Navigating Depression and Suicidal Thoughts: To Hospitalize or Not? - Psychiatry

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Depression is associated with a high risk of suicidal ideation?


Hello Doctor, I would like your advice because I really don't know what to do (´;ω;`).
I had a follow-up appointment today, and due to strong suicidal thoughts, my doctor suggested hospitalization for treatment.
However, I am still a student, and if I were to be hospitalized, I might have to take a leave of absence from school.
Personally, I feel that my depression is mild, and it seems a bit extreme to go into the hospital for suicidal thoughts when I could potentially continue my studies.
I don't think my situation is severe enough to require hospitalization, but the doctor mentioned that hospitalization is one option, while not being hospitalized is another.
However, they are concerned that my suicidal thoughts are too strong, and that I might suddenly act on them one day, so they advised me to think it over carefully.
Now, I am very hesitant about whether to pursue hospitalization.
This would be my first time in a psychiatric ward, and I am quite scared—actually, I am very anxious.
On one hand, I fear that I might commit suicide one day, and on the other hand, I don't want to give up my education.
Doctor, what should I do?

Nan, 10~19 year old female. Ask Date: 2021/08/03

Dr. Wu Enliang reply Psychiatry


Hello, online friend: I suggest you consider hospitalization for proper treatment.
Discharging before the start of school will not affect your studies, and you won't need to take a leave of absence.
If you choose not to be hospitalized, it's important to have family or friends nearby to ensure your safety, remove any dangerous items, and attend follow-up appointments regularly.
You may also consider self-funded repetitive transcranial magnetic stimulation (rTMS).
Take care, Dr.
Wu Enliang.

Reply Date: 2021/08/03

More Info


Navigating the complexities of depression, especially when accompanied by suicidal thoughts, can be an incredibly challenging experience. It’s understandable to feel torn between the need for immediate safety and the desire to maintain your academic pursuits. Here’s a comprehensive look at your situation, along with some insights that may help you make an informed decision.

Firstly, it’s crucial to acknowledge that your feelings are valid. Depression can distort your perception of reality, making it difficult to see the full scope of your situation. The fact that your doctor has recommended hospitalization indicates that they are concerned about your safety and well-being. When suicidal thoughts become frequent or intense, it’s often a sign that additional support is needed. Hospitalization can provide a structured environment where you can receive intensive care, stabilize your mood, and develop coping strategies under the supervision of mental health professionals.

On the other hand, the fear of leaving your academic life behind is also understandable. Education is a significant part of your identity and future aspirations. However, it’s essential to consider that your mental health must come first. If your current state of mind is putting you at risk of self-harm, prioritizing your health is crucial. Many students have successfully returned to their studies after receiving treatment, often finding that they are better equipped to handle academic pressures once they have addressed their mental health needs.

In terms of alternatives to hospitalization, it’s important to discuss these options with your healthcare provider. Some individuals benefit from intensive outpatient programs, which provide structured support while allowing you to remain at home. This could be a viable option if you feel that hospitalization might disrupt your studies too significantly. Additionally, regular therapy sessions, medication adjustments, and support groups can also be beneficial in managing your symptoms without the need for hospitalization.

If you decide to pursue hospitalization, it’s worth noting that many facilities are designed to be supportive and therapeutic rather than punitive. You will have access to professionals who understand what you’re going through and can provide you with tools to manage your thoughts and feelings. Moreover, many hospitals have programs that allow you to continue your education while receiving treatment, so you may not have to sacrifice your academic goals entirely.

Ultimately, the decision to hospitalize should be based on a careful assessment of your current mental state and the level of risk you feel you are facing. If you find that your suicidal thoughts are overwhelming and you feel unable to cope, it may be time to prioritize your safety and consider hospitalization as a necessary step. On the other hand, if you believe you can manage your symptoms with outpatient support and feel comfortable discussing this with your doctor, that could also be a valid path.

In conclusion, it’s essential to have open and honest conversations with your healthcare provider about your fears, concerns, and the potential impact on your education. They can help you weigh the pros and cons of hospitalization versus outpatient treatment and guide you toward the best decision for your circumstances. Remember, prioritizing your mental health is not a sign of weakness; it’s a courageous step toward healing and ultimately achieving your academic and personal goals.

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