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I need help! Inpatient or Outpatient?


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I have been depressed for several years now and have always gone through my family doctor for medicine. Tried Zoloft, Citalopram, Effexor, Vybriid, and something else. Currently I am on Cymbalta 60mg and Buspar 15mg twice daily but its not working. 

I constantly struggle with depression but its been getting worse lately and came to a head last Friday. I got so down that I became very suicidal. I knew exactly how and where and I struggled with it all day Friday and Saturday. I have since gotten past the suicide scare and have talked to my wife about most of what was going on in my head. I sometimes write in wordpad when I am struggling and I will paste it at the bottom. It was a little worse than whats written because I knew this time when I was pouring out my thoughts that I was going to let me wife read them.   We both agree that I need to get some professional help but neither of us know what is the best route to take. I am still thinking about it but I know that I am not going to do anything stupid.

 

This is what I wrote on Saturday at different times throughout the day. Sorry I was not too caught up with proper formatting or spelling at the time.

 

Some days I just feel like I dont want to live anymore. Everything is so painful. My feelings, thoughts, pain itself. It is almost as if being alive hurts. I spent my morning thinking about suicide. I researched it online and even learned about a place at the foot of Mt. Fuji nicknamed Suicide Forrest. Found pictures and thought would it really be so bad if it was me. I don't particularily want to die but it makes me feel better to think about it sometimes. I wont do it of course because death is not fair to my family who care so much about me. I have read that death is the lowest form of selfishness and I agree with that. Also that Suicide is NOT chosen. It happens when pain exceeds resources for coping with pain. I dont think I am at that point. I dont want to get to that point either. I hate everything about myself and I feel like a complete failure. I have ruined my wifes life by keeping her from being with someone great. I think she would be better off without me dragging her down. My pain makes me miserable, it makes my life hard to deal with because I am a drain on my family financially . I dont know what to do to get better. I am taking medicine but I still feel this way a lot. I don't know if it helps. I take it just in case it is what keeps me from going over the edge. This morning I had to force myself to take it though because I wanted to lose that inhibition. I'm glad I took it now, a little. I am telling all this to nobody because I am ashamed; Ashamed of who I am and what I have become. I love my family so much and I would hate to ever lose them. How can I escape these feelings of dread... of soo much doubt about wanting to go on. It is pathetic that I choose to talk to my computer instead of my wife but I dont want to be put in a spotlight or get paraded around to some psych place because I am troubled. It would make things worse. I feel bad enough as it is. I want to feel better buy I dont know how to. I saw a girl that lost her mother to suicide and she later tried it herself because of the emotional problems that stemmed from her moms death. I would not do that to my son, not ever. So I keep on going and hurting. Sometimes it hurts so bad that I cannot hide it and everyone around me knows something is "off" Sometimes I have a good day and sometimes I just pretend but I still keep going. I keep going because I love my family and I want to be a better person for them some day. I want to feel like they are proud of me and that I have not let them down. I dont feel like a good father. I can think of so many things about my dad that I remember and it makes me smile. I dont think I have given him any. I am not a good husband. I am selfish and dont pay enough attention to what will make her happy. I feel like I've been put into a dark ravine and I dont know if I should just lay down and give up or try to climb out. I don't know whats even on the other side - is it happiness or just another deep dark hole to fall in to.

 

 

TL;DR I'm Sad Bro.

 

 

 

edit: Oh yea my question! What should I do for help? Would I get better treatment as an inpatient or do you fine folk think I would be just as well off getting seen as an out patient?

Edited by Atoka
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I think it depends on whether you have insurance or not.  I only know what to do for the US.  When I didn't have insurance, I presented at the emergency room and they helped me to fill out the forms for indigent care.  I don't know if that's available where you are.  When I had insurance we called the mental health number on the back and they got me set up with a psychiatrist and therapist the same day.

 

Sorry you are hurting.  I hope you get all the help you need.

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I am in Tennessee and have United Health Care community plan but I don't know what it covers. I'm sure I read a post on here talking about how bad they were with situations like this.

 

I found my card and I have a mental health number on it I can call if needed tho, thank you

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Can your family doctor give you a referral to a psychiatrist or mental health services in your area?  Or, like the previous poster mentioned, you can check to see what providers are on you insurance plan. 

 

Seeing an outpatient psychistrist and a therapist is a great starting point for treatment.  Your treatment providers can help you determine a treatment plan and will recommend more intensive services, such as hospitalization, if they think you need more help or more immediate intervention.

 

However, if you are in crisis, actively suicidal, and in danger of hurthing yourself (or someone else), then go to the nearest ER.

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I don't know what I am in anymore. I opened up to my wife and at first she was very helpful but now it's more "Do you know how hard this is on me?" and "I guess me and cody(our son) aren't enough to make you happy" shit like that and all it does it make me feel so stupid for not keeping this all to myself. I want to just lie and say I am feeling better and go on pretending.

 

Thanks for the advice

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You need a psychiatrist. Like now. Call your family doctor and tell them what is going on and that you need to see a psychiatrist ASAP. Tell them that they can stress the urgency of the request and probably get you an appointment more quickly than you can yourself. You should do this now. As in, right after you read this.   

 

I'm shocked that your family doctor hasn't sent you to a psychiatrist before now. When you're feeling better and have the chance, I'd talk to him about that.

 

Please let us know what happens. I wish you the best.

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I called and got an apt for today and they scheduled me for therapy and to see the doc about meds. talked some but mostly just questionnaire stuff. I go back next Monday so I am on my own til then lol

Edited by Atoka
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  • 2 months later...

Inpatient hospitalization is generally used as a preventative to keep suicidal people with a plan from following through with it. It is also good for medication stabilization and as a way to relax and escape from life. The physicians will act as if the hospital walls will keep all of your problems in the outside world at bay. As if your landlord cares that he doesn't have your rent check from the month because you were thinking about killing yourself.

Have you been inpatient before? I've been three times and the staff did seem to want to help me, but I had to want to help myself first. I was there until I was at that point and there was no longer a worry of me harming myself or others. This option is good in a crisis situation.

Outpatient resources are difficult to manage because of insurance issues. If you have private insurance you can usually get in to a psychiatrist or therapist within a couple of weeks. Tell them you need an appointment as soon as possible because of suicidal tendencies and sometimes they can get you in faster, but they'll likely tell you to go to an ER if you have a plan and are seriously anticipating following through. If you have Medicaid then a lot of those places won't accept you. You'll have to go through hoops just to get a social worker which they think is equivalent to a therapist. Either way, don't give up hope. Just keep pushing and try to recruit medical professions that can advocate for you and tell you the next steps to take.

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