#psychiaty

[belis86]

‘Supporting & empowering ND doctors towards equality, inclusion & thriving at work’

Are you a neurodivergent doctor or a medical student? Please consider responding to the survey to help capture more lived experience to inform work around reasonable adjustments.

[belis86]

Identifying autism

Autism assessments rely way too much on observable external signs and behaviours.You don't make any other psychiatric diagnosis with so little consideration of internal ward and direct experiences. Diagnostic criteria need to be rewritten.

[lavie31]

The mental alters the physical.

Here's a little tip to those on psychiatric medications. A study was done proving treatment was much more successful when medication therapy was combined with psychotherapy. Putting our mind and attitude into the right mindset physically alters the brain...in a good way. That goes to show that mind over matter is right on track. People who are always pessimists don't achieve a great reaction from the meds. Here's something I do after a bad day. Point out one good thing from the day. There always is one. It may be a small minor thing like getting extra sprinkles on your ice cream. Something so small but yet it sets off an explosion of psychological growth. I had to learn myself that there is power in positive thinking. It can't be seen by the naked eye, but your neurons are working better.

[psycheapuleius]

First Clinical Trial of Intranasal Esketamine Shows Positive Results for Treatment-Resistant Depression

A recent phase 2 clinical trial was conducted to assess the efficacy and safety of intranasal esketamine adjunctive to oral antidepressant therapy in treatment-resistant depression (TRD). In period 1, participants were randomized to placebo, 28 mg of esketamine, 56 mg esketamine, or 84 mg of esketamine twice weekly. In period 2, 28 of the 33 participants in the placebo condition were re-randomized to one of the 4 treatment arms. Participants continued their existing antidepressant treatment during the study. During the open-label phase, dosing frequency was reduced from twice weekly to weekly, and then every 2 weeks. The primary efficacy end point was change from baseline to day 8 in the Montgomery-Asberg Depression Rating Scale (MADRS). Change in MADRS total score in all esketamine groups was superior to placebo with ascending dose-response relationship. The results suggest that intranasal esketamine may be effective adjunctive treatment for depression in patients with TRD, however larger trials are needed.

JAMA Psychiatry. Published online December 27, 2017. doi:10.1001/jamapsychiatry.2017.3739

[psycheapuleius]

Blog Efforts and Goals

I will reserve this blog for thoughts and opinions and images about psychiatry, cognitive science, and psychology. The name of the blog refers to Psyche and Cupid the two elements of psychological life and the goals of people who seek help. Psyche being the mind or representing mindedness and Cupid love or positive sensations and romantic attachment.

[belis86]

How can you ever justify restraining people to feed or wash them? That's not care. It's abuse. Why would you force them? It's institutional abuse and the fact that you see nothing wrong with it because it's 'safe' shows how ableist you are.

It is always going to be open to discussion at which point (if any) does it become ok to override another person’s wishes and forcibly intervene. I will give you some real life examples when I personally felt it justified.

Let’s take a person in seclusion room. There have been placed there because they have been extremely violent in the prison setting and clearly experiencing psychotic symptoms. They have stabbed prison officer with a makeshift weapon and have been trying to injure nursing staff every time we enter the room. They have urinated and defecated all over themselves and the room. Now they are eating the excrements. They are extremely distressed by the auditory hallucinations. Do we leave them or enter the room to clean them up and give them medication?

New patient arrives. They have been self neglecting for months due to untreated psychosis. They are paranoid and suspicious to high heaven and so disorganized in their thinking that they can’t follow simple instructions. They are literally crawling with neets and have scabies that makes them so itchy that they scratch themselves raw all the time. Do we leave them to it or intervene?

Patient with anorexia has been refusing oral intake for days. They became dangerously dehydrated due to a belief that water has calories and will make them fat. Refused showers for ages as calories can possibly be absorbed from water through her skin. Are we going to leave her to die from dehydration in front of our eyes?

Little old lady comes to hospital. She succumbed to an infection and is now delirious and confused on top of her dementia. She is fighting nurses off when they try to change her. She is doubly incontinent and has bed sores already. Do we leave her lying in her own excrement or change and turn her regularly despite her protests?

Those are extreme examples but those are the situations when we resort to restraint in order to provide basic care. It’s not a decision made lightly. Sometimes though people are genuinely so unwell that they can’t take care of themselves.

[zz-akmetroid]

I'm going to see a psych today...

And I am really actually quite nervous. I mean, I can barely talk to my friends and family about what I'm going through, and I'm expected to open up to a complete stranger. Oh it won't be so bad, they're trying to help. 

Uh-huh.

Just thought I would let you guys know. 

[back-to-beautiful]

Understanding Beauty (College Essay)

The most intriguing quote I've heard is by Gandhi, it goes “whatever you do will be insignificant, but it is very important that you do it.” Short, simple, very contradicting, but for some reason I can very much validate with it. I believe I will spend the rest of my life trying to understand it fully, just like I try to understand myself, and every other person I meet in this life.

Growing up I had never been able to blend with a certain “group” of people. But I was never an outsider, just more of a person looking in on everyone else, observing others. I always tried to understand why things were the way they were when I was little, I still do. I tried so hard to understand everything and feel everything, at times it became extreme. I called this my gift. My teachers, parents and doctors called this bipolar disorder, or my “curse”. This made life in my eyes the most beautiful thing, or the most awful thing. Although, the awful things could never take away from those beautiful moments.

When I started high school I was beyond excited. Also, overwhelmed, anxious, restless and a little bit nauseous to be honest. At first, time started to go by pretty fast. I made new friends, got very involved in choir, and did school activities. But slowly all the stress started to build up. Time began to slow down, or almost stop. I began to feel the beauty of life drifting away from my mind. Whenever I would try to think I would hear my thoughts race. The combination of stress at home, school work, anxiety about being around people, and so many other things that were going on began to build up. Suddenly everything stopped. At that moment, there was no beauty left in my life. At that moment, I lost myself.

I found myself in Childrens Psychiatric Hospital. I felt like the hospital is where society decided to put its broken children. They also gave us different labels to describe why we were all broke such as anorexia, OCD, depression, bipolar-disorder, a slur of personality disorders and many other labels. At first I was concerned about fitting in, as I always am, but then I came to realize that no one person was a like. We didn’t get to see our families much, some weren’t even allowed to because their parents were abusive, so we became eachothers family. I have never felt such profound love for a group of human beings I had just met in my entire life. We we’re like the lost boys from Peter Pan, but only in real life.

Towards the end of my stay I began to notice that almost all of my hospital family members excelled exceptionally well in some of the activities. We got to do art, yoga, P.E., and my favorite, music class. On one of the last days of my stay at Children’s we attended music class, this day we all got to pick an instrument and play it for the class. I chose the piano because I knew how to play a few songs. We went around the circle and when it finally came to me, my nurse suggested I sing also, since she knew I was in choir. I got very nervous when she said this because it was the first time I had ever sang alone in front of a group of people, but for some reason I felt safe. I sang and played on the piano Creep by Radiohead. After I finished singing I saw tear roll down the side of my nurses cheek, it was the first time in my life that I felt like I did something very well, enough to impact someone else's life. All my friends stood and clapped. Life began to have beauty again.

Since my stay at the hospital I have still dealt with downsides to my disease, but it can only make me stronger and wiser. The one thing that my experience did make me realize was that I do have a gift. I have the gift of understanding people, being able to relate to them, and wanting to help them. I am determined to spend the rest of my life helping and counselling these “broken” children to believe that they are gifted, not flawed. Every human deserves to believe they have a profound purpose on this planet, and nothing less.

To me the quote “whatever you do will be insignificant, but it is very important that you do it” was defined by my experience in life. That one small act of kindness, although insignificant at the time, can cause a chain reaction. That is very crucial to humanity as a whole in my opinion. So that must mean that one life spent helping people find a purpose can cause another lifetime of happiness, and if that is true then I want to devote my entire existence to studying psychology and helping people like me, so those people can help other people. The possibilities of my life and a career in psychology are endless. All I must do is apply myself. I believe Gandhi would agree with me.