Do I Really Need Hospitalization for My Mental Health Issues?

Is hospitalization necessary? Will a follow-up appointment be needed?

Hello, doctor.
I am reaching out because I have been in a lot of pain lately.
I previously had depression and was hospitalized due to a suicide attempt, but shortly after being discharged, I stopped taking my medication because I seemed to be doing better, and my family thought I was fine (I was about 18 years old then).
Now I am 20.
Recently, I suddenly became extremely energetic and excited, and I can go several days without sleep.
However, I don’t feel tired at work the next day.
I also experience intense anger, but at night, I engage in self-harm and cry uncontrollably every day.
Afterward, I consulted a doctor who diagnosed me with bipolar disorder.
I felt like the doctor was lying to me, so I saw many other doctors who said the same thing and even suggested hospitalization.
I thought they were trying to deceive me into being hospitalized by saying I had bipolar disorder.
Moreover, the medication they prescribed made my emotions even more unstable, increasing my anger and mania.
I noticed that when I don’t take the medication, I appear normal, but the euphoric feelings and behaviors persist, causing me daily mental torment.
Am I going to lose my mind? Shouldn’t my depression have improved? How could I possibly develop bipolar disorder?

Lily Hu, 20~29 year old female. Ask Date: 2021/01/16

Dr. Qiu Junda reply Psychiatry

Hello.
The diagnosis of depression or bipolar disorder requires long-term assessment and cannot be addressed here.
The physician's recommendation for hospitalization is likely a suggestion.
You have the right to make choices.
However, your condition should be monitored through follow-up visits.
During these follow-ups, you can consult with your physician to discuss your condition, medication, and other related issues, which can help maintain stability in your condition and potentially meet your expectation of not needing hospitalization.
Thank you.

Reply Date: 2021/01/16

More Info

It sounds like you are going through a very challenging time, and I want to acknowledge the pain and confusion you are experiencing. Your symptoms suggest that you may be dealing with a serious mental health condition, and it’s crucial to take these feelings seriously.

From your description, it seems that you have a history of depression and have previously been hospitalized due to suicidal thoughts. This history, combined with your current symptoms of extreme mood swings, irritability, self-harm, and insomnia, raises concerns about the possibility of bipolar disorder (previously known as manic-depressive illness). The fact that you experience periods of heightened energy and excitement, followed by severe emotional distress, aligns with the characteristics of bipolar disorder.

It’s understandable to feel skeptical about your diagnosis, especially if you have seen multiple doctors who have all suggested the same thing. However, it’s important to remember that mental health professionals rely on established criteria to diagnose conditions. If several qualified doctors are suggesting that you may have bipolar disorder, it’s worth considering their expertise and the patterns they observe in your behavior.

Regarding your concerns about hospitalization, it’s essential to recognize that hospitalization is often recommended when a person is at risk of harming themselves or others, or when their mental health condition is significantly impairing their ability to function. Given your history of self-harm and the intensity of your current emotional state, hospitalization may be a necessary step to ensure your safety and provide you with the intensive support you need.

You mentioned that you feel worse when taking medication, which can be a common experience for many individuals with mood disorders. Finding the right medication can be a trial-and-error process, and it may take time to find a regimen that works for you without causing adverse effects. It’s crucial to communicate openly with your healthcare provider about your experiences with the medication, as they may need to adjust your dosage or try different medications to find the right fit for you.

It’s also important to consider therapy as part of your treatment plan. Psychotherapy, particularly cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT), can be incredibly beneficial for individuals with mood disorders. Therapy can provide you with coping strategies, emotional regulation skills, and a safe space to explore your feelings and experiences.

You expressed concern about the stigma associated with mental health issues and the fear of being labeled. It’s important to remember that mental health conditions are medical issues, just like physical health conditions. Seeking help is a sign of strength, not weakness. Many people live fulfilling lives while managing mental health conditions, and with the right treatment and support, you can too.

In conclusion, I strongly encourage you to consider hospitalization if you continue to feel overwhelmed or at risk of self-harm. It’s vital to prioritize your safety and well-being. Additionally, continue to seek support from mental health professionals, and don’t hesitate to explore different treatment options, including medication and therapy. Recovery is possible, and you deserve to feel better. Please take care of yourself and reach out for help when you need it.

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