Hospital treatment for depression
Hospital treatment can be beneficial because doctors can make a more rigorous assessment of your condition, so they can offer the most appropriate treatments. They will also receive feedback from the nurses on the ward and others involved in your care. On the other hand, admission will disrupt your life. In the case of severely depressed or psychotic patients, who may constitute a threat to others or themselves, it may be the only sensible course until their condition has improved.
Psychiatric in-patients can be given higher doses of anti-depressants and anxiolytics than out-patients. Side effects can be continuously monitored and the patient’s condition regularly observed.
Electroconvulsive therapy (ECT)
This treatment can work well in cases of recurrent severe depression that resist treatment with medication and psychotherapy and in which there is a high risk of suicide. The patient is given a short-acting anesthetic, a muscle relaxant and oxygen ventilation before an electric current is passed through the brain via electrodes. This induces a fit lasting about 30 seconds. The treatment may be repeated several times within a week and for several weeks. There may be some temporary memory loss.
Surgery uses short-acting radioactive isotopes to produce lesions in those parts of the brain involved in the process of depression. Recovery is usually quick – within a couple of days. It is now very rarely performed.
Why some people need to stay in hospital
- They pose a threat to themselves or to other people.
- They require increased medication or medication with troublesome side effects.
- They need intensive psychotherapy and support, for example, in cases of sever postnatal depression.
- ECT, which can be an effective treatment for the severely depressed where other treatments have failed, can only be administered in hospital.
- Psychosurgery may be required for someone with severe, recurrent depression when other treatments have failed.
Those caring for you in the hospital
Consultant Psychiatrist – You will be under the care of a senior doctor with an additional qualification in psychiatry, but you may not see him every day.
Psychiatrist – With the same qualifications as the consultant, but at a more junior level, this doctor is likely to take responsibility for your day-to-day treatment.
Psychologist – This member of the team has a degree in psychology and may or may not be a medical doctor.
Psychiatric Nurse – Nurses specializing in psychiatry will be on hand as your first point of contact throughout the day and night.
Key Facts: However bad you feel about being in hospital, always remember that depression is curable and you will get better. Don’t be put off by out-of-date images of psychiatric wards – modern psychiatric wards are nothing like those of the past. You can accept or decline treatment in consultation with your psychiatrist. Even if you have been legally detained, you can still discuss the merits and risks of treatment with those responsible for your care. You have the right of appeal. You can also choose to accept or decline visitors. Stringent guidelines for administering ECT are adhered to and were developed in response to criticisms of the treatment when it was first introduced.