Patients with major depression occasionally require psychiatric hospitalization. This may be voluntary or court-ordered. Inpatient settings offer a variety of treatments. According to the Mayo Clinic, a combination of psychotherapy and medicine is often considered the best therapeutic approach. Occasionally, a psychiatrist will hospitalize a patient so that he can learn whether she is depressed or suffering from a medical or other psychiatric condition that mimics the symptoms of depression. Both children and adults may be hospitalized for depression.
Suicidal Patients
People who make suicide attempts or seem to be at risk of suicide are often hospitalized until they are no longer a danger to themselves. During this time, a staff member may watch the patient at all times until he is no longer deemed to be an active threat to himself. The staff members are rotated so that the patient's behavior is monitored 24 hours a day. He may be placed in a room that contains nothing he could harm himself with. The doctor may prescribe antidepressants, anti-anxiety medications and other psychiatric medications. Antidepressants may take several weeks to begin working, but the other medications usually begin working within an hour of administration. Therapy is also used to treat the depression, and it usually begins after the patient is stabilized. The hospital ward itself is a "therapeutic environment," which is a specific type of setting that encourages self-sufficiency, appropriate communication and respect for oneself and others.
Electroconvulsive Therapy Patients
Psychiatrists sometimes admit patients to the psychiatric hospital to begin a course of electroconvulsive therapy (ECT). Due to potential side effects such as memory loss, this therapy is usually reserved for severely depressed patients who have not responded to multiple trials of drug treatment and therapy. "Psychiatric Mental Health Nursing" explains that a patient receiving ECT is induced to have a seizure by the application of electricity to her brain. This electrical current is thought to positively affect the brain chemicals, relieving depression. The psychiatrist applies the electrical current only after anesthesia has taken effect. Nursing staff carefully monitor the patient before, during and after each procedure. Several treatments are usually given, spread over a number of days.
Catatonic Patients
According to "Psychiatric Mental Health Nursing," some patients with severe depression become catatonic. Untreated, this patient may sit or lie silently and not move for hours or days at a time. He may not speak or only repeat the words that are spoken to him. This patient usually requires hospitalization in order to be fed and medicated. Patients with less extreme symptoms may move around but refuse to feed, groom or bathe themselves. This patient may also benefit from psychiatric hospitalization until his symptoms abate. The psychiatrist usually initiates medication and the nursing staff encourages the patient to interact in the therapeutic environment. The staff may employ behavioral modification techniques to assist the patient toward a return to caring for himself. Therapy begins immediately or as soon as the patient is able to interact with the therapist.
Residential Treatment Patients
Occasionally, a psychiatrist will place a patient in residential treatment for major depression. A patient in this category usually has long-standing depression that is affecting quality of life, relationships and the ability to manage her career. The nursing staff and therapists teach her coping skills to manage her emotions and encourage her to use the time to consider how to change any areas of her life that feel out of control. Medication, psychotherapy, group therapy are usually employed, as well as the therapeutic environment. The staff often keep the patient busy with activities from early morning until bedtime -- this helps bring structure back into her life. Often, an added benefit of residential treatment is removal from an environment filled with drug use, unhealthy relationships or intense stress. Residential treatment often lasts from a month to a year.
References
- Cincinnatti Children's Hospital Medical Center: Menatl Health Conditions and Diagnoses: Major Depression
- Mayo Clinic: Depression: Treatment and Drugs
- "Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based Practice;" Mary C. Townsend, M.N., A.P.R.N; 2006
