Do I need to go back to the psych ward?

[jw112798]

A few months ago I was diagnosed Bipolar and I was in a mild psychosis, I went to the psych ward for help and I came out feeling so much better. Before treatment I was hearing voices, couldn’t sleep, experiencing paranoia, and was violent. It’s been about 4 months since I was released. I recently moved into my grandfathers basement and since then my depression has gotten so bad I cry all day, I can’t leave my bed, the voices have come back, and I am starting to get thoughts about harming myself or others. I am supposed to be starting a new job on Tuesday and I don’t want to mess it up but I’m scared. I feel so defeated, and empty. I don’t know what to do anymore.

[Paxiled]

When you came out of the hospital, I'm assuming you were feeling better because they had you on medication that helped with the symptoms.  Unlike those of us who suffer anxiety, which might actually be cured through therapy or lifestyle changes or just blind luck, bipolar as far as we know is not curable.  It must be treated with medication or it will continue to flare up.  But medications don't always continue to work -- sometimes they stop working, sometimes the dose needs to be tweaked, and very often those who suffer with psychoses don't like how the medication makes them feel and stop taking it.  Which eventually causes it to flare up again.  So the question is, are you taking medication?  When you got out of the hospital were you referred to a permanent outpatient psychiatrist to monitor you?  If so, do you feel that person is doing a good job?  If not, find another.  If you don't have a permanent outpatient psychiatrist, get one.  Hospitals can stabilize you while you're there, but again, the meds and the severity of your illness will change and you need help with that.  Having a therapist will also be helpful -- they can't cure you but can help you cope better.  Also, are you cooped up in that basement isolated or are you getting out and doing things and do you have friends and family to talk to and do things with?  Did you get back to your life after coming out of the hospital?  This is akin to having a chronic illness like diabetes -- not fun, not fair, but if you do the right things, you can have a life.