How Do You Know When It’s Time To Go to the ER for Bipolar?
If you are in the midst of a mental health crisis, it can be difficult to know when to go to the hospital. It’s a good idea to think ahead about when you might need emergency psych help. If symptoms are severe or you pose a threat to yourself or others, getting urgent help is necessary. So, how do you know if this is happening? Let’s take a closer look.
What Is a Bipolar Emergency?
A psychiatric emergency is a serious situation that requires urgent care. It may require bipolar disorder hospitalization. Here are some signs that a trip to the emergency room (ER) might be necessary.
Suicidal or Homicidal Thoughts
If you are having thoughts of harming yourself or someone else and have thought about how you would do it — or have a plan to act on these thoughts- it’s an emergency. If someone close to you is threatening to harm themselves or others and refusing to go to the hospital, then you can call 911 (in the U.S.) for help. Request a mental health or crisis response team to respond if one is available in your location.
Unable To Take Care of Your Basic Needs
When severe, bipolar disorder can make it extremely difficult to take care of your basic needs. For example, severe mania can make it hard to eat or stay hydrated. If there is a question of your ability to care for yourself, seeking a mental health evaluation at the emergency room is vital.
Destructive, Impulsive, Dangerous Behavior
Sometimes, while in a manic episode, people with bipolar become extremely agitated. They may engage in bipolar behavior that is dangerous or destructive. If this is the case, the person may need to be taken to the emergency room for an evaluation.
Psychotic Symptoms
If you are experiencing psychosis, you might have trouble knowing what is real and what isn’t. Psychotic symptoms in bipolar indicate severe mania and requires urgent care. Symptoms of psychosis include:
Delusions - A delusion is a false belief. For example, a person may believe that they are in a coma, in spite of evidence to the contrary. They may have the belief that a famous person is in love with them even though they have never spoken to the celebrity in question.
Paranoia - Feelings that others are out to harm you or are secretly watching you.
Auditory or visual hallucinations - These involve seeing or hearing things that are not real.
Confusion - Extreme difficulty remembering things or concentrating is a sign of psychosis, and so is confused, jumbled thoughts.
Severe Sleep Loss
During manic episodes, a person may not feel a need to sleep. They may be unable to sleep even if they want to because of manic symptoms. After several days of not sleeping, a person can begin to experience hallucinations and psychosis. This is an emergency. It’s best to go sooner rather than wait. The longer you go without sleep, the worse these symptoms get.
If you are experiencing any of the above things, it’s best to go to the ER. The doctors and nurses there can determine whether or not you need to be admitted to a psych unit.
What Options Are There if You Don’t Need an ER?
Perhaps you have run out of your medication and have no way to reach your psychiatrist because it’s the weekend. Right now, your symptoms aren’t severe enough to warrant an ER trip, but they might be if you wait to get medications. Or, you have just experienced the death of someone close and you need help right away to keep from spiraling. What can you do then? Here are some options:
Contact your mental health provider’s on-call crisis number - Most therapists and psychiatrists offer after-hours support. Call the regular number to see if there is an option to reach someone.
Visit a walk-in crisis clinic - Many larger cities have crisis clinics that offer walk-in psychiatric services. You can find these by doing a Google search for crisis clinics.
Reach out to a psych helpline - You can call or text the 988 Lifeline for confidential, free support 24/7.
The Bottom Line
If you are in the midst of a bipolar episode and are worried about safety, you should go to the emergency room. The medical staff can determine if you need to go to an inpatient mental hospital. There are other options available if you need urgent help but it’s not an emergency, such as calling your outpatient provider for urgent help.
