When Hospitalization For Depression Is Needed
- For those experiencing suicidal thoughts, please contact the 988 Suicide & Crisis Lifeline at 988
- For those experiencing abuse, please contact the Domestic Violence Hotline at 1-800-799-SAFE (7233)
- For those experiencing substance use, please contact SAMHSA National Helpline at 1-800-662-4357
Depression is more than feeling sad; it’s a label for several profound depressive disorders that can affect every facet of an individual’s life. While some people may benefit from outpatient treatments like therapy and medication, there are circumstances when hospitalization is required for the safety and well-being of the individual with depression. By understanding when and why hospitalization might be necessary for people living with severe depression, you can take steps to safeguard yourself and those you love.
Reasons someone might be hospitalized for depression
Below are a few reasons someone might be hospitalized for depression.
Suicidal thoughts or behaviors
An immediate reason for hospitalization for depression is the emergence of suicidal thoughts, urges, or behaviors. These can manifest in several ways, including the following:
- Passive Suicidal Ideation: An individual might express a desire to die or believe that life isn’t worth living but does not have an active plan.
- Active Suicidal Ideation: Active ideation involves specific plans to end one’s life. In this case, the person may have already procured the means to execute their plan and may have written a note to their loved ones.
- Previous Suicide Attempts: A history of past suicide attempts significantly increases the risk of future attempts. Such a history can indicate the benefit of monitoring.
The primary concern in these cases is often safety. Hospitalization provides a safe, controlled environment where risks can be minimized. In some hospitals, clients can receive 24/7 medical and therapeutic care, and the environment is structured to prevent self-harm.
Severe functional impairment
Depression symptoms may become so severe that they impede one’s ability to engage in daily activities. Such severe functional impairment might manifest in the following ways:
- Neglect of Personal Hygiene: Someone might stop bathing, brushing their teeth, or changing their clothes. This neglect is not out of laziness but rather an overwhelming sense of despair or lack of energy.
- Difficulty Performing Daily Tasks: Tasks like cooking, cleaning, or getting out of bed might become insurmountable challenges.
- Social Isolation: An individual might begin withdrawing from friends and family, avoiding social interactions, and staying secluded. This isolation can further exacerbate loneliness and despair.
- Work or School Dysfunction: An individual might frequently miss work or school, or when they do attend, their performance significantly drops.
When an individual’s level of functioning deteriorates to such an extent, the focus may not only be on mental well-being, as their physical health can also be at risk. They might neglect nutrition, medication, or other critical health needs.
Hospitalization offers an environment where people with depression can receive structured care, addressing their mental and physical needs. The aim is to stabilize the individual, helping them regain their functional abilities and safely return to their daily lives.
Psychotic symptoms
Depression, in its severe forms, can sometimes be accompanied by psychosis, a condition where a person may lose touch with reality. Symptoms of psychosis often include hallucinations and delusions.
Hallucinations are sensory perceptions in the absence of external stimuli. An individual might hear voices (auditory hallucinations) that aren’t there or see what others don’t (visual hallucinations). These hallucinations can be distressing and can sometimes cause harmful actions.
Delusions are false beliefs held with firm conviction, even when presented with evidence to the contrary. For instance, a person might believe they are responsible for a catastrophic event they had no connection to or believe they possess extraordinary powers or wealth.
Hospitalization may be beneficial in these cases, as the combination of depression and psychosis can be dangerous. A structured hospital environment ensures safety, correct diagnosis, and administration of specialized treatments like antipsychotic medications. However, consult a doctor before starting, changing, or stopping any medication.
Other harmful behaviors
Beyond suicidality, depression can sometimes manifest in other harmful behaviors like self-harm and aggression.
Self-harm isn’t necessarily a suicide attempt. Instead, behaviors like cutting, burning, or scratching oneself can be ways some individuals cope with overwhelming emotions. However, they can pose significant risks and indicate profound distress. In addition, self-harm is a leading risk factor for future suicidal behavior.
In addition to self-harm, some individuals may exhibit outbursts of aggression, either verbally or physically, which might be uncharacteristic of their usual behavior. This aggression could be directed toward others or inanimate objects.
Such behaviors can be a risk to the individual or those around them. Hospitalization provides a controlled setting where these behaviors can be addressed, underlying causes can be identified, and healthier coping strategies may be taught.
Ineffective outpatient treatment
Not all treatments work uniformly for everyone. In some cases, despite sincere efforts, outpatient treatments may fall short due to the following:
- Non-Response to Treatments: Some individuals might not respond to standard therapeutic interventions or medications. Their depression may remain as severe as ever or worsen over time.
- Inconsistency in Treatment Adherence: The weight of depression can make consistent attendance to therapy sessions or regular medication intake challenging.
When traditional avenues don’t provide relief, an inpatient setting can offer more intensive, tailored, and monitored treatments. Hospitalization allows for a thorough re-evaluation of the individual’s condition, potential adjustments in medication, and the introduction of alternative therapeutic modalities.
Requiring medically assisted detox
Depression can often occur alongside substance use disorders, creating a complicated web of symptoms and challenges:
- Dual Diagnosis: Dual diagnosis refers to the co-existence of a mental health disorder (like depression) and a substance use disorder. Each can exacerbate the symptoms of the other, making treatment more complex.
- Physical Dependence: Individuals may turn to substances to self-medicate or escape the pain of depression. Over time, they can develop a physical dependence on these substances, meaning their bodies crave the substance to function normally.
- Withdrawal Symptoms: Stopping a substance suddenly can lead to withdrawal symptoms. These can range from mild (like headaches or irritability) to severe and life-threatening (like seizures or hallucinations).
In cases where depression and severe substance dependence co-exist, hospitalization is often the safest option. It provides a controlled environment for medically supervised detox. Professionals can manage withdrawal symptoms, ensure the individual’s safety, and concurrently address the underlying depression.
What are your rights regarding hospitalization for depression?
Note: The following information is not a substitute for legal advice. Reach out to an attorney or patient advocate to understand the laws in your state and county.
Being hospitalized, especially for mental health reasons, can be an overwhelming experience. In these situations, individuals in the US have rights, including the following.
Right to informed consent
Patients have the right to be informed about any proposed treatment, procedure, or medication. This right includes the following guidelines:
- Medical professionals should explain treatments in understandable terms, covering the benefits, risks, and alternatives.
- Except in emergencies or specific legal situations, you can accept or refuse treatment.
To understand what situations may require involuntary hospitalization, speak to a lawyer or patient advocate for further information.
Information rights
Your medical information is sensitive, so discussions about your health, records, treatment plans, and any therapies must remain discreet. Personal health information can’t be divulged without your permission, except in specific legally defined situations.
Right to respect and dignity
You deserve to be treated with respect, regardless of the reason for your hospitalization. When hospitalized, it may be illegal for providers and institutions to discriminate against you based on race, gender, religion, nationality, or other safeguarded identifiers. Medical staff must treat you with dignity, respect your autonomy, and be sensitive to your needs and concerns.
Right to safety
Hospitals are obligated to provide a safe environment. You have the right to be safeguarded from harm, including self-harm, while in the hospital. Restraints or seclusion should only be used as a last resort and should comply with medical standards and laws.
Right to communication
Unless medically contraindicated, you should be allowed to communicate with family, friends, or legal representatives through visits, calls, or letters.
Right to legal representation
If you feel your rights are being violated or there are legal proceedings concerning your hospitalization (like involuntary commitment), you have the right to an attorney.
Right to review your medical records
Understanding your medical situation is crucial. You may have the right to view and obtain a copy of your medical records. Some restrictions might apply, but patients generally can obtain to their sensitive information. One restriction may be therapist notes, often not divulged with clients to safeguard the therapeutic relationship.
Right to discharge and second opinion
Unless you’re under a specific legal hold, you have the right to be discharged from the hospital. If you’re unsure about the treatment plan or diagnosis, you have the right to seek a second opinion from another medical professional.
Long-term support options
Not everyone with depression requires or benefits from hospitalization. If you’re not in crisis, you might benefit from talking to a therapist in the long term to develop a treatment plan. However, if you face barriers to in-person therapy, online platforms like BetterHelp may be more convenient.
One benefit of online therapy is flexibility. Breaking down geographical barriers ensures that even those in remote areas or those without easy transportation can obtain care. The inherent flexibility of online platforms means clients can tailor therapy sessions around their schedules, potentially aiding in consistent attendance.
With some platforms offering real-time communication, the digital approach ensures consistent support for those experiencing major depression (major depressive disorder). While online therapy benefits many people with depression, it does not replace hospitalization. However, an online therapist may be able to help you determine whether hospitalization is suitable for you.
Research increasingly validates the efficacy of online therapy, for several mental health conditions. Studies have found online cognitive-behavioral therapy (CBT) to be as effective as in-person therapy for depression.
Takeaway
In this journey, prioritizing well-being and advocating for oneself or loved ones can be important. Consider reaching out to a long-term therapist online or in your area to get started.
When is hospitalization needed for depression?
There are several depression-related situations that may require someone to be hospitalized, including:
- Observation After a New Medication: Some physicians and mental health professionals require a period of close supervision following the administration of a new medication. This is typically in order to see how a patient reacts, as some medications may have immediate adverse effects that could require assistance.
- Risk of Harm: A recent suicide attempt, self-harming event, or violent instance may result in the need to be hospitalized. Depending on the nature of the event, a person may need to stay hospitalized for a significant period of time and could face legal ramifications as a result of their behavior.
- Unable to Function: If the symptoms of depression are so severe that a person is unable to function, they may need to be hospitalized. This may include situations where a person is unable to eat, experiences frequent sleep disturbances, or is dealing with thoughts of suicide.
Is it possible to get hospitalized for depression?
Yes, it is possible for depression-associated hospitalization to occur. There are two primary situations where you can be hospitalized for depression.
- Voluntary hospitalization: A person who is struggling with their depression may admit themselves to a hospital in order to seek treatment. This may be done for a number of reasons besides depression as well, such as having suicidal thoughts, a manic episode, or entering psychosis. After release, a person may follow up their hospitalization with regular treatment by a therapist, medication, or other approaches recommended by their doctors.
- Involuntary Commitment: If a person meets the criteria set by their state or country, which often involves causing harm to themselves or others as a result of mental illness, they may be involuntarily committed. This means an individual will be hospitalized against their will for a set period of time, usually 72 hours, while mental health professionals determine whether further action or longer hospitalization is necessary.
What is the major reason for hospitalization for depressed patients?
Two of the most common reasons that a person will be involuntarily hospitalized is due to a suicide attempt or an act of violence. In these cases, individuals will typically first be assessed at a hospital and treated for any injuries they’ve recently sustained. From there, a doctor will usually determine whether you need to be hospitalized based on interviews with the individual, friends and family members, or witnesses to recent events. If they decide that hospitalization is necessary, the individual may be held for a longer evaluation period in a mental treatment facility. After this, a person may be required to stay longer if they are still a danger to themselves or others.
Can the ER do anything for depression?
While an emergency room, or ER, may be able to help with certain aspects of depression, it is often more beneficial to seek out a facility dedicated to mental health. An ER can help to address any injuries someone has experienced that are associated with their depression, such as the consequences of self-harm. ERs will also typically be able to assist with non-mental health-related concerns, such as hypothyroidism or heart disease. Heart disease can lead to a heart attack, the symptoms of which can include chest pain. Other conditions may cause chest pain, so it’s often recommended that people with this symptom seek help immediately.
In contrast to an ER, a mental health facility may be able to address the specific causes of a depressive episode and recommend therapy or other treatments that can help to alleviate symptoms. In addition, it may be helpful to look at other local or state mental health resources. For example, you may be able to get assistance from your state’s Protection and Advocacy Agency.
How long do you stay in a mental hospital?
The length of mental hospital stays will vary based on the laws of their state, their condition, and whether they are in the hospital voluntarily or involuntarily. In involuntary cases, a person may have to wait until a doctor clears them to do so, usually determining they are no longer a danger to anyone. If a person voluntarily admits themselves, they may leave early, even if health care professionals recommend against it. However, this may not be applicable in every case, such as when a person presents a danger to themselves or others. In these situations, certain states allow a hospital to hold someone for two to seven days after their request to leave.
Is depression a psychiatric emergency?
Depending on the nature and severity of a person's depression, it may qualify as a psychiatric emergency. For example, a person who is having suicidal thoughts needs immediate support and a stable environment, as they may cause themselves harm. In some cases, these individuals may be involuntarily hospitalized for a period of time to allow health care providers to evaluate their situation. The situation surrounding this observation period may be referred to as an “emergency detention.” These emergency measures can vary in length, but often last for 72 hours.
When should I commit myself to a psychiatric hospital?
According to the University of Utah, there are several signs that a person may want to commit themselves to a psychiatric hospital, including:
- Posing a danger to yourself or others
- Having suicidal ideation or behavior
- An inability to eat, bathe, or sleep
- Stopping medication against doctors' recommendations
- Refusing to go to work or school and withdrawing from loved ones
- Experiencing a psychotic episode
If you are experiencing one or more of these signs or symptoms, it may be beneficial to contact a crisis line for support. One example is the Crisis Text Line, which can be reached 24/7 by texting HOME to 741741. In cases involving suicidal thoughts, individuals can contact the 988 Suicide & Crisis Lifeline by dialing 988.
Should I go to the ER if I'm having a mental breakdown?
Individuals who experience a mental breakdown should seek help immediately, and an ER may be the most convenient or appropriate place depending on their circumstances. In many areas, an emergency room can be the fastest source of medical treatment. Immediate medical help can be necessary in numerous mental health situations, including those involving suicidal thoughts or behavior, psychosis, severe side effects relating to medication, manic episodes, hallucinations, and a number of other symptoms that may be related to mental breakdowns.
If you become hospitalized for mental health concerns, it's understandable to feel distressed. However, organizations like the Depression and Bipolar Support Alliance believe it's important for individuals to know that hospitalization for depression or bipolar disorder is not a punishment. Instead, being hospitalized can provide those experiencing overwhelming mental health struggles with a safe place to stabilize. Hospitalization isn’t meant to be a punishment, and a person does not need to feel shame when seeking help.
Do people get admitted to the hospital for anxiety?
While many anxiety cases are handled on an outpatient basis, It is possible for individuals to be hospitalized for anxiety, especially if their symptoms are severe or interfere with their ability to function. Individuals who are hospitalized tend to be watched closely by a medical team for a shorter period of time (sometimes referred to as an “observation period”) before longer-term hospitalization is considered. Doctors may also take other factors, like your health insurance, into consideration. Overall, hospitalization may help to provide those with anxiety with a safe and stable environment, immediate care, and the ability to find a viable treatment plan moving forward.
What are the 5 psychiatric emergencies?
While professionals in the field of clinical psychiatry may have varied opinions on the topic, five common psychiatric emergencies may include the following.
- Suicidal Thoughts or Behavior: Attempted suicide, thoughts of suicide, and self-harm can all be considered psychiatric emergencies. Certain signs may precede these events, such as giving away possessions to loved ones, irregular behavior, and expression of guilt or hopelessness. Spreading information about the warning signs can be vital for suicide prevention.
- Psychosis: Psychosis can cause several symptoms, including delusions, hallucinations, an inability to communicate, and irrational or violent behavior. These individuals may also be unable to perceive reality, which could make them a danger to themselves or others.
- Serotonin Syndrome: Serotonin syndrome is a rare but potentially fatal side effect of several different kinds of medication. While this syndrome can initially present with mild symptoms like diarrhea, tremors, nausea, nervousness, and vomiting, it may progress to increased heart rate, high body temperature, seizures, delirium, and even death.
- Substance Misuse: Numerous events related to substance misuse may qualify as a psychiatric emergency, such as delirium tremens (DTs). DTs are a result of acute alcohol withdrawal and may cause insomnia, body tremors, nausea, vomiting, severe confusion, hallucinations, seizures, and even cardiovascular. Substance use can also result in other serious diseases that may exacerbate certain mental health conditions.
- Violent Episodes: Becoming violent or presenting an immediate danger to others as a result of a mental disorder can also qualify as a psychiatric emergency. These individuals may end up in more restrictive facilities or units in the hospital, such as a locked ward. If you or a loved one is exhibiting violent behavior, it's important to reach out for support immediately. One resource that may be helpful is the Crisis Text Line, which can be reached 24/7 by texting HOME to 741741.
- Previous Article
- Next Article