When Should Hospitalization be Considered for Depression?

Introduction 

This post is significant to me because one area I really enjoy working is the inpatient psychiatric unit. This might seem strange, but it’s a place I just gravitate towards and fell like I’m having a meaningful impact. You can think of it as the equivalent to the medical intensive care unit (ICU). It’s a place to learn about the most severe psychiatric pathologies and medication management.

In this post I will cover some of the signs and symptoms that may indicate inpatient hospitalization could help and possibly be lifesaving. 

Signs and Symptoms

Suicidal Ideation:

If your depression has become so profound that you have thoughts about “killing yourself,” then it might be time for inpatient treatment. Many clinicians, especially those not working in mental health, feel uncomfortable asking direct questions about suicide. Contrary to a common belief, asking about suicide does not increase the risk of suicide. I like to use the term “kill yourself” when doing a suicide assesment. It’s very definitive and clear to the patient what I’m talking about. The concern increases if there is a plan in place for the person to kill themselves, the plan is logical, feasible, and the person intends to carry out the plan. All of these are warnings that the person is at high risk. If these thoughts are persistent that’s another indicator that the problem is more serious. 

There is a significant difference between the above situation and the person who has “passive suicidal thoughts.” Passive suicidal thoughts are statements like “If I didn’t wake up tomorrow, I would be okay with it.” It’s not that the person is actively trying to prematurely end their life, rather they would not mind if something happened that hastened the path towards death. 

Hopelessness:

Another validated risk factor for suicide is severe, unremitting hopelessness. Hopelessness consists of feeling that nothing is getting better, nothing will ever get better, and there’s nothing I can do about it. This, independent of other risk factors, puts the person at high risk for suicide.

Loss of Interest:

Severe anhedonia (loss of interest) in previously pleasurable activities is part of the diagnostic criteria for depression, it’s also something that can increase suicide risk. If a person previously went to the gym five days a week or watched every new episode of The Bachelor and suddenly no longer cares about these things, it may be cause for concern.

Poor Response to Outpatient Treatment:

If you have been in traditional outpatient therapy and medication management for many years with minimal or no improvement, and you have never been hospitalized for psychiatric purposes before, then inpatient hospitalization may help. Sometimes the break from the daily life stressors for 3-5 days allows the mind and body to rest. If you tried everything else, then who knows? This could be the intervention that changes your life.

Seeking inpatient psychiatric care is nothing to be ashamed of, and many mental health professionals are working hard to destigmatize psychiatric care. I like to think about inpatient psychiatric care as a mental wellness camp, and not as a punishment for mental illness.

If this information is useful please like, share, and subscribe to the blog and other social media sites. Drop us a comment about what topics you are interested in, and we will try to cover them. 

If you or someone you love is at risk for suicide, the following resources are available. 

National Suicide Prevention Lifeline: https://suicidepreventionlifeline.org

National Suicide Prevention Hotline: 1-800-273-8255

SAMHSA: https://www.samhsa.gov/grants/grant-announcements/sm-20-011

How to Tell if You Have Depression

Images that show what it feels like to suffer from mental illness. Bringing the inside to the outside.

Depression is not always easy to spot, and in a world filled with social media it always seems like everyone is living their best life. 

In the most severe states people can have suicidal thoughts and profound hopelessness. The symptoms can be mild, moderate, or severe. Depression can affect anyone. 

Depression is an illness like any other disease (diabetes, hypertension, heart disease) that affects thoughts, feelings, physical health, and behaviors. 

People with major depressive disorder have several of these symptoms every day or nearly every day for 2 weeks or more. 

Here are some signs that you may have depression 

At least one of the following, loss of interest in things you previously enjoyed or depressed mood  

At least 3 of the following 

  • Feeling slow or restless 
  • Feeling guilty or worthless
  • Increased or decreased appetite
  • Suicidal thoughts 
  • Problems concentrating, making choices, or remembering things 
  • Difficulty sleeping or sleeping too much 
  • Having low energy 

Potential physical signs of depression include 

  • Headaches
  • Muscle tension 
  • Digestive symptoms 
  • Sexual problems 
  • Feeling “keyed up”

This can be summed up in the mnemonic SIGECAPS taught to medical students everywhere. The mnemonic comes from the prescription a doctor might write for a depressed patient

 SIG:  1 energy capsules per day 

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