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As a person with DID I have been hospitalized 4 times related to DID issues. I decided after my last hospital stay (June of 2003) that I should talk about what to expect when you are hospitalized. It is not unusual to expect that at some point in your life you may need to go into the hospital. While I have had fairly decent hospital stays, (except for the latter which was due to the lack of organization of the staff)I do know that it is in your best interest to look into hospital options in your area. Research this on a day when you are feeling okay and write down the information you find out and keep it handy. What are some of the things you should for in a good mental health ward in the hospital?
1.Ask about the unit and the leadership that is placed on the unit. Who runs the ward? What is their approach in treating DID? What is the staff-to-patient ratio? Are there mainly techs on staff or are their plenty of nurses and qualified psychologists on hand?
2.Research the policies and procedures regarding restraints and seclusion. I would like to note here that this is ALWAYS a last resort option, to keep someone who is out of control and a threat to themselves and other patients. I have never personally in all 4 hospital stays witnessed this happen. So don't let that frighten you. It is just important you know there standards on this issue.
3.Find out if they offer any services for significant others and family members. Most wards do offer a family group at least once a week to help educate everyone as a whole.
It's time to consider going when:
You are a threat to others
You are having unmanageable flash backs
Before making the decision it is a good idea to call your therapist, who can help guide you in making the decision and also help get the process rolling. If the situation is dire and you need help immediately go directly to the emergency room. Do not attempt to drive yourself. Have a friend, family member, neighbor drive you or call 911.
Most wards do offer laundry facilities so keep that in mind when packing.
The hospital staff will go through your things to remove anything they consider "SHARPS". So here is a list of the things to leave at home:
The first thing you should expect, and if it doesn't happen ask for it, is you should receive a Patient's Bill Of Right's. This is VERY important and should be read over carefully!
The following is an example of your rights. I was given permission by Thomas V. Maguire, Ph.D to share this. Thanks Dr. Maguire!
As a Matter of Personal AUTHORITY,
You Have the Right . . .
· to manage your life according to your own values and judgment.
· to direct your recovery, answerable to no one for your goals, effort, or progress.
· to gather information to make intelligent decisions about your recovery.
· to seek help from a variety of sources, unhindered by demands for exclusivity.
· to decline help from anyone without having to justify the decision.
· to have faith in your powers of self restoration -- and to seek allies who share it.
· to trust allies in healing as much as any adult can trust another, but no more.
· to be afraid and to avoid what frightens you.
· to decide for yourself whether, when, and where to confront your fear.
· to learn by experimenting, that is, to make mistakes.
For the Preservation of Personal BOUNDARIES, You Have the Right . . .
· to be touched only with your permission, and only in ways that are comfortable.
· to choose to speak or remain silent, about any topic or at any moment.
· to choose to accept or decline feedback, suggestions, or interpretations.
· to challenge any crossing of your boundaries.
· to take appropriate action to end any trespass that does not cease when challenged.
In the Sphere of Personal COMMUNICATION, You Have the Right . . .
· to ask for explanation of communications you do not understand.
· to express a contrary view when you do understand and you disagree.
· to acknowledge your feelings, without having to justify them as assertions of fact or actions affecting
· to ask for changes when your needs are not being met.
· to speak of your experience, with respect for your doubts and uncertainties.
· to resolve doubt without deferring to the views or wishes of anyone.
Specific to the DOMAIN of Psychotherapy, You Have the Right . . .
· to hire a therapist or counselor as coach, not boss, of your recovery.
· to receive expert and faithful assistance in healing from your therapist.
· to be assured that your therapist will refuse to engage in any other relationship with you -- business, social, or sexual -- for life.
· to be secure against revelation of anything you have disclosed to your therapist, unless a court of law commands it.
· to have your therapist's undivided loyalty in relation to any and all perpetrators, abusers, or oppressors.
· to receive informative answers to questions about your condition, your hopes for recovery, the goals and methods of treatment, the therapist's qualifications.
· to have a strong interest by your therapist in your safety, with a readiness to use all legal means to neutralize an imminent threat to your life or someone else's.
· to have your therapist's commitment to you not depend on your "good behavior," unless criminal activity or ongoing threats to safety are involved.
· to know reliably the times of sessions and of your therapist's availability, including, if you so desire, a commitment to work together for a set term.
· to telephone your therapist between regular scheduled sessions, in urgent need, and have the call returned within a reasonable time.
· to be taught skills that lessen risk of re-traumatization: containment (reliable temporal/spatial boundaries for recovery work); systematic relaxation; control of attention and imagery (through trance or other techniques)
· to reasonable physical comfort during sessions.
You will be shown to your room, given the daily schedule, and a basic orientation of your treatment plan while you are there. It can feel a bit over whelming and even scary but you will find that you will become accustomed fairly quickly to the routines and meeting the other patient's. These wards are not like what they show in the movies. Most are very nice and have lots of activities going on all the time.
The average hospital stay is 3-5 days, basically once the crisis is settled down. Most insurance companies only authorize 4 days in a psychiatric ward. After that every subsequent visit needs to go before your insurance company review board, to see if your extended days are deemed "medically necessary." Your Doctor may have to fight to keep you in longer but the bottom line is that if you are not unsafe, feeling suicidal then that is considered medically necessary by most insurance companies.
What do you do if you have no insurance? The hospital admissions office may be able to help you get "Catastrophic Medicaid, help arrange a bank loan or negotiate another payment method. Contact a social service worker while you are in and they can help you with this. I personally know of patients who have had their whole hospital bill covered with the help of a social worker!
Just a few cost facts (don't let it scare you) that is outrageous:
Therapy fees (rounds) $1,600.00
This is why you need to explore your financial options carefully! You can still be helped without losing all your assets.
Partial care or day program is often the best step down from an in-patient hospital stay. It involves spending time in the hospital from 6-8 hours, learning coping skills, recreational therapy and educational groups. The unfortunate part of this program is it is often not covered buy a lot of insurance companies. If your insurance will pay for this option then you should take advantage of it! The idea is to heal, after all. Make the best of your hospital stay whether it be in-patient or out-patient. It is hard work and it is not fun but it is enormously helpful! You can do it!
While in the hospital you may be offered different medications. I have compiled a list of different meds commonly used in treating DID.
| celexa (citalopram) | lexapro (escitalopram oxalate) |
| luvox (fluvoxamine) | paxil (paroxetine) |
| Prozac (fluoxetine) | Zoloft (sertraline) |
| Adapin (doxepin) | Anafranil (clomipramine) |
| Elavil (amitriptyline) | Endep (amitriptyline) |
| Ludiomil (maprotiline) | Norpramin (desipramine) |
| Pamelor (nortryptyline) | Pertofrane (desipramine) |
| Sinequan (doxepin) | Surmontil (trimipramine) |
| Tofranil (imipramine) | Vivactil (protriptyline |
| Buspar (buspirone) | Edronax, Vestra (reboxetine) |
| Cymbalta (duloxetine) | Desyrel (trazodone) |
| Effexor (venlafaxine) | Remeron (mirtazapine) | Serzone ( nefazodone) | Wellbutrin (bupropion) |
| alprazolam (xanax) |
| chlordiazepoxide (librium) |
| clonazepam (klonopin) |
| clorazepate (tranxene) |
| diazepam (valium) |
| lorazepam (ativan) |
| oxazepam (serax) |
| prazepam (centrax) |
| Risperidone (Risperdal) |
| Olanzapine (Zyprexa) |
| Quetiapine (Seroquel) |
| Abilify (Aripiprazole) |