Please offer advice as I consider checking myself into a psych ward.
August 18, 2011 3:35 PM   Subscribe

It has been recommended to me by my therapist to check myself into a pysch hospital this weekend. I have depression, and I am in a severe down cycle that has not been triggered by any outside situations. Additionally, I am a recovering alcoholic with 9 months sober. My capacity for self-harm is high. I am looking for advise on checking in, warnings, experiences, etc.

For the past month or two my depression has gotten much worse than I remember it being. Prior to my sobriety I believe that I drank or used drugs to "self-medicate" when the depression got this bad and so I was able to cover up or ignore the way that I was feeling. I am working very hard to avoid self-harming behavior (which can take other forms besides drugs and alcohol).
A month ago when I spoke to my psychaitrist he put me on a new anti-depressant which ended up causing severe anxiety and a panic attack. It turned out that I was given double the dosage I was supposed to be given, so I tried a smaller dose and found that I had the same panic and physical symptoms even at a 1/4 of the original dose.
I am now seeing a new psychiatrist and have been taken off that medication and the other medications have been adjusted.
I am considered dual-diagnosed, and I work a 12-step program for alcoholism/addiction, as well as see a therapist and a psychiatrist for my mental illness. I am able to get out of bed and go to work, I make myself eat something a few times a day, and I sleep about 5 hours a night.
On Tuesday night I told my therapist that I didn't know how much longer I could last like this. It is dangerous to go almost anywhere because the thoughts of self-harm are very pervasive. That is when she suggested that I go to a hospital where they can closely watch and adjust my meds, and I can be in a safe environment, away from the temptation to do something stupid.

Honestly, the idea is a relief. I have taken Monday off work and I plan to walk in on Friday and tell them I have a plan to hurt myself, in order to be 5150'd for 72 hours.

I have told my closest friends and my roommates the plan. I am in regular contact with my therapist and I am calling my new psychiatrist today to ask for her advice. Is there anything that I am missing? Does anyone have any advice for me? I am looking for your experiences, or your advice, or your warnings to help me make the right decision for my mental health.

Also: I am not an immediate danger to myself, I believe that I'll be okay in the short run and can probably hang on indefinitely. I am NOT suicidal, but I am concerned that if I don't get more help than what I have right now I am headed somewhere dangerous. I am just exhausted and looking for help. I'm sorry for rambling I am just trying to include as many relevant details as possible. Thank you.

I am in the state of California, if it matters. My throwaway email is mentalhealthquestion@gmail.com.
posted by anonymous to Health & Fitness (16 answers total) 10 users marked this as a favorite
 
Can you go to the hospital now? Why wait, if you are at risk of self harm?
posted by sweetkid at 3:40 PM on August 18, 2011


check your mefimail. Please.
posted by emhutchinson at 3:58 PM on August 18, 2011


Oh, gosh, I meant your throwaway email. Just check it, okay?
Please.
posted by emhutchinson at 4:00 PM on August 18, 2011


Do you have family or friends who can visit and bring you decent food? This will help a lot, and if you drink coffee, you might also ask them to stop off at Dunkin' Donuts or whatever, because for some reason a lot of inpatient mental health programs only have Sanka.

Pack some comfortable clothes: yoga pants, t-shirts, flip-flops or other shoes that don't have laces. If you have drawstring pants, you're going to need to snip the string out and rely on the elastic alone, because you won't be allowed to wear anything with strings for the first day or two of your hospital stay. You may not be allowed to wear a belt or shoes at all for a few days. Don't sweat it.

Find out, if you can, what the hospital's policy is on electronics. Many don't allow them at all, some allow them as long as there are no wires, etc. You will almost certainly not be able to bring a cell phone in with you. If you can get a friend to bring you a calling card, you will be able to make and receive calls from the pay phones on the unit.

Some hospitals sometimes have computer and internet access, but in very small amounts. Like, fifteen minutes a day, max. Trust me, you'll need the pay phones.

Also, the hospital tends to be very boring. There are groups, yes, and you see doctors, yes. And there are other patients, with whom you can always start a game of Scrabble. But there's also a lot of down time. Be prepared for that, with books or crossword puzzles or a deck of cards.

Do try to go in voluntarily without the need for a 72-hour hold; I'm not saying you should withhold information at all, but just that you should clarify that while you have a plan you don't have the intent to carry out the plan and have decided to go to the hospital instead. (By the way: Good for you. Seriously.) Anyway, if the staff thinks you are planning to hurt yourself there, in their facility, you will probably be assigned a guard to sit watch over you 24 hours a day. Including when you go to the bathroom. It's much nicer to be able to take in your own shampoo and whatnot without anyone thinking you're going to try to bludgeon yourself to death with the bottle.

Speaking of which, don't bother packing perfume or Listerine (alcohol). You might want to leave your makeup at home and/or forgo shaving for a few days: too much hassle in the hospital. Leave jewelry at home.

Be sure to pack a sweater, and some socks. Hospitals, like movie theaters, are cold. And honestly, you could pack a blanket, too, because hospital blankets are awful.

Try to line up a visitor for every day you are in the hospital -- it helps. You can do this once you're there, though. Just make sure to take a notebook with you with people's phone numbers in them, since you won't be able to use your cell phone in the hospital to look up people's contact info.

Now, as soon as you are packed and have alerted your family members and friends, just call a taxi and go. There's no need to wait, unless you've been told they'll have a bed available for you tomorrow but don't have one today. If you feel you do need to wait for some reason, do you have someone who can sit with you for the night, or someone you can call if you feel out of control?

One last thing: When you walk in, you may have to go through a psychiatric emergency room. It will be pretty unpleasant, because it's sort of a holding place for everybody, where you get sorted, before you're placed in a unit. So it has to be really high security. If you're allowed to have a significant other or mom or best friend come with you, that might be really good. Line up whatever support you can.

So many hugs! If I were in California I'd come and visit you myself.
posted by brina at 4:02 PM on August 18, 2011 [19 favorites]


If you feel that you are getting intensly anxious, or hyper, or likely to lose control of your impulses, and you have someone who can support you, try to get them to be around until you go to hospital. If you are a man, or a strong woman, make sure this is a burly person. Also, not someone to be freaked out - you don't want to end up making sure they are OK!

Then, gather a bit of information about the hospital you would be checked into. Are you gonna be alone in your room? Are they going to try to return you to neutral mood by medication? If it seems like this is an option, treat it like a sanatory. Have a bag packed with your things: towel, fresh rove/nightcloths etc., also books, and maybe any hobby thing you can take along. When I went to hospital, I brought along knitting, which I had never done before, but it helped. This won't work if you're a guy, I suppose, and not if they decide knitting needles are dangerous, but any feasable hobby might not be a bad idea - to my surprise, I was in a sort of calm no-man's land very quickly, they wanted to keep me on, so it was like a gift-space in which I could test some things out. Book-wise: maybe anything you find inspiring, or that has a bearing on you, somehow, I found Thomas Mann's "Magic Mountain" absolutely compelling when in a (slightly) similar situation.

When you feel like self-harming, arrange a pillow, or a couple of them somewhere at a comfortable height, and start kicking. Try to take the boxer's pose - maybe youtube it - and, keeping in mind to keep the adequate foot-play going, kick the pillows. Try to get one of those multiple punches going, where left follows right follows left follows right etc relentlessly. Then do that boxing hop-dance, then again, and again, and again, then, when you are exhausted, see how cool it is to have done so much and check how amazing it is to be in one piece - even if this elation doesn't last long.

I hope you get through this. If you do go to hospital, and however perverse this sounds, take advantage of it. I have nostalgia for my stay (even if in some ways it was horrible, too).
posted by miorita at 4:05 PM on August 18, 2011


There have been some posts on AskMe about people's experiences with doing this- they've been a mixed bag- so it might be worth it to hunt some down. I won't be back on a computer for a while but if you can't find any, memail me and I'll track them down.

Also, there are dual diagnosis 12 Step meetings in some areas. I've heard them referred to as "Double Trouble," though that might be a localized name, I'm not sure.
posted by small_ruminant at 5:02 PM on August 18, 2011


I've checked into a psych ward a few times, and I don't mind talking about it. Please MeMail me if you feel like talking to someone who's been there.

Like some of the other folks upthread, I'm curious why you want to get yourself 5150ed instead of just checking in voluntarily. Keep in mind you can walk up to the front desk and say "Hey, I'm having thoughts of self-harm, I need to be in the hospital" — and they'll be happy to let you in. (My experience is also that checking out of a voluntary hospital stay is still a pretty long and involved process. It's not something you can just up and do all of a sudden on a momentary self-destructive impulse.)

If you can, get one of your doctors to recommend you a specific hospital. It makes a big difference — some places will give you a bit of real psychiatric care, other places the best you can hope for is really expensive babysitting.

You will probably be on a locked ward, even if you go in voluntarily. Some places have two separate locked wards — they segregate out people who are truly unhinged or delusional into a higher-security ward, and they have a lower-security ward for people like you who are just sitting out the worst of a mood disorder or the aftermath of a bad bender or whatever. But still, expect at least a little security.

Bring books. Bring paper and a pen. If you've got them on hand, bring some photos of people or places you like. It might seem cheesy but little things really help.

Tell your friends where you are. If they're not total heartless monsters they'll be more understanding than you expect, and visitors and phone calls are nice. (I wouldn't tell your co-workers if you can help it — but if you do, or they find out, keep in mind that the law is on your side. They can't fire you for being crazy on your own time if you're still keeping it together on the clock. Still, it's better just to avoid letting them know, if that's an option for you.)

Good on you for taking care of yourself. Get some rest! Feel better!
posted by nebulawindphone at 5:34 PM on August 18, 2011 [2 favorites]


I know it sounds complicated to go to the hospital right now. I mean, you walk in, tell them you want to stay for a while, and you have to go into this big explanation of what you need and all that. BUT--they've seen this a thousand times before. They have this whole protocol. They're totally experts in this sort of thing. Just go, and tell them what you told us, and they'll take care of the rest.
posted by MrMoonPie at 6:15 PM on August 18, 2011 [1 favorite]


I just want to chime in and offer you hope. Good for you for going in. You can pull out of this and be a happy productive person. Don't stop believing that. Take it from someone who has been there. It's difficult but you can do it. Hang in there.
posted by DesmondDoomsday at 10:02 PM on August 18, 2011


OP, I could have written this at 9 months sober, had I been brave enough to see a therapist. I had never been prone to depression while drunk because - hey! Drink worked for me! Nine months in and it was like the light was snuffed out from my universe. (I don't know how you got sober. I used AA and it took me until step nine to start feeling anything like normal. Until then, I was terrified that "normal" was doomed to feel like shit if I was going to stay sober). However way you got sober, you have the strength in you to see it out.

Keep reminding yourself of what you've had to do to just to get to this point. With lessening consequences from your past usage and more days learning how to live in the real world, it can only get better.

And it does. It really does get better, but you have to stay alive to see it. Hospital sounds like the right thing for you, and you should be proud of yourself for doing right for yourself. Please memail me if you need a friend, or talk about all the things we had to lose before we woke up one day and decided to get better.
posted by katiecat at 5:15 AM on August 19, 2011


Message from the OP:
Would you mind posting a follow up in the thread that I will be admitting myself voluntarily and I was planning to 5150 myself because I didn't know you could just admit yourself. And also that I'm waiting until tomorrow [i.e. today, Friday] because I need to be very careful at my work right now (there have been recent layoffs). Thanks to everyone for the feedback and advice.
I suggested she follow up again when she checks back out and let us know how it went.
posted by nebulawindphone at 7:37 AM on August 19, 2011 [2 favorites]


I had a partner who checked herself into a psych ward twice while we were together, so this is mostly my experience of it. Actually the second time I think she was technically 5150'd because she had intentionally hurt herself. I wouldn't describe it as a pleasant experience for either of us. She did feel a lot safer while she was there. Mostly she was really bored.

Coordination with current therapist and psychiatrist is really key. Make sure they know where you're going and when so that they can make their calls to coordinate your care with whoever is there. My partner's therapist came to see her regularly while she was there and they had a case conference in which they included me (and her) to talk about how to manage things better when she was discharged.

I visited her every day, as did a bunch of other people, including folks from her home AA meeting. If you think visitors will be helpful, let your sponsor know and ask for visitors. She wanted crossword puzzles and things to read, too.

Overall, her psych ward experiences were healing in that they gave her time to be in a safe place and focus on what she needed to (including adjusting her meds). The worst parts for her were not having much privacy and being bored.

My sympathies to you for going through this. Please take good care of yourself.
posted by gingerbeer at 8:40 AM on August 19, 2011


I went in for anxiety and suicidal ideation (for the same reason as you; I couldn't hang on much longer and it wasn't getting better). You may not have the same experience, but I was medicated so I slept. A lot. They kept trying to get me up for therapy, and I was too sleepy to get out of bed.

When I was awake, I did crosswords, and a big jigsaw puzzle they had in the dayroom. They'd sit there with me to do individual therapy. I had a couple group sessions, but there were only a couple of us there, so they didn't last long. They also had TV. I wore hospital socks (with the non-skid bottoms), not shoes, and sweats and t-shirts. I had to leave my door open so they could do periodic checks on me.

They had me talk about my situation in a room full of med students. That was weird. I wondered what they said about me after I was gone.

After I was no longer a danger to myself (about 3 days), they discharged me, but I wasn't all the way well. I spent another 6 weeks off work doing outpatient therapy until I was well enough to go back.
posted by cereselle at 9:07 AM on August 19, 2011


Oh, I forgot one thing. I had the impression that psych wards were dank and dirty and filled with Nurse Ratcheds. It wasn't. It was no different than any other hospital ward.
posted by cereselle at 9:10 AM on August 19, 2011 [1 favorite]


More update!
I wanted to follow up with you and ask you to post this in the thread. Hopefully, if someone else is looking for advice in the future and finds this question my experience can help. The hospital I originally planned on going to didn't have any beds, but I found a pretty nice private hospital that was in my network. I went to their ER and had to wait about 5 hours in a hallway and then another 4 hours in an er waiting room bed. I fell asleep around midnight and was taken to the psychiatric ward around 4am. Once I was there, however, I was really relieved. I had to go through all the intake stuff, and I was asked the same questions by at least 7 different people.

It wasn't dirty or gross (although the showers were kinda nasty). The nurses, doctors, and social workers were all kind, helpful and patient. I was able to explain my situation without feeling judged or uncomfortable. I talked a lot about what I'd been feeling and what brought it on, and it helped me to be around professionals who advocated for mental health patients. Most of my life my depression has been marginalized and dismissed. Even now if I hint that I'm depressed, my sponsor (who I am replacing soon), loves to tell me that I'm in self-pity.

Overall, it was a safe place for me to be, with virtually no responsibilities or stressors. I arranged to have a friend sit with me at the ER, and I had visitors on Saturday and Sunday, which was tremendously helpful. It gave me something to shower and get out of my pj's for which can be really important when you're depressed. Other advice I found really helpful was to bring books, blankets, pillows, pjs slippers and write down the phone numbers of anyone you may want to contact. Also, keeping the name and numbers of my doctors and therapists was very helpful.

I am on a new combo of anti-depressants. Most importantly, I was able to take atavan (a benzodiazepam) as well as sleeping pills. I cannot take drugs like this without being under a doctor's supervision because they can be addicting. However, it was a relief to just be able to tune out and not worry about how I felt, and how I was acting, and how people were perceiving me, and all the minutae that I constantly worry about from day-to-day.

I left feeling very refreshed and I hope that the new medication begins making a difference soon. Mostly, I'm glad I checked myself in before something happened that forced me to be checked in. I think that's everything. Thanks again to everyone who offered advice in the thread.
posted by nebulawindphone at 10:44 AM on August 23, 2011 [3 favorites]


Yay! Thank you so much for the update! And yes, glad you're getting a less ignorant sponsor!
posted by small_ruminant at 11:02 AM on August 23, 2011 [1 favorite]


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