How do I know if it’s really necessary? I have Bipolar II and am on a mood stabilizer (Trileptal) and a small dose of an antidepressant (Lexapro.) I’ve been having a very rough time with depressive symptoms over the last few months – it started with just not being interested in anything, sleeping a lot, and eating a lot, and got up to crying at the slightest provocation and bouts of leaden paralysis.
At my most recent psychiatric appointment, I asked for an increase in my Lexapro dose, because it makes the most sense to me (I’ve been on doses up to 2.5 times what I was on at the moment, with no clear manic symptoms.) But my psychiatrist asked instead if I’d be willing to enroll in a partial hospitalization program.
We’re going to talk more about it at my next appointment, because we ran out of time. But I’ve been looking online at partial hospitalization programs in my area, and I’m confused. What are they, really? They sound like they’re just classes – not focused on adjusting my drug regimen so it’s perfect, but rather on the “coping with life” stuff that is basically impossible for me when I’m in the middle of an improperly medicated depressive episode. And how bad off do you have to be before they’ll let you in one of these programs? Yes, I need help, but do I really need that much help?
I’m also quite alarmed and sort of offended by the “you can’t have your phone and we take your shoelaces” stuff. I’m not psychotic or suicidal. Why on earth would they want to isolate me more, and make me feel more crazy than I already do?
Partial hospitalization refers to a comprehensive, short-term, intensive, clinical treatment program. With regard to level of treatment, partial hospitalization is a step below inpatient hospitalization but more concentrated than traditional outpatient care. Clients are generally referred to partial programs when they are experiencing acute psychiatric symptoms that are difficult to manage but that do not require 24-hour care.
Individuals in partial hospitalization programs attend structured programming throughout the day, three to five days a week and return home in the evenings. To ensure client safety, many of the inpatient hospitalization rules apply (i.e. no phones, no shoelaces) to partial hospitalization programs.
There are many advantages to participating in a partial hospitalization program. You are worried that the program may isolate you but the opposite would be true. Many partial programs provide group therapy which would allow you to interact with other people experiencing similar problems. You would also have the opportunity to interact with psychiatrists, social workers, nurses, and other mental health practitioners. The goal of many partial hospital programs is the development of skills that help clients better manage their lives and their symptoms.
Consider attending the program. Your doctor thinks it is necessary. I have worked with many clients that had expressed similar concerns about partial programs but who were later glad they attended. Remember that the program is short-term. It has the potential to help you tremendously.
At your next appointment, I would recommend discussing your concerns with your doctor. He or she may provide more information about the program which could give you a better understanding of what to expect. I wish you well. Please take care.
Dr. Kristina Randle