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Hospitalization: When Is It Appropriate?

The very idea of going to a psychiatric hospital is an anathema to most people. Being "locked up" in a "funny farm" or "loony bin" elicits feelings of shame and stigma. Columnist Art Buchwald recounted how he felt "humiliated" and "a total failure" when he was hospitalized for his manic depression. There are, however, times when a person who is severely depressed or anxious should consider committing himself to a psychiatric ward for a period of time.

Hospitalization may be a positive option for you when:

  • You are suicidal.
  • You are psychotic (hearing voices, feeling paranoid or having delusional beliefs).
  • You are harming yourself in some way or are afraid you will harm others.
  • You are unable to perform the tasks of daily living (for yourself and others), such as bathing, feeding yourself (or others), dressing or getting out of bed.
  • You cannot handle being left alone.
  • You feel that you can no longer cope.
  • You lack the support you need to keep you safe.
  • Your medication requires monitoring or changing.

If you need to go to the hospital, remember that it is a temporary situation that is designed to keep you safe. Try to let go of any feelings of shame or failure. You are still a worthy person regardless of your external circumstances.

Unfortunately, hospital stays are shorter than they might ideally be. When William Styron experienced his depressive breakdown in 1985, he convalesced for six weeks, a respite that he credits with saving his life. Today, in the age of managed care, such multi-week stays are unheard of, unless one has the money to pay for a private hospital that specializes in long-term residential care. While I am not advocating returning to a time when chronically mentally ill people were warehoused in large institutions, it is clear that the pendulum has swung too far in the opposite direction.