DH sectioned - struggling to cope

[ResidentPike]

Hi all,

I don’t really know where to start. My DH has bipolar and has been struggling for a while, but things escalated massively last week, and he was sectioned under the Mental Health Act. I feel like I’m in shock. One minute he was home, not great but manageable, and the next he was in hospital, and I had MH professionals telling me he wasn’t safe. I knew he was unwell, but I still feel blindsided.

The DC are young (under 10), and I’m trying to keep things as normal as possible for them, but inside I feel like I’m crumbling. I swing between relief that he’s somewhere safe and being looked after, and absolute panic about what happens next. Will he get better? How long will this last? I’ve barely slept since it happened.

Has anyone else been through similar? How did you cope? I don’t want to offload too much onto family/friends, as they’re already worried. Just feeling very alone right now.

Any advice or hand-holding much appreciated.

I did not cope.

I divorced him.

Life got so much better for me and my son.

I think it's a shock all around when a loved one has their first admission. Take things slow, take time to process things and maybe look to see if there's any counselling you can access to help you process it all.

I've been under mental health teams since 2006 and it was 2021 that I had my admission. There's been a few occasions when it's been close (once when I absolutely should have been!) and I've always managed to just about cling on in the community. Despite nearly 20 years of being mentally ill it's when it got real for me.
Lifestyle and medication compliance makes a big difference for long term stability for me. My mood was very unstable when I was first diagnosed but I was doing a PhD but I was under immense amount of pressure, working crazy hours ridiculously stressed it was a recipe for disaster. I was depressed every year August to January then hypomanic- manic every April to June.

I finished and moved into regular employment 8 years ago and I've had just 2 episodes since! A mild hypomanic episode 7 years ago almost exactly when I moved house, moved job sites the same week the clocks changed. My mood is sensitive to daylight as soon as the days start to get longer my brain starts fizzing nowadays it does come to anything but this year when it was coupled with change and stress it was enough to tip me over. Luckily I recognise stress as a trigger and got a medication increase quite quickly and it didn't escalate. The second episode was depression after having my daughter that led to my admission. I developed severe depression and psychosis which didn't respond to medication. There were two advantages to the admission - keeping me safe and continuous support and much greater access to psychiatrist support which allowed quicker and bolder medication changes. I saw her twice a week compared to every 6-10 weeks in the community. In 10 weeks I went from treatment resistant to home making significant improvements and started a very slow phased return back to work a week after getting home - in hindsight I probably needed a bit longer off! I've been stable ever since and last year reduced from 4 medications back to 1 and have even weathered some stressful periods without relapse.

He is safe right now, so although it might be hard, please make sure you look after yourself and your children.

Do they understand or know that dad is unwell and in hospital until he gets better?

There's no right or wrong way to feel, if you want to try and carry on as normal if it keeps you busy and your mind occupied, that's OK. If you want to cuddle up on the sofa with your kids and watch films, that's OK too.

Maybe when you speak to his care team ask if you are able to visit if he's stable enough, or can you arrange a phone call?

Take care of yourself on all this, is so easy to concentrate on supporting him and your children, but don't let yourself burn out either.

Your husband is also entitled to a mental health advocate. Ask the ward about it. Edited to say it may not be relevant at this stage but I found out much later on and it would have been helpful to know earlier. Our local Mind were also very knowledgeable and kind.

Well done for calling crisis OP, it's what was required to get him the help he needs.

I have worked on a mental health ward and a good friend who has bipolar has been sectioned twice. The first time they booked a flight to somewhere 10-12 hrs away and their partner had to go collect them. When unwell people with mental health issues can really put themselves in harms way. There is typically also no insight (they believe there is nothing wrong) which makes it hard for families to manage. The ward represents somewhere he can be assessed, have therapy and be given treatment. When his insight returns things will get better. Focus on yourself and your kids. Goodluck and come here to chat to strangers who can try to support you.

Hi OP.
I have bipolar and BPD.
I've been sectioned quite a few times. I've always wanted to see my husband but I appreciate people are different.

Is your husband compus mentis at all? Or is he in full blown mania? If so I would leave it abit longer until he is settled.

Would he be able to follow conversation etc, asking for you, has capacity ( of sorts)? If so I would definitely go to see him.
I wouldn't go for long visits, short at first then extend but let your husband lead on this. It's important to let him have as much autonomy over his own mental health needs as possible.

He will have a designated mental health nurse on the ward. He will also have a consultant meeting every week ( on a designated day)

Oh and also Heavy Light by Horatio Clare is essential reading when you’re ready. It documents his descent into full mania and recovery from it, but it’s exquisitely written and very positive. It was the turning point in my ability to handle DH - predominantly in saying enough is enough sooner than the first occasion and handing him over to the professionals. The second half is dedicated to treatments other than the heavy duty medicines. It’s very enlightening.

Actually, no. There's usually a private family room just outside the unit where the patient can meet family. Including stuff for the children. Of course only one patient/their family can use it at a time

Before he went in, he really wasn’t making much sense his thoughts were all over the place, and it was hard to have a proper conversation with him. That’s part of why I’ve been so unsure about visiting I don’t know if he’d even be able to engage with me properly yet. But I’ll phone the ward in the morning and see what they think about how he’s doing.

The kids know that daddy is unwell and in hospital, but I’ve kept it quite simple for now. They seem to be taking it in their stride, but I know they must be processing it in their own way. I just want to keep things as normal and stable as possible for them.

Going to try and get an early night while they’re asleep it’s been a lot to take in, and I know I need to look after myself too. Thanks again for all the support, it really does mean a lot.

My husband wasn’t sectioned but he’d phoned a counsellor who told him to give me the phone . They told me to take him to A and E and when there, they recommended strongly he stay in the mental health unit.
He was unable to make a decision and looked to me to make it for him. I took the consultant’s recommendation and had him admitted. He was in a locked ward, on suicide watch every 15 minutes . He stayed for 3 weeks
. It was awful but the right decision. He doesn’t really remember it as he was having a complete mental breakdown. I remember it only too well. He was off work completely for 3 months then went back on a part time basis for 3 months, gradually working his way up to full time hours.
This was over 15 years ago. He still takes antidepressants and will probably be on them for life. They were reduced from the heavy dose at the time of the breakdown and are now a maintenance dose . He does still have down days or short spells but nothing at all like he had at the time of his breakdown. And he has never needed another hospital stay.

@ResidentPike Mental health wards are slightly different to normal wards in that everyone has their own bedroom. There will also be a shared “living room” with a tv, armchairs and usually a dining table for crafts and board games, a dining room for meals and a larger meeting room for ward rounds and other assessments, as well as other more “medical spaces” like clinic rooms. Most units also have “family rooms” for visits and many will also have a “therapy kitchen” with a patient fridge where they can store their own snacks and drinks and a microwave for ready meals, although, like in all NHS hospitals, all meals are also provided. I would take him in some things from home. NHS bedding in particular can be quite rustly and uncomfortable, so maybe a blanket? He might also be quite bored so bring him something (safe!) to do, although pretty much all MH wards run a programme of activities and therapy sessions.

In the long run, I would attend ward rounds and maybe ask to speak to his psychiatrist. If there’s concerns about treatment compliance, some medications can be given in “longer acting” formats, although most people do understand that the medications help them stay well and so keep taking them.

For now, one foot in front of the other and keep talking to the ward x

Hi @ResidentPike hope you’re okay. I’m sorry to hear that your husband is unwell.

I visit lots of different NHS mental health units and wards as part of my job. There not as scary as people think, although in my honest opinion they’re not the most therapeutic places.

Firstly, try and find out what section he’s on, so you’ll have a rough idea of how long he may be there. For example if he’s on Section 2 he may be in hospital for up to 28 days.

Also find out what type of ward it is. (Acute/PICU etc.) there will be info online about the ward, who the manager is, photos etc. However, the staff should be able to give you an information pack for carers and relatives. Have a look at the CQC rating and the latest CQC inspection and comments.

He’ll be under a Responsible Clinician who’ll be responsible for your husbands care whilst he’s on the ward. He’ll be invited to MDT (multidisciplinary team) meetings, usually, once a week to make decisions around his care.

Be prepared for him to be medicated. He may become spaced out or zombie-fied if the RC prescribe him strong stuff. Sleeping pills such as Zopiclone, antipsychotics and antidepressants are the ones I’ve found they prescribe the most.

As I said, mental health wards aren’t the most therapeutic environments. Usually they have Occupational Therapists or Activity Coordinators that organise activities for the patients. It’s normally 1-2 activity per weekday (not much happens on a weekend) such as a quiz, music therapy session, yoga, skittles. So most of the time the patients are left with little to do apart from watch TV. Depending on the ward- some have their own gyms, games rooms etc. where patients can use when they want. There’s honestly not much individual therapy sadly.

If you can, I would try and take him things to keep him occupied. (Depending they’re not on the blanket restrictions list, or a ligature risk). Books, colouring/art supplies, puzzles. Also any nice toiletries if his ward allows, as the soap and hygiene products in hospitals are so basic.

Encourage him to keep any of his valuables in his safe/locker if he has one, but if not, ask him to keep them in the nurses office. Patients aren’t aloud in the nurses office (usually can only be opened with a key) as sometimes theft can be rife on wards.

I really hope he’s on the road to recovery and you get change to visit him soon. Some wards also allow children in visiting rooms - just make sure you’re in regular contact with the staff as all visits must be approved beforehand. You just can’t randomly turn up.

Also, he may be approved S17 leave. Which means he may be allowed escorted leave for an hour (e.g go for a walk in the local area with the staff) or 6 hour unescorted leave, where he can leave the ward and come home for a few hours. It will all depend on his mood and how he is responding to medication and treatment.

Wishing you all the best!

Hope this link is helpful for you aswell:

www.mind.org.uk/information-support/legal-rights/sectioning/about-sectioning/

I have bipolar disorder and have been sectioned several times.

one of my biggest fears that this will just keep happening. I know he’s safe right now, but I just keep thinking about what comes next and how we stop it from getting to this point again.

How long have you known him? Is he on medication? People can go for years between episodes.

Stress is my biggest trigger. The others are staying up all night, moving time zones and changing seasons. It’s quite common for people to have episodes in the spring. It’s thought that bipolar disorder is caused by a dysfunctional circadian rhythm.

If he gets hypomania before the mania (most people do) there are tactics that can help nip it in the bud. They mostly revolve around reducing stimulation, so, for example, not listening to music, lying in a dark room, wearing sunglasses when out, not drinking caffeine or alcohol, limiting stress and generally making life as dull as possible. If this doesn’t work then taking a PRN medication for a few days can bring it down. I have a box of olanzapine and a box of clonazepam in my medicine cabinet for this reason. I’ve only needed to do this twice in two years and on both occasions it’s prevented me from going into a full blown episode.

How has he been managing it up until this point?

I would recommend contacting BipolarUK. They also have a forum with a section for family I believe.

This is really important and why OP needs to find out how the ward operates with children visiting, before she takes them. Not wanting to scare anyone but they can sometimes be quite daunting places with a lot of very distressed people in different states of ill health. Some may absolutely be inappropriate for children to be around (I've been given a panic button on some wards) and the hospital should make arrangements to ensure they have a private space away from other patients to facilitate children's visits.

I'm glad you're feeling supported by this thread though OP and I hope I'm not making you feel more overwhelmed and anxious, but it's important to be realistic and prepared. Not just for seeing your DH, but for there possibly being some seriously unwell people around, depending on the ward. You'll be able to tell a lot by the time staff have to speak to you and how helpful they are on the phone. Some wards are fabulous though, and I really hope that's the case for you. I do second all the other posts saying you absolutely must not feel guilty for not visiting straight away. Put yourself and your children first and let things settle.

I didn’t see your post before I posted. It sounds like yours is very similar to mine, except I would generally get depressed in the spring and hypomanic in the autumn. An exception to this was the spring I marched to my psychiatrist’s clinic in a cocktail dress laughing my head off and accepting my prescription for olanzapine as if I were accepting an award. Even he was laughing. I’m extremely sensitive to changes in the light and I dread the clocks changing.

Really glad you’re in a much more stable place now and congratulations on your PhD. I had an intense period of stress a couple of years ago and I remember thinking it would be a miracle if I made it through without an episode. I’m not sure who was more surprised when I didn’t - me or my CPN!

Hi OP,

I have been there recently with my husband. I understand how you feel. It was the most painful and horrific time ever.

My husband has been home for a few months now, but still unwell- although not in mania or psychosis anymore.

It was fucking traumatising. I feel for you so so much. I am a little further down the road, and there were times I felt I couldn't cope, but I did and you will too.

His stay was long- that's a bit of a story! (most patients came and went within a few weeks) and he was extremely unwell, and the things I witnessed and what he went through has left us both with a lot of trauma, but we are getting through it.

However, a few months ago I had little hope that things would improve. They have though and I am less shell shocked and we are healing together slowly.

It was just so awful and the way I coped was by talking. I remember the nights crying, not being able to sleep, the fear and the difficulty of supporting children through it too. The grief is what got me the most. Psychosis obviously caused my husband to act in ways that he never usually would and it felt like grief- it was ambiguous loss. I am pleased to say that that part is over now.

I would be more than happy to talk to you if you feel it would help. Feel free to PM me if you like. I am more than happy to share more or just listen to you. You have got so much great advice here, but I wish I had someone to talk to who completely gets it.

You will be ok, you will get through this.

I have been sectioned a number of times, under various sections of the Mental Health Act. Although not pleasant, it's not as scary as people think. It's just a hospital ward at the end of the day, albeit more restrictive for obvious reasons.

He might seem a little bit 'out of it' whilst he adjusts and gets on the right meds etc. But he'll stabilise and all will be ok. You will all be coming through the other side of this soon enough 💐

Your rights as a nearest relative should have been explained to you by the AMHP or the local authority who employs the AMHP.
Im sorry it wasn’t.
I frequently support relatives/carers of people detained or voluntarily admitted to mental health units - no one in those units wants anyone on there longer than is necessary ie to stabilise the person so that they are safe enough to receive support from the community mental health teams and their GP.
What happens next? Your husband has the right to appeal his section 2, if he does not get better he may be detained for longer under a section 3.
I would call your local adult social services and explain you are the next of kin and ask to speak with the AMHP who detained and conveyed your husband - they have a legal responsibility to explain things to you and involve you.

Morning all, just wanted to update and say thank you again for all the support. I managed to get some sleep last night, which has helped a bit, though I still feel emotionally drained.

I called the ward this morning, and they said DH is a little calmer than when he was admitted, but still quite unsettled. They’ve started him on medication, but it’ll take time to properly kick in. He hasn’t asked to see me, but they didn’t think a short visit would do any harm if I wanted to come in. I’m still nervous about how he’ll react, but I think I’ll go later today just a short visit to see how he is.

The DC are okay. We’re having a quiet morning, just watching TV and taking things easy. I’ll keep things as normal as I can for them.

Feeling a bit wobbly about seeing DH, but I know I need to. Will update later.

OP I hope all goes well later. It must be scary but knowing what you're dealing with will help you to plan and access the right support for your family.

I'll be thinking of you.

Yes, good luck OP, hope it's not too upsetting. In a way you're doing this for future DH - he will really appreciate your going right now, even if he might not seem like it today.

Just make sure you have something nice to come back home to later. Lots of self care and treats for you and DC.

Children will not be able to visit, nor should you take them. If he’s having a good day when you visit, you could call/video call them for a quick hello. Definitely check out what you are and are not allowed to take as could be quite strict. Label everything, things easily go missing. Be prepared for this to be to longer than the 28 days of a section 2, he won’t necessarily be sent home at the end, he could move to a section 3 for further treatment, or stay as an informal patient if he has capacity to agree to that and isn’t ready to go home. Be prepared for progress/getting better to not be linea. Have a look at Mind - lots of useful information in terms of what to expect and rights. In my recent experience, communication about what is happening is not always forthcoming, and info and help post discharge even worse. Reading up snd figuring out entitlement ourselves has been only way we have got anywhere.

Went to see DH today, and it was really tough. He seemed completely out of it, just staring into space and barely talking. I tried chatting to him, but he didn’t say much at all. Took him some of his favourite snacks, a book, and the DC’s drawings he looked at them for a bit, which was something, but mostly he just seemed exhausted. He said he was really tired and had a headache.

I only stayed about 20 minutes as I didn’t want to push it but right before I left, he asked me to visit again soon, which made me feel a bit better. At least he still wants me there.

Feeling pretty drained now. I know he’s in the right place, but it’s hard seeing him like that. Just hoping the meds start helping soon. Taking it one day at a time.

The thing with mania is the body survives on the bare minimum and then when you start to come down you have quite a deficit in sleep and energy especially cognitive energy. As I was coming out of one of my manic episodes I slept for 26h and was very confused when I woke up and found it was still night time and had lost a day! The meds to bring you down are quite sedating and can dull your cognitive functions.

20 minutes is a good amount of time for the first visit. Get plenty of rest and take care of yourself too. Do you have anyone you can talk to about this? It's good that he wants to see you again. Hopefully next time you'll see a shift even if it's small and slow.

Snacks and activities are good things to take in. The food isn't always the best and you can have quite a bit of down time. I always find books I've read before easier when I'm recovering from an episode. When I went into hospital I reread the harry potter books.

Been where you are, but a long time ago now. It will get better, but the hard thing is that nobody can give you a time frame. Hang on in, look after yourself and your wee ones, and try to trust that the doctors will be able to help him.