Hi @A MyDepressionTeam Member,

First, I am so sorry you’re going through this. Being told you need a higher level of care can feel heartbreaking, scary, and honestly a little like being emotionally evicted from your own treatment team. But please hear this: you are not a failure. Not even close.

I went through something very similar from 2017–2019. After having gastric bypass surgery in late 2016, I experienced a severe prolonged episode of TR-MDD. At the time, the gut-brain connection and the psychiatric effects that can happen after bariatric surgery were not as well understood as they are now.

After being discharged from a psychiatric hospital, my longtime psychiatrist told me my case had become “too complicated” for his practice. I ended up in a couple of different residential treatment centers, and afterward, trying to find ongoing psychiatric care felt nearly impossible. I kept hearing phrases like:
“complex psychiatric presentation,”
“requires a higher level of care,”
or
“beyond the scope of this practice.”

Translation: “This case is above my pay grade, and I don’t know what to do with it, or I don’t want to deal with it.” Not exactly comforting.

as I said, I bounced through several residential programs around Florida, only to discover there often weren’t private psychiatrists nearby willing to take on medically and psychiatrically complex patients after discharge. Eventually, I relocated to a larger city, found a practice willing to work with me, and slowly — very slowly — found my way back to what I jokingly call my “factory settings.” (Well… close enough anyway. 😂)

So truly, this is not just you. You are not “too much,” too broken, too complicated, or beyond help. What you are experiencing is, in many ways, a failure of our mental health system. There is a huge gap between short-term hospitalization/PHP/IOP care and extremely expensive intermediate-term residential treatment, or intermediate home based care, especially for people with chronic, treatment-resistant, or medically complex depression.

Please keep advocating for yourself. There are doctors and programs out there that understand complex cases and genuinely want to help.

And one thing I learned the hard way: do not let a hospital or residential program discharge you without confirming — and ideally directly coordinating with — the psychiatrist or provider you’ll be seeing afterward. Continuity of care matters so much when you’re already exhausted and overwhelmed.

You deserve care, support, dignity, and hope. Even if your brain is telling you otherwise right now.

Mentioned Users

A MyDepre...

Is there a social services department that can help you with your insurance navigation? I know that where my grandmother lived, there was a woman who worked at the senior center to help the town's seniors with their health insurance needs. And my primary care practice found psychiatric providers that took my insurance, giving me the choice of who I wanted to see.

@A MyDepressionTeam Member, IOP is an outpatient program that meets typical for 2 - 4 hours 3 - 5 days a week. It usually consists of:
* Group therapy
* Some individual therapy
* Medication management if needed
* CBT, DBT, stress management, relapse prevention, and coping skills

It is a step down from a PHP, Partial Hospitalization Program, which meets typically for 4 - 8 hours 5 days a week and usually consists of:
* Group therapy
* Individual therapy
* Psychiatric medication management
* Skills training (CBT, DBT, coping skills)
* Education about depression, anxiety, trauma, bipolar disorder, etc.

Think of the programs as intensive Group Therapy. Many people are surprised to discover that a few weeks of structured treatment can help them regain momentum when depression, anxiety, trauma, or bipolar symptoms have made daily life feel overwhelming.

I recently finished IOP and found the routine, therapy, and social interaction helped with my depression.

Hope this helps,

Pam

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A MyDepre...

Thankfully yes, my Therapist did not have the experience to deal with someone suffering from chronic illness and pain.

This song was in my head earlier so wanted to share it with you all and hope God's blessings being amongst you all.
https://youtu.be/PUtll3mNj5U?si=5CN0iW4AM0CBJrnH