When to go into the hospital

[PenelopeAnn]

Do you have certain things that tell you when it is time to make a call about needing to be hospitalized or going to the ER? Certain behaviors or thought processes?

I was this close to making that call today. I've been severely depressed for about 12 days (been treated for bipolar over 10 years) but it was the heavy, slow, flat kind that I can usually muster through. But it has changed into the weeping, constant negative self talk, and the desire to find a quiet, dark, tight place to hide in. Hide from the world and cry and hope the world forgets all about me. I was THIS close to calling my pdoc or therapist but I took a walk, reminded myself of things I had been looking forward to, and I think I'm ok as long as I stay away from triggers, such as certain music, and I can talk to my therapist when I see her tomorrow. I will be calling my pdoc tomorrow too, because she said to if I needed to and I have a scary history of suicide attempts and psychosis and mixed episodes.

I was curious about other people with bipolar disorder. When do they make that call?

[paranoid_cataclysm]

I'd say when you can't stand what you're going through to function on a daily basis such as you can't take care of yourself and your meds aren't working for it.  I've been told when you have a loss of control you should go and especially if you're a danger to yourself or others such as feeling suicidal or homicidal.

[PenelopeAnn]

I woke up feeling better. I talked to my therapist. I have plans for the end of the month, something I am looking forward to, so I don't think I am in danger right now. I still feel depressed, just not as severe. So I will see how things go. Earlier today I felt just fine but dipped a little bit in the evening. Maybe it means I am cycling out. But I'm tired of cycling- period. People are like 'But you know you'll be cycling out of it so just wait'. Yes, but I also know I'll cycle up again, then down again, then up again and if I'm lucky I'll get a normal chunk in there. Previous to this mess, I lived with low grade fluctuations, no all out cycling, for 3-4 years. People that aren't dealing with it don't seem to understand how infuriating it is to be constantly cycling. So NO I don't look forward to cycling out of the depression, which I know will happen, because it only means the beginning of yet another cycle. At least they are getting longer. I had been changing mood states every three days and at times in one day. Now it is a week or two in one state. But it is still too drastic a level for my tastes. I don't want to live with this severe of cycles. I used to only get severe cycles every three years, which lasted weeks to months, and in between I lived with light changes. This is new. A crisis every few weeks? I don't think so. Not when it spells psychotic bizarre death-melancholy-euphoria states. Then I have NO insight and as long as my moods are this extreme, there is the risk of landing there.

Sorry, I'm ranting. I was stable for 3-4 years until a crappy pdoc said I didn't need to take the Seroquel anymore because I wasn't having psychotic symptoms anymore. I titrated down and everything came unhinged. That was in the winter and I haven't stopped cycling since. What a mess.

[PenelopeAnn]

I will see my therapist tomorrow and definitely call my pdoc when I get home from that. We don't have a whole lot of pleasant options to treat the depression. Side effects on all other mood stabilizers, antidepressants have caused manic and mixed episodes in the past, and I won't go near ECT again. Possibly just touching base will make me feel safer. I'll let you know what my pdoc says.

I feel better after my long walk. I always do, but it is a short term remedy. I always wake up depressed again, for these couple weeks anyway.

[ILADVOCATE]

I have not needed hospitalization since my current recovery. However, before that the times that I went to the hospital were when I did things that were destructive and that got out of control but I'd rather not detail them on a public thread. Any realistic suicidal ideations or urges to engage in behavior that is destructive to oneself or others is a sign that hospitalization might be needed. If there are any concerns though its worth calling your psychiatrist for follow up at any time and ask them what to do. I always keep in close contact with my psychiatrist including now.

[Xila31]

I don't know about me because I've never been to the hospital. Another person I know with bipolar 1 she would just suddenly spiral out of control internally. Externally what I would notice is she would rock back and forth more than normal and just seemed completely out of herself. (She normally had some rocking but it would be much worse.) It was always a choice she would make and not really explain it, but I took her two times to the hospital. One time she stayed the other time she did not.

I wish I could be more help.