How do you know when you need IP?

I might need to go IP but I won't be able to see a nurse until the 2nd and I'm sure I'll be fine until then but my condition is deteriorating .. I'm not showering like I'm supposed to .. eating only once a day (if that) .. I feel numb .. nothing feels right .. my house is a mess .. and my mind is moving so slow. So I'm having another bipolar depressive episode. My problem is I know how deep this can go and I want to avoid that while I'm in the right mind. Is it time to go IP? I'm sleeping 24/7 and have no energy to do the simplest things. I haven't been IP in 7 years so I'm terrified!! I'm literally so scared!! My last hospitalization was when I was 17 so this would be my first time in an adult unit. What's it like in an adult unit?? I also have a broken foot, will they look after it while I'm IP?? I'm just worried about who's going to look after my bearded dragon and help look after my house while I'm gone since I live alone and 12 hours away from my immediate family.

Do you have friends that could help or neighbors?

I have been IP many times and for those that are bipolar it does help. I myself am BPD so it doesn't help as much, but that's me. If you still have control over the impulse to sui then I would say no need just keep going and distracting yourself but the fact that you are sleeping so much is a concern! Do you feel tired? Or is it all mood related? For all my times going IP I end up forcing myself to do things because I hate the places they limit everything you do, but for good reason. Besides the sleeping 24/7 what else are you experiencing? That is if you are comfortable sharing. Please be kind to yourself, you are worth the time and effort. How else can we here help you?

In my experience they won't hospitalize you unless you are suicidal. It's possible your nurse can get you admitted for a quick med change, if that is what you want.

Can you investigate IOP or PHP programs? There are none in my area, but I know that they have been helpful to some people.

Do you see a therapist? Can you call/text/email them?

I don't want to be awake .. because then I have to face the fact that my life is total and complete mess right now. I lost my brother to sui on Christmas Day this year and it's eating me up. I've been depressed ever since. So I've been sleeping a lot to avoid the reality that he is gone. I really don't want to go IP but I'm afraid in a few weeks things will be worse and I won't be able to control my impulses anymore. I don't want to hurt my family so I'm looking at IP as a preventative measure to get my depression under control before it gets out of hand. My depressive episodes get to the point to where I start seeing/hearing things too, and I want to avoid that as well. I'm also looking into changing my medicines around. Maybe they're not as affective as they should be. As for other things I'm experiencing is a lack of any energy to do anything, my house is a mess and I haven't cooked in over 2 weeks. I eat once a day, if that and it's usually just a sandwich. Something that doesn't require too much energy. I don't shower regularly anymore. I don't have a job or anything so I rarely have a reason to leave the house and where I live it's like 4 degrees right now so it's too cold to go out to the park or something like that. My mom has agreed for me to move back home, she doesn't feel comfortable with me living on my own so far away from her. Mainly I need help with trying to figure out if IP is a good option for me. I'm just scared of things progressing to the point of sui because they have before.

Yeah that's what I thought, I'm not sure if my medications are working right so I might need them changed soon. I just looked up those programs you mentioned and there's a few options here where I stay. If I'm not mistaken I think my case manager at the mental clinic I go to mentioned them having one. I'll have to see about getting into it, if I don't get admitted when I go see the nurses. I'm getting worse by the day now. I do see a therapist but I don't have any way to contact him other than his work number and the office is closed till Tuesday and that's when I can go see the nurse also. I'm really out of options until Tuesday, I won't be able to do anything until then. Thanks for the reply!!

With what you said, I believe you need more treatment. You know what you need, to simply make it to Tuesday when you can see your team. Could you stay with your mom until then? Maybe try to get out of bed and eat twice a day. It's something simple but you seem very vulnerable right now.

With the sui of a family member, do you want your mom to morn for your loss?

Sorry to be blunt but I think that's what needed to be said. I'm worried about you. Please keep writing on here and reaching out, it does help.

I know you need more help, and to be kind to yourself in the mean time. I know moving in with a parent can be hard but then you have support that is built in. It's what I had to do a year ago. Even if it is for a short time, it will help. Just stay there, do it for yourself. It will also show to the nurses that you are willing to do something and it will help!!

My mom stays in Texas and I stay in Kansas, I live alone but my brother is here with me till tomorrow then he leave out of the state for work. I should be fine until Tuesday. I call my mom everyday to check in with her and let her know I'm still okay and still going to see the nurses on Tuesday. && no it's okay to be blunt!! I appreciate it. I do not want my family hurt by my actions so that's why I'm seeking extra help now before it gets to that point. I don't ever want to get to that point again. I will be moving back to my moms in Texas once I figure out what's going on with my disability case. I have a lawyer up here in Kansas now and things are progressing as far as that goes. So I don't want to have to start the whole process over in Texas just yet. I'm just waiting to see if I'm approved or not right now.

If you need to be IP, you can always say that you are suicidal.

With that said, there probably are no meds that will make much of a dent in the grief that a loss like yours would cause. Losing someone is always hard, and when it is a suicide, that makes it worse.

It is actually fairly normal for someone in your situation to wish that they were dead also. So what you are facing may be grief, complicated by the multiple losses and the suicide. Yikes. That would be really hard.

I don't know if that helps, but I think that your symptoms may be a normal response to a time of great loss rather than a worsening of your MI.

Take care, hang out here if that helps.

I'm glad to hear you will be safe and you are reaching out for support. You're doing things that I sometimes don't. That's a good thing!! I know how you feel for waiting on disability, I'm in the same vote. But then we both can focus on healing!! Great job, I wouldn't worry about going IP, just be patient with yourself, let the treatment team make that call. But that's my opinion.

Hope you are doing ok today.

Today hasn't been too great and I'm alone now since my brother left. I've been sleeping most of the day. I feel empty though and numb. It's weird .. it's like I don't have any emotions. I see the nurses in the morning to figure out what we're going to do about my depression progressing the way it is. I know how bad my depressive episodes can get and my family is now getting concerned for my health and safety since they're all the way in Texas. I have been keeping in contact with them though and letting them know I'm still okay. I'm just not well at the moment. My friends aren't really messaging me back but that's okay at least my family is keeping up with me. It's been a rough day really. My family wants me in the hospital because they're afraid I'm sui even though I've told them I'm not. I'm really not but the thoughts are there, but that's kind of normal for me actually since the thoughts are always there. Even when I'm not depressed they pop up. No actions or plans just thoughts. Idk I feel like I'm rambling, so I'll stop here.

Hoping that the visit with the nurse is soon. You definitely need extra support given your history and recent tragic events. Go inpatient. Being alone right now is not a good place to be.

Do not apologize for expressing yourself. You need help. You need care. You need support. If help is there take it.

Yeah, what possum said. Hope your appointment is helpful.

I'm currently still waiting on my sister to be able to come get me and take my to the nurses office. I would drive there but my foot is broken and I'm on a strictly no driving rule from my doctor. So I'll have to wait until she can get here. I'm really thinking hard about going IP .. it seems like a good option since I'm getting worse everyday. I'll update you guys as to what happens if I can.

Sitting here with you until your sister comes to get you.

I'm sorry you're feeling so bad.

Something my pdoc shared with me:
Early November was kind of hectic - I got really ill and had to quit all my meds because of that, while my grandmother was dying. She passed away a few days later and 24 hours later, so did my grandfather.
I was feeling understandably crappy. I had had to quit my antipsychotic (so I was going crazy from lack of sleep and PTSD symptoms), had had to quit my antidepressant (which hadn't started working yet - or maybe it had just a little bit, but not significantly - so it was more frustrating than return-of-depression), and had had to quit my stomach medicine (so I wasn't able to eat much of anything).
Pdoc said: yes, of course the medication quitting doesn't help. But it isn't strange you're having trouble coping - your grandparents did just die. It might be depression, it might also be natural grief.

That sort of stuck with me and it reminded me of your situation. I'm not going to mention that it is all depression and very little grief - while I'm not saying it can't be that, it's not really something I can say much about. But it is possible it's part depression and part grief and they reinforce one another, and that sucks. It's also possible it's part depression and part grief, and that they reinforce another, but once the shock and immediate grief (of course you'll be grieving for a very long time, but in the beginning it's more intense, in my experience. At some point you 'learn to live with the grief' and you can cope again, not thinking about it all the time) wear off, your depression will also lessen. It's also possible the grief "induces" the depression, and that the depression will now run its "natural" course with very little regard for the lessening of the grief.

You mention you think you need a med change - do you need to be IP for that, or can you also try it at home first?

Also, I think with your history and situation (your depression is increasing quickly, for the most part you aren't getting up or eating, and in the past your depression has gotten to the part of psychotic depression) they might be willing to admit you without being suicidal.
In my experience doctors are more willing to admit you if you're heading towards psychosis than if you're heading towards being suicidal.
Also, another point in your favour (regarding being admitted) is that you haven't been IP in 7 years, so they (probably) won't turn you away thinking you're a revolving door patient.
On the other hand, you mention in your signature you have BPD - some doctors don't want to admit BPD people. That's shame on them, but it might be something you'll have to deal with.

As for the difference between youth and adult wards - in my experience, youth wards focus on you going to school/working on your homework in the ward (depending on whether the ward has a classroom attached) and adult wards have groups. There's other differences too, of course: in a youth ward you'll probably have people between at most 12 and 21, while in an adult ward you'll have people from 18 to ... (probably around 60-65, usually older people go to a geriatric psych ward).

Is your doctor or nurse affiliated with a psych ward? If so, they might be able to tell you more - and also talk to the psych ward doctor/admission people about you, as in, should they admit you or not? is there anything they should or shouldn't do in regards to how to 'handle' you? (I don't mean that in a bad way, but you have PTSD. Most people with PTSD have triggers, and a hospital stay can be really upsetting if those triggers are triggered. Being triggered when they don't know something triggered you, can get you labeled as being uncompliant with the treatment, and can potentially get you either a discharge or harsher treatment/restrictions/stuff like that. Best to avoid that. (Example: I am 'afraid' of the colour orange.. can't really talk when there is more than a tiny bit of orange in the room (and honestly, I prefer not even that tiny bit), refuse to touch anything orange (although orange lights might be OK, because it's light, not ink or anything - so are mandarins and stuff, because it's also not ink), and stuff like that. If they know that, it greatly lessens the change of: - my bed having an orange pillow case, and thus me refusing to go to bed. - a nurse wanting to use an orange blood pressure cuff, and thus me refusing to have my BP taken. - the pdoc's office having an orange chair, and thus me being unable to talk about anything even slightly important. If they didn't know that, it might be possible they'd say "She refuses to go to bed, won't have her blood pressure taken so she can't start on the new meds, and she doesn't talk to the doctor! Let's discharge/move her to a secure ward!" So when I went inpatient during the summer (my first time in an adult ward also), I, my parents and my pdoc all mentioned several times: "Orange + Breadfish = not a good combination)
Of course, doctors and nurses can also do that if it's a ward they aren't affiliated with - but usually they have more success if they are.

What did your treatment team say??

Wondering if the silence means you are getting the care you need.

I went to IP on the 3rd .. I got out last night. I'm feeling much better!! My medicines were changed around a bit and now I'm taking Risperdal and Seroquel .. my brain feels a little foggy but other than that I'm fine now.

Good to hear from you; and I am glad you are doing better. That's awesome.

Thanks for the update. Good to hear that you are feeling better.

Will you be going to take some time out with your family?

I won't be able to see my family until I move back home around May .. so that's a bit of a bummer. But they're giving me support even from far away, my mom has told me to call her anytime I need to talk and to keep taking baby steps into doing things so I don't overwhelm myself. I don't work or anything so I'm pretty much a hermit it feels like. But I made some friends in IP that I'm keeping in contact with so hopefully we will be able to meet up every so often until I can move back home to my main support system.

You don't know me from adam, but for what it's worth... I lost my grandmother on December 14th, 9 days after her 93rd birthday.

IP would make me "frenzy," to borrow a term from V:TM. I would lose it and freak out and try to claw my way out until my fingers were bloody stumps. The sight of cops makes me paranoid and the sound of keys jangling...let's not go there. *shudders*

Just be gentle with yourself. Don't feel like you absolutely have to feel a certain way--you're grieving, and have every right to feel down. It's okay to grieve.

At least...that's this wolf's perspective on it.

When my decisions are against my own self-interest..bad decisions however you define it.