Depression

As you know, having a major depression is very different than being sad. Because of your depression, you usually see everything with a more negative attitude. You cannot imagine that any problem or situation will get better. Feelings interfere with daily activities, such as taking care of family, spending time with friends, or going to work or school. And this condition may be compounded by the added burden of a co-occurring disorder.

Silver Hill is a top depression treatment center, with the breadth and depth of experience to properly evaluate your condition, make an accurate diagnosis, and develop an effective treatment plan that is precisely right for you. We use only evidence-based therapies. Our warm and caring environment will help you on your way to renewal and reconnection.

Silver Hill Hospital treats adults who need treatment for depression as well as teens – who are treated in a separate unit to address their particular needs. After an evaluation, you are placed in a level of care depending upon the stage of your illness. Silver Hill offers three levels of comprehensive care for adults and adolescents corresponding to your need:

Depression Treatment for Adults

Adult Inpatient – for the acute phase of illness
Inpatient treatment is right for you if your depression is in a crisis phase that requires medical intervention to stabilize your symptoms. Our program offers a high clinician-to-patient ratio so that you can receive the individual attention you require, and be prepared for subsequent levels of care.

The goals of your inpatient treatment are a thorough diagnostic assessment, safe detoxification if required, plus symptom reduction and stabilization. Treatment includes the following:

• Psychiatric Diagnostic Evaluation – Based on information gathered from you, your family and your community clinicians, we develop a preliminary diagnosis and treatment plan.
• Medical Detoxification – We initiate medically supervised treatment designed to safely eliminate intoxicating or addictive substances from your body if necessary.
• Pharmacologic Therapies – We use medications in the treatment of co-occurring mental health disorders as necessary.
• Individual and Group Counseling – We provide counseling both one-to-one and in groups.
• Structured Treatment Environment – You will live in a supportive environment in which you can constructively apply the skills you are learning to achieve your treatment goals.
• Aftercare Planning – We will work with you, your family and community clinicians to develop a safe, healthy and meaningful plan for life after discharge. 

Adult Transitional Living – for continued therapeutic recovery
After your symptoms are stabilized, you can continue treatment on an extended basis in our Transitional Living Program. Here you live on the Silver Hill campus, in a house that is staffed 24-hours a day with clinicians highly trained in practicing Dialectical Behavior Therapy (DBT).

Our transitional living program is one of the very few programs in the country that focuses on treatment with DBT. It is designed for patients who experience difficulty with emotional control, impulsivity, self-damaging behaviors and interpersonal disorganization. This highly structured, intensive program is right for you if you do not need close inpatient supervision, but are not able to manage successfully yet in an outpatient setting.

Through DBT skills training groups and coaching, you learn how to better regulate your emotions and to replace dysfunctional coping strategies with more adaptive behaviors. Under the guidance of highly trained staff, you “live” the skills and coping strategies you are learning, as you learn them. Core DBT skills are Mindfulness, Emotion Regulation, Interpersonal Effectiveness, Distress Tolerance and the Middle Path.

Adult Intensive Outpatient – for ongoing treatment from home
We offer an Intensive Outpatient Program for you if you are at low risk for self-harm, and if you have a stable living environment. You live at home and come to Silver Hill two or three days a week for DBT skills training led by licensed clinicians.

Depression Treatment for Adolescents

Adolescent Inpatient – for the acute phase of illness
Teens ages 13 – 17 are often first admitted to our inpatient unit for crisis management and stabilization. Our staff of board-certified adolescent psychiatrists, social workers and nurses are here to help you and your family manage this difficult time. In this safe, stable, nurturing environment you will be guided through your depression crisis. After an initial diagnostic assessment, a treatment plan will be created specifically for you.

Our patient-focused, evidence-based treatments include:

• Psychiatric Diagnostic Evaluation – Based on information gathered from you, your family and your community clinicians, we develop a preliminary diagnosis and treatment plan.
• Medical Detoxification (if necessary) – We initiate medically supervised treatment designed to safely eliminate intoxicating or addictive substances from your body.
• Pharmacologic Therapies – We use medications in the treatment of co-occurring mental health disorders as necessary.
• Individual and Group Counseling – We provide counseling both one-to-one and in groups.
• Structured Treatment Environment – You will live in a supportive environment in which you can constructively apply the skills you are learning to achieve your treatment goals.
• Aftercare Planning – We will work with you, your family and community clinicians to develop a safe, healthy and meaningful plan for life after discharge.

Adolescent Transitional Living – for continued therapeutic recovery
The Adolescent Traditional Living Program is designed for teens aged 13 – 17 who struggle with emotional control, impulsivity, self-damaging behaviors and interpersonal disorganization. It is right for you if you do not need close inpatient supervision but are not yet ready to manage successfully in an outpatient setting.

The foundation of your treatment  for depression is Dialectical Behavior Therapy (DBT) – a highly-structured form of behavioral therapy that provides you with the skills necessary to regulate emotions, control destructive behaviors and improve interpersonal relations. Core DBT skills are Mindfulness, Emotion Regulation, Interpersonal Effectiveness, Distress Tolerance and the Middle Path.

You will reside on the Silver Hill campus in a house that is staffed 24/7 with highly trained DBT personnel. The minimum length of stay for this phase of treatment is 4 weeks, and you may choose to extend your treatment.

Adolescent Intensive Outpatient – for ongoing treatment from home
Our Adolescent Intensive Outpatient program provides treatment for teens who are willing and able to live at home, yet require psychological treatment and skill building to function effectively at home and in school.

You learn the core skills of Dialectical Behavior Therapy (DBT) to help you understand and manage powerful emotions, become more aware of yourself and how you think, and find effective ways of coping with stress.

To ensure positive outcomes we work closely with you, your community-based clinicians, and your family to create a working diagnosis, develop a treatment plan, and implement a comprehensive plan for life after discharge.

Because Silver Hill is a multidisciplinary psychiatric hospital, we are uniquely qualified to provide comprehensive care for patients who need treatment for more than one disorder.

These psychiatric conditions may co-occur with depression, and require simultaneous treatment:

• Addiction and Substance Abuse
• Anxiety Disorders 

We use Dialectical Behavior (DBT) at Silver Hill to treat depression because in clinical tests it is proven to help adults and adolescents regulate their emotions. DBT works by giving you the tools you need to manage the pervasive sadness you experience.

In addition, accepted psychiatric assessment tools show significant improvement in patients completing our Adolescent Transitional Living Program.

Our patients:

• Were significantly better able to regulate their emotions compared to when they entered the program, as measured by the Difficulties in Emotion Regulation Scale (DERS)
• Had significantly improved understanding of directness and openness, as measured by the Dominance, Influencing, Steadiness and Compliance evaluation (DISC)
• Reported significantly less anxiety as measured by the Screen for Child Anxiety Related Disorders (SCARED)

These measures correlated in a way that showed that improvements in one dimension matched improvements in the others. These correlations suggest very strongly that this high-intensity DBT treatment for adolescents has robust, clinically significant effects.

Entering treatment is a big step. Information is key to your peace of mind. Following is more detail about what you will experience as an adult or as an adolescent patient for Depression at Silver Hill, during each level of care.

Adult Levels of Care

Adult Inpatient – for the acute phase of illness
Our Main House Inpatient Service takes place at the Patricia Regnemer Main House building. You are assigned according to diagnosis and the type of inpatient treatment that is best suited to assisting in your recovery. The average length of stay varies by diagnosis, ranging from 5 to 12 days.

Visit Being At Silver Hill for more information about adult inpatient care.

Adult Transitional Living – for continued therapeutic recovery
When you come to Silver Hill for treatment for depression, you can expect a safe environment that promotes healing and recovery. You will reside in a well-appointed residence on our beautiful campus, chosen to best fit your symptoms, for a minimum of 28 days. You may extend treatment if you choose.

Visit Being At Silver Hill for more information about adult transitional living care.

Adult Intensive Outpatient – for ongoing treatment from home
We offer two Intensive Outpatient Dialectical Behavior Therapy Skills groups for Depression. One is a six-week program and the other an extended nine-week program. Check the Events Calendar for meeting time and place. Both programs teach you the core DBT skills of Mindfulness, Emotion Regulation, Interpersonal Effectiveness, Distress Tolerance and the Middle Path.

In addition, the Women’s DBT and Safe Relationships Intensive Outpatient Program focuses on education and skills needed to improve relationships, maximize the presence of supportive people, and let go of destructive relationships. You are guided through explorations of parallel relationships with self and others, personal values, and underlying emotional triggers. Self-esteem, healthy boundaries, stress management, and self-care issues are also addressed. The program utilizes core components from DBT and Seeking Safety treatment modules. Check the Events Calendar for meeting time and place.

Adult Family Participation
At Silver Hill, we believe your family’s support is important from the moment enter treatment, and we encourage your family members to meet with your social worker, psychiatrist or other members of the treatment team.

We offer programs designed to educate family members about the patient’s illness and to improve family communication and functioning. Weekly Family Forums address coping strategies specific to your condition. You are encouraged to join Family Forums with family members over 13 years of age.

We also offer DBT education and skills training during a weekly DBT Family Program.

Wellness Services
You may also choose to purchase our Wellness Services during your treatment, which offers a holistic approach to recovery in recognition of the integration of body, mind and spirit. Services include yoga, acupuncture, personal fitness training, meditation and massage therapy. These alternative therapies complement rather than replace traditional medical care. They are most effective when combined with medical treatment to help alleviate symptoms of pain and anxiety. The benefits, both short term and long, help promote a feeling of wellness.

Adolescent Levels of Care

Adolescent Inpatient – for the acute phase of illness
Adolescent inpatient treatment for Depression takes place on the third floor of the Patricia Regnemer Main House. There are five double rooms, each with their own private bath. All units are locked for your safety and no personal computers or cellphones are permitted. A large open common area is used for groups as well as free time.

You will have daily meetings with a board-certified adolescent psychiatrist and frequent meetings with a social worker. Group therapy will address issues such as conflict management, self-esteem and managing emotions. There is also time allotted to keep up with your school work. Family members twelve years of age and older may visit you during scheduled visiting hours. The average length of stay is seven to 10 days.

Visit Being At Silver Hill for more information about adolescent inpatient care.

Adolescent Transitional Living – for residential treatment
During your stay, you will reside in K-House. This residence features two large common rooms and an outdoor area. It contains both double and single rooms, each with its own bath. There is a washing machine and a dryer on premises for laundry.

While personal cellphones and computers are not permitted, you will have access to iPads and computers within the residence. An onsite fitness center, large gymnasium and indoor pool are available. Visitors are welcome during regular visiting hours.

Visit Being At Silver Hill for more information about adolescent transitional living care.

Adolescent Intensive Outpatient – for ongoing treatment from home
Our 6-week Adolescent Intensive Outpatient Program meets in the large group room in Klingenstein  House. Check the Events Calendar for the meeting time. While you are attending the program, you will continue to maintain a therapeutic relationship with your community-based therapist and psychiatrist for medication management, where indicated.

Adolescent Family Participation
Our collaboration with your family is fundamental to your success in the adolescent treatment program. Like medical illnesses, psychiatric illnesses are a family affair and we dedicate time to understanding and helping the family system.

Support for families includes:

• Weekly Family Therapy – Family therapy addresses problematic behavior patterns, communication struggles, and difficulties understanding you, with the goal of promoting family healing.
• Weekly Multi-Family DBT Group (Parents Only) – This program teaches parents the same DBT skills you are learning.
• Monthly Meetings – This full-day program educates families about brain and emotional development in adolescence. It facilitates a greater understanding of mental illness and substance abuse and helps improve communication between you and your family. It also provides supportive resources for families prior to discharge that help prepare you and your family for a successful return home.

This program is divided into morning and afternoon sessions:

Morning (Family Members Only)
Education, information and support for family members including time for questions and answers with the program facilitator.

Afternoon (Adolescent Patients and Family Members)
Patients and their families are encouraged to reflect on family relationships through supportive, non-confrontational exercises. They learn about family roles and dynamics and how to improve communication. They also discuss aftercare and discharge planning.

Family Resource Program – This program offers support and education to families following discharge should any questions or concerns arise at any point in the recovery process. The program was uniquely designed with our families in mind and in keeping with the hospital’s vision to establish a helpful, lasting relationship with our families, as well as to remain involved for as long as we are asked.