I was diagnosed in early 2019 and have had several manic and hypomanic episodes both before and since the diagnosis. Two of these episodes in particular have been rather severe, to the point that I couldn’t hold a job, purposefully damaged relationships/hurt those close to me for no reason, nearly (unintentionally) killed myself with depressant/alcohol combinations to try to quiet my brain, had mild auditory hallucinations, and so on and so forth. But as of yet, I have not been hospitalized, either voluntarily or involuntarily. I’m rather scared of hospitals, so I try to avoid them at all cost. 

What I’m wondering is for those of you that have been hospitalized, what were the conditions that got you to that point? Are there certain criteria that you had to meet, or was it a personal decision made by you or a loved one? I’m just not sure at what point an episode would be considered so severe (aside from being actively suicidal) that hospitalization would be the right route. No judgment to anyone that’s been, you’re probably braver than I am, just curious is all!