Posted by antennastoheaven on June 6, 2013, at 3:48:43
So at my most recent therapy visit my therapist recommended that I consider a partial hospitalization program. My depression has been worsening over the past month or so, and for the few weeks I've been on Emsam. It hasn't been going so well: http://www.dr-bob.org/babble/20130527/msgs/1044478.html
Before quitting Wellbutrin and stopping Emsam I wasn't doing too bad. I was unhappy, and not particularly enjoying life, but I was at least able to show up at work and be relatively productive. This is important to me. Since then anhedonia has gotten worse and motivation has dropped a lot, and I haven't been going to work for the past four days and won't be going in tomorrow. I need to get medical leave paperwork soon, and according to my therapist I need to enter a treatment program for that to happen (not sure if this is actually necessary under California short term disability, but sitting at home doing nothing isn't really going to be helpful.) My therapist said I should go for the "Acute Partial Hospitalization" program and NOT the "dual diagnosis" program. The dual diagnosis program is for those that have a mental health disorder and substance abuse problem/addiction.
The partial hospitalization program would be 5 days a week, 6 hours a day, mostly group therapy, with individual counseling and meeting with a psychiatrist. I'd be able to start a day or two after they determine I'm eligible, I imagine. I'd be going in for some period of time, the average supposedly being 15 days but with some patients staying for up to 5-6 weeks.
When I saw my therapist on Tuesday she referred me to the partial hospitalization program at a local hospital. I called on Tuesday, and when the program therapist returned my call on Wednesday, provided some introductory information - current problems, medications, current drug use, demographic/insurance info, etc. I made an appointment to talk more in-person the same day. On the phone call I mentioned that I had used marijuana in the past (as recently as a few months ago) and currently drink alcohol a few nights a week. It turns out that based on the phone call they want me to go into the dual diagnosis program. They didn't mention this to me until the end of the in-person assessment, but they had all the papers ready to go for the dual diagnosis program in the folder they had given to me when I walked in.
Anyway, I talked with the therapist about my symptoms for about an hour, describing my current issues and how they have progressed, past psychiatric history, past drug use, any family issues growing up etc. I explained that I'd used more drugs in the past, but have not done so as of 2013. She asked for consent to talk to my therapist and psychiatric nurse practitioner, and I agreed. She then asked how soon I'd be able to start the program, and I said immediately.
At the end, when finishing out the paperwork, she mentioned that the dual diagnosis program would require me to attend outside meetings at a drug support group. This is something I do not want to do. They also mentioned that there would be random drug tests. I told her I do not want to attend this program, and that my therapist told me that the dual diagnosis program was not for me. The intake therapist said she would talk to my regular therapist about that. I don't feel like I have a drug problem and I think my friends and other psych care providers would agree. She said that I was a likely candidate for partial hospitalization but that the decisions were up to someone else - she just collects information, contacts the other providers, ensures insurance eligibility, etc., so now I'm waiting on a call back, hopefully tomorrow, and hopefully in the morning so I can figure out what I'm doing for the next few weeks so I can appropriately handle work and family obligations. In any case, I do not want to do the dual diagnosis program.
I'm not entirely sure what to do at this point, if I don't get in to the regular (non-dual diagnosis) program. I could press on my regular therapist/psych nurse practitioner to get them to change their minds. Or I could try again at another hospital, which would be inconvenient for me given location.. Or I could try something else. Maybe try to get time off work anyway and go back to Wellbutrin and hope things get better? I don't know.
poster:antennastoheaven
thread:1044771
URL: http://www.dr-bob.org/babble/psycho/20130309/msgs/1044771.html