What's being an inpatient like?

[Stuffragette]

I have bipolar and I am currently amidst a severely depressive episode, which has been going on for a while. My psychiatrist has said I can come in for an inpatient for a while if I want to. But I just can't see how it will make things better. I am having regular suicidal thoughts but they feel quite 'rational'. What I mean is i know I am not going to do it as I don't want to do it to my children.

[celtictoast]

Has your pyschiatrist said what the pros and cons would be?

[Stuffragette]

Not really. It was just suggested as an option. I just keep thinking, what will it achieve. How will it be different from being st home. This recent episode seems particularly drug resistant. The other option is ect. But that seems to be a separate suggestion from being admitted.

You know when you have an appointment and you don't ask the questions you should have done? I've done that.

[NanaNina]

Hi there - I have been an IP twice (15 years apart) both times for 3 months, with a diagnosis of severe depression. The first time was ok as I got better really quickly and so the fact that the nurses didn't really bother much about the patients, other than make sure we got meds etc didn't bother me that much. The 2nd time in 2010 was different as I was very up and down (mostly down) and the nurses were always in the office or busying themselves with meds. The nursing assistants sat among the patients but talked to each other, rather than to us. The food was grim and it was very boring although there was a good OT who provided activities in the morning that helped pass the time.

On a more positive note we had our own rooms and there was a small garden for sitting out weather permitting. There was a weekly review with the consultant psychiatrist (who was a horrible man) and several others, ward staff, the OT and CPN but they were all intimidated by the psychiatrist and were afraid to open their mouths.

My kids were grown up both times, so am not sure if having a break from your children would be a good thing if there's someone to care for them. It is a relief to not have to think about anything, but that's about all I think.

My depression this year has worsened considerably and the psychiatrist was trying to get me to agree to be an IP but no way thanks. Then we discussed ECT and I actually got around to signing the consents (it's usually done as an IP but can be done on an OP basis) I said I was worried about memory loss and she glossed over this saying there was no real evidence. I researched it myself on the Royal College of Psychiatrists website and found there was indeed a risk of memory loss, both short and long term and whilst it's usually temporary, it can be permanent. Also she had not followed the NICE guidelines which stated that risks should be discussed in detail before consents are signed. I wrote a letter of complaint to her (she's left the Trust now) apart from that she was very nice and caring, but was only in post for 6 months, so now it's back to a locum psychiatrist who is useless. Told me my depression would get better once the summer came!!

I'm feeling pretty desperate at the moment and suicidal thoughts (and plans) much to the fore, so I might have to risk ECT.

[Stuffragette]

Hi NanaNina, really sorry to hear you are feeling so shocking. You sound exactly how I feel. I've got 3 dc, 10, 8, and 3. So I suppose it would be a break from life. But I need to start getting better. I am sat here planning an escape at the mo. The kids are asleep upstairs, as are my parents. I am seriously considering getting in my car and driving away. I know the kids will be safe with them. I am having some horrible horrible thoughts at the moment and I just don't know what to do.

I have been told ect is pretty effective. But don't you wish you had more choices/options?

I just wish I wasn't me.

[NanaNina]

I think we often think of "driving away" or running away when we are severely depressed, like we can drive away from ourselves really, when of course we can't - but I know what you mean. I think given you have 3 children to look after it might be better if you did go into hospital for a time, at least you could "zone out" of life for a while and you would be safe.

I didn't get up till 2.00 pm and have already had 2 crying bouts and feel utterly shite again. Fortunately I have a supportive DP but I hate putting him through this all the time. It's impossible to describe to anyone how severe depression feels isn't it - I can't find words that even begin to describe it.

Yes I wish there were more options - I'm on 2 different ADs and a mood stabiliser but they are mostly ineffective, and I'm scared of memory loss with ECT although I remember last time I was in hospital a nice young doctor on the ward said he wouldn't hesitate to have ECT as it had a high success rate.

Do you have a DH/DP and is he supportive. Your parents must be worried about you.

Oh god your comment "I just wish I wasn't me" - that is SO how I feel. I keep saying to DP "this isn't who I am" and I know it's horrible but when I see people outside laughing and being normal I hate looking at them. Stay safe - the depression will pass - we just have to ride it out. Do you have a CPN? I have a lovely one but she can't do very much to help.

[dontrunwithscissors]

I've been an inpatient 4 timestwice this year. Psych wards vary a lot. The one I've been in, you have your own ensuite room. There's a TV room. I find its nothing more than a holding pen for when you can't keep yourself safe. Virtually nothing to do, besides smoke (which I don't) and watch TV or sleep. Theres a weekly yoga class, a painting class and a film discussion night. There's a rigid schedule of meals, cup of tea and meds. It's very hard to sleep: it's noisy, there are hourly checks, which wake me up. Some people in there are very, very poorly. Some people that have been on the ward Have scared me and I've just stayed on my room. It can be hard to track down a nurse. It's very restrictiveI can't have things like phone chargers or a hair dryer. And, my goodness, once you're past the really 'out of control' stage, it is so, so boring.

I think it comes down to how dangerous your suicidal thoughts are (& I don't know--you may not be the best judge of that) and whether there are stresses at home that would be helpful to have a break.

On the positive side, I have met some lovely people on the ward, the nurses are mostly lovely (just very overworked), and it can be a help to 'just' be depressed. No having to put a face on for other people.

Before I was admitted the first time, I went to the ward and had a look around--that might be a possibility?

personally, I much prefer the crisis team. I get support while still being around my kids and familiar environment.

[rosenylund]

Hello dontrun, can I ask what help you get from the crisis team? I'm low at the moment and struggling, I don't want to go inpatient for a lot of the reasons you describe. Do you have to go to A and E to see them?

I'm languishing on months long waiting lists for cbt, there doesn't seem to be any more support available - my gp is excellent but is a bit frustrated for me as well. I'm feeling rather desperate at the moment.

[rosenylund]

Nana, 'Oh god your comment "I just wish I wasn't me" - that is SO how I feel. I keep saying to DP "this isn't who I am" and I know it's horrible but when I see people outside laughing and being normal I hate looking at them,

I totally agree with this, i can't bear to be around even my family because of this. I've met with friends and just feel even more wretched and bitter because i can't recall the last time I felt relaxed or happy.

[howcanikeepdoingthis]

I have had a lot of inpatient stays over the years for different lengths of time and have found them of varying benefit.

My experiences echo a lot of what has already been said. The qualified staff who perhaps have the skills to offer therapeutic benefit are extremely busy and often tied to paperwork in the office. There is very little to do so days can seem extremely long and boring. I have found the activities often meaningless and futile, there is only so many cupcakes one can bake! And yes often wards can be extremely chaotic, as you would expect holding 20 adults with extreme distress in one place. I have had some pretty traumatic interactions with other patients especially when I have been 'high.' For people like me who have maladaptive ways of getting their needs met it can be a difficult environment to be in.

Despite this, being an inpatient has saved my life in times when I couldn't cope with real life. It allowed me to address my medication and think about only myself. I would recommend having a look round and if you do decide to go in have a very structured plan about how long your admission is for and what the purpose is. A break from the mundane daily grind may well give you the space to relax, and think about the future. People can and do recover from depression, there is always hope that things can be different and better. I found meeting other service users gave me inspiration as people are often at different stages in there recovery journey and that does provide hope.

It must be an extremely difficult situation to be in but perhaps if you are seriously considering running away then an inpatient stay might provide that escape whilst keeping you safe. Thinking of you tonight x

[dontrunwithscissors]

@roseylund, the crisis team where I am is very good (quality varies a lot, place by place). The crisis team is (in most places) the gate keeper to hospital beds. The nurses can visit my house up to 3 times a day, although daily in most normal whilst in crisis. There's usually two people and they visit for an hour. It's pretty similar to seeing a CPN--they're basically checking that I'm managing my safety enough to stay at home. They listen, recommend coping strategies, speak to my husband and make sure he's managing. There's a pdoc attached to the team and she usually visits the house 1-2 a week and makes changes to meds, where needed.

I can also ring them if I need--even if it's just to talk to someone. I've been under the team that many times over the last five years that I know a lot of them. I find the opportunity to be able to talk things through helps.

I was an inpatient for two weeks in June. The only time I got to talk to a nurse about how I was feeling was when I was on constant observations. After that, if I said I was struggling (once I'd tracked a nurse down), they would throw a diazepam at me. But as a PP said, being an inpatient has saved my life. There's a place for admissions and, yes, having the chance to just 'be' without fretting over caring for the kids etc also helped for a short while.

I've been put under the crisis team via my CPN/CMHT. Your GP should have the contact details, I would think. Or you could try ringing your CMHT and ask to speak to the duty worker & explain you're struggling. You should be able to speak to someone if you go to a & e, but each area has its own rules that it's impossible to say exactly. For example, my cpn can't refer me to the crisis team unless she's spoken to me three times in three days.

[rosenylund]

Thanks dontrun that's really helpful, I've been told by the gp i can just call the crisis team for advice at any time but haven't as yet.

Stuffragette hope you're ok x