hours, I left because it was bitter cold in there. The nurses were okay with me leaving. A nurse had said that she was wondering what I expected them to do for me.

Wow, Rose, this is tough! I am not sure how getting an advocate would work, but it sounds like you definitely need someone to help you. Have you discussed any of this with a general doctor? It seems that he/she could help you with some type of referral.
It is terrible that the nurses are comfortable making such negative statements to patients.
I know how hard it is to stand up for yourself when you are really depressed; however, I wonder if you can call the hospital and express your dissatisfaction with the way you were treated.
Hugs,
Bluemountains

Rose, the best resource would be a medical doctor, who could give you a referal. If that's not an option, are there any local radio, TV, or newspaper column therapists in your area? You might be able to find a sympathetic hearing from one of these.

Third choice, and outside shot--how about a college or university in the area with a psychology department? A student looking for a project would seem to me the most likely prospect.

It could be anyone with determination, Rose. Look around ... someone obvious, but just not not someone you focus on maybe.

I'm so sorry it's so hard.

Thank all of you above for your posts. I think you have been very kind and I am crying now because sometimes it makes me cry to have people be nice to me when I feel this bad. Also - you give me some hope.

Rohag -I will look into getting some advocacy help. You have reminded me that I did that once, and it did make a difference. I had forgotten, as that was back in 2004, and I am not thinking real effectively.

You each make good observations. DepressedAlaskan - I think where I live has something to do with it. There is no first class anything in my state. I don't really blame the state. It's just a product of history.

I am sort of thinking about how I might pull myself up by my own bootstraps. That would be preferable to going inpatient at a place that has always been pretty crummy. Maybe if I could just start picking up the house and putting things in order. That has worked for me many times.

Still, I know as many times as I pull myself up, I will continue to have episodes of decompensation. That is what it means to have a chronic problem. It's chronic. I can be very well at times. My goal is to make those times last longer. My goal is to reduce the frequency of downturns and to reduce how long they last. I might be more successful over the long haul, if I was plugged into an appropriate level of services. Not to foster dependency. I could game the system and get a lot more than I am getting. I am trying to ask only for what I need when I really am in need.

Where I go is a public facility. Those places always serve a population bigger than they can really do the best by everyone for. It becomes a case of prioritizing the most severely needy. I understand the realities.

My primary care doctor seems to be above average good. We have a pleasant relationship, so I hate to ruin it by telling him about psych stuff. I'm at an age where, unfortunately, I am starting to have a number of health concerns. I'm afraid that if I give him too many things to think about, then he won't be able to do a good job on any one thing.

What you say BlueMountains, is an idea I will use. I will tell my primary care doctor that I am not getting adequate follow up at the psych center. He seems genuinely caring.

There are ways of expressing dissatisfaction and I would like to do that, but carefully in a way that does not just get me labeled a pain in the butt.

I feel better just thinking about what has been suggested here. Maybe I can go make the bed, while I feel a little better. Then - maybe - do something else.

Thank you for believing me. I wouldn't say I am seriously depressed if I weren't. It's an awful feeling of failure to get this way.

Many, many, many hugs, ((((((Rose))))),

Please keep us posted as you explore your options. I, too, didn't want my primary care doctor to know why I was on ad medication. When I started falling apart I had to tell her. I am so thankful that she is an excellent physician and makes sure to check on my mental health with each visit. Also, she doesn't treat me any differently than before, except when she has to treat me while I am in an extreme depressed or hypo-manic state. I'll bet that you will find that your doctor will continue with his same caring manner.

Bluemountains

oh dear, Rose, that's terrible. I do hope you are able to get proper attention and treatment. Depression is an illness and you are entitled to get treatment, not to be put at the bottom of the list. And as for what that nurse said to you!!! That, surely, is a reportable incident to the hospital management.

Triage usually works well, but in the case of mental illness, there is still a lot of ignorance among nursing staff. When a patient comes in and is polite, non-violent and well-behaved, they assume we're okay! It happened to me lots of times. Too many times. One nurse who came for a home visit after I went home from hospital one time, said she would stop coming to see me because she thought I was doing pretty well!!! Just because I made her a cup of tea and had a polite conversation with her. She said she had "sicker" patients, one who had set his bed on fire. At the time, I thought, oh, okay.
Now I know better, I would say something like "Just because I seem to be functioning well on the outside, and I'm not violent or suicidal, doesn't mean I'm okay. I'm actually not okay, not at all, and I need to see a doctor - NOW".

HTH and wish you the best. If we can't go to hospital when we are sick, then where on earth are we supposed to go??? Try to ignore those stupid nurses, BTW.

PS Rose, I forgot to say, it's hard to pull yourself up by the bootstraps when your brain is tired and isn't working properly. I seriously wouldn't worry about tidying the house - you might get too exhausted and that will make you feel worse. I know because I do that all the time! LOL Just make a neat little corner - e.g. a corner of your coffee table, where you sit - for your cup, book, magazine, phone. That might make you feel a bit better. Don't overdo it. And take a warm fleecy blanket next time you go to hospital. Tell them you might look and act fine, but you're feeling really bad and need help.

Rose, I'm sorry you're feeling this way AND not getting the right care for it. Maybe, you could wait out the triage next time, or maybe next time you can ask a friend to drive you. Hope things turn around some for you

I am having constant on-going soreness in my back now, except when I lie down or recline in my chair. It was a very mild problem for years, but recently became much worse and incapacitating at times. I will get appropriate care for it. That was the stress that really triggered me.

It limits my time on the computer. It is so tiring just sitting straight in the chair at this desk. I would have more to say to the posters above, individually, if I felt less back fatigue/discomfort. Please know I truly appreciate all the posts and you all really helped me.

When I am sore like this, I tend to want to keep moving around and not stay in one position long. That helps the back. Well after reading the replies the other night, I got up a made the bed and TO MY OWN AMAZEMENT I did succeed in stopping the tailspin.

I had worked so hard to make my place nice for Christmas, I didn't want it all to go into disarray, which is what happens during a bad "tailspin." So I kind of did manage to pull myself up by my bootstraps. Now - this was an uncommon success for me. I attribute it, in very large measure, to the understanding I got here.

I will run out of an important med soon and have called twice to try and get a pdoc to write a script for me. It's a controlled substance (sleeping pill) so I have to get a hard-copy paper script to bring to the pharmacy. No luck these past few days getting a response. I WILL take the advice offered above and stop being so passive about just accepting being rescheduled and put to the bottom of the priority list.

HotTinRoof, yes - I am being dismissed because I am "well-behaved" and appear to be functioning okay. There is an administrative manager of the out-patient clinic who is very decent. I appealed to him once, when I needed more help than I was being given and was surprised at how helpful he tried to be. I am going to make an appointment to see him. AND - I will follow through with a certified letter about my inadeqate care and keep documenting what is not a reasonable level of services.

My functional capacity could be used by me to help me. Functioning fairly okay does not mean there is no real problem. I am not currently suicidal and I do not say this out of any desire to sound tragically afflicted: The majority of successful suicides are committed by persons with no history of any unsuccessful attempts. (At least, that's what I read on-line.) Often they are persons whose level of function caused no one to be overly concerned with their state of mind. President Lincoln's friends used to take turns doing one-on-one suicide watch over him, while he was conducting his leadership of the Union forces during the Civil War. He was extremely high functioning AND extemely depressed at the same time.

In no way, do I consider my problems remotely as burdensome as the weight that was on old Abe's shoulders. But I am not a person of his profound internal resources, either. My individual situation is what it is, and I have requested help in managing it for very good reasons.

Thank you all again.

Hi Rose--I used to have lower back pain and this site had some easy exercises. (and I hate exercising)

http://www.bigbackpain.com/back_exercises.html

and I do understand what you mean about being functionally depressed. I was that for years. Oh how I longed for someone to notice. Just a "how are you doing now?" would have been so appreciated. If only they knew right? It's a good thing you are posting your feelings. oh, and I also love it when my place is tidy and neat. (that also doubles as my exercise;p)

TerryL - Thanks for the link. They have exercises for the upper back, also, which is what I need.

I am doing okay now, and today called a supervisor at the psych center because I am having a hard time getting a med renewed. I am going to also look into advocacy for backup. I appreciate all the suggestions and I re-read them to remind myself of options.

I have started to try and find an advocate to help me. That was a good suggestion. Once, years ago, an advocate helped me get partial hospitalization that helped me a lot. I improved for years. Now I have gone further and further down and my appointments just get canceled.

I know everyone has problems and has to just do the best they can. I was trying hard. Now there is no trying left in me and this is very hard.

I must have changed a setting somewhere and now I am all confused. This thread comes up on my computer all out of order. I'm trying to get back on track. This post helped me before. I'm trying to make an entry that goes to the bottom, but not succeeding.

Rose, I am so sorry that you have been ignored like that. It disgusts me! I also am fairly "high functioning", and it annoys me when people assume that I don't have a problem. Oftentimes, I'm miserable and I'm not high functioning by my standards. People should be aware that in order to have a psych disorder, you must have either distress or impaired functioning. It seems to me that distress ought to be the focal point, as I'd imagine that serious problems functioning are only bad because they are distressing! To a mental health professional, however, it is easier to see that someone who set his bed on fire is sick than it is to pick up on subtler but equally serious presentations of psychiatric disease.

Perhaps you should join a depression support group, like the ones offered by NAMI. If you work, ask a co-worker out for lunch. Loneliness can really, really contribute to depression (and is a nasty enough beast in its own right). It's hard, I know. Trust me, I really know. You need to try, though. If you had close friends near you, you might gain more than just a person to drive you to the hospital.

Rose76,

Gentle hugs to you, Rose.

What state do you live in? Different states do have different policies, but there are likely assistants like...

http://www.disability.gov
or call 1-866-833-2466

NAMI is a terrific resource with support groups and education.

Secretum Thank you. What you have said above is very intelligent and insightful. Also, it is a kindness to me to be understood and have my situation appreciated. Not much of that comes my way, outside of PC. I've made exactly the same analysis about how distress and functionality are perceived by the System and how one's subjunctive experience is not ever remotely as important to "the System" as ones objective behavior.

I believe I understand why that is. Behavior that is low functional or dysfunctional is more apt to cause problems for others . . . . for one's family/community . . . . for society. That's what provokes a response. In responding, the intention - really - in my opinion - is to stop the afflicted person from becoming a problem to others. Also, health care professionals have to concern themselves with liability issues. If the afflicted person credibly threatens self-harm, there is a legal mandate for the system to respond. The system will respond, even, to less than truly credible threats, sometimes, just to avert potential liability in the short and long term.

If the afflicted person demonstrates "grave self-neglect," again, there is a legal mandate to intervene.

There really is no mandate to intervene in ameliorating personal internal anguish, in the absence of incompetent functioning. The bar for what constitutes competent functioning is set fairly low. A rationale for that partly concerns respecting the rights of individuals to not function highly. One must be gravely dysfunctional to be considered "incompetent," and I suppose most of us, including myself, wouldn't have it any other way.

Still - there is a mandate to respond to severe emotional distress that gets assessed as constituting clinical disorder. What I suspect confuses the issue is that experiencing considerable emotional distress is a part of normal living for even psychologically well-integrated persons. Furthermore, people experience great emotional distress often due to choices they are at liberty to make. It would be counter-productive to undermine the feedback system that motivates change.

Deciding when a person has truly exhausted their internal coping capacity/mechanisms can require a fineness of judgement that may indeed exceed what clinicians are even capable of exercising. There is an arbitrariness to specifying where the limit lies. It is only ever truly known after the fact - when tragedy establishes that the limit of a person's tolerance got exceeded.

Even then - circumstances beg the question: Did the afflicted person truly run out of resilience - or, maybe, just . . . patience? One does have the freedom to simply give up.

Loneliness, as you point out is a "nasty enough beast" all on its own. For the depressively inclined, it hugely exacerbates that problem.

I thank all members who have posted here. I feel less alone, and that is no small thing.

I'ld feel better if I cleaned up the mess into which my apartment has fallen. Thought I was up to at least starting. Now, instead, I feel sleepy and wan't to go back to bed. Maybe, after some more rest. I even took some Ritalin. But I feel so tired.

Hugs to you Rose76(((((((Rose76))))))) Not much I can say that has not already been said lots of good advice. That is why I say depression is the invisible disease I look ok on the outside but inside I am falling to pieces. I know last time I did just what you did drove myself etc...Sometimes just trying to deal with the system is trying to say the least! Just want to say you are not alone I go through the same thing myself and I don't like to cause a scene so how could anything be wrong!DUH!

Hi, I have never been to a facility like that before, but I am also suffering from depression and also the chronic back pain due to my job (I sit at a computer typing financial stuff all day). I think you're right and if those nurses are making assumptions about your health based off of the fact that you drove yourself over there, they really don't understand much about you at all. To me, I feel very disconnected from other people, very alone, and it seems like no one can understand me.

About burdens, sure you can think some people may have had what seems like way worse of a situation or problem to overcome, but everyone is different, and even small things can affect us so much that we cannot cope with it anymore.

To: GMA45 I'm sorry to hear you went through the experience of driving yourself over for help, only to have your pain discounted. Sounds like you have gone through what I'm talking about here. It can get rough - inside, for you. But, if your behavior isn't making life rough for anyone else, then you go to the back of the line. I was okay with being sent to the back of the line. Trouble is - I move up in line a bit, and then I get sent to the back of the line again. Thanks for sharing what you've gone through.

To: CgRgSm Thank you for your affirmations. I take my hat off to you that you manage to keep working despite the pain. It's only lately that I have been having to cope with chronic pain, and mine is actually not severe, at all. My tolerance for discomfort is very low. Even my dentist gives me extra Novocaine. I will admit: I am a complete baby. You are working, tolerating pain, and enduring social isolation. That's really a lot - and, yet, you are able to extend compassion toward me. What amazing people I encounter here at PC.

Hugs to all of you above who struggle, sometimes with not much support.
Again, thanks to everyone for being so kind.

I am thinking of going to the psych hospital because I have been relapsing very badly for intervals. They kind of pass for a spell and then return.

I want to tell them that I don't find any entertainment value in going to that psych center, where I have to sit for hours after getting triaged. Also, I get embarrassed to even be there.

I want to tell them that I am feeling like I am being overwhelmed to where I can't cope and that I think I am potentially in need of serious help. I want them to stop telling me to come back when I am really a danger to myself. I think that is a dangerous policy.

I go months seeing no one at the center and I have almost unbearable feelings of failure.

Hi Rose--I read your mood of the day and understand why you are feeling down but good for you for trying that assignment! I hope you will feel better soon and I do hope you will get other assignments soon also. or maybe come to a plan B of some sort? Hang on to that inner strength. All the best

I went over to where I get services and made it plain that I was not "low acuity." That got me to the head of the line. I was assessed by a really committed, caring pdoc. I told about how I have been left without followup. We were honest with each other. We looked at 2 options, and I accepted the invitation to pick one. This pdoc admitted that there was no telling how it would work out and could be a gamble.

I went in-patient. The experience was pretty totally miserable. At least, now, I know better how the place operates. I won't be continuing wasting time wondering if I should, or shouldn't check in. I got in and, mercifully, got out, and I would rather poke sharp sticks in my eyes, than ever go there again. The place is terrible. I'll concentrate on what other options are available when I need serious help. I'll start researching other ways of getting supported.

I must believe that it isn't impossible to get support, but it will take looking into where that can be found.

I am grateful for Psych Central. Coming here for awhile this evening has helped me begin to recover from a rotten outcome to a decision made in good faith on the advice of a well-intentioned pdoc. This web site is a great place of safety to come to. I left that facility in very bad shape. I felt so lucky just to get out the door.