Expert: Ivan Goldberg, M.D. - 12/3/2003

Question
My friend is bipolar.  He was institutionalized for a few months when he was very young, and also as a young man.  He was subjected to a lot of dubious experimental therapy and '70's kiddy drugs, and he's very mistrustful of psychiatrists.  Now he's considering seeking help, but since he sometimes gets in physical fights with strangers over petty stuff(you don't ask the obligatory domestic violence questions; he's 100% sweetheart with me)he's afraid that if he seeks help he'll be viewed "a danger to himself or others" (which he basically is) and locked up.  Is there anything you can tell me that might make him feel more optimistic that he won't be institutionalized if he honestly describes the extent of his anger and sporadic violence?

I'd appreciate any information and advice.  Thank you.

Answer
Hi  . . .

Lost of people who have mood problems are irritable and easily angered. if all such people were to be locked up, there would not be enough hospital beds in the entire country for them. The only people who are involuntarily hospitalized are those who are out of control at the moment they are being evaluated. If your friend does not attack the psychiatrist he chooses to see there is  no chance he will be forced into a hospital.

I treat a lot of people with mood disorders. In the past 40 years of practice I have not hospitalized a single person against their will. Most psychiatrists I know have similar track records.

Of course, if your friend were to be brought to a hospital emergency room by the police, after they observe him being violent, those are entirely different circumstances. Under such conditions there is a good chance that he will be hospitalized against his will.

Best regards . . .

Ivan
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