When to Go to the Hospital for Depression

Via Peters

If your depression symptoms are serious or you’re having a mental health crisis, it may be time to visit the hospital.

Sometimes depression can be all-consuming and overwhelming. It’s important to remember that this isn’t your fault. If you feel completely hopeless and alone and if it’s difficult for you to imagine staying alive, then this is a mental health emergency.

People who work at general hospitals and psychiatric hospitals have the skills, knowledge, and ability to support you through this difficult time and help you feel comfortable throughout the process.

Some signs that it’s time to visit the hospital for depression include the following:

You’re thinking about suicide

If you’re thinking about hurting yourself, about death or suicide, or you’re actively planning to end your life, it’s important to seek immediate help. You might reach out to a suicide prevention hotline or visit the emergency room for mental health support.

“Depression can be treated more aggressively until these urges go away at a psychiatric hospital,“ explains Lisa Anderson, an LCSW in Nashville, Tennessee who has experience working in psychiatric hospitals.

Sometimes, starting an antidepressant medication or changing your antidepressant prescription can cause suicidal thoughts or make them worse.

Suicidal ideation can be active or passive. Passive ideation means you’re having thoughts of suicide or dying, but you don’t have an intent or will to act on them, and therefore you don’t have a plan to do so. Active ideation means you have a plan.

Speaking with a mental health professional can help with all types of suicidal ideation.

You’re unable to care for yourself

Even if you’re not thinking of hurting yourself, depression can make it difficult to take care of yourself. You might sleep excessively, known as hypersomnia, and not want to get out of bed or function at all.

If it has become hard to do anything at all — including eat or sleep — you might consider visiting a hospital for support. The doctors and nurses can help you get back on track.

You feel like nothing is helping you feel better

“If therapy or psychiatric treatment have not been working and you are falling into a worse state, it may be time to move into a setting that has the resources and bandwidth to respond to any situation the depression might provoke,“ explains Nima Fahimian, MD, associate professor of clinical psychiatry at the University of California, Riverside.

You’re experiencing new symptoms

Some potential new symptoms that require immediate medical care include:

  • symptoms of psychosis, such as hallucinations or delusions, which can sometimes occur in more severe depression
  • mania, in the case of bipolar depression
  • severe side effects from antidepressant medication

There are a few ways you can admit yourself to a hospital to get crisis help.

“If you are already working with a physician, psychiatrist, or psychotherapist, you can reach out to them and let them know how you are feeling,“ says Anderson. Your therapist can then walk you through the steps you should take. Or, they might call the hospital for you.

You could also call a trusted loved one to help you with the admission process.

Another option is to call 911 or go to the nearest emergency room and let them know how you’re feeling and that you need help.

“If you are living in an area where there is a psychiatric hospital — a hospital specializing in mental health support — nearby, you can typically go directly to that hospital and request an assessment for admission,“ says Anderson.

If you feel like it’s possible, consider calling the hospital ahead of time to ask about their rules, admission procedures, and what items you should take with you.

Your experience varies depending on whether you go to the emergency room or a psychiatric hospital.

In general, you’ll be given food, water, and warm blankets. You’ll be asked to fill out some paperwork, including forms about your medical history and health insurance.

Then, explains Anderson, “You will meet with a team of providers, including psychiatrists, nurses, and social workers.“

This team will talk you through the process, perform a few assessments, and ultimately develop a treatment plan to support you. You might also receive crisis counseling, medication, or a physical exam.

At the emergency room (ER)

At the ER, the team will assess whether they think you’re in immediate danger. If you are, they may require you to stay for 72 hours. Any longer than this requires a court order.

If you admit yourself voluntarily to the ER, the team may or may not issue a hold. They may instead transfer you to a psychiatric hospital soon after you arrive.

If they admit you for a hold — which is more often the case when you’re admitted involuntarily — you won’t be able to leave at will during this time. The doctor or nurse may take away items that you could use to harm yourself, like a belt or shoelaces.

At the psychiatric hospital

The doctors or nurses at the psychiatric hospital will begin by assessing how best to help you and what treatment is best for you.

Even if you admit yourself to the hospital, you will initially be in a locked ward and not leave.

However, if you are voluntarily admitting yourself, you will have the right to sign yourself back out — unless the hospital staff thinks you are a danger to yourself or others — within 48 hours to multiple days of your request, depending on which state you live in. You can find out the laws and standards in your state using the map provided by the Treatment Advocacy Center.

Besides your insurance provider, no one will be told that you have admitted yourself unless you want to inform someone.

Treatment will vary between hospitals and between patients. In general, “You will work with a psychiatrist to ensure that you are taking the correct types and doses of medication to effectively treat your depression,“ explains Anderson.

To help manage your symptoms, you might also take part in:

Some people are prescribed electroconvulsive therapy (ECT). Modern ECT is highly controlled and very safe. This is usually prescribed only when people do not respond to medication and talk therapy, meaning they have treatment-resistant depression.

“A social worker will also help you come up with a plan for continuing your treatment once you are discharged from the hospital,“ Anderson adds.

During this discharge process, you can involve your family or friends if you want. In general, it’s recommended that you have a positive and helpful support system in place for your transition to being an outpatient.

“Typically, clients admitted to inpatient psychiatric hospitals for stabilization will stay at the hospital anywhere from 3 days to 2 weeks,“ explains Anderson. The exact amount of time depends on the severity of your symptoms and your response to the treatment provided.

If, during your stay at the hospital, your care team thinks you can benefit from a long-term treatment program, they’ll let you know and help facilitate your transfer.

According to Anderson, these long-term treatment programs generally last 30 to 45 days and can involve:

  • additional medication
  • family therapy sessions
  • individual psychotherapy

Once you are discharged, your doctor or therapist will work with you to continue your treatment.

If you feel like you can’t function, you’re thinking about death or suicide, or you’re experiencing new symptoms, you might want to consider going to the hospital for treatment to keep yourself safe.

It can be overwhelming to feel like this, but it’s important to know that at the hospital, there are people who can help you.

There are also 24/7 crisis helplines if you’re unsure if the hospital is the right place to go. Consider reaching out to:

https://psychcentral.com/depression/when-should-you-consider-hospitalization-for-depression

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