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At what point is the emergency room necessary?
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SuniDawn posted:
[TRIGGER] I have been treated for depression in the past, and have had issues with suicidal thoughts years ago, but the depression that i'm dealing with right now is much more painful in the rest of my body than i've ever felt in my life. I don't have suicidal thoughts, but i'm not sure if seeking ER treatment is called at this point. At what point does one go to the ER, do you wait until you feel the suicidal thoughts or is there something else to be looked for
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susiemargaret responded:
hello, S --

first let me give you a link to a list of crisis resources where you can call and talk with someone, http://www.webmd.com/help/crisis-resources?printing=true , to get some guidance on whether or not you should go to the ER. in fact, why don't you go print it out right now and keep one in every room, in every bathroom, and in your wallet/purse. that way it will be easy to find if you need it.

you do not have to be suicidal to call one of these resources; don't keep waiting, thinking, "i don't feel bad enough yet, i don't feel bad enough yet." when you are in such emotional or physical pain that you are losing confidence in your own judgment, it is time to call one of these crisis resources.

the people at these crisis-resources places will help you calm yourself down, but they will also have the judgment -- which you're obviously not sure you have right now -- to say, let me check on you in five mins, or it is time to go to the ER, or i'm sending an ambulance, or whatever. in other words, if you don't have confidence in your own judgment, rely on someone else's judgment whom you can trust.

if you don't feel you have the judgment to be able to tell if your life is in danger, go to the ER instead. if you don't have anyone to drive you, call 911 or the police if you have to. don't keep waiting, thinking, "i'm not at the verge of taking my life yet, i'm not at the verge of taking my own life yet." if you're not sure you have the judgment to decide when to go to the ER, that means it is time to go.

here is the bottom line -- if you start losing confidence in your own judgment (should i call? should i go?), it is time to call or go. don't wait until you are 100% sure you should call or go; the test (for me, anyway) is not, "am i sure what to do?" but, "how sure am i that i know what to do?" or "how much faith do i have in my own judgment right now?" if the answer is "not very much" or even "i don't know," it is time to call or go.

i am sure that others have different tests, or frame their tests in a different way, but after reflecting for a while, this is my test -- briefly put, if you're not sure what to do, err on the side of acting rather than not acting. note that this test does not revolve around whether you have suicidal thoughts; it revolves around a simple, almost mathematical Q -- "how sure am i that i know what to do?" if your answer is any variation of "not sure enough," it is time to act.

i hope this helped; in your case, as i read the circumstances from your post, i would decide to go ahead and call one of the crisis-resources places and talk with someone there. if you feel more confident in your judgment afterward, good; if you don't, head for the ER.

i send you caring thoughts and hope that you will keep us posted on how you are doing.

-- susie margaret
what good is gold, or silver too, if your heart's not good and true -- hank williams, sr.
 
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SuniDawn replied to susiemargaret's response:
Well, I did go to the ER for the amount of pain that I was in, but they told me nothing really. It was mainly a headache. The said I had a tension headache, because my body was so bound up that my muscles were pulling my head. I was basically told to go home and get some sleep, and take some pain reliever for the pain. I told them about the depression, but that really wasn't addressed. I've been pretty much in bed sleeping for the last two days, except that I dragged myself out of the house and cashed in my gift card that my grandmother gave me. I'm worried about my job as I don't know that I have the energy to even get out of bed in the morning. I managed to get myself to church this morning, but didn't even have the energy to stick around very long. Since i've been with my work for more than a year, i'm going to apply for FMLA leave, but I need to take the paperwork to the therapist, which I haven't seen before, I just got insurance to be able to get help. The very few people that i'm close to don't seem to understand that this depression isn't a character flaw, it's a condition that can happen to anyone. I have very few friends, and i'm scared to even talk to my parents about what's going on. My mother is very much anti therapy, and is a holistic practitioner. While I know some of what she does is very helpful to me, I also need to turn to traditional treatment methods when things get very bad., So, the long and short, I don't have much support from people who know what i'm going through. In fact, those people that are closest to me say they don't know what to do to help, and I can't even tell them either. So much of the time, I don't want to be around people, but yet if someone would just call me or decide i'm worth their time to just say hello, it would make me feel better. It's frustrating to have those conflicting feelings. I work in customer service taking escalated calls, so as you can imagine, it affects my job a lot. I've never had depression this long standing before, and it's really scary for me. I've been accused of being dramatic, wanting to be the center of attention, being over the top. I fight with wanting someone to pay attention to me, and not being too needy.
 
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susiemargaret replied to SuniDawn's response:
hello, S --

i don't understand why the ER people failed to address your depression, but what's done is done in that dept. right now i think you are on the right track seeing a therapist and then deciding what to do next.

the only other thing i would suggest at this point is that you also get a checkup with your primary-care dr, just to make sure that nothing "physical" is causing you to feel so fatigued. this could range from anemia to a thyroid deficiency, for example.

please keep us posted on how you are doing.

-- susie margaret
what good is gold, or silver too, if your heart's not good and true -- hank williams, sr.
 
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SuniDawn replied to susiemargaret's response:
I am still not doing well. I can't get any information from my insurance company on if I have a deductible or if it's strictly co-pay. I cannot afford a deductible, money is tight as it is. I know they have mental health coverage, but with the deductible, I won't be able to meet my other financial obligations and get the care I need. My employer has an Employee Assistance Program, but I can't seem to get the phone number from anyone to use it. I feel like those that I called friends still treat me like i'm a plague or something.
 
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susiemargaret replied to SuniDawn's response:
hello, S --

it is ridiculous that you can't get a straight answer from your ins co on the financial requirements re mental health care under your policy! it is also ridiculous that you can't get the phone number for the EAP! somebody has to know these things. the trick is figuring out who and how to reach them.

i have a couple of ideas, but let me suggest initially that you write down all of the things you want to know; this will help avoid to some extent the having-to-call-back-several-times problem. then i have two general suggestions.


my first general suggestion is to call the ins co over and over, asking for the claims dept. then one of three things will likely happen.

(1) the person you talk to will give you an answer. if so, get their name. then call back later and ask someone else, whose name you also need to find out. if you get the same answer, good. if you don't, keep calling until you get the same answer at least twice, plus the names of everyone you talk with.

(2) the first person you talk to doesn't know the answer. if not, get their name, then ask to speak to their supervisor, whose name and direct number you also need to find out ("just in case i get cut off"). if the supervisor doesn't know, get their name and ask to speak to their supervisor. go as high up the line as you can until you get an answer or until it's clear you are being shuttled in circles.

(3) the first person or their supervisor or their supervisor wants to "transfer" you to somewhere else. before you let them do this, get their name, their direct number, the name of their dept, then the name of the person/dept you are allegedly being transferred to and their direct number. try not to be transferred to the same dept twice.


my second general suggestion is to call the human resources dept of your employer to get a policy interpretation and/or the phone number for the EAP. in addition, there might be an 800 number in the part of the policy where they discuss mental health coverage.


i can see that i am coming close to the word limit, and i have a few more things to say, so let's meet at my subsequent post!

-- susie margaret
what good is gold, or silver too, if your heart's not good and true -- hank williams, sr.
 
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susiemargaret replied to SuniDawn's response:
hello again, S --

this is the second part of my response to your inquiry about ins coverage for mental health care under your employer's' health ins coverage plan.

helpful-i-hope hints when dealing with the ins co or the HR dept --

-- get the names, depts, and direct numbers of everyone you talk to. make a note of what each person says.

-- if you leave a message, don't count on it being returned. you should still go back and start over at the step of the process where you got sidetracked into leaving a message.

-- when you describe what you want, stick to basics, such as "(a) i need to know if there is a deductible or a copay or both with mental health coverage, and (b) am i limited to a certain number of visits? and(c) what is the number for the EAP?"

-- except to say you've already talked to a certain dept, don't waste your time listing all the frustrating things you've already done, other than saying, "no, i already talked with them, i want to talk with someone different this time." they don't care about the other people's names or what you already did.

-- be humble, not indignant. "i'm so frustrated, i can't seem to find out where to get this answer, you're my last resort, please help me," not "i've had it with you people. nobody knows anything, i don't see how you stay in business," etc. remember, what you want is an answer, not necessarily a self-righteous "i guess i told them off!" if you have a gripe about how you were treated, write a letter later; get your answer first.


i don't know how to answer the problem of the friends-abandoning-you situation. i know this is no consolation, but it is based in fear and ignorance, not on their true emotions about you, and the only way of countering that is education, education, education. but who has the energy to educate everyone when you barely have the energy to get ready for work every day?

maybe choose the person to whom you feel closest and talk in depth with them, or give them some pamphlets? those ideas sound hopelessly inadequate, but they are the only ones i can come up with right now. except that if people ask how they can help, or say they don't know how to help, tell them -- listen but don't try to fix, hold you, call you a couple of times/week, go out for coffee occasionally. in other words, make it clear that you don't need them to be your therapist, you need them to be your friend. then try to talk about things other than, or at least as well as, how you feel.

i hope you can find some relief soon.

-- susie margaret
what good is gold, or silver too, if your heart's not good and true -- hank williams, sr.
 
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tiffanysue22 responded:
Dear SuniDawn, Last night I went to the ER without suicidal thoughts, but couldn't deal physically. All that they could do was give me an anti anxiety shot, but for the first time in 5 months I went home and slept for 8 hours.
 
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SuniDawn replied to tiffanysue22's response:
I ended up being taken to the emergency room from my job yesterday. I started having trouble breathing, and then I started getting dizzy.My blood pressure was too high. I don't have problems with my blood pressure, it's usually on the low side. I had just made an appointment to go to my PCP to get checked out, thinking that would get me in the right direction. The EMT was asking me questions, and then the subject came up about my depression and how long it had been going on. I started crying half way into the sentence, and I couldn't stop crying. They then decided it was best to take me to the ER. I was completely embarrassed by the whole situation.I was given Ativan for anxiety. It worked, but i'm so sensitive to medication that even after the 8 hours it was supposed to work, I felt groggy and disconnected. I found out that I have a deductible for not only mental health but also for the ER visits that i've had. It isn't helping my depression and anxiety knowing that I've missed a day and a half of work, unpaid, because of this, and not only that, I now have to pay out of pocket up to $1000 for deductibles, money I don't have.
 
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An_203902 replied to SuniDawn's response:
Hi SuniDawn, I don't have answers for you but I can relate in many ways. I am thinking good thoughts for you!
 
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An_203903 replied to SuniDawn's response:
Hi SuniDawn, I tried to post earlier, but was unable to get through. I wish I had answers for you. We have similar situations. I just want you to know I am sending you good thoughts


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