I need rehab for depression.

February 5, 2011 1:28 PM

I need rehab for depression.

I've watched the show Intervention many times. It's nice to see the people who they follow up on a few months later and see how much better they are doing. Can this happen to me?

I just had my own intervention with myself. I'm not addicted to drugs. I've just concluded I can't bootstrap this life-long depression. I've tried outpatient therapy/meds in the past many times, but I'm too unreliable for it, and now I don't even have transportation to get to appointments.

I would like to go to a depression rehab. I don't mean like a mental hospital. I think if I could be in a situation where I had daily help of making sure I do therapy, meds, exercise, and what not for a good period of time, that might be the foothold I need to continue following through on my own. I don't have family/friends or any other support for this type of endeavor, it would have to be a facility.

I know places like this exist, as I've done some googling, but a lot of these places seem to focus on depression with a chemical addiction.

So does a depression-focused rehab exist? I need help with mainly depression, but I would like help with exercise/nutrition and general health as well.

I guess I'm open to anywhere in the US, but I'm in Massachusetts and closer is better. I don't have any money, but I do have health insurance. I don't know if such a thing would be covered anyhow. I'm desperate enough to beg my parents to see if they can pay for it, cause I'm about at the end of my rope here.

Other pertinent info: 30yo female
throwaway email: [e-mail]

posted by anonymous to Health & Fitness (15 answers total)

Look for a Women's Intensive Outpatient program in Dialectical Behavioral Therapy, preferably one with a supervising psychiatrist to handle medication issues. Insurance companies seldom pay for inpatient depression care, but these are half-day hospitalizations with intensive group and cognitive therapy, usually with an emphasis on maintaining your health on your own later. They typically last 4-6 weeks. Western Psych Hospital in Pittsburgh has a good one...maybe McLean in your area?

Best of luck for you..you sound self-aware and ready to change, and those are two good indicators for success.
posted by skidoom at 1:41 PM on February 5, 2011 [1 favorite]

ps. By the way, these IOPs are usually affiliated with "mental hospitals" as you called them. Don't be too quick to dismiss these type of institutions...many of them are on the cutting edge of depression research, especially teaching hospitals affiliated with a medical school.
posted by skidoom at 1:45 PM on February 5, 2011

What about looking into a Life Coach to support you to find and implement effective systems in your life? I'm thinking of this as someone who will help you decide on and find appropriate professionals/services (e.g. counseling, CBT, medical, nutritional, exercise, massage, alt medicine, social) which might (or might not be covered) and then help you implement them and stay on track. I understand that this is not a 'retreat', but it might provide you the supports you need to pull off a range of changes without the readjustments of integrating back into your own life.
posted by sockraticpielogue at 1:52 PM on February 5, 2011

Google results for depression rehab massachusetts.

The link for Walden Behavioral Care seems ideal for you. Be sure to read the information under "Admissions" which directly addresses your insurance coverage concerns. Good luck.
posted by TryTheTilapia at 2:28 PM on February 5, 2011

I feel compelled to mention to you---

I am a lifelong depressive. As recently as 7 days ago, I was more or less at my worst in my worst and longest episode ever. Ready to throw up my hands. And for seemingly little reason at all, in the space of two days, the symptoms just sort of fell away. Suddenly I was hungry for the experiences that I had been depriving myself of for so long. It has only been a few days, but I think my life may finally be approaching something near normal again. It feels profound, whatever is happening.

The point being I was not expecting this to happen, and had fully reached a point were I didn't even BELIEVE it could happen. But it did anyway. It can to you, as well. Take care of yourself as best you can, take, meds, go to therapy. You don't have to enjoy it, just treat it like work or exercise. With some time and a bit of luck, the sun DOES come out again.

Thank fucking christ. Me and Egypt, baby.
posted by TheRedArmy at 2:33 PM on February 5, 2011 [8 favorites]

When I was a chair-throwing 20something problem patient in MA, the phrase "McLean Hospital in Belmont" came up a great deal. I never actually ended up going there, but they are the people you want:

Hill Center for Women

Behavioral Health Partial Hospital Program

These look very similar to the women's IOP at Western Psych the previous poster mentioned. McLean is a very, very good facility-- they are evidence-based and on the cutting edge of the research available.
posted by fairytale of los angeles at 3:09 PM on February 5, 2011

I was reading an article recently about emerging adulthood and it mentioned the Yellowbrick treatment center. That might be what you're looking for?

I don't believe it's about depression specifically, but it is about getting yourself to being able to cover your basic life survival skills, etc. It's a "supported living experience."
posted by hansbrough at 4:21 PM on February 5, 2011

I know this isn't quite what you were looking for, but what worked for me after a bad bout of depression (three months of hiding in my dorm room, only leaving at night to get food, culminating in failing out of college) was a summer job in Boston Harbor as a park ranger on one of the islands. Gave me some time to clear my head, some income, and there's nothing to recalibrate your sense of being and self-worth like the tides and phases of the moon and the ringing of a distant bell buoy.

It had sort of the same effect as I think you might be looking for – a sense of structure and peace and of freedom from one's cares so that one has the time to really do some serious self-work. I went there feeling like a sack of shit, and I left having come to the conclusion that I was a pretty alright guy and with a much more optimistic view of my future. Everything from there has been a slow climb back up, with each year a bit better than the last.

So if you can't quite find a rehab situation that works for you, or maybe just if you think it might serve the same purpose, you might look for some summer work outdoors, with a park or an adventure guide organization or something like that. You're at about the right age for it, and I know I wasn't the only person in my group who was there to figure some things out about himself.

Just a thought. MeMail me if you'd like to talk any more about it.
posted by Scientist at 5:45 PM on February 5, 2011

If you're into the idea of working on yourself while you do some other kind of productive work, Gould Farm is in Mass. It's a working farm with clinical support and a pretty strong community spirit- not for everyone, but a different sort of thing from what's already been mentioned.
posted by MadamM at 5:58 PM on February 5, 2011 [1 favorite]

Some really good advice has been given already. I would just add, or reiterate, to not worry too much about where the treatment you need is held (i.e. a psychiatric hospital or program), but rather focus on what you want your outcome to be and what you need in order to achieve your goal of having your depression treated. DBT is good therapy, typically used for persons with Borderline Personality Disorder (BPD) or bipolar disorder. Have you had a psychiatric evaluation? That's an important step -- if you haven't had one, but do have insurance, why not take advantage of that? Even if you've had a psych eval before, but it's been a while, it's good to get a recent eval done. There are so many different treatment routes to take -- I think it's awesome that you're taking steps toward treatment. Best of luck!
posted by Twoapennything at 6:31 PM on February 5, 2011

Unfortunately, these programs are rarely covered by insurance. You may want to look into a day program that includes groups and medication management. The Behavioral Health Partial Hospital Program at McLean Hospital might be a good fit, although I'm not sure of the cost or whether they accept insurance. Might be worth it to give them a call. If nothing else they would likely be able to refer you to similar programs.

If Gould Farm is appealing to you I can't recommend it enough, although I believe it is quite expensive and not covered by insurance.

Another option to consider is to find a social worker for case management services, in addition to therapy and medication management. They could come to your home or meet you in the community regularly to help you with the practical aspects of living and recovery.

There are also some programs that integrate case management, therapy and medication management into a single outpatient program. These are called Programs for Assertive Community Treatment (PACT) and I believe there are some in Mass.
posted by smokingmonkey at 6:44 PM on February 5, 2011

When I was in the emergency room, out of my mind, the social worker presented several options to me, two of which she described as "day camp" and "sleep-away camp." Sleep-away camp was, obviously, admission to a mental hospital, which as I understood it from her description was actually a lot like what you're describing. But day camp was therapy every day from either 9:00am to 3:00 PM or 8am to 5pm, depending, and very definitely included exercise and other things. Both were covered by my admittedly gold-plated insurance, though I ended up needing neither of them.

I guess what I'm saying is, before you write off a mental hospital entirely, contact several and ask what their inpatient and outpatient programs are actually LIKE. I was really surprised, it was quite different than how I'd imagined it.
posted by KathrynT at 8:24 PM on February 5, 2011

I don't know why people say that inpatient services are "rarely" covered. I don't think that's true (at least, even my crappiest insurances have had at least a few days of inpatient services covered). Read your coverage & benefits (do this anyway, in general--it is really good to know what is covered BEFORE you need it). Make sure to pay attention to things like deductibles and co-insurance.

Here's a start on choosing inpatient services: http://www.nmha.org/go/help/finding-help/find-treatment/in-patient-care/how-do-i-find-inpatient-or-residential-treatment

I second (or Nth) calling your insurance and going through them. Many employers also have a hotline you can call that can help you with things like this (called Employee Assistance Programs).
posted by amberwb at 8:59 PM on February 5, 2011

I know you're not nuts about mental hospitals (pun intended) and there are some people here trying to convince you otherwise, but they won't be a magic solution-- your experience may vary.

One hospital I was in as a teenager was run like a boot camp; everything was run on a strict schedule, you had to attend all therapy sessions, disobedience was resolved by strapping you to a gurney in the BCR (the "padded wall room") and pumping you full of drugs, you had to compete for basic privileges (such as rec time or phone usage) by actively participating in programs, and the "doctors" took their cues from Dr. Phil-- they believed the best way to help depressed, suicidal, dysfunctional or addicted teenagers was to shame them repeatedly before a group of their peers. The place was run by sadists with PhDs and the "health technicians" or whatever they called the staff weren't any better.

I went to another hospital years later but was given a choice of venue, unlike the first time. It turned out to be little more than adult daycare. You can lay around all day, don't have to do anything, can call home anytime, the therapy sessions were optional...at its most basic, the hospital staff are there just to check your vitals and make sure you don't hurt yourself. I didn't find this particularly helpful either, but it did give me a few days to get my mind together in the short-term.

I only point this out as testament to the fact that not all hospitals are alike. Don't give up if you bite the bullet, check into one and have a bad experience. If I had the money I'd continue making the rounds, searching for the right kind of therapy for me.
posted by Ziggy Zaga at 12:32 PM on February 6, 2011

Please, please, PLEASE don't dismiss or be afraid of psychiatric programs based on the above opinion. That may be how psch hospitalization was in the past, or seemed to one particular person at one particular place at one particular time. Many, many lifelong depressives have been helped by intensive outpatient programs.

Quick clarification on my original comment: I should have said insurance seldom covers LONG stays for inpatient care, i.e. more than a few days. By all means go through your insurance company first, if nothing else because it's an easy way to get started and you might need a referral from them anyway.

One other clarification: DBT (dialectical behavioural therapy, what an albatross of a name) can be highly effective for recurrent major depression, not just borderline personality disorder and manic depression. It's a subtype of cognitive therapy which, particularly when combined with the right medications (which have also changed dramatically in the last few years), can be very effective. Cognitive therapy is especially good if you're a brainy person who tends to think too much :-)
posted by skidoom at 11:54 AM on February 7, 2011