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19 December 2008

AskMeCha: how best to help my friend in the psychiatric unit? [More:]A good friend has recently been admitted to the psychiatric unit. I knew she had a history of depression going back years (well before I knew her) and she had quite a bad episode last year. This year is worse, however, despite various tries at adjusting her medication, and now she's been admitted to hospital.

It's hard to know what's really going on- as far as I know she's there of her own free will, but she says the doctors have said she'll be kept there against her will ('sectioned' in the UK lingo) if she tries to discharge herself. She is now having electro-convulsive therapy.

What can I do? Mr alto and I have been to see her a couple of times since her admission- last time she seemed relatively ok but today she was really withdrawn. We did a crossword together, at her suggestion. It's hard to know what to say, as she seems so defeated by the treatment process. I don't know if the doctors are doing the right thing, but she keeps asking my opinion...

sorry this is long, guys - it's been preying on my mind. Any thoughts?
IANAS (I Am Not A Shrink) but I have to think that just having you show up and spend time is the best thing you can do. There is probably nothing you can do, not being family, about the course of treatment she is getting. So, keep visiting. You don't have to say anything, you don't have to try and cheer her up. Simply be there with her.
posted by trinity8-director 19 December | 18:33
Oh, alto, that sounds awful. *hugs*

I would say, just keep being there and being supportive. I wouldn't try to give much advice to her, even if she asks your opinion -- that puts you in a weird position, anyway. Maybe just try more active-listening type stuff, like, "That seems really hard," or "What are you most worried about?" or "What concerns you about X?".

That'll give her a chance to talk, if she wants, and keeps her in the driver's seat. Which is good, because being hospitalized can just be a giant vat of giving up control; treating her like she has some control and worthwhile opinions on her own life (which of course she does) can be helpful.

But mostly just be accepting and be there, in whatever ways you can. It's probably pretty hard to see her like that, and it's sometimes just good for people in those situations to see that other people can stand to be around them without wanting to run screaming from the room.
posted by occhiblu 19 December | 18:38
My sister was in a similar position a year ago, but she wasn't depressed, she was psychotic.

I don't know what to suggest to say to your friend when she asks for your opinion on her treatment, except perhaps to say that you're sure they're doing everything they can to help her get well.

It's when she's discharged that she'll need your help. Although I'd been told that my sister would be sectioned if she tried to leave hospital, the day after I'd talked to her on the phone when she was ranting nonsensically about a celebrity party she was hosting (in her mind), she was sent home, with just the number of the so-called Crisis Team to call in case of emergency. Once someone is no longer at crisis point, the hospital will free up the bed for the next acute case.

I can't say if that'll happen with your friend, but be prepared for there to be a quick discharge, with her being sent home at short notice. Rally as much support as you can from her friends, family, neighbours, etc. but don't take on too much yourself or you might be seen by both social workers and your friend to have adopted the role of carer. It's far better for ten people each to do one thing for her, than one person doing ten things.

Good luck.
posted by essexjan 19 December | 18:39
You're doing the right thing, alto. And you're a great friend for doing so. As for her asking if she's getting the right treatment, you can only say you really don't know. She's the one that has to decide what is right for her.

Also, can you go for walks? Is there some sort of outdoor activity area? I think getting outside of the building itself may help.
posted by deborah 19 December | 18:39
My ex tried suicide long after our split and although we pretty much hated each other, I still visited regularly. I learned a few years later that I was the only visitor she had the entire time.
posted by Ardiril 19 December | 19:12
FWIW, ECT works really well for some people. I hope it works for your friend. It's not like it was in the 1970s.

I don't know how you can help her therapeutically, but I know my step daughter really likes coloring and reading really easy fluffy girly books (when she's not so medicated she can't read.) She's an adult, but the coloring is mindless and pretty and soothing.

Also, If you can bring some of her comfort items like a favorite pair of slippers, clothing or blanket (marked clearly with her name) do it. Also, ask at the desk if you can bring her some comfort foods: e.g. takeout that she really, really likes, or something in a sealed package. Many times they won't let you bring home made things because they are afraid you will have drugged it, but you can often bring sealed things or takeout that is delivered to the facility.

Hospitalizations can be difficult and scary and I applaud you for trying to help your friend.

Best Wishes.
posted by Luminous Phenomena 19 December | 19:23
I was in a psych hospital as a teenager. It's incredibly isolating from the outside world. Bring her newspapers/magazines if they allow it, discuss non-disturbing events (e.g. not the economy or the war!). Pictures of puppies, kittens, flowers, or anything she'd find cheerful. Food, if allowed. New clothes, if allowed (she could probably only bring so much, and it gets boring to wear the same stuff every day.)
posted by desjardins 19 December | 20:13
I was in the psych hospital several years ago. People just visiting meant the world to me...it can be a scary place to the non-admitted, and knowing people braved the weirdness to come visit meant the world. The food sucked, so find out if you can bring in takeout. One friend brought a travel pack of shampoos and soaps...that was loads better than the hospital issue stuff. If she smokes, bring cigarettes if allowed. For me at the time, smoking every two hours at our mandated time kept me sane.
posted by Twiggy 19 December | 21:28
Keep visiting. If you can't visit, call. It is isolating as hell, like any hospitilization. And remember your friend's day to day affect may be a result of drugs, or the treatment. It's hard. Hugs.
posted by rainbaby 19 December | 21:30
Okay. I ... umm ... just recently left the hospital. I was there over Thanksgiving. For depression, like your friend. Here's what I suggest:

Do keep visiting. Sometimes she'll be withdrawn. On those occasions you might keep your visits short. But the important thing is to bring her stuff. Seriously.

The food at hospitals is terrible, so edibles are always welcome. Anything she particularly likes -- say, iced coffee -- would probably be seen as miraculous. Don't bring things in large quantities: patients generally cannot keep food or beverages in their rooms overnight. Anything you bring will be checked by the nursing staff.

She may also need stuff like nice shampoo, face wash, moisturizer, etc. It must all be alcohol-free, because on a psychiatric unit there is usually no alcohol of any sort allowed. Definitely check with the nurses before you visit to make sure you're not bringing any contraband.

Also: bring her stuff to do. Books (light reading only -- no one I've ever met has been able to focus on heavy reading while in a psych hospital), movies (if she's allowed to have them on her unit), a yoga mat and yoga DVD if she's interested, a big book of crossword puzzles. A deck of cards. Clean clothes. Blankets that are soft and fuzzy and don't smell of hospital.

There are generally two main problems in psychiatric hospitals: boredom and hunger. (Or, I should say, disgust with the food you're being given.)

Don't ask too many questions about her treatment -- it may stress her out. Keep the conversations light if you can. Above all, make her laugh.
posted by brina 20 December | 00:43
((brina))

Thanks all, and sorry last night's post was somewhat incoherent- I left out lots of potentially identifying detail, and I realise I didn't make it easy for people to advise.

The main problem is that she can't see into the future to a time when she won't be feeling so ill (which is, of course, a function of depression). I've been there, though not to the point of hospitalisation, and she leans on me because she knows I 'get it' to an extent. But I find it very difficult to imagine what it must be like in there.

We do take her for walks, as we tend to arrive outside formal visiting hours. I think it helps a bit.

again, thanks everyone for the kind words.
posted by altolinguistic 20 December | 06:26
((alto))

You're a good egg.
posted by brina 20 December | 13:47
Just to reiterate, what you're doing is helping a great deal, probably more than anything else could. I admire your courage.
posted by ikkyu2 20 December | 22:59
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