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hospitalization for mania


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I think what matters most is whether or not you are an immediate danger to yourself or others. That is when hospitalizations are necessary. If you have immediate definite plans of harming someone else and have date, time , and weapon, you need to be IP. If you are suicidal to the point of saying you are going to kill yourself this time and date and have a weapon you need to be IP. If you are so manic you try flying off a building and hurt yourself seriously, you can be forced IP.

That really is the only time you can be forced IP against your will. Pdocs can recommend all they want, but unless those criteria are met, they cannot legally hold you against your will IP. The first time I was taken IP while full blown manic the pdoc couldn't hold me because I was not an immediate danger to myslef or others at least to what I'd admit fully to. So I was let go. Now if taken to court he may have won but for some reason he didn't think he would win and decided to let me go home.

Now, really though, some people who are not a danger to themselves or others and are full blown manic probably could  be "saved from themselves" because of irreversible damage they will do to their lives and to the lives of others. Sometimes I wish I would have been kept against my will when I fought to leave tbh in the end of it all after my senses came back to me. This is how I personally feel. I wish I would have been saved from myslef.

But it is improtant to remember the criteria for involuntary IP. No one can hold put you IP against your will unless that criteria is met fwiw. 

Hope that helps clarify. 

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Well the first time I was manic/psychotic and hospitalized (no prior dx, got diagnosed bp in the hospital). 

The second time I was in a foreign country and was surviving on extra Seroquel (available without an Rx in Greece).  I came home really sick but not quite psychotic and I did NOT want to go into the hospital.  In retrospect I should have probably gone, but I got an order to take extra Seroquel (without an extra prescription, which means I would have run out without the extra pills).  I also had a scheduled appointment with the tdoc, which may have affected things (also I think the pdoc I was seeing at the time was on vacation).  

The last time I noticed myself getting really manic was on a weekend.  I basically tried to keep myself distracted but I managed to be able to see pdoc on Monday.  In that case I was just able to increase Seroquel and no hospital was needed.  So I think a lot of it depends on how aware you are of your symptoms, how soon you can see pdoc, stuff like that.  If you get psychotic you'd probably end up in the hospital.  

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I was only hospitalised once, in the US. They can't make you go in unless you meet the criteria cheese mentioned, but if you do go at doctor's recommendation, insurance can penalise you if you try to leave before the inpatient doctor discharges you officially. They threatened to hand me the entire bill and insurance wouldn'tcover a cent of it. Basically forced me to be there with the threat of financial ruin. I mean how the hell do you pay an inpatient 2.5 week USA hospital bill on your own?? It was 10 grand a night or something. 

As for where I am now, you can't get into the hospital unless you are absolutely a threat to yourself or others. Go to treatment for most non-lethal, emergency situations is the crisis team. They visit you every day, call you multiple times every day. You go to the pdoc several times a week or more as needed. The crisis team can come at any time of day or night if you are losing control. If they can treat you at home, they will.

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I think standards for hospitalization vary depending on where you are and what type of services are available. When I was hospitalized (entirely in the US), there were people in there who definitely weren't a threat to themselves or others, but were very symptomatic. Most of those people were in there as voluntary admits though, so standards might have been different for involuntary admissions. Where I am now, public hospitals take the more severe cases, and private hospitals take anyone who can be a voluntary admit, for med changes, symptom monitoring, or sometimes for suicide attempts. My pdoc said that if I ever can't talk again because I'm so manic, that I'd go to the public system.

In terms of my own experiences, I was hospitalized involuntary for a few weeks earlier this year for mania. It was my first (and only) mania; my elevated moods since have been hypomania. Though I had violent plans and thoughts, I didn't mention these to anyone, and though I was delusional, I didn't tell anyone about these delusions. I had also been self harming, but hadn't mentioned this to the doctor who admitted me. Yet I was still hospitalized. In terms of my symptoms, my speech was rapid gibberish, I was running around my therapist's office because I was so agitated, I was completely disheveled when I presented, and I was very anxious. I was told there was no question about hospitalizing me.

So I'm still not sure how they legally hospitalized me. When I was in the hospital and wanted to leave a few days in, the doctor told me that if I left, someone would send me back within 24 hours. So I guess there was a reason. Maybe, in some states, you can legally hospitalize someone if they are gravely disabled, and perhaps I fit in under that category. Months later though, my therapist told me that I was so manic I was a risk to myself, but I just don't know what I said that gave that impression, even though I definitely was a threat. 

Sorry for the essay. I hope that something in here helps someone. 

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9 hours ago, aura said:

When you become full-blown manic, does your pdoc usually recommend (or require) hospitalization? Or do you ride it out at home? Does it depend at all on the severity of the mania or on your particular symptoms?

No, not unless I am a danger to myself or others.

Quote

insurance can penalise you if you try to leave before the inpatient doctor discharges you officially.

Here I have seen people go AMA (against medical advice) without a problem (I think though that is if you are admitted voluntary and you've been there for 3 days or more;  Involuntary I'm not sure about).  I have never heard of an insurance company handing a person a bill if you leave before you are discharged officially.

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Thank you all for responding; this is really helpful.

I guess I was asking because I was hospitalized voluntarily for mania in October, and was wondering if I should expect hospitalization if and when I become manic again. My pdoc's reasoning, he later told me, was that I was refusing a lot of medications that might help and he was running out of options; on top of that, I was paranoid and driving really dangerously. I was tired of the cacophony in my head, so I was willing to try anything.

Now I'm wondering... what happens when I become a bit manic, a usual, at the beginning of spring? Has a kind of precedent been set that I go to hospital when I'm manic? I don't know if this makes any sense. This question doesn't have an answer; I was just curious about others' experiences. When you do get manic, do you end up in hospital voluntarily or involuntarily, or do you manage to stay home?

Edited by aura
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IME I am most definitely not hospitalized for every single mood episode or psychotic episode that occurred or will occur. Hell, if that happened I'd be living in one. Constantly, like a revolving door.

That's not something I want to achieve. I never want to make a habit of it thinking I need it for every setback that occurs. I was hospital free for 2 years before this summer's full blown manic episode. Yes I had other very serious episodes but I didn't go running to the hospital like some people I know IRL.

The IRL people I know want to never be out of the hospital. They go there in and out for every troubling time. Even if it isn't an immediate risk to their safety or safety of others. 

But ultimately it's up to you how you want to manage your illness. If you want to use the hospital every episode with your pdoc's approval then you have every right to do so. It's a tool to use for sure.

I'm not judging. I'm no stranger to IP land. It's just that that isn't for me and I've never experienced a pdoc or tdoc who would hospitalize me every time I got manic or suicidal with a plan in place. Maybe the public system is different? Not sure.

And you might not even get manic in the spring. Nothing is a for sure thing I've learned with this illness. You are on better meds now than before. 

I find that I cannot obsess about "the next time I become...manic or depressed or psychotic or suicidal etc." It leads to constant anxiety and even brings on episodes IME. It's good to have a plan in place yes. But I try to keep in mind I'm so much more than this disease. It doesn't have to be my life. Yes there are limitations probably. But I still am not this illness and I won't let it become my identity. 

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6 hours ago, aura said:

Now I'm wondering... what happens when I become a bit manic, a usual, at the beginning of spring? Has a kind of precedent been set that I go to hospital when I'm manic? I don't know if this makes any sense. This question doesn't have an answer; I was just curious about others' experiences. When you do get manic, do you end up in hospital voluntarily or involuntarily, or do you manage to stay home?

I don't think any precedent has been set, tbh. Just because you were manic with a particular set of symptoms and level of insight doesn't mean it will happen again, let alone soon. As cheese said, you're on better medications, and you've been in therapy longer to learn about warning signs and coping strategies. If you don't want to go to hospital, you can always say no when your pdoc brings it up as a possibility, unless you'd be an involuntary patient. If you want to use it as a tool, go ahead. Since my last hospitalization, I've been offered three times to go IP (through the private system) and I've said no every time as hospital makes me feel worse. But each to their own. 

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I've never been hospitalized for being just manic

I've only been sectioned for mania when I had psychotic features when I was 15 in a medium secure hospital for punching a copper who tried to take me to hospital.

Delusions of immortality usually equal danger to yourself.

Edited by StJimmy9151
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Aura, I'm not going all back over my mental history, but when we're a danger to others; which for anyone that has manias, and start to believe we don't need our meds, and more so get in a car and drive! Well we need to be taken off the streets, until we learn the signs as they appear, and call our docs as fast as we can!

Believe me, I wish someone would have done that for me, when I was like that. It would have saved a world of hurt. State prison isn't conducive to mental health care. When I first got there they take all your meds from you, then stick you in a 6x9 cell with whoever that did whatever. It takes about 3 months to get into their "doc", and they tell you what you're going to get.

I had to check self in, after getting home around anniversary of crash for many years. The agitation, my speech, I pace like a caged animal. That's not safe for anyone. Of course I've since learned from those times (about time huh, but this is mental illness, it fucks with your brain, thought process) to be on high alert for quite sometime prior and around the time.

I have great husband that knows signs, I keep journal of sleep, what I eat, did I do yoga.

If someone lives with you, tell them to hide car keys, and if you get so out of control to call ambulance, or police. 

Peace

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16 minutes ago, zooeyo said:

Aura, I'm not going all back over my mental history, but when we're a danger to others; which for anyone that has manias, and start to believe we don't need our meds, and more so get in a car and drive! Well we need to be taken off the streets, until we learn the signs as they appear, and call our docs as fast as we can!

Believe me, I wish someone would have done that for me, when I was like that. It would have saved a world of hurt. State prison isn't conducive to mental health care. When I first got there they take all your meds from you, then stick you in a 6x9 cell with whoever that did whatever. It takes about 3 months to get into their "doc", and they tell you what you're going to get.

I had to check self in, after getting home around anniversary of crash for many years. The agitation, my speech, I pace like a caged animal. That's not safe for anyone. Of course I've since learned from those times (about time huh, but this is mental illness, it fucks with your brain, thought process) to be on high alert for quite sometime prior and around the time.

I have great husband that knows signs, I keep journal of sleep, what I eat, did I do yoga.

If someone lives with you, tell them to hide car keys, and if you get so out of control to call ambulance, or police. 

Peace

"Nothing can be loved or hated unless it is first understood.” 

― Leonardo da Vinci

 

Edited by zooeyo
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59 minutes ago, zooeyo said:

Aura, I'm not going all back over my mental history, but when we're a danger to others; which for anyone that has manias, and start to believe we don't need our meds, and more so get in a car and drive! Well we need to be taken off the streets, until we learn the signs as they appear, and call our docs as fast as we can!

Believe me, I wish someone would have done that for me, when I was like that. It would have saved a world of hurt. State prison isn't conducive to mental health care. When I first got there they take all your meds from you, then stick you in a 6x9 cell with whoever that did whatever. It takes about 3 months to get into their "doc", and they tell you what you're going to get.

I had to check self in, after getting home around anniversary of crash for many years. The agitation, my speech, I pace like a caged animal. That's not safe for anyone. Of course I've since learned from those times (about time huh, but this is mental illness, it fucks with your brain, thought process) to be on high alert for quite sometime prior and around the time.

I have great husband that knows signs, I keep journal of sleep, what I eat, did I do yoga.

If someone lives with you, tell them to hide car keys, and if you get so out of control to call ambulance, or police. 

Peace

Thank you for writing this. When I was manic I was driving really aggressively. I was also paranoid. For example, I would think someone cut me off (even though they hadn't) and then chase them through a red light. I don't interact well with cops on a good day, so it's really a blessing that I never got pulled over. My fiancee couldn't keep the keys away from me. There were lots of times where I thought this was a silly reason to hospitalize me, but in hindsight it makes sense. 

I guess I'm just hoping that other measures can be taken if and when there is a next time so I don't need to be stabilized in hospital. Sounds like from this thread that a lot of people manage this, which is giving me some hope.

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1 hour ago, zooeyo said:

Aura You're so very welcome. All any of us can do is share our experiences with you. Hopefully something will stick out that you can relate too, if even just a little event. Always remember you are an unique individual, and no two people are exactly alike.

But, I too have found along with prevention, to learn to not place so much on times, etc. I have found that fear, will hold me down, and become my self-fulfilling prophecy.

"Nothing can be loved or hated unless it is first understood.” 

― Leonardo da Vinci

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