Unlike her dramatic Jan. 3 hospitalization – in which a wild-eyed Spears was captured on camera being hauled away – her current hospital stay had been planned in advance, sources say, and did not involve her children.
What's more, sources say Spears was more receptive to treatment this time, which experts call a promising sign.
Other key differences between then and now:
Her Psychiatrist Gave the OrderOnce again, Spears was committed using California's 5150 emergency hold, but this time, a source says, it was her psychiatrist – Santa Monica-based Dr. Deborah Nadel, who is certified by the American Board of Psychiatry and Neurology – not police, who issued the order.
"This means it might be a more favorable outcome," says Dr. Diana Kirschner, a New York City psychologist who has not treated Spears. With mental illness such as bipolar disorder – which two sources tell PEOPLE Spears has been diagnosed with – patients "have to make a connection [with a mental health professional] to move forward," says Kirschner. "There is a way you can bond with a client even though you are slapping them with something like [the 5150]."
Although pal Sam Lutfi told PEOPLE that Spears entered the hospital "willingly," Dr. Mark Goulston, a Santa Monica psychiatrist, points out that the 5150 is by necessity "an involuntary hold. ... It may be that she went in willingly, [but] her mental state was seen to be so volatile that whomever evaluated her didn't trust it would change."
Her Severe Lack of SleepSleeplessness – friends say Spears hadn't slept since Saturday – "is a cardinal symptom of bipolar disorder," says Dr. Goulston, who has not treated Spears. "Not sleeping for three days could interfere with all of us functioning at a reasonable level. In someone who has bipolar disorder, sleep deprivation can trigger a full-blown episode. One of the things they will want to do in the hospital is get her to sleep. The question is: When she wakes up, will she be sane enough to leave, and then not accept treatment? That will be the challenge."
Possibility of Longer HospitalizationAlthough the 5150 typically involves a 72-hour hospitalization for treatment and evaluation, when she was last hospitalized Spears left Cedars-Sinai Medical Center after just two nights. Currently, "[Nadel] has the power to decide whether Spears can be released in that time frame or not," says a veteran L.A. psychiatric social worker. "However, [Nadel] is only one opinion. Within the three-day hold, patients-rights workers from the L.A. County Department of Mental Health will interview Spears and review her charts to determine whether the hold is legally justified." After 72 hours, "[Nadel] can request a 14-additional-day hold called a 5250."
MedicationAlthough Spears is more likely to comply with medical orders in a hospital setting, forcing her to take medication can still be challenging. "If she refuses to take meds that a doctor determines she needs, [Nadel] can request a court to grant that power – but that's a lengthy process that won't happen in just 72 hours," says the social worker. "I've seen patients housed for 40 days with not a single pill given."
Family InvolvementAlthough her dad Jamie visited Britney in the hospital during her Jan. 3 hospitalization, her mom Lynne remained in Kentwood. This time, Lynne has been present throughout the crisis. Still, "during a 5150 hold, a patient's family has no power unless the patient is a minor," says the social worker. "This is because, in part, family involvement could create further conflict. Even visitation can't be granted to family unless the patient asks for it in writing."
Says Dr. Kirschner: "The fact that the person's family is around them is generally favorable." Given the fact that she was hospitalized a second time under a 5150, "she was probably increasingly worrying people who were worried for her well-being," says Dr. Goulston. "If she's driving and she's actively bipolar she is a danger to herself. The question is: How many of these will it take to stick and for Britney to be willing to get help?"
Reporting by KEN LEE, LISA INGRASSIA and RYAN PIENCIAK