Written by Colter Bloxom, LPC

Colter is a licensed psychotherapist and the owner and founder of Thrive Therapy. He specializes in the treatment of anxiety, OCD, pornography addiction, identity issues, and more.

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Severe anxiety can be overwhelming and may sometimes feel impossible to manage on your own. While most people with anxiety won’t need to be hospitalized, there are times when symptoms can escalate to the point where hospital care becomes necessary. If you're wondering if you can be hospitalized for severe anxiety, the answer is yes — but it's not your only option. 

Here, we'll talk about hospitalization for severe anxiety, including what to expect and tips on when to know when it's time to seek emergency help.

Reasons you might be hospitalized for anxiety

Most of the 40 million people across the U.S. who live with generalized anxiety, or other conditions like social anxiety disorder or panic disorder, probably won’t need to be hospitalized for it. But sometimes, anxiety symptoms can become too much to handle on your own – and that’s nothing to be ashamed about.

When it gets to this point, you can be hospitalized for severe anxiety. This includes voluntarily going to a hospital or ER for support, as well as, in some cases, being involuntarily hospitalized.

People with severe anxiety can stay in the hospital for different lengths of time. Sometimes, you might just be held in the emergency room overnight until your symptoms stabilize and you’re safe. Others might choose to stay in an inpatient treatment setting for weeks, or even months, to get the support they need.

Some common situations that might lead to you being hospitalized for anxiety include:

• You are having a panic attack and experience heart pain and difficulty breathing; you might even mistake it for a heart attack or asthma attack. Reports show that over half of the people who end up in the ER for chest pain are actually having a panic or anxiety attack.
  
  
• Your anxiety symptoms become so severe that you begin to have suicidal thoughts (thoughts about hurting yourself or ending your life). You head to the hospital because you don’t feel safe alone.
  
  
• You can no longer do your everyday tasks – like going to work, driving, basic self-care like showering, etc. – without help because your anxiety is so severe.
  
  
• You tell your therapist or another healthcare professional that you are planning to hurt yourself or another person, and they put you on a psychiatric hold.
  
  

It’s important to note that this isn’t an exhaustive list; whether or not you’d be hospitalized (especially involuntarily) depends on so many factors, including your unique symptoms at the time and the healthcare provider’s observations. Hospitalization is usually up to the discretion of the treating physician, and they should discuss your options with you.

Involuntary hospitalization for anxiety

To be involuntarily hospitalized for severe anxiety (or any other mental health reason), your healthcare provider must believe that you pose a threat to yourself or others. Most mental health professionals believe that involuntary hospitalization should only happen as a last resort. Most of the time, your therapist will work with you to create a safety plan that helps you cope with anxiety on your own.

Almost always, involuntary hospitalization is only short-term – it’s also called a psychiatric “hold.” If you're in the emergency room for severe anxiety and the attending physician determines that you can’t safely stay at home, then they may put you on a temporary psychiatric hold for up to 72 hours.

Voluntary hospitalization for anxiety

You can also choose to be voluntarily hospitalized for severe anxiety or decide to receive treatment in an inpatient or residential setting. Inpatient treatment centers can range from psychiatric hospitals to home-like settings where you might live with other people who are going through similar issues.

Regardless of the setting you choose, inpatient treatment can provide you with more intensive treatment when you feel like going to therapy once a week isn’t enough. Note: If you need more than once-a-week outpatient therapy, but don’t think inpatient treatment or hospitalization is for you, then you might want to consider intensive outpatient programs, or IOPs.

When should I go to the hospital for severe anxiety?

It’s hard to know when your anxiety symptoms have become severe enough to warrant going to the hospital. There are no hard-and-fast rules about when you should consider going to the hospital for severe anxiety. It depends on the type of anxiety you have and what your symptoms are like now.

You know yourself best – your safety should always come first, and if you feel like you need immediate medical attention (whether it’s for anxiety or not), you should do whatever it takes to get it.

Some signs you may need to be hospitalized for anxiety include:

• Chest pains or tremors that don’t subside over time
  
  
• Having increasing thoughts of suicide or self-harm
  
  
• Being unable to take care of yourself, like transport yourself to work
  
  
• Feeling dissociated or disconnected from reality because of anxiety
  
  
• Being unable to sleep or eat for an extended period of time
  
  
• Severe agitation or restlessness that feels uncontrollable
  
  
• Panic attacks that don’t subside after 30 minutes
  
  

Going to the hospital for anxiety doesn’t necessarily mean you will be held there, but it can often be the first step to getting relief if you need immediate help.

What to expect: What does ER do for anxiety?

Going to the ER for anxiety can be both overwhelming and reassuring. It’s important to know that the staff there are trained to handle mental health crises just as seriously as physical ones. Here’s a basic rundown of what you can expect:

1. Triage and assessment: The first step is triage. A nurse will ask you some questions about your symptoms, medical history, and what brought you in. They’ll use this information to figure out how urgent your situation is and how quickly you need to be seen.

2. Physical examination: Severe anxiety has physical symptoms that can feel and look a lot like other serious health conditions; for example, chest pain that might make you think you’re having a heart attack or shortness of breath that feels like an asthma attack. Because of this, the ER staff will usually do a physical exam. They might check your heart rate, blood pressure, and oxygen levels, and maybe even run some tests like an EKG to rule out anything else.

3. Mental health evaluation: Once they’re sure there’s nothing physically wrong, you’ll probably talk to a mental health professional like a psychiatrist, social worker, or crisis counselor. They’ll ask more in-depth questions to get a better sense of your anxiety, any other mental health issues, and whether you’re at risk of hurting yourself or someone else. You can expect questions about what’s been stressing you out, what’s going on in your life, and how you’ve been coping.

If the ER staff believes you’re a danger to yourself or others, they might place you on a temporary psychiatric hold. 

4. Immediate treatment options: If your anxiety is really intense, the ER staff might offer something to help you calm down right away. This could be medication, like a benzodiazepine, to take the edge off. They might also give you some oxygen if you’re having trouble breathing or hyperventilating.

5. Observation and monitoring: If your symptoms are severe or there’s concern for your safety, you might need to stay in the ER for a few hours or overnight. During this time, they’ll keep an eye on your vitals, monitor how you’re doing mentally, and provide support as needed. The goal is to make sure you’re stable before they send you home.

6. Discharge planning: Ideally, the ER staff will help you figure out what to do next. This could include a referral to a therapist or psychiatrist, resources for outpatient treatment, or even recommendations for an intensive outpatient program (IOP) if you need more help. They might send you home with a new prescription for an anti-anxiety medication. In some cases, they might suggest inpatient care for more intensive treatment.

What other treatment options are there for severe anxiety?

It’s possible that you live with severe anxiety and need treatment, but don’t necessarily require immediate crisis intervention. If you feel safe at the moment, but are looking for support with managing your symptoms, you have other treatment options available to you that don’t require going to the hospital or ER.

Many people with anxiety choose to attend outpatient individual therapy or psychiatry appointments – where you continue to live at home but attend sessions once, sometimes twice, a week. Therapy is the first-choice treatment for anxiety disorders, and a psychiatrist can prescribe you medication if your symptoms are more severe. You can also attend group therapy on an outpatient basis, where you participate in therapy sessions with other people who are facing similar issues.

You can also choose to enter into an inpatient or residential treatment program without going to the ER first. Going through your insurance provider can be a good way to start looking for residential treatment programs that are covered by your plan; you can also search for residential treatment in your area. In residential programs, you will live inside a facility and receive treatment there as well. Many programs offer 24/7 supervision and monitoring.

 If you’re looking for something in between, an intensive outpatient program (IOP) could be the best fit for you. Once-a-week therapy often feels like not enough support for those with severe anxiety, but you might also not have the flexibility to do a full inpatient program. 

IOPs provide you with treatment several days a week, including both individual and group therapy. You’ll still live at home, but receive intensive support – sometimes for several hours per day. This helps you get a similar level of support that you’d get in a residential treatment program, but without having to leave your home.

Learn more about Thrive Therapy’s IOP for anxiety in AZ

 For example, we designed Thrive Therapy’s IOP in Phoenix, AZ specifically to support people with severe anxiety and other mental health concerns like depression and PTSD. Although many IOPs cater to people with substance use disorder, our program is for all mental health issues whether you have a co-occurring addiction or not.

We meet 3 days a week for 3 hours per day (9 hours total per week) for 12 weeks, which allows you the flexibility to continue with your daily routine. Because our IOP is designed for mental health issues, we use the most effective evidence-based methods to help you beat severe anxiety. 

Give us a call for a free 20-minute phone consultation to answer any questions regarding programming, insurance, or any other questions that you might have.

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