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I've never been to the hospital for my bipolar but I came close and basically had to convince my therapist that I didn't need to go, because we made the deal that I'd do IOP instead. I probably should have gone to the hospital but I'm thankful things worked out.

I've learned that sometimes people notice the red flags that things are getting bad before I do. I think the concerning thing you mentioned is the fact that you wish your chronic illness or your bipolar would just let you die. That is a sign that things are going downhill for sure and you may need an extra level of care, whether IOP, PHP, the hospital, or something else. Are you feeling suicidal or like you are going to harm yourself? Those are 100% signs to go to the hospital.

Did the people around you say what the red flags that they noticed are? It may be a good time to think about what they are saying and how it applies to you. I don't think they're lying to you when they say they worried or when they say they've noticed things. Sometimes denial hits us and we don't even realize that we're doing certain things or having certain thought patterns until someone points it out to us.

If you're having a hard time functioning to some degree it may be worth seeking some form of a higher level of care, again whether it's stepping up from just therapy first or going to the hospital.