Do I Have Depression Or Dementia? Doctor Suggested Hospitalization For Behavioral Therapy.

Posted on Wed, 12 Sep 2012

Question: I wish to address Dr Susanta Padhy. Thank you very much for your guidance. I wish you could have determined depression or dementia. I know that I am in trouble and will take your advice and seek psychiatric help. I have been looking at my genealogy and find one ancester died by Hanging, another as an inpatient at a Mental Hospital whilst my two grandfathers died whilst formal npatients in Mental Hospitals. My early psychiatric advice ended with a recomendation that I become hospitalised for behavoural therapy. When they saw the immense fear they relented. I think I should have been sectioned then and some recurring problems would not have existed. Knowing about me as you now do, and I am not averse to Hospitals any more, what is the likelyhood of me becoming an in patient in a psychiatric ward in the future. I must prepare for it. Fore knowledge would be helpful.

Answered by Dr. Susanta Padhy (6 hours later)

Hello.

Thanks for posting your query and your active interest in seeking information for your well being, which motivates me to answer and I enjoy it.

However, Coming to a conclusion and giving a tailor-made single final diagnosis without seeing you, without examining your body, brain and mind may not be a good idea, in the best interest of my client, that is you. Though seemingly having a psychiatric illness might take precedence than dementia keeping the prior information in mind. Again this would be more of at presumptive level. A professional need to assess you OBJECTIVELY.

Sometimes, differentiating dementia and depression at older age is actually a challenging task.

Moreover, keeping your very strong family history of suicide in multiple relative, that to by lethal means, that to in inpatient settings, where all kind of professional supervision for suicide prevention are expected, a high possibility of psychiatric consultation at and early intervention is warranted.

May be, because your multiple relatives died in inpatient hospital settings, that may be a possible reason for aversion, but as a professional I would say it may not not be logical, may be by chance, may be superstitious or may be undue apprehension.
This can possibly explain why your early psychiatric advice ended with a recommendation for hospitalization. This does not mean that you should be guilty about that and keep nagging on past, because this might worsen your problem.

Rather cooperating with hospital staff and advice would help.

Usually, Psychiatric assessment takes time, need multiple observation, not only by doctor but also by psychiatric nurses, tests etc to come to a conclusion, for which inpatient settings are ideal and preferred.

Finally, It is better late than never.

Hope I was informative. Wish you a comfort and successful hospital stay and speedy recovery.

Regards.

Above answer was peer-reviewed by : Dr. Jyoti Patil

Follow up: Dr. Susanta Padhy (1 hour later)

Sir, This is my last comment. Firstly may I say that I am very happy with the gentle way that I have been treated by you, and thank you for confirming the probability of Hospitalisation. I can now work on that to ease my mind. Whilst I have every intention of going along with everything they may want to do, I am a little worried that I might get fed up and want to walk out. Is there anyway I can get them to section me to ensure the process of healing is completed. I would sign anything on going in, but may regret it later but then it would be too late. Again Sir, thank you for your kindness. XXXXXXX

Answered by Dr. Susanta Padhy (17 minutes later)

Yes, I do understand your worry of getting fed up during the process of healing, XXXXXXX.

Partly it is true because often the assessment, planning for management of such conditions and relatively longer lag period for response of such treatment to come, are the issues.

Having this piece of information is likely to decrease your worry, provided you are acknowledging this and putting some extra effort to keep you patience.

Nonetheless, you can freely discuss the issues as and when they come during the process. As this is an important point that can keep you in "less-worry state", which in turn will determine the successful outcome of treatment in such cases.

Thank you for your kind words

Wish you good luck and happy life

Above answer was peer-reviewed by : Dr. Jyoti Patil

Follow up: Dr. Susanta Padhy (32 minutes later)

Sorry, I don't quite understand. In England being sectioned means that by law you have to stay in the Hospital until they let you go. As you can see in my case this would be ideal. Again thanks

Answered by Dr. Susanta Padhy (1 hour later)

The rules for admission and discharge laws varies from country to country.

I am not too knowledgeable about policies in England so far as admission and discharge are concerned.

You can discuss with the personnel concerned.

Thanks

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Susanta Padhy (1 hour later)

Thank you for your response. If you are admitted to a Mental Hospital in India, are you allowed to come and go or wait until you are discharged. In England I believe if you are sectioned you would only have to stay in Hospital until the process is complete. You cannot come and go, and you might have secure wards to prevent wandering. It is this area I wished to address. Once I start I do not want to be allowed to walk away. (Police would return you to the Hospital if you absconded whilst sectioned) Its is the only way I can overcome my change of mind possibilities. Regards XXXXXXX (ps I have posted a approval comment with HealthCareMagic)

Answered by Dr. Susanta Padhy (7 hours later)

Dear XXXXXXX,

In India, we have three settings for such admissions:

1. GHPU, General hospital Psychiatric Unit, where the psychiatric department is a part of the general /speciality / superspeciality hospital, where "parole" provision is provided - in which patient can be allowed to go home with family members maximum for 24-48 hrs with an undertaking that he will come back after that. But this decision lies with the treating team. After waiting for 24 hrs, if he does not return, then we inform police as a formal procedure.

And if still patients want to go home, he can leave hospital by "LAMA", leave against medical advice, where patient will not be given any discharge card, but he can visit hospital anytime for treatment and have no legal consequences.

3. Second setting is to "mental hospitals" where if patient is admitted via reception order from magistrate, then he cannot be discharged without an opinion of at least two authorised psychiatrists of the hospital.

4. Third possibility is seeking treatment from private psychiatrists who are practicing independently, without getting attached to any mental hospital on OPD basis. Patients are treated on out-patient basis without hospitalization.

Hope I have provided you with the necessary information.

Thanks once again and regards

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad