Senator John Fetterman made headlines in mid-February after his spokesman announced that the Pennsylvania Democrat was receiving inpatient treatment for depression.
Adam Jentleson said in a rack on Twitter that Fetterman checked himself into Walter Reed National Military Medical Center in Bethesda, Md., to receive treatment for clinical depression. “While John has had intermittent depression throughout his life, it has only gotten more severe in recent weeks,” the statement said. “After examining John, Walter Reed’s doctors told us that John is getting the care he needs and will be back to himself soon.”
So is the senator’s wife, Gisele Fetterman tweeted of her husband’s inpatient treatment, writing, “After what he’s been through over the past year, there’s probably no one who wanted to talk less about his own health than John. I’m so proud of him for asking for help and getting the care he needs.”
Fetterman suffered a stroke last May and was elected in November. He went to George Washington University Hospital in early February after feeling light-headed, his office said in early February. He was fired two days later.
But news of his treatment has raised many questions — and confusion — about what it means to receive inpatient therapy for depression. Patients who have experienced it, as well as doctors, explain.
What Is Inpatient Treatment for Depression?
Mental health therapy is generally divided into two broad camps: outpatient, when you see a therapist in their office, and inpatient, where you stay in a facility to receive care, Dr. Thea Gallagher, a clinical assistant professor at NYU Langone Health and co-host of the Ghost in sight podcast, tells Yahoo Life. “Inpatient treatment means you need more care than what you would get on an outpatient basis, which is probably once a week, or even less than that.”
People who are hospitalized generally do so because they feel they are in a crisis situation, are not as stable as they should be, are a danger to themselves or others, or are unable to carry out their daily activities. to perform, Gallagher explains.
“In an inpatient setting, care is much more intensive than outpatient treatment,” Dr. Erick Cheung, the interim chief medical officer of the Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA, told Yahoo Life.
At a basic level, “inpatient treatment usually means staying in a psychiatric hospital overnight for more intensive treatment — evaluation and testing, psychotherapy, medication management, providing a safe environment during a time of mental health crisis, and a team to help plan and care coordinate for outside the hospital,” Elizabeth Shultz, assistant professor of clinical psychiatry at Vanderbilt University Medical Center, tells Yahoo Life.
A person can enter a hospital voluntarily, which is when they decide to admit themselves, or they can be admitted involuntarily, which is “often decided by a medical professional” if it is “deemed you pose a risk to yourself or others Hillary Ammon, a clinical psychologist at the Center for Anxiety and Women’s Emotional Wellness, tells Yahoo Life.
What does an inpatient treatment look like?
It is largely tailored to the needs of the patient, Cheung says. Because of this, everyone’s experience – and each treatment center – is slightly different.
But in general, “there’s a combination and a range of group therapies that occur,” he says. “Patients usually meet in small groups to do different types of activities and rehabilitation, and then have one-on-one meetings with doctors, therapists and nurses.”
Patients are assigned to a treatment team that includes a psychiatrist or psychiatric nurse, social worker, nursing staff and other mental health specialists, Shultz says. In addition to individual and group therapy, “there may also be times for educational sessions — about medications, nutrition, or physical activity,” she says. “There are often fixed visiting times during the day and other opportunities for extra rest, reflection or relaxation.”
Shultz says a treatment team will meet with a patient to talk about ongoing assessments, symptoms, treatment recommendations, readiness for discharge, and next steps after hospitalization. “Medication is often prescribed or discussed, but admission to the psychiatric hospital does not automatically mean that you have to take medication,” she says. “For many people, due to the severity or cause of the symptoms leading to hospitalization, medication may be beneficial. However, there are certainly people for whom medication is not part of their treatment plan.”
The length of stay can vary based on a patient’s needs, but Ammon says it usually ranges from two to 14 days.
‘Everything started crashing around me’
Allison Krawiec-Thayer tells Yahoo Life that she was treated inpatient for six days in 2018, after developing depression when she and her husband moved to a new city. “One day, after my anxiety and depression had steadily increased for weeks, everything around me started crashing,” she says. “My mind moved to a darker place than ever before, and the hopelessness was deep. Even though I had no plan and I hadn’t tried anything, I knew it was time to be taken in.”
Krawiec-Thayer says she was “absolutely sad” for the first few days of her treatment. “I remember crying into my husband’s chest on the Lyft on the way to the emergency room,” she says. “I called home every day and reminded myself that I was going in the right direction.”
Her treatment was rooted in dialectical behavior therapy, a form of therapy intended for people experiencing intense emotions. “We had group sessions that ranged from talk therapy to making music together,” she says. “There was free time outside on the rec court on the roof of the building. I spent time with fellow patients playing cards and watching movies.”
Krawiec-Thayer says she was visited by a therapy dog, there was a tai chi group in the mornings, and she was able to meet and pray with a chaplain. “I also met with members of my medical team on a daily basis to discuss medication and how I was feeling,” she says. “The beauty of being inpatient is that I really didn’t have to worry about anything and could just focus on my healing. I circled the food I wanted on a menu and it showed up. I didn’t have to do my laundry or clean If I felt a panic attack coming on I could ask a nurse to sit with me My cellphone wasn’t there as a constant outside distraction and attraction I had room to move through what I needed so I refreshed from the hospital.”
Ultimately, Krawiec-Thayer says, “I knew this was the right choice for me.”
What are the signs that someone needs inpatient treatment?
The severity of a person’s symptoms matters, including how much it affects their functioning, says Gallagher. “If people are active, severely suicidal, or their functioning is affected — they don’t go to work or school — an hour a week of therapy isn’t going to have the same effect as inpatient treatment,” she says. “You need a higher dose of care.”
Inpatient care may also be recommended “when the severity of symptoms calls for faster diagnosis, treatment, or coordination of services,” says Shultz.
Doctors emphasize that inpatient treatment should be normalized
There’s a lot of stigma surrounding inpatient treatment for depression, and Fetterman’s recent decision showed that it persists despite advances in how Americans generally view mental health. On Twitterpeople have labeled him as “mentally unstable” and as a “mentally and physically disabled” patient, among other things.
People seeking inpatient care are often aware of this stigma. The novelist Wednesday Lee Friday tells Yahoo Life that she felt a “vague sense of shame, a feeling like I should have handled all of this without hospitalization,” when she sought inpatient therapy after attempting suicide 26 years ago. “Eventually I realized this was like telling a diabetic to control his blood sugar by thinking about it,” she says. “Diseases need treatment – period.”
Doctors say it’s important to normalize all treatments for depression, both inpatient and outpatient. “Depression is a very common disease and diagnosis,” says Cheung. “It’s part of the human body. If you had pneumonia and needed help breathing, you went to the hospital. If you had a heart attack, you went to the hospital. The same goes for depression. If you have a have a severe form of depression and need help, you should get treatment.”
Ammon agrees. “Inpatient care is necessary for some, whether it’s short-term care for stabilization or long-term treatment,” she says. “This higher level of care can save lives.”
Krawiec-Thayer says she has “grown and transformed” since her inpatient treatment. “It’s also a much more nurturing experience than I expected,” she says. “The media makes it pretty intense at times, but honestly my experience was super peaceful and healing.”
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Originally published