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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Smeegle on February 8, 2005, at 0:10:55
It have only just begun to open up to my pdoc (also my T) about what is really going on in my mind. I held back quite a bit (including serious suicidal thoughts and even one failed attempt). Eventually even I was afraid for my own safety (and the added risk that I needed to get stablized before my marriage was completely destroyed). My primary reason for holding back was a fear of him hospitalizing me. I am not so much concerned about the being in the hospital part, as I am about the stigma attached and that it would forever be on my medical records. I worry that it would come back to haunt me one day way down the road some day. To me this sounds rational, but I still wonder. Part of me says why should I care, if I am sick I need help. Sometimes giving in and going inpatient really sounds like a good idea. But I have no concept of what that would entail. What happens when one goes inpatient? How long would a typical stay entail? (my insurance limits to 30 inpatient days per year so I know it would be less than that). I am not psychotic, and I am not a threat to anyone other than myself (and not even that...not today anyhow). So many times I have wanted so much to truely open completely up, but can't seem to get past this issue. Insight anyone? I know everyone's situation is unique and no two cases are the exact same. But I need to hear it from this side of things from people who have been there, done that.
Smeegs
Posted by Shortelise on February 8, 2005, at 0:37:07
In reply to Hospitalization stigma?, posted by Smeegle on February 8, 2005, at 0:10:55
Hey Smeegs, ask the doc about where on your medical record this info would show up. I mean, if you go in for a PAP test, would the doc see it? It's possible that sort of thing is only available to the docs who need to know.
Hospitalization for psychiatric care does'nt mean you're nuts and docs know that. It's just for the best sometimes.
Hugs to you Smeegs. I so feel for you.
ShortE
Posted by Emily Elizabeth on February 8, 2005, at 8:27:49
In reply to Hospitalization stigma?, posted by Smeegle on February 8, 2005, at 0:10:55
Are you in the US? Speaking as someone who works in mental health, it is VERY difficult to get someone admitted to the hospital, even when they really need it. It is a sad reality. I guess I'm sharing this b/c I really want to encourage you to be open w/ your T and pdoc about what's really going on w/ you. They won't rush to hospitalize you if you simply mention suicidal thoughts.
Sounds like you are struggling right now. I wish you the best in getting through it.
EE
Posted by Dinah on February 8, 2005, at 9:08:20
In reply to Hospitalization stigma?, posted by Smeegle on February 8, 2005, at 0:10:55
At those times when I'm in crisis, my therapist works really hard with me to do what it takes to keep me out of the hospital. He knows I don't want it.
If you're feeling relatively ok at the moment, it might be a good time to bring it up and sound out your therapist's philosophies. I've heard of therapists (those doing DBT for example) who try to avoid hospitalization. It depends on their risk tolerance.
Posted by sunny10 on February 8, 2005, at 11:51:30
In reply to Re: Hospitalization stigma? » Smeegle, posted by Dinah on February 8, 2005, at 9:08:20
Smeegle,
I will always say that if you aren't completely honest with your T, they will never be able to help you.
A T will refer you to a pdoc if necessary, and they may, with your permission, work together to help you. If helping you means inpatient, there you go. HOWEVER, unless you are truly in danger of harming yourself or others, in the US there are lots of other options.
Besides intense daily therapy sessions (I think difficult to get, but I'm guessing here...)we have what are called day programs. It is inpatient "care" on an outpatient basis. You go home to eat dinner (practice what they tell you), go to sleep, et cetera, in your own home. But you must be at the center from about 8:30 or 9 am until 4 or 5 pm.
In terms of your health records, what harm will it do if your records proved you had an illness and was treated for it?
I hope you get the help you need and feel better soon,
Sunny10
Posted by cubic_me on February 8, 2005, at 13:44:42
In reply to Re: Hospitalization stigma?, posted by sunny10 on February 8, 2005, at 11:51:30
> It is inpatient "care" on an outpatient basis. You go home to eat dinner (practice what they tell you), go to sleep, et cetera, in your own home. But you must be at the center from about 8:30 or 9 am until 4 or 5 pm.It's interesting you mention this, because my pdoc wanted me to do it a couple of years ago. The trouble was that I'm at university and didn't want to miss lectures etc (despite being suicidal), and they wouldn't have me if I didn't go 9-5 every day. Oh the joys of being a high functioning depressive!
Posted by cubic_me on February 8, 2005, at 13:50:24
In reply to Hospitalization stigma?, posted by Smeegle on February 8, 2005, at 0:10:55
Smeegle (I love your name by the way!), I'm paranoid about things going on my medical record too. It took me 7 years to seek any help at all, and then it took my T 3 months to convince me to see a doctor, even though it was obvious I needed a bit of medical help.
The stigma of mental illness and hospitalisation is still there, but it is getting less. I've decided within myself that if I am a VERY serious threat to myself, then it is better to be hospitalised and deal with what comes with it, than not be alive at all.
I think that there are other options before hospital, but inpatient is worth considering alongside the rest.
Posted by judy1 on February 8, 2005, at 14:30:07
In reply to Hospitalization stigma?, posted by Smeegle on February 8, 2005, at 0:10:55
Hi,
I've been hospitalized several times- all involuntarily. Several were for manic episodes, which averaged about a week- I was psychotic. The other 2( in the last 5 years) were for suicide attempts (not ideation) and it is a 72 hour hold in those situations. I loathe being hospitalized, despite the 'cushy' hospital my insurance is willing to allow for. My feelings stem from being held against my will, it is a situation that I fear and will do anything to avoid. All hospitalizations had day sessions afterward- these were voluntary and I chose not to attend after a day. It is critical to me to see where my pdoc/therp stands with suicidal ideation- all of them know that I will not be truthful if they threaten hospitalization so they promise to be available to me at all times should I have serious ideation. The only stigma I had was from the circumstances leading to the hospitalizations- manic behaviors and police questioning neighbors after suicide attempts. The police questioning was a small price to pay when my life was saved- despite my anger at the time. Nobody but immediate family knows about hospitalizations due to manic episodes- I'll assume this isn't a problem for you. You just need to find out your pdoc/therps stand(s) when it comes to ideation- be truthful about any fears you have of being hospitalized and ask that they be available to you if you do indeed experience serious suicidal ideation.
take care, judy
Posted by sunny10 on February 8, 2005, at 16:33:10
In reply to Re: Hospitalization stigma? » sunny10, posted by cubic_me on February 8, 2005, at 13:44:42
sucks, doesn't it?!?
Be strong- take any help you can get!
Posted by Smeegle on February 9, 2005, at 0:14:12
In reply to Re: Hospitalization stigma?, posted by sunny10 on February 8, 2005, at 16:33:10
Yeah, it does suck sometimes. I work with both a T and Pdoc, more closely with my pdoc lately due to serious suicidal thoughts. I have come so close so many times since my one failed attempt a little over two years ago. The most recent episode really scared me into action. I didn't know whether to call their emergency number (yeah, should've), drive myself to the hospital (figured it would be perceived as attention seeking...rational or irrational thinking?), wake the husband up (quite honestly he wouldn't have been able to deal with me in my state of mind), try to ride it out, or just get on with it. I chose to try to ride it out as long as possible. Since I had awakened at 3am with the idea that it was time (no trigger, no idea why...just that it was too much to deal with), I told myself just wait until the [Sunday] paper is delivered (perhaps a distraction would help), then see how I felt. Too agitated to read the paper, I tried reading, watching TV and a DVD. Couldn't concentrate. Bouncing off the walls! Finally around 6 or 7 am I called my mom who lives three hours away and told her I was heading over for a couple of days (thankfully was off work anyhow). Didn't tell her why (she would freak), just that I was off, didn't have any homework (night school...yuk) and just wanted to see her. She was suspicious but said come on over. I just knew I COULD NOT be alone. My pdoc has asked the usual questions as to whether I have a gun in the house, etc (none my preferred methods) and even asked me whether I felt the need to be hospitalized. Of course I said no. So far I have been able to ride it out. Put myself in a safe place (even when the people I get around have no clue that their very presence is saving my life) until it passes. It always does. I am just afraid of that day when it doesn't pass and when I have no safe place to be, no one to call. Will I make the right decision (to pick up the phone). Then I have to call my pdoc and let him make the decision.
I have a difficult (and nosey) boss. To be out of work would create a hardship (like I should care when we are talking about my life, but I do care even if I do detest my job...it's more about work ethics). We have strict HIPAA rules at work so she cannot ask questions (I have already reported her twice for asking too many questions and my next step will be a formal grievance...and that's just over a surgery I have coming up in two months. It's none of her business and I want to keep it that way. Additionally, she is a major gossip hound and within hours I know she would have made the rounds to tell everyone (not paranoid...this is 100% fact). I need the job. Being a cancer survivor I cannot be without insurance. Also, my insurance covers psychiatric benefits 100%, no deductible, no copay. I also qualify for short and long term disability at work if needed.
I know we have a outpatient day program close to where I live. I have no idea where they send psychiatric patients while inpatient. Sometimes it actually sounds like a good idea to get away from all the stressors in my life and just focus on me and only me. It has come up recently with my pdoc so I know if I don't improve it is a distinct possibility. I just hope my new med helps (Geodon...four or five days in and I still can't tell). All I know is today was bearable and I hope tomorrow is too. One day at a time.
Smeegs
Posted by Smeegle on February 9, 2005, at 0:16:34
In reply to Re: Hospitalization stigma?, posted by Smeegle on February 9, 2005, at 0:14:12
You know, it just occurred to me that the new HIPAA laws are in place for this exact type of situation. I don't know why I didn't realize that before.
Hmmmm.
Smeegs - needing some sleep
Posted by judy1 on February 9, 2005, at 11:35:17
In reply to Re: Hospitalization stigma?, posted by Smeegle on February 9, 2005, at 0:16:34
I'm glad that you are slowly feeling better. The best time to put things in place are when you do feel better since most people with MDD are almost certain to have another depressive episode. During my stays at psych hospitals I have met people who have voluntarily committed themselves, they needed a place to feel safe- and for some people (unlike me) a hospital is a very safe place. You have no access to anything dangerous (they take your shoelaces for heavens sake), you can get stabilized on a med, and you have access to daily group therapy. Usually your personal pdoc visits briefly each day- maybe 10 or 15 minutes at a time. You have the right to sign yourself out at any time, and in my experience most people did that after a week or so, then blended into the day program. Since you have family, it is really critical to get them on board. I cannot tell you how many times my husband has literally saved me, but that took trust. We developed that together with my pdoc, he came to a few sessions with me and knew what to look for in order to prevent a dangerous (to me) episode. I hope you avail yourself of your spouse's help.
take care, judy
Posted by sunny10 on February 9, 2005, at 18:47:03
In reply to Re: Hospitalization stigma? » Smeegle, posted by judy1 on February 9, 2005, at 11:35:17
I'm very happy that you have safe places and people to be with when you feel badly.
As you say you are high functioning, do you think that a stress or depression group might be a small help? I mean something like a night time group, once a week or more... It would be another safe place, but one where you can talk about what you're going through. If this interests you, maybe your T or one of T's colleagues will know how to get you into one.
Just a suggestion. By the way, I TOTALLY know what you mean about your boss- some people's mouths are just too wide open, aren't they?!?
Keep letting us know how you're doing. You can always let out your feelings here!
-sunny10
Posted by Smeegle on February 10, 2005, at 0:31:41
In reply to Re: Hospitalization stigma? » Smeegle, posted by judy1 on February 9, 2005, at 11:35:17
In some of my other posts, I have probably mentioned several times that one of my main problems in moving forward is that I internalize. It's almost like I would rather chew off my arm than ask for help (not literally, of course...but you get my drift). I LOATHE asking for help or admitting to weakness. Irrational? Sure. They can't read minds and I know that. I lock myself away in the guest room and hide away in my depressed little world. I shut it all out and everyone out. My husband really tries to be there for me, but he really just doesn't get it. For someone who has rarely known a sad day in his life, he certainly cannot comprehend the degree of depression I deal with on a very regular basis. My episodes are quite frequent and can go on and on. I retreat more and more. No idea what the triggers are at this point. Only very recently (after my most recent scare questioning my own safey/sanity...understatement!) have I let myself be totally vulnerable in his presence. To have someone sobbing for hours for no apparent reason (that I could explain) at 3am was totally baffling to him. I have repeatedly explained to him that I don't need him to "fix" my problems or tell me what I need to do. I don't need/want advice. I just need him to hold me and help me ride it out. Just tell me it will be okay. Eventually I will cry myself out and fall asleep. He is just at a loss as to what his role in all this is. I see my pdoc and counselor regularly. My husband joins us about every third week. (probably going to move that up to every other week now that his work schedule has been adjusted...he has quite a commute which complicates things). I just need to get better at letting him be there and telling him what I need (and don't need). Our joint sessin is this Friday and I know my most recent episode is going to be the primary focus (yeah...not). Perhaps our counselor can help me help him understand why I can't just decide to be happy. Maybe he can help him understand what I am going thru and how to help me be rational when I am being irrational.
And back on the hospitalization issue. I better ask about that one tomorrow with pdoc. I certainly would want to make sure HE is the one who would be coming to see me since he knows my history. I can't imagine dealing with a stranger in a crisis situation. And the whole day program thing...I don't quess I could work since I would be at the program all day. Even though I detest my job, I get stressed just thinking about the wrath of the wicked boss for being so selfish and leaving her with all that work (that "I" do...god forbid she should have to work). Not a very understanding person to say the least. She can be very conniving and vindictive when she wants to be.
Today was a realitively stressful day. I think I handled it all okay though. Not sleeping much at night (too much on my mind or is it the Geodon...what is it? Five days into it now). No episodes or major crisis in almost a week. Very, very aggitated and need to discuss that for sure. Can't always tell when it's merely nerves or hypo episode. (I turn over the check book and all credit cards when I know somethings coming on...aint going down that road again). Glad that appt is already in place for tomorrow.
Smeegs
Posted by sunny10 on February 10, 2005, at 10:50:39
In reply to Re: Hospitalization stigma?, posted by Smeegle on February 10, 2005, at 0:31:41
don't be too hard on yourself OR hubby. Remember that hubby is probably like most men- they are used to SOLVING problems. In his own way, he could be just as depressed as you because he doesn't know how to solve your problem for you.
I really do think that you should give a little thought to a once a week group therapy situation. No loss of work, and people to listen who won't be overwhelmed. And, believe it or not, it will help you to listen to them, too. This MAY also be the nudge that you need to give yourself to stop hiding that depression away... You really aren't alone in this. Millions of people suffer from anxiety and/or depression. There are plenty of people out there who would understand and not judge you.
just my 2c,
sunny10
Posted by Smeegle on February 10, 2005, at 13:33:51
In reply to Re: Hospitalization stigma?, posted by sunny10 on February 10, 2005, at 10:50:39
Thanks Sunny. At my appt with my pdoc today we decided that it was in my best interests to check in for a few days. He said I can check out at any time I want and HIPAA protects my privacy. I know that my absence will create a hardship on my coworkers (actually only my boss...and the only way it will affect her is that she is going to actually have to work). Stigma or no stigma, my personal safety is in question. But I need to get going now, just stopping by to say I'll post when I get back home. I made an appt with our counselor for my husband because when I don't him I was being admitted, he just kept repeating that he just doesn't understand. I sure hope our counselor can help him understand.
Smeegs - taking care of herself for a change
Posted by sunny10 on February 11, 2005, at 11:58:19
In reply to Re: Hospitalization stigma?, posted by Smeegle on February 10, 2005, at 13:33:51
Posted by Smeegle on February 19, 2005, at 11:10:21
In reply to Re: Hospitalization stigma?, posted by Smeegle on February 10, 2005, at 13:33:51
Smeegs is back! It took eight days and a complete change in my medication regiment, but boy am I glad I gave in. I was terrified going in, but in acutality, the people there were just like me and anyone I know. My mind is now clear and rational. I once again have hope. I know all my problems aren't instantly gone, but at least I now believe I am better equipment to face them head on. Still lots of work to do weekly with my pdoc, but overall feeling wonderfull.
Smeegs
Posted by B2chica on February 20, 2005, at 18:15:37
In reply to Re: Hospitalization stigma?, posted by Smeegle on February 19, 2005, at 11:10:21
Posted by Shortelise on February 20, 2005, at 19:25:36
In reply to Re: Hospitalization stigma?, posted by Smeegle on February 19, 2005, at 11:10:21
Welcome home!
I'm so glad you are feelings better, and more prepared to go on and thrive.
Hugs
ShortE
Posted by Smeegle on February 21, 2005, at 17:01:35
In reply to Re: Hospitalization » Smeegle, posted by Shortelise on February 20, 2005, at 19:25:36
Still major anxiety about returning to work (boss issues), but armed with knowledge about my rights under ADA which makes me feel a little better. I have the whole week off to relax and prepare mentally for my full-blown return to life and all that entails. Can't avoid it forever.
Smeegs
Posted by terrics on February 25, 2005, at 21:56:48
In reply to Re: Hospitalization stigma?, posted by Smeegle on February 19, 2005, at 11:10:21
Hi, I had similar experience. I was involuntarily commited. I have never been hospitalized before. My job was too much pressure. After being in hosp. with great staff and patients I came out feeling quite good about myself...and as you say still need work. Glad you are doing well. terics
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