If You Have Severe Depression, Hospitalization Could Be Helpful
By Jon Jaehnig
Updated August 29, 2019
Reviewer Lauren Guilbeault
Most people who have depression are offered prescription medications and have the option to meet with a therapist or counselor if they so choose. However, some people need a little more help.
The methods for treating severe depression are more or less the same as treating milder cases. However, if depression is serious enough, the patient may undergo part of the process in a hospital.
Here, we'll talk about how to know when depression is severe and how depression hospitalization is different from the typical depression treatment experience.
What Is Depression?
Everyone feels sad sometimes, or has a day when they don't feel like working or even getting out of bed. However, most people only have these feelings for a day or two and - while they may not like it - they can usually convince themselves to get out of bed and go about their day.
When someone has depression, they have feelings of sadness, hopelessness, or apathy that are so severe that they may not be able to go about their lives. They may also have physical symptoms like loss of appetite, unexplained weight loss or gain, and even unexplainable aches and pains. People with depression may also have trouble sleeping, or sleep at odd times. These symptoms also persist for at least a few consecutive weeks and, without treatment, may never go away.
In addition to the physical symptoms and risks, people with depression may be unable to maintain healthy relationships and meet their commitments and responsibilities.
In severe cases of depression, as we'll be talking about in this article, the symptoms are the same but may be more extreme. The individual may not eat at all, or may seem unable to engage with the world around them. In other cases, they may hurt themselves or attempt suicide. If you or a loved one engages in self-harm, you must alert healthcare professionals or local law enforcement. If you have thoughts of suicide, talk to a doctor immediately. Later in this article, we'll talk about recognizing self-harm and suicidal tendencies in people that you care about and what to do about them.
Causes Of Depression
Emotional issues, biological issues, or a combination of the two can cause depression. The cause of depression can affect the severity but more importantly, it affects the kind and length of treatment, which we'll talk about next.
Depression can be caused by an imbalance of messenger molecules in the brain called "neurotransmitters." Specifically, a neurotransmitter called serotonin is largely responsible for feelings of happiness and contentment as well as for regulating sleep and digestion. This imbalance may be because the body doesn't create enough serotonin, because the serotonin disappears before the brain can use it, or because serotonin receptors aren't working the way that they should. This kind of depression is usually treated with long-term medication that restores the balance of serotonin in the brain. It may also be treated with talk therapy.
Depression can also be caused by life events like the death of a loved one, the loss of a job, or other difficult circumstances. This kind of depression can be treated with medication but also responds well to talk therapy with and without medication. Whether medication, talk therapy, or a combination of the two, treatment for this kind of depression is usually shorter-term - weeks, months, or years.
Finally, some experts believe that some people have a serotonin imbalance that puts them at a predisposition for depression that may only manifest symptoms when it is triggered by a traumatic event. People in this case may live healthy normal lives for long stretches but then have recurring bouts of more severe depression. Because of its trickier nature, how these people manage their treatment is more of an ongoing conversation with their health providers than a one-time diagnosis.
Treatments For Depression
Just as there are two distinct causes for depression and one that is a mix between the two, there are two distinct treatment methods for depression and one that is a mix between the two.
There are a few types of medication used for treating depression but the most common are selective serotonin reuptake inhibitors. These medications prevent serotonin from being reabsorbed before receptors have a chance to use it. This makes the availability of serotonin to the brain steadier and more reliable without actually increasing the volume of serotonin.
Talk therapy is also useful for treating depression, especially depression brought on by life events rather than biology. Talk therapy works on helping the patient identify events, feelings, and thought processes that contribute to depression. They also help give the patient tools that can be used to protect against or work through feelings of depression. Talk therapy can be a long-term process, or may only last weeks or months.
Finally, many people elect to take medications as well as undergo talk therapy. The two treatments complement each other as the medications make talk therapy more effective and talk therapy provides emotional tools that medication doesn't.
Identifying Severe Depression In Yourself And Others
So, how do you know when depression is severe?
Some people are diagnosed with severe depression when they go to - or are brought to - the hospital because of the physical symptoms that depression can cause, like weight loss and loss of appetite.
As mentioned above, self-harm can also be a symptom of severe depression. People who self-harm commonly cut or burn themselves, usually in a place that is not readily visible, such as the upper arms and legs. Different people do this for different reasons. Some people find that it gives them a sense of control. There is also a neurotransmitter that the body releases in response to pain to help ease it, so it could also be a primitive and misguided form of self-medication.
Whatever the reason, self-harm is dangerous and should not be taken lightly. Even injuries that are too superficial to be dangerous due to blood loss can become infected. If you engage in self-harm, seek help immediately. In the event that someone you know is self-harming, the situation can be more delicate. The most you will likely be able to di is support the person and encourage them to seek help themselves. If you notify your local authorities they will be able to perform "wellbeing checks" on the individual but you cannot force another person to seek out or undergo treatment.
Thoughts of suicide or attempted suicide are more serious symptoms of severe depression. If you are thinking about suicide, talk to a doctor immediately or call a local crisis prevention center. They will direct you toward options for help and will stay on the line with you while they help you find help. Recognizing thoughts of suicide in other people is more difficult because they seldom outright say that they are thinking about suicide.
However, suicide is a big decision and people have "tells" that will usually give them away. If someone has been depressed for an extended period and seem to be happy and carefree the next day, it could be a sign that they have decided to attempt suicide. Further, if someone begins giving away their possessions, especially possessions that you know were important to them. It could be a sign that they will attempt suicide. If you are worried that a loved one will attempt suicide, ask them. They may tell you or they may try to avoid answering or obviously lie. Offer them all of the support that you can and encourage them to seek help. Don't leave them alone if you are with them and if you are not with them call law enforcement.
Beginning Depression Hospitalization
People can begin depression hospitalization in a number of different ways. How this plays out can impact what happens next.
If someone goes to the hospital because of symptoms of severe depression like self-harm or thoughts of suicide, they will usually meet with a doctor. Depending on the hospital's abilities, they may be transferred to another hospital to undergo a psychological evaluation. The evaluation will determine what kind of care they receive and what happens next.
If a person is brought in because they are dangerously underweight or because their severe depression has impacted them in other physical ways, the hospital will usually prioritize stabilizing their physical condition, which may take some time. During this time, the patient may undergo a psychological evaluation or meet with counselors and therapists before being prescribed a medication.
Finally, people can be hospitalized for depression if they are brought into the hospital after attempting suicide. This can change a number of things. For example, the person may be denied rights like the right to refuse treatment. A loved one or next-of-kin may become involved. Medication will likely be prescribed and there is a possibility of the individual undergoing in-patient care or being sent to another facility for care, depending on the abilities of the hospital.
Why Depression Hospitalization Is Important
Depression hospitalization for depression is important for a number of reasons. For one thing, the person will have an easier time receiving and physical care that they may need to deal with the effects of their depression. In the event of suicide-risks, the individual will be more closely monitored and in a safer environment.
Finally, depression hospitalization gives healthcare providers an extended opportunity to work out medication possibilities. Determining medication and dosage is sometimes difficult, especially in the event that the individual is undergoing treatment for physical symptoms. Further, some therapies can only be carried out in a hospital setting.
Leaving The Hospital
How long a person stays in the hospital and the condition in which they leave depends on their condition and the speed of their recovery.
Some people leave the hospital and return home. They may have a prescription and they may have appointments to meet with a counselor or therapist. They may also go to live with a loved one for a time.
Some people leave the hospital to receive care from another institution. This is only the case for people who have shown little improvement in the hospital and who are deemed to still be at risk and in need of extended care.
Life After Depression Hospitalization
Most people who leave depression hospitalization have a follow-up care plan depending on the results of their evaluation.
Most people who leave the hospital after depression have medications to take and many will be seeing a therapist for help. Some people will only have medication but may be required to see a counselor or therapist on a regular basis in order to check on their wellbeing and progress.
In cases of severe depression, you will probably be seeing a counselor or therapist in your area. If you aren't required to see a counselor or therapist as part of your treatment, your options may be a little more open. One course of increasing popularity is seeing a counselor or depression online. This is often more affordable and more convenient, especially in areas where there aren't a lot of counselors or therapists readily available.
To learn more about how you or a loved one could benefit from meeting with a counselor or therapist online, visit https://www.betterhelp.com/online-therapy/.