When Hospitalization for Depression is Needed?

In cases of severe depression or treatment-resistant depression, some people need to stay in the hospital for a short time. You might check into the hospital yourself. Or you could be hospitalized under a doctor's order.

There is a powerful stigma associated with being hospitalized. Many people feel ashamed, as if it's a sign that they are "crazy." Some people fear that being hospitalized is the same thing as being institutionalized or sent to an asylum.

But that's not the case. Usually, a stay in the hospital is just a way for you to recover in a safe and stable environment. This allows you to take a break from some of the daily stresses that contributed to your depression. Your doctors can work with you to try different treatments and figure out which one is best.

Most people don't like being in the hospital. You may not like the routine, the food, or the other patients. It might be frightening. But look at it this way: Depression is an illness, as real and as serious as heart disease or cancer. And sometimes depression -- just like other serious diseases -- requires treatments that can only be provided in a hospital.

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Who Needs to Be Hospitalized for Depression?
Hospital admission can allow an extremely depressed individual to receive higher and more detailed care than if they were treated on an out-patient basis. It allows for doctors and other hospital staff to better assess a depressive condition and make important treatment recommendations.

There are many people with depression who might benefit from a hospital stay. Here are some examples.
  • People who are at risk of hurting themselves or others. Preventing suicide and violence is the most common reason for hospitalization. A stay in the hospital allows you to get back in control.
  • People who are unable to function. Hospitalization makes sense if you are so depressed that you can't take care of yourself.
  • People who need observation when trying a new medication. Sometimes, your doctor may be fine-tuning your depression medicine and may want you to check into the hospital. Since you will be under constant observation there, your doctor will be able to see more easily how well a treatment is working.
  • People who need treatments that are given only in a hospital. Some treatments, like electroconvulsive therapy (ECT) are usually given in the hospital. A stay in the hospital allows you to recover from anesthesia and gives your doctors a chance to see how you're doing after treatment.

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Relief From a Hospital Stay: Is It Possible?
Some people actually experience great relief from their time in a hospital and don't find it difficult to cope. Everyday challenges and worries involved in providing for home or career may be temporarily alleviated and a person might find they can better focus on getting well. For others, however, hospital treatment can be frightening and intimidating and the time away from regular support sources can be difficult.

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What Are Your Rights Regarding Hospitalization for Depression?
Many people with depression check themselves into the hospital because they feel unstable or suicidal. But others are hospitalized against their will. The laws concerning hospitalization for depression vary from state to state. Generally, you can only be hospitalized against your wishes if you are considered to be a risk to yourself or others.

During an emergency, a health care professional or police officer may require you to be evaluated by a hospital. Once there, a hospital doctor will talk to you and decide whether you actually need to be hospitalized.

Note that hospitalization of an individual suffering from the severe depression is deemed absolutely necessary when that person has attempted suicide or has serious suicidal ideation or plan for doing so. However, such suicidal intentions must be carefully and fully assessed during an initial meeting. The individual must be imminent danger of harming themselves (or another). Daily, routine daily functioning will likely be negatively affected by the presence of a clear and severe major depression. Most individuals who suffer from major depression, however, are usually only mildly suicidal and most also often lack the energy or will (at least initially) to carry out any suicidal plan.

Care must be taken with regards to any hospitalization procedure. When possible, the patient’s consent and full understanding would first be obtained and you as a client would be encouraged to check yourself in. Hospitalization is usually relatively short, until you state becomes fully stabilized and the therapeutic effects of an appropriate antidepressant medication can be realized (3 to 4 weeks). A partial hospitalization program might also be considered.

Suicidal ideation will be assessed during regular intervals throughout therapy (every week during the therapy session is not uncommon). Often, as the individual who suffers from a depressive disorder is beginning to feel the energizing effects of a medication, they will be at higher risk for acting on their suicidal thoughts. Care should be used at this time and hospitalization may need to be again considered.

The length of your stay is set by the staff. If the doctors no longer think that you are in danger, you will be released within two to seven days -- depending on the laws in your state. Keep in mind, if you disagree with the hospital's assessment, you can take legal action. Talk to your state's Protection and Advocacy agency.

When you're in the hospital, you may face some tough restrictions. Even if you check yourself in, you may not be able to leave as soon as you want. The hospital may strictly control visits from family and friends, and limit the items you can take in with you. You may be on a locked ward for at least some of your stay. You may also be expected to follow a certain schedule. While the restrictions can be hard to accept, keep in mind that they are in place for the safety of you and the other patients.

Some health insurance policies will cover hospitalization for a limited amount of time. Others won't cover it at all. Before a person can be hospitalized, some insurers require that he or she be evaluated by an expert under contract with their company. Very few insurers will cover a hospital stay for depression that isn't an emergency.

Keep in mind that most hospital stays for depression are brief and voluntary. The goal is for you to stay until your doctors are confident that you are safe and stable.

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