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How to Know When Hospitalization is Best

Making the decision for yourself or for someone that you love about getting inpatient psychiatric hospitalization can be very difficult. If you are experiencing life as extremely out of control due to either yours, or your loved ones symptoms of bipolar and you have exhausted other treatment options including enhanced outpatient treatment, changing medications if appropriate, and following identified interventions in your wellness and recovery plan, hospitalization might be necessary in order to help you or your loved one regain stability. Below is a list of some indicators that hospitalization might be the best course of action.

1. Suicidal

2. Self harm (cutting, head banging, hurting yourself )

3. Homicidal (ruminating about killing someone, fantasizing or plotting how you might carry your actions out)

4. Psychosis/Hallucinations (audio, visual, tactile olfactory)

5. Delusions (believing something bizarre-even though evidence is contrary to your belief)

6. Extreme Depression (To the point of being in physical danger due to the depression- not eating for days, not being able to get out of bed to do anything, comatose like behavior) and in need of electric shock therapy

7. Have not eaten or slept for several days

8. Using street drugs and cannot stop

9. Outpatient medication and treatment is not working, symptoms are still expressed to a level that is interfering with ability to function in daily life activities

10. Need to change current medication routine, and need to proceed with the process with caution and under the care of a treatment team

Symptoms of mania or depression are significantly interfering with activities of daily living

Two types of hospitalization in clued voluntary hospitalization and involuntary hospitalization. If you are choosing to go into inpatient psychiatric hospitalization, you will want a trusted family member or friend to bring you. You will then sign forms that indicate you are agreeing to be treated in the inpatient setting. You are free to change your mind and leave. As long as you are not a danger to yourself or others, your stay remains voluntary. Depending on what state you live in, your stay will likely be between 2 and 10 days. The purpose of hospitalization is usually to regain stability; then you can maintain stability by utilizing out patient care.

Involuntary psychiatric hospitalization occurs only as a last resort, when a person is either a danger to him or herself, a danger to others, or is so gravely disabled that they cannot care for themselves in the most basic way. For example, if a person is actively suicidal, or actively homicidal, the person can be hospitalized without consent. This usually occurs when the person’s symptoms are so extremely severe that they cannot consent, and if a person resists hospitalization in this state of mind, he/she us usually thankful for the hospitalization after he or she has become stable. Likewise, if a person is so impaired that he or she cannot attend to activities of daily living such as bathing, or eating, or is not able to care for himself or herself he or she might be considered to be gravely disabled. This means that the person requires 24 hour care due to the severe expression of symptoms such as mania or depression. The issue of being gravely disabled is also relevant in cases where a person’s judgment is so severely impaired that he or she is making seriously dangerous choices due to being very confused or out of touch with reality. This person might be experiencing audio or visual hallucination, and in some cases, olfactory or tactile hallucinations (smelling or feeling things that are not really there).

This is truly a limited and brief overview of factors that might lead to inpatient psychiatric hospitalization. However, this brief post can guide you when creating your relapse and prevention plan, or if you are someone who loves a person with the mental health issues of bipolar disorder. Part of a wellness and Recovery plan should include a section on what to do if symptoms become unmanageable. Or perhaps you are worried about yourself or a loved one, and are wondering if it is time to go into inpatient psychiatric hospitalization. Understanding the level of acuity that justifies or warrants this high level of intervention might be very helpful to you.

Photo by dholdesign