Every Single Psych Consult…
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- Опубликовано: 24 май 2024
- A mind is a terrible thing to waste
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I had the opposite, a now diagnosed heart condition that kept getting dismissed as anxiety even though emotionally I felt pretty chill and unbothered.
Yep.
What condition if you don’t mind me asking?
@@jasonbourne2264 a type of tachycardia. I won't give the specific one but functionally they all act pretty similar in the heart forgetting to send blood to the brain and extremities sometimes and depending on the patient that can lead to things like sometimes the heart decides to do a fake heart attack(s) and freak you out, sometimes you lose the ability to walk, migraines, etc. All the different tachycardia versions are just named after the first cause found that makes symptoms flare up. Anyway I started fainting a lot and lost the ability to walk and got bouts of temporary blindness as a kid and doctors just dismissed that I was anxious and didn't actually do any tests to see if my body physically was fine.
Let me guess, Female? Or effeminate male? Unfortunately hysteria has had a long lasting impact on medical bias.
I have a lot of heart conditions and getting symptoms excused as "anxiety" is always the most frustrating thing :(
How did you get my last psychiatrist to be in your video?! Did he also charge you $300 and give you a seroquel script?
If this was MY psychiatrist, when the patient gets better, HE will take ALL of the credit, even though he did NOTHING.
Fuck seroquel, absolutely overused
✨healthcare✨ *cries quietly*
Ah, quetiapine. The ibuprofen of psychiatry.
SEROQUEL my beloved 😆
I thought it was gonna be, "Yeah, his EtOH use disorder began as self-medicating for depression, so he needs outpatient follow-up on discharge. Nothing to do inpatient."
They are actually kinda right about that though.
Nope
I worked in opioid addiction/drug detox for a couple years. Most of the patients had underlying trauma and mental illnesses...and most of THOSE patients grew up with parents who "didn't believe in that crap" -.-
@@sarahsatyr7133 I worked on GI and 75% were etoh cirrhosis/withdrawal/encephalopathy. What the families discussed always made sense. I never question how people cope but its sad :/
Nothing to do except establish rapport and start and SSRI you mean….
Literally had to fight for 2 years to get my brother in to a psychiatrist. We would take him to the ER and they would say it was drugs(he was always negative for any substances), then the argument was he was just sleepy, then a therapist said it might be him rebelling. Finally got him referred to a psychiatrist and he was diagnosed with schizophrenia and a scan showed calcification in two areas of his brain. I feel so sorry for those who don't have family or advocates to continue pushing the issue.
This totally matches our family's story trying to get help for my sister.
No offense, but it's almost like the ER isn't the appropriate place to get a diagnosis for a chronic life long condition that should be evaluated at the primary physician and refered to a specialty appointment during "normal"/ baseline health. If someone comes to an ER with psychosis he should be screened for reasonable infections, drugs, metabolic changes, etc. given enough symptomatic treatment to not be a danger to himself or others (or otherwise be admited to psych ward) and TOLD TO GO TO HIS PRIMARY CARE PHYSICIAN for further evaluation and eventual referral.
@@myturtlekillsharks like 5 years later
@@myturtlekillsharks He has routine appointments because he also suffers from seizures and his doctor would only send us to therapist. Never someone with a MD. This went on for months. He was almost non verbal and consistent in a state of speaking, yelling, cursing, mouthing etc. To himself or aloud. We finally had a nurse recommend taking him to the ER everytime this happens until they let him speak to a psychiatrist. They would never put him on a psych hold because they'd ask if he wanted to harm himself and he'd say no (this was one of the times they recommended sleep). But they'd ignore or try to explain away his hallucinations and tics. While I agree the ER is not the best place and your primary physician should be the first choice but what options do you have when they are ignoring it and you are watching your family member descend into chaos and you don't know how to pull them out of it? They should have helped but they didn't. So this was a way to get consistent eyes on it besides his doctors and the therapists who kept writing it off.
This whole country put mental health on the far back burner.. I get better attention for my car than myself.
No lie, my dad's doctor dumped every single one of his symptoms into the "he was an alcoholic" bucket and outright refused to even refer him to specialists. She even went out of her way to call up a dementia program he qualified for and get him thrown out. He hadn't drank at that point in months.
Turns out he had fluid on the brain (encephelopathy?), which was causing a lot of his symptoms, and needed a shunt.
Unfortunately that is because they always are taught to assume the patient is lying about their alcohol intake.
Well
Encefalopathy may be caused from liver failure... Caused by alcoholism
@@Lucasp110 That is if you consider "encephalopathy" to be the cue word. It isn't. The original commentator wrote ' "encephalopathy?" ', indicating he isn't sure whether that term is correct. What he did describe quite fittingly is "excessive fluid in his brain". Next he described a dementia program. Sounds a lot like normal pressure hydrocephalus to me. @Kyle Rae I'm willing to bet your dad also became urine incontinent and had problems walking?
I am so sorry you had to go through all that. Hopefully your dad is doing better now.
Probably low pressure hydrocephalus. UGH!!! New symptoms means new work up!
I love when any and every symptom I've had that falls under ASD/ADHD is simply....anxiety.
Man I feel you! Even though years of untreated ASD/ADHD causes anxiety. I am so fed up with the "experts" not knowing their shit.
@@kc6828 right? AND getting mad when you have the audacity to ask questions or advocate for yourself…
@@Triss_Joy Yep. But if you don't advocate you don't get anywhere. It's exhausting.
It’s why a lot of neurodivergent people are accepting of people looking through a list of symptoms and then saying “hey, I think I have this too.” In fact, it’s how I was diagnosed with ADHD.
@@darkstarr984 Absolutely! There are so many helpful and supportive online communities. But getting an official diagnosis is absolutely exhausting. Just getting to a provider that knows what they're doing can take forever.
Yeeeaah they tell this to the patients, too. I got told in an acute psych care unit that my symptoms were because I was overweight (not joking). I used to be nearly 300 lbs, but when I got down to 190, I'm still mentally ill!!! 🤯
UGH sounds like psych care units. i once got punished for screaming in a ward specifically for violent and unruly patients bc “they weren’t going to acknowledge this kind of behavior”. the behavior being… me being mentally ill…
hope you have a decent psych or therapist outside of hospital these days who knows what they’re talking abt… what a ridiculous thing to say to someone
Wow! Absolutely shocking! 🤦🏼♀️
But, the mental illness was living in the fat cells!
This is vexing. Maybe people actually can have mental illness for realzies?
This is awful. And for me, my mental health causes my weight problems. Treating my depression was all that helped me lose anything.
Gotta love folks who prescribe medication that causes weight gain then blame you for being fat
My doctor kept insisting I was pregnant from the age of 10 and my coming to the doctor with abdominal pain was “a cry for attention.” In reality I had an ovarian tumor so large that it eventually made it difficult for me to breathe, because it was pushing against my diaphragm.
In USA?!?
Your doctor is a horrible person for dismissing you. Especially if he seriously thought you as a 10 year old were pregnant
@@emmacrumley8870For real. If you think a 10yo is pregnant, how are you not following up as if they're a potential assault victim? Wtf.
😳 what?!
NO CHILD GETS PREGNANT FOR ATTENTION OMFG@@panpolypuff
My husband is an alcoholic, and I can relate to this… Nobody wants to help me, to help him, treat the real reason he self-medicates with alcohol. And I’m an RN and have known him for 12 years. I KNOW there’s an underlying issue! 😢
Low dose stimulants to break the cycle. Withdrawl stabilization. Nicotine gum. Wellbutrin. Adhd meds. Or at least switching to a less harmful self-med to break the cycle... potentially weed.
💕 it’s a fucked system. i hope you and the person who replied to this both eventually find that one golden goose psych or doctor that actually gives a damn about the entirety of the problem. wishing extra luck & strength for you both, and your husbands too
I don't know if you're Canadian or not but if you are the RAAM clinic is really amazing.
Exactly doctors have tunnel vision if you have a psych history. All they see is psych and want psychiatry to treat everything. Those of us working in psych push back because we don’t treat medical conditions. The way the medical community treats or refuses to treat psych medications she patients is horrible and discrimination
I have many health conditions that need to be addressed and all of them started before I started downing significant amounts of alcohol…they even knew I was having seizures triggered by iced drinks, margaritas specifically, about seven years back, and just told me to not just drink anything frozen anymore…I have been on disability for PTSD, panic disorder, bipolar I, and GAD since 2014 and I have experienced more negligence and malpractice than you could imagine in my life. I’ve just given up. I try my best the just never see any sort of doctor that isn’t for mental health even if I am waking up on the floor, unable to use my limbs, vomiting, losing eight hours at a time…it isn’t worth what they put me through.
Inevitable consequences of expecting psychiatric symptoms to exist independently of "the body."
Can we talk about this?? Because. I. Have. Feelings!
In some ways it's like western medicine believes/encourages/grew out of a profound disassociation of mind body *and* society. Which makes sense when thinking about the cultural/psychic violence required and affirmed by processes like colonization/the slave trade/massive growth of capitalism but so much of the recent scholarly work on these topics hasn't trickled into clinical settings yet!! And it's so FRUSTRATING to encounter, at the doctor's office, especially when dealing with chronic illnesses that are acknowledged as reciprocal (i.e. stress/mental health exacerbates symptoms) but the support/care to actually treat them in a holistic modality is limited.
Sorry, I just had an PCP appointment that I left wanting to cry because of the just terrible ways health care plays out in the US, for the like 12th time post COVID infection and I just...rant lol.
@@andemiller16 can we please be friends?
Seriously I've had such a hard time getting doctors to understand that my PTSD and epilepsy affect each other. They're literally both primarily issues with the brain but one is a "mental" issue and one is "physical" and it's known that seizures can cause psychological trauma and that stress can trigger seizures (some people even think trauma might cause epilepsy in certain people) and yet it took me 5 YEARS to convince my doctors that my epilepsy medications were negatively impacting my mental (and physical) health. And I can't get disability because neither condition alone is considered enough to not be able to work.
And you are so right about colonization mind sets leading to this separation. Taking people's circumstances into account requires seeing everyone as fully complex emotional and physical beings. It's much easier to abuse people (and other creatures) when mental issues are seen as less important or non existent.
Also, I'm sorry your doctor's appointment didn't go well. It took me years to find someone who even kind of listened and he just moved away so I feel you.
@@mrsslibby6857 heck yeah we can! I always appreciate a friend who teaches me new things and BABYYYY you did because when I read your post I was like "duh", but had I ever encountered it before? Of course not.
Add a similar experience with my little sister, who is type 1 diabetes and chronic mental health issues. We kept pinging between Endo and her psychiatrist about how her mental health meds were having an impact on her insulin regulation levels. They both acted like we were crazy. And this AFTER one of her mental health meds triggered her T1D (which tbh, I don't think I'll ever forgive myself or her psych for because now she has this new condition FOR LIFE that requires all this maintainence and it all started when we were trying to help her mental health). Mind-body care shouldn't be some privileged kind of care but it totally is.
I'm sorry your kinda competent doctor moved away! I'm also sorry that the disability system in the US, sidenote: that's where it sounds like you are if you're not my bad for assuming, is not set up to acknowledge the interplay between your conditions in such a way that is actually based on science.
@@andemiller16 I'm so sorry your sister is going through that. It's obsurd that doctors don't recognize the link considering it's well known that cortisol (the main stress hormone) makes insulin less effective.
Do you have some other sort of social media where I could message you directly? I don't think we can here but I could be mistaken.
@@andemiller16 Lots of psych meds absolutely have endocrine side effects and endocrine disorders definitely have psychological symptoms. This is something that all of textbooks are crystal ear on, but practitioners (on both sides) seem to forget this the instant they leave school.
For me it went both ways. My GP kept recommending psych consults and my therapist kept saying even though I had anxiety that wasn’t causing my physical symptoms. Turns out I was severely anemic, had stomach ulcers due to being on pain meds constantly for severe migraines and I had a dairy allergy which also happened to be triggering my migraines. It took trying 4 doctors and a neurologist before they finally stopped assuming it was psychiatric. Thank god for that neurologist! He COMPLETELY changed my life!
Wow that sounds so frustrating, glad you got it figured out!
Yeah it's either that they assume ALL your mental issues come down to physical ones or that the physical ones cause ALL the mental issues. Usually is a mix of both, that both need to be treated separately AND together, if that makes sense? Instead of treating one thing and assuming it'll fix everything else.
Neurologists are life
Did they take the mental illness off your file? They refuse to mine. Sigh.
The perceived disconnection of mind + body is so detrimental to treatment and prevention in both areas!! The body-brain link is rarely taken as literal as it is... Your brain is a physical body part. Psychological/emotional irregularities are defined by symptoms that are... inherently physical (nevermind that chemical imbalances ARE physical, to be fair).
I've had chronic physical health conditions for years. It's almost like the brain, having constant communication with the rest of the body, causes symptoms in other organs that very often become inherent issues of their own, from the constant strain... :P
Like how chronic pulmonary heart disease stems from damaged lungs, but is still a separate condition of it's own merit. Continuing to treat the lungs isn't going to improve that, just lets it worsen through inaction over time. Same sort of relationship.
My dad was picked up wandering without clothes during the middle of a 110-degree southwest summer. He had no idea who he was. Finally, the hospital figured out who he was. After I arrived, the hospital refused to treat my dad's obvious DTs. I was a detox nurse, and it was obvious to me what was happening, but they would not listen. They told me this was just his baseline now. He was totally paranoid, hallucinating, and could not walk. Finally, after they transferred him to long-term care and he assaulted staff due to hallucinations, they transferred him into a detox facility. It was ridiculous and scary. Not one of my detox patients ever got to the stage because we actually treated withdrawal before it got to that point. Still infuriating 8 years later.
Omg, they would rather let him die. Idiots. Thank God for you!!
A psychiatrist once diagnosed me with BPD after having a single 10 min conversation with me. He gave me a bunch of drugs and just bid me farewell without any explanation. Lost a lot of respect for the field back then.
Literally same
Ditto. I guess there was SOME validity because I did get re-diagnosed by a different psychologist, but I still have a problem with the first diagnosis. I was newly sober, pregnant, 19yo and only met the methadone clinic psychiatrist (who didn’t know my name) for half an hour. I simply cried that whole time. Not sure how you could professionally look at that situation and go “Yup. Clearly the serious diagnoses of BPD.”
R/Antipsychiatry has a bunch of stories like this. It’s crazy, I never learned about this until after I was a victim of the med field.
Same
That wasn’t a good psychiatrist then…
Every single ER visit: Lose some weight, you just have anxiety.
“Patient faking seizures even tho she’s diagnosed with epilepsy” is what I got 🙄 I almost died! They would just hold me down with every single one. All because I couldn’t stay in the CT scan long, cuz I kept going in and put with seizures. I managed 1 minute in there. I just have a rare form so it looks fake but it isn’t. I should be dead rn! I was literally seeing dead relatives by that point, I was almost gone! No idea how I survived. I’m just gonna thank my spiritual team and hope for the best I suppose.
Ha! It's stress/depression/anxiety/ptsd! Um, night sweats, constantly feeling cold, weight loss of more than 40 something pounds in a year without trying and all that, enlarged lymph nodes and pain when I even drink water? Yeah no. And the pain is spreading, and I have painless lump under my hip as well? Not stress, not anxiety.@@hekategoddess
Not just ER visits, I was told for almost a decade that losing weight and antidepressants would cure my genetic syndrome, autonomic neuropathy, and ascending aortic aneurysm.
Haha this is why addiction is a mental health issue. :) Because on top of not being able to afford treatment, if you're even able to find a decent provider, they might not give a flying flip.
I had a provider who just sat and nodded to everything I said. She didn't dig deeper, she didn't ask questions, she didn't bloody try to do her job.
She kept promising me the psychologist but never set me up to see them. I finally decided to leave her after a year and she didn't even finish our session or properly close out. She practically kicked me out of the office, saying I've improved so much.
I started working with my new therapist. Yeah, turns out I had several mental disorders including PTSD, and a lot of trauma to unpack.
So yeah. Mental health provisions suck major. I'm just thankful for my new therapist who is a gem.
I'm glad your new therapist is good for you, it really does take so long to find someone who actually listens, cares, is good at their job and actually TRIES to help. So many people who know what they're doing and don't care, or who care and don't know what they're doing. Such a shame tbh.
I think they all "just listen" and "get you to talk more".
The gem liked you. You got into "special".
Psychiatry is an incredibly important field and yet it is one of the worst when it comes to how it actually treats people. So many people get diagnosed with mental health conditions at the drop of a hat that ends up following them for the rest of their lives while their conditions they actually have are the result of physical symptoms get ignored and brushed off and treated like they’re just imaginary mental health disorders. I once heard Of a woman in her 40s who was constantly in and out of doctors offices complaining of chronic abdominal pain. She was brushed off total with period pain thought it was anxiety blah blah blah. Well she ended up dying and I found out the story from the guy who did the autopsy on her who posted it online. Turns out she had severe endometriosis and her entire abdominal cavity was covered in endometrial scarring and so she suffered in pain Bree much ever since she got her first period for no fucking reason because docs rushed off her actual physical symptoms as mental health issues.
Meanwhile people with actual mental health conditions get ignored and treated like it’s some other problem. And don’t even get me started on if you’re one of those people who uses drugs or alcohol to try to cope with your untreated mental health issue. Because stuff like this will happen where they say it’s due to the drugs and alcohol and has nothing to do with the fact that you have a mental health condition that you’ve been trying to get help for but you can’t and so your treat with drugs and alcohol which just makes everything worse. He’s a fucking ridiculous system that hurts people no matter which side of this you’re on
Happens the other way around too. Someone could have mental health issues but never get diagnosed because doctors believe the symptoms are all due to a physical condition.
I had edometriosis. It took a long time to get diagnosed and my pain was ignored for a long time. Unfortunately with any condition that involves women symptoms get passed off as normal "period pain."
@@lilyblossom9438 oh yes i know thats the point i was trying to convey as well. It suck either way. Physical symptoms get brushed off as mental and mental illness gets brushed off as physical. Anything rather then have to do real work I guess
I had to wait two years to get to a psychiatrist from the public care system. Described to her all my trauma, suicidal thoughts etc. She told me that I should first have a few months of psychological help before she gives me any medication (you first have to go to a psychiatrist either way). So I did. She ended up telling me that I have depressive episodes and prescribed medication that reduced my appetite to a 0 and made me feel (somehow) worse, so I wanted them changed... Unfortunately, I turned 18 two weeks later and had to go to an adult psych. Again, had to explain my whole life, suicidal thoughts and how bad the meds worked on me. What did she reply with? That she doesn't like to prescribe medication and that I should just keep taking them regardless. After that, she told my mum (I was fine with them discussing the whole thing, since I was barely a legal adult) that I was overexaggerating.
Yeah, my mum (bless her heart) just decided to FUCK IT and pay up for ACTUAL help.
@@thecolourfulpill so, so glad that your mom was able to do that for you and ignored the psychiatrist. It can be so hard to find decent mental health help.
I've seen this and sometimes it gets worse before it gets better. Unfortunately turned out he had stage for 4 lung cancer and things did not improve. His lungs failed before his liver did.
Can you imagine if this patient actually had cancer with Mets to his brain and all that happened was that the medical doctors got the psychiatrist to label his as psychotic.
Sad thing is…with a consult like this…so can totally see that happening.
@@sallycinnamon5370 and maybe, just maybe, the treating physicians, in this case GI, should order the relevant organic psychosis work up (which includes brain imaging) before calling psychiatry? Because, by your example, if the patient has brain tumours he doesn't need a psychiatrist now does he?
@@myturtlekillsharks That’s EXACTLY my point. The organic causes should always be ruled out by medical staff and then pursue psych. It should never be consulted to psych with the hope that a psychiatrist will be able to tell them if they are maybe dealing with something organic.
@@myturtlekillsharks brain tumors can cause psychosis and cause the need for a psychiatrist so no that's not how it works at all.
@@sallycinnamon5370 Yes but the situation is pretty unique in that the person isn't in acute crisis physically, but IS mentally. There's a big difference between alcohol induced withdrawals and hallucinations/delusionals. Someone with brain cancer also has a lot of physical symptoms of it especially if it's bad enough to cause psychiatric symptoms. This makes total sense in the context this short is given in.
This is 100% accurate. Every psych Note: "continue with current treatment"
We had one patient with diagnosed schizoaffective disorder, documented severe infection, petitioned, wouldn’t let anyone touch her, waited 2 days for the tele psych consult to get her something to calm her enough to receive treatment for her infection.
“Continue current treatment regimen.”
If she’d allow treatment, we would!!!
@@bonzahrn5148 haha classic psych.
Haha, meanwhile you have a medicine pt dying on the mental health ward and the only way to get them into medicine is if they code.
Yup. Once a psych patient ever a psych patient.
I can only speak for myself, but having quit alcohol probably 30 times over the last 6 or 7 years you're probably past the worst of it after 5 days.
The shakes and sweat make it hard to quit if you're functional and working because you look like and act like a diseased zombie for the first 3 days. That's why we drink at work. Not because we want to, but because withdrawal is a disturbing thing to see. It freaks out your co-workers and it only takes a few hours before the symptoms start. You need a good 3 or 4 day weekend to detoxify.
The depression and anxiety can last for a couple weeks. Much less, though, if you're used to it. Gotta keep your mind occupied.
After two weeks you feel like a new person and can't believe how you've been destroying yourself all that time. After 30 days, you can't believe how easy it is to just stop drinking... and so you have a drink.
I can't imagine the benefit of a psych consultation right after someone has stopped drinking.
I did a 30 day rehab. Missed work, ouch on bills but could work extra afterwards. It all worked out for the best. Boss was much happier with my being sober. It's been 20 years. You're worth it even if it means you lose your job. If you can't do an inpatient program, go to AA get a sponsor. Stick with it please. Your writing shows your deep desire. You're not stuck. Good luck, it's hard work, you sound ready.
Just making sure the person is put in contact with programs that can help moving forward is about the most psych could really do so soon after someone stops drinking.
Congratulations on your commitment to keeping on quitting.
I wonder what would happen if the next time you reach 30 days you practiced thinking something other than “I can’t believe how easy it is to stop drinking”
Wishing you the best in finding alternatives that support you.
Over the course of 2 years I quit for 3 months and then 6 months. I tried again December 31st of 2023 so almost a full year sober now and honestly that’s the end of it. Won’t have a single drop ever, I actually have a physical reaction when looking at or smelling alcohol now. I literally can’t drink unless actually forced now.
Do you know how hard I have to push an MD to do an STD screen on geriatrics in lock down wards!!! Yeah, not every confused geriatric has dementia.... UTI .... recent med adjustment....... some geriactrics have super colorful pasts and syphilis loves to party on & on & on
Syphilis loves to party on and on and on
Just like the patients 😀
I'll see myself out.
For male patients, accurate. For female patients, there tends to be over-diagnosis, over-medication, and then attributing almost all medical complaints to psychiatric illness, whether it's real or not.
Actually women usually are under and mis diagnosed because all the textbook symptoms in medicine are based off symptoms of men. Women display symptoms differently (similar to womens heart attack symptoms vs mens) so it’s usually underdiagnosed because it doesn’t match textbooks
@@laurens3857 good point, for things that are historically 'male'-associated. Heart attack is a very good example. Also ADHD & autism.
And if you're a high-functioning Borderline man, good luck getting a diagnosis or treatment.
BUT if you're a woman with a rare genetic disorder, complicated pain, a skin condition... Hello SSRIs! It's labeled depression, anxiety, bipolar, BPD, or psychosis.
Yep. And the majority have no clue past the absolutely inadequate DSM model. As soon as they can write it off as anxiety/depression they refuse to consider anything else.
@@kc6828 It's not the DSM model, it's sexist doctors who overdiagnose them. The model is fine
@@VictoriatheWolfGirl I totally agree that women are more likely to be sent down the "mental health" rabbit hole. My issue with the DSM is that many providers spend an hour with you (if you're lucky), then say "well you check all the boxes for XYZ", then refuse to consider anything else.
5 days is within the realm of possibility for DTs… Does he have a history of DTs and what is his CIWA score? I’d def treat any EtOH withdrawal with lorazepam first, however a bit of haldol could be helpful if the benzo does not help. I thought for sure you were going to say they thought he had delirium from his acute medical issues. Psychiatrist here BTW 😂
I was thinking the same thing
I agree. Treating the acute medical illnesses, his alcoholic cirrhosis and alcohol withdrawal…when all that is stabilized then consult psych if there are concerning persistent psychotic symptoms. I don’t totally understand why this is being posed as if the psychiatrist is being unreasonable.
Nothing could be more detrimental to a patients long term prognosis than slapping him with an unjustified psychotic disorder based of an assessment while delirious from potentially 2 organic causes. It could lead to dismissiveness of future somatic or psychiatric concerns. Not to mention overmedication and stigma if he doesn’t follow through with the psych meds.
When I did my MSN one of the areas I studied in my research courses was medical providers biased toward psychiatric patients, and their attitudes affecting the patient’s medical care. I think this video illustrates what the research concluded.
@@Elizabeth-kk8hz And what exactly is it demonstrating?
Because to me it demonstrates the desire for medical doctors to dismiss somatic complaints as psychiatric in nature instead of dealing with the somatic source.
Can’t tell you the number of stories of people later diagnosed with legitimate somatic complaints that it turned out were dismissed as psychiatric for month or years. Young people with what is later discover to be SVT told that their “episodes” are panic attacks. Or psych patient having somatic complaints not investigated at all as every vague somatic complaint is dismissed as being related to their primary psych diagnosis.
Basically what the research summarized is that the negative biased toward psychiatric patients among medical providers lead to decreased responses by the medical providers to provide treatment and ultimately lead to worse healthcare outcomes for the patients
Treat the underlying medical condition
-Psych 101
If you dont learn anything else of psych on med school learn at least that. How many waisted calls i would not have. Half were for delirium
Yeah that'd sure be nice if they did that instead of "oh it's definitely depression/anxiety/in your head."
Yeah, it was in my head! As in, _physically_ in my head!
Why is this soooooooo accurate!
Psych would've/should've mentioned trauma assessment - most or even all addictions trace back to traumas in childhood.
Stabilize pt, suggest DBT group IOP if he has a stable supportive living situation. Follow with trauma therapy such as EMDR.
This comment 👏🏻👏🏻
Lies, most psychs don't care about trauma or real causes like that. Most are victim blaming cbt snake oil peddlers
Small note: DBT can be harmful if the patient is neurodivergent. CBT may be a better option unless/until you know if they're neurodivergent.
I had considered DBT until I read about outcomes in ND people like myself. Not good.
Emdr? I thought that was considered quack science
Sounds about right. The last therapist I saw I told her the first session that I wanted to learn some coping methods for the extreme anxiety my (abusive) college professors were causing. All she did was try and pull other areas of my life into it, make me cry and then not do any kind of restoration before I left, and push meds I'd already told her I wanted to keep as a last resort. We didn't talk about any coping techniques until my last session. Seemed like she just wanted to throw pills at me and write me off.
My daughter has had some mental issues and is in therapy. She also seen a psychiatrist but hasn't gone for awhile she's on 3rd one. Every time she got comfortable with 1 they would retire. Finally she told me she just wants to go to just therapy for now. I let her do that as Long as she's doing ok and it gives her some control over her treatment. She's 16 and pretty mature for her age
@@chrisbolhuis297 I can imagine that this feeling of having some control over your life is extremely important for teenagers and will contribute to healing. You seem to be a good parent, at least in that regard. :)
@@johannageisel5390 thank you. I try. My husband and I went thru what is called dbt therapy in a group with our daughter too. That was helpful for all 3 of us.
Med: "Hey, this pt is acting different. Is this a psych issue?"
Psych: "Have all medical etiologies been ruled out?"
Med: "Uhm... Sort of?" *Pt has known neurological issues, 5 lab abnormalities and on 30 medications*
Psych: *Spends an hour trying to assess a patient who is throwing up every 20 seconds and hasn't slept in 3 days* [...]
"They may have a psych issue...? Treat underlying medical illness, and we'll follow up."
Med: *Pikachu shocked face*
I’m not surprised, based on the number of people who are sent to psych when a doctor gives up on trying to find out what’s really wrong or just can’t figure it out. That’s obviously not what happened here, but the psych consult has probably seen enough of this to want to be certain and might go overboard in the other direction.
That's... surprisingly true? Back when I didn't have it controlled, I got transient aphasia as migraine auras. One day it didn't go away like it usually did. It was worse, longer, and I felt really wierd, and I was worried. Dropped to the ER.
Neuro referred me to psych... who wrote a very lenghty summary of "my colleague is dumb, but I can't say he's dumb, so I'll just very strongly suggest he's dumb, and for Christ's sake this is not a psych issue."
@@Olivia-W Oh my God. I love that doctor!! I only hope the neuro was able to see it!!
As a psyche nurse, we get the most random shit for psyche consults. We had a patient referred from the ER for sporadic Catalonia and sporadic instances of appearing to be lost in space with no understanding of what people were saying to her. We checked her in, and while doing the intake checkin, noticed a rash, and asked the ER why they didn’t think to rule out Steven Johnson’s syndrome, especially since her history showed she had recently been started on Lamictal. Also had ER nurses refuse to keep a patient who was having drug-induced psychosis because, and I quote verbatim, “we have patients who are actually sick.” There is a huge lack of understanding of mental health in the ER, often with then just trying to send anyone to us who they don’t want to treat. Then, as a result, it’s the mental health department that gets ridiculed by society, and people keep praising the ER.
Both problems can exist. But it's not bullshit. In the US people with real mental health conditions are not being treated and are being shoved onto the street. Basically the last counselor said my brother could be homeless if he wanted despite the fact he has active delusions and hallucinations and often comes to us because he wants help. He just does not know how to get it for himself. But apparently he's sane mind and completely responsible.
And yes I've had ER doctors who literally just won't accept any other diagnosis except for a mental health one because they don't know what to do with my symptoms. Both of these are problems and both need to be solved.
💯
Delirium! Nobody thinks about DELIRIUM!
You're singing the song of my people!
but his last drink was 5 days ago. can delirium tremens last that long?
@@PutinsMommyNeverHuggedHim withdrawal may not start until several days after the last drink. One addiction provider I've worked with was super conservative and monitored for up to 14 days after. It's less likely to result in delirium tremens but people can still experience hallucinations and other delirium-lite symptoms as part of the normal withdrawal process. The patient could also be suffering from basic delirium too, which is much more difficult to treat since it's more of a guideline of what not to do.
@@faeriegal713 i didn’t know that! thank you
Delirium is different from delirium tremens
I have a weird condition that is only being studied today (like they're doing trials) because for the past few centuries,* any time anyone who had this condition went to a doctor, they'd refer them to psych, who'd say, "That's schizophrenia. No? Ok it's a permanent drug trip then. You did it to yourself! Byeeeeee..."
It's actually a disorder of the sensory organs. My identical twin and I both have it, it's from my mom, who also does. But hers is MILD compared to what we have going on.
My vision is a mess, it's hard to even describe. Like,
- I get after images if I look at anything for more than a couple seconds
- Little squiggling lights swirl around
- Shadows grow and shrink, it looks like static and geometric patterns in the air and on surfaces like walls
- Little dots zoom by my peripherals
- I see almost like auras around people and stuff, like a bird flying in the sky has a little orb around it
- When I close my eyes, I see geometric patterns and fractals, behind my eyelids
- Lights have orbs around them and rays shoot off them
- I see a wider variety of colours
- I can see rainbows long before they become visible to others and rainbows repeat, something most people don't see, I guess, I do. Often they will just repeat the last two or three colours, the ultra violet side.
- My vision is outstanding, I can find anything, I can see in the dark way better than other people
- My eyes move around so much that I have lightning fast reflexes to others, but things actually move slower for me compared to other people, like something that seems easy and slow to me impresses other people
- I have way more extensive observations, again with the eye movement, so I'll frequently say things to people like, "That rug in there was hideous" or "That painting above the fireplace was beautiful" and people are like... Uh I did not see that. They're not looking around and flicking their eyes around rapid fire to avoid getting bad after images
It's weird. Right now the closest is visual snow syndrome, but I don't match all the criteria, my vision is a lot like a Van Gogh painting. I actually think he had the same condition. Probably part of the reason he was put in an asylum.
It does sound a little nuts. But I'm not disoriented and I don't suffer, it's normal to me, people who get it as adults seem to really have a bad time. I like it. Aside from the headaches and stuff, it's rather pretty, I enjoy it for the most part.
At least doctors listen to me lol. Even twenty years ago they'd be telling me I'm crazy or a drug abuser.
It's different from the fourth vision cone (present in some women and genetic), right?
@@tymondabrowski12 To my understanding, my brain has overstimulated sensory organs, so my senses are constantly fabricating more stimuli to justify the overactivity. It is an effort on the part of the brain to make sense of the situation. Like how your brain just erases your nose from your vision or how you can't detect the human blind spot in daily life. It's making executive decisions above my pay grade lol.
My sensory organs also don't communicate correctly, they add stuff during the transfer too, so my brain will maybe create a tone or sound, give colours meanings, add swirls of light, because it figures there must be more going on if my sensory organs are being so intensely stimulated.
My most significant symptom is visual noise. My identical twin's most significant symptom is synesthesia. But it's an across the board thing.
For instance, I stayed at this cottage this spring, and I was being driven absolutely mad by this high pitched drone. It was giving me extreme anxiety, I didn't eat for several days, it was intense. It was an ultrasonic spider device. The owners had it going for a decade and never heard it or felt anything from it.
My hearing, like my vision, and other senses, are insanely sensitive to stimuli, so I not only perceive them more intensely, my brain cranks up the intensity and I can feel physical symptoms. Like headaches. I get a lot of headaches.
I'm not exactly sure what the physical expressions are, like I can tell you it's genetic but I can't say what that difference in the body is, but yeah I'd think seeing way more colour and seeing it more clearly would indicate there's extra cone cells.
It's obviously caused by some genetic abnormalities concerning sensory organs within the brain. I also have ADHD, so it's like parts of my brain are overstimulated and the rest are understimulated, if that makes sense.
Hi there! I'm a 4th year medical student that just came across your post the other day and I was so interested in it that I took a screenshot. Amazing thing is that today in the office I met a patient with similar symptoms and as I shared your post with him he was nodding his head. I think he might be experiencing sensory overload and processing disorders from decades of untreated PTSD. I know you said that you were participating in a study, do you have any updates that you would be willing to share on your case or your symptoms/diagnosis? I'd love to find more information to help this patient because it has left him nearly disabled with the headaches, neuropathic pain, poor sleep, and loss of concentration. Thank you for sharing your story on here; I hope that you & your family are getting closer to finding answers and solutions to any of your unpleasant symptoms.
I think I have visual snow, I relate a lot to the first set of symptoms you mentioned there.
I was waiting for "it's just stress🙃"
That’s what I fear hearing tomorrow at the docs. I’ve been in so much pain for a year. Shitting blood, eating tums like it’s candy even if I just drink water cuz it hurts so bad. Ain’t as bad if I just let myself puke but I have minor teeth erosion now because of that so I resorted to tums, like 10 times a day.
If it’s just stress, I’m fucked. I keep fainting too for the last year. We thought it was my acid reflux getting worse but the extra meds did NOTHING. I’m currently laying down rn cuz I’m so nauseous I can’t move much. I hope it’s not just stress so it’s something that can be fixed. Cuz I can’t fix my stress rn, I’m out of options.
This is the last drink I’m having for a looooong time. Although this started before I was of age to drink, so it’s not the alcohol that started it, but it can make it worse. I stopped drinking coffee awhile ago cuz it just hurts so bad I wanna cry but alcohol hurts less? Fricken weird.
It better not be just stress. It better be something I can fix.
I've fought for 10 years to be heard, I ended up using alcohol to cope, I finally in the last month am getting help. Words cannot express how validated I feel, even if I am really overwhelmed by appointments.
Would be great to see this from psychiatry’s point of view. As a psych resident we often don’t get taken seriously but then the Tox fellow comes along with the same recs and all of a sudden things get done
I am not in the field and dont understand your comment. He's a fellow so post doc? Tox ie poison specialist? What if it isnt poison? See, how I have missed the point?
@@dreamervanroomA medical toxicologist would have training in addiction medicine and drug overdoses. I think a medical fellow has more training than a medical resident (a residency comes before a fellowship). Residents have graduated med school but are still not fully trained in a way because they need more real life experience in their field. Whereas fellows are fully fledged doctors doing more specialized training. I think a residency is not optional to practice medicine, but a fellowship is optional (it is for people who want to become more advanced). Also, not every psychiatry resident sub-specializes in addiction medicine, and I think you usually can't sub-specialize in addiction medicine until fellowship (at least that is the order of things according to the American Board of Medical Specialties). So it makes sense to me to get a second opinion from the medical toxicology fellow after asking a psychiatry resident. But I am sure it is frustrating to the psychiatry resident when the toxicology fellow just says what they already said. 😅
Check thiamine levels lol
The Psych doc's hair and glasses! 😹 Also, the use of "we" in "we think it's a withdrawal issue". Is he using "the royal "we"? 😂🤪
🤣
I was just watching a video about psychiatry, great timing 🤣
Ofc the psychiatrist you're playing here is neglectful and stonewalling, but I kinda get why he's not that keen on dealing with a vague matter like this - medicine might come off to him like they're trying to turf an unpleasant patient to the psych ward. They could probably help improve the quality of that conversation by being more specific in HOW the behaviour is strange and WHY you feel there is a need for a consult instead of outpatient follow-up immediately when you start the call. I know that's usually how we handle talking to surgery, but it does help with other disciplines as well.
You get emotional when people don’t listen to you and treat you poorly this is definitely a sign of mental illness
It really does feel like this. I literally had to bring my fiancee to an ER for a anxiety/ severe depression breakdown, and all they wanted to do was physical evaluations like noting she was overweight. Like thanks, that note is really going to help the depression. This couldn't possibly have anything to do with the doctor AT THIS SAME HOSPITAL giving her a medication that didn't work well with her and then going on maternity leave immediately after without scheduling a follow up assessment with any other practitioner. Nah, the issue has got to be weight or something.
With a lotta Docs, the issue is always weight. I have chronic neck pain after a car accident. Tried for years to get an accurate diagnosis. One Doc told me he'd only order a CT scan if I lost 50 pounds first. Then he offered to sell me his own meal replacement shakes. I never went back.
Psych quick? IN WHAT WORLD!!!!
I went to the ER for withdrawl recently, one lady took me seriously, the rest brushed me off. I am so grateful to that nurse.
can this video be shown to all the people who don’t believe in self-diagnosis? Also specifically the neurologist I went to who was actually really nice and accommodating, realized I was having trouble with the lights in his room and dimmed them without me even asking because he knew I wouldn’t, especially on my first visit with him… and then proceeded to “get on a soapbox” (his words, not mine, I wouldn’t even call it that as a soapbox implies you have something at least mildly important to say) in my second visit with him about how he “didn’t take much stock” in my autism diagnosis because I’m “a girl” (in quotes because I’m nb, something I was not going to tell him after that point), and also about how “adhd is so over diagnosed these days, especially in young girls” like…. First of all I wasn’t that young….
And then I realized in the first visit, he thought I was having a photo-sensitive migraine, not that the stress of meeting a new doctor was making the lights just that bit more overstimulating. I rarely have photo-sensitive migraines and was not having one then, but he probably made a false assumption about me if he didn’t really believe I was autistic (which I don’t think he did seeing as he tried to order a re-evaluation, “just to see”)….
My brother is still seeing that neurologist (can I get a “pretty much every medical condition I have is familial”???) and hasn’t had quite as many problems with him. But even still, stories like this make me think about how I’m actually in the more lucky group, here. Growing up my family had enough money to shuffle me around to different doctors constantly because half of them just wouldn’t treat me and the other half had no idea what was going on even if they did try… and even if it affected me, having to go to doctor’s appointments so much, so many different specialties, a lot of them like an hour away (because they were all in the big city hospitals near the big airport, which makes sense) taking time away from school, friends… it would have been worse if they’d just believed the first doctor’s opinion because they didn’t have the money to think about going to a second one. :/
What does your story have to do with self diagnosis? Not to mention that of course no doctor will blindly just accept a self diagnosis, things need to be confirmed or exclude other possibilities. There's such a thing as talking to your doctor about a SUSPECTED diagnosis, which is incredibly valid. But no, nobody should "believe in self diagnosis". I also have no clue to what degree your comment has anything to do with the video/subject at hand, which is about psych consults. Self diagnosis can delay the proper treatment if incorrect, causing permanent damage or even a terminal diagnosis out of what would have been survivable if caught early. I have a very personal story about this and stories are easy to find of people assuming something is one thing and it being cancer.
@@livyann2143 They're not talking about self diagnosing and just going with that despite a reasonable alternative diagnosis. They are talking about getting another opinion and not taking the word of a doctor that doesn't listen or obviously doesn't know what they are talking about. (Saying girls dont have autism and ADHD is overdianosed in girls just showed that that Dr was completely uneducated on the topic.) Sometimes that means fighting to find someone that does. And unfortunately not everyone has the resources to do that, or to even get a 1st opinion. So sometimes the only option is to try and figure it out on their own.
@@livyann2143 my story, like this video, has to do with self-diagnosis in that it’s talking about how doctors aren’t infallible. And they’re not smarter than anyone else. They’ve just studied, and are continuing to study, hopefully, in a specific field that is helpful to us, especially combined with their networking resources and medical equipment! They’re usually very diligent people who have a wide base of knowledge in how to diagnose you… but they’re also not the only ones who can have that. I’m sorry if you have ever come to a false conclusion about your health or have been lead down the wrong path by someone else, but that didn’t happen because you’re not a doctor. Many of us with chronic pain HAVE to self-diagnose, due to doctors like the one I mentioned not understanding us or taking us seriously, and ESPECIALLY in the psychiatric world there are people who think “young girls” just have anxiety and “girl hormones” and therefore don’t need treatment. I was saying I was one of the lucky ones because in the end, I did get an autism diagnosis! But many can’t get that and it’s ableist, classist, and just plain rude to insinuate someone must go to the doctor to say they identify with a certain label that helps them.
Also, about stories of people thinking they have a smaller problem but really it’s cancer… that’s actually more proof of my point. I want more people to go to the doctor, I want more people to seek treatment for their problems, I want more people to be ABLE to, whether or not they have been “diagnosed” by a doctor yet. If my mom listened to the first or even third doctor she went to, she would not have been diagnosed with cancer. But because she knew something was WRONG, she kept seeking someone who would run the correct tests, and treat her. Just like she did when she hurt her knee in college and was told she would never run again. She shouldn’t have to be an “inspiring story”, she should be the norm. If you’re given bad, or no, professional medical advice, you should continue to seek treatment, and be ABLE to continue to seek treatment, and a diagnosis, whether given by a doctor’s or your own research and evaluation, should be something you identify yourself. I mean, think about it, no one tells you you need to get a medical diagnosis to say you’re trans anymore, hopefully, and the reason is because as society has become more accepting and understanding of trans people, we’re not treated the same anymore! … In a lot of cases! But my point is the idea that someone else had to “confirm” that we are trans for us to simply use the label within the community was based in a lack of understanding and an over abundance of fear. Like, “well what if someone’s not actually trans and they’re lead to believe they are, resulting in them getting surgeries they don’t actually want???” but as time went on people have come to accept that that doesn’t usually happen, at leas more than any other type of permanently life-altering bad decision people make, and it does more harm than good to claim people inherently can’t know themselves and need someone else to tell them things about them. As if being trans is something inherently hard to understand and only people who have studied it IN A COLLEGE can really get it. Or, you know, people who studied something similar to being trans and it’s close enough that they’re the one called to examine if someone is trans or not.
It’s really, REALLY the same thing with physical and mental illnesses and neurodivergencies, especially when it comes to chronic or lifelong conditions. It’s actually saving more people than it’s killing. Also the medical industry is not as foolproof as you think about diagnosis obvious things, like for years I told doctors I was diagnosed with ADHD, believing it to be true, though as I’m gearing up for my every-two-years evaluation I found that diagnosis was somehow scrubbed from my record a while ago and never introduced. Kinda felt like I was in the twilight zone because at the same time I found out my old therapist (who by the way is a great woman, I don’t actually hate her, I just don’t agree with the way she tried to treat/gaslight me) had lied to me about being diagnosed with OCD. I’d just trusted her when she said I was diagnosed with OCD-like symptoms but not enough to actually qualify, when, in fact, I did actually have enough to actually qualify. she said my “main thing” was “minor generalized anxiety” and I just needed to “focus on that”. My personal hypothesis (not saying theory because I have not done enough research/testing, hehe) is that doctors just… can’t compute how many diagnoses I have so they try to pretend like I just have a few, like, Pick The Big Three (usually autism, dysautonomia, and whatever they specialize in), and get really overwhelmed when I try to explain how their treatment plan is probably going to fail because of like seven different factors they aren’t considering. But I also have some amazing doctors, like my physical therapist, who found connections and side effects of the drugs I was taking *I* didn’t even know about!!
Anyways, yeah, self-diagnosis is helpful and definitely a real diagnosis, even if in certain contexts it’s important to know the difference! You can’t change my mind with a personal anecdote because no matter how much I like to base my explanations in allegory, my knowledge is based in so much more experience than just my own!
Sorry this is so long, but you seemed to read it the first time!
100% sure my boyfriend is autistic. Symptoms fit. Our issues with communication are very specific and fit. My mistake was to tell this to my psychologist friend, whom I hadn't seen in person in a while. She got on the proverbial soap box too and proceeded to tell me how overdiagnosed autism was nowadays because it was lucrative for doctors to do so, and that it was impossible for him not to have been diagnosed as a child, etc. I had not been this disgusted in a while. If this is not autism, then tell me what it is because it sure looks like it to me. And you're not the one living with him. It's not because he's good at masking it that it's not autism. It's also part of the problem. I want him to get help because he's riddled with anxiety, and I'm sure it's related to the autism and the masking.
So true. Western medicine loves to treat the secondary problems and not the primary ones.
Yep, that's why they're so obsessed with Mental Health.
Or the opposite- people diagnosed with psychiatric disorders but have only had hallucinations and paranoia while under the influence of substances or withdrawals that can induce those things...
Taking the whole picture into account is so important!
As a person who’s been in three psych wards and was raised by an alcoholic… It’s alcohol withdrawal.
I mean yeah can't take mental health of any kind at all seriously. That would require effort and cooperation and actual progress in society.
And on the flip side, I feel like there are doctors who purposely slow down and slightly talk down to me because I have ADHD. Like, my guys, I took my meds this morning, I brought my brain, and I'm not a child. What do you want, me to change my medical history?
My pharm teacher started our first class with-you aren’t allowed to be crazy until you are healthy and crazy. Pretty good starting point, imo.
Can you elaborate? I don't understand.
glad to see the psych departments are just as helpful to the rest of the hospital as they are to the patients 🙄 72h holds always felt more like “i am taking up bed space these sick people could use and wasting these nurses’ time” than “i am receiving care for my mental illness and am safer in this environment than i would be alone”. i think i talked to maybe 1 actual psych lady when i was there. she was there for 5 minutes, did NOT seem busy, literally smiled nonstop at me while saying “you’re not allowed to leave because what you did was very serious” (i threw up the damn pills 1min after taking them i just went in to ER to make sure they were actually out of my system) and then she ditched and left a terrified kid with thoroughly unresolved mental issues just screaming for help with these poor exhausted nurses who did not know what tf to do with me. i think they actually could not get authorization to sedate me with a tranquilizer or benzo despite the fact i was screaming in terror for hours. thanks, hospital psych!
(sorry to the 1 competent psych out there, i know you exist in theory but your cruddier colleagues are my current experience and apparently the experience of many others lol)
I had a complicated case of suprarrenal insufficiency and when the meds didn't work out my endocrine decided I had a mental illness and refused to listen to the psychiatrist and psychologist. She got a psychiatrist friend to make the diagnosis and basically ruined my life. Any time I go to the ed they call psychiatry and blame everything in that. It's been 10 years with constant fainting, extreme fatigue, mind fog and finally I'm getting better thanks to a very experienced endocrine. Turns out I had an untreated thyroid issue too since I was super young. :)
Omg this felt too real! Basically,y fiance smokes MJ, he's smoked it since he was 18 and he's 28 now. He has adhd his whole life, has bpd and ptsd since childhood and anxiety since he was 11 BUT nhs psych absolutely will not treat him unless he stops the MJ because, according to them, the MJ is the reason for his adhd (diagnosed at 5) his anxiety (diagnosed at 11) his ptsd (diagnosed at 6) and his depression, bpd and insomnia (diagnosed at 15) and when we pointed out MJ doesn't cause bpd, ptsd, insomnia and adhd they STILL said it was cause of the MJ! We asked them to send it in writing and they did 🤦🏼♀️ they genuinely believe smoking MJ at 18 caused his adhd at 5 years old.......I've said it before and I'll say it again, free healthcare does not mean good healthcare
This depends a lot on where you are in the UK too. Old mental health rules are if you are on any substance they can't check for mental health because they don't know what's the substance and what's the brain. This is obviously a bullshit reason not to give someone mental healthcare, but some doctors still go by it. "quit the substance/methadone, then we'll talk to you" and then everything is blamed on the substance anyway and you'll have to wait for years in practice to make sure it's "out of your system" before they might help. This is slowly changing and I encourage you to try again and again as staff get retrained and retire, and you might get lucky, but it is so hard, especially with the lack of resources that mental health services have. Sometimes a drug service can help advocate - doesn't help asking a charity. They will totally understand about mental health, even if they can only sympathise. There are medical advocate charities too. It's so based on luck. I work in Grampian and we were one of the last to officially give up on this strategy in 2018, and I still see it practised.
Also, weed causes insomnia!?
But DON'T GIVE UP because everyone is learning. Slowly but surely we'll get there. (have you looked into the twenty 21 cannabis project for subsidised and legal cannabis prescriptions?)
Tbf…. Expensive healthcare doesn’t mean good healthcare either. I told my doctor that i had an edible every once in a great while and she refused to renew my adhd (diagnosed at seven) prescription (i’ve been on it for years) until i paid for a urine test and it came back negative. She claimed it was “the law” and when i asked her if it was state or federal so i could read up on it (knowing the answer already) she admitted it was just an internal policy but insisted it was for “my safety”. Bullshit i read that policy and its for people with no prior diagnosis who habitually consume marijuana multiple times a week, and its to make sure it isnt the weed causing the lack of focus. The entire process was exhausting, expensive, affected my work performance, and i’m still mad about it months later.
@@jaymesl7360 almost as if no matter where you are, the personal bias of individuals affects you! Alas...
It’s such a time tax and emotional tax - real costs - for people trying to navigate an unhelpful medical system. It can take so much valuable energy you don’t have to find a psychologist or psychotherapist that fits you. Psychiatrists I would avoid like the plague.
My tip. Look for a psychologist or psychotherapist that actually specialises in your area - the more niche the better. Your boyfriend has PTSD and anxiety. Start there. If a psychologist lists lots of different areas and is a generalist then avoid them. If there is a national association for childhood trauma in your country see if they have any recommendations or a list of shrinks they have vetted.
Any Dr that doesn’t understand that smoking as a form of self medication is a valid form of self preservation when faced with limited external support is a Dr not worthy of your time.
Wishing you both the best.
@@kayelle8005 I appreciate that but unfortunately in the uk we dont have the luxury america does. We have to go through our gp (primary care) and we just get assigned whoever they (the mental health team) deem suitable based on availability. Getting a private care mental health professional is more difficult and as we are both medically retired, we cant afford the added expenses of private :-/ it's like I've said before, free healthcare doesn't mean good healthcare. We literally just get a dr/therapist/dentist based on whoever is available to take on that patient and I say that as a chronically ill patient and a former nurse
Yeah and when it comes down to it the mental illness is a far greater problem than any of the other addictions or problems in this world in fact often it's the reason for them.
ok
Sigh..... Mental health wellness is extremely complicated and overlooked in many societies.
Here in America, specifically southern Louisiana, my mental health struggle was belittled and ignored growing up and even as an adult by most of my family.
"It's cause you're gay"
"It's the devil's temptations ruining your mind and soul"
"It's cause you smoked 🌿 that one time as a teenager"
"It's because you were raised by your grandma so you had no strong father figure"
"You're just being a wimp"
Well, once my husband helped me ACTUALLY seek therapy and medical attention for my mental health......turns out that years of being abused as a child mixed with neurodivergence being passed to me genetically, meant I had schizophrenia, PTSD, and clinical anxiety disorder.
Thankfully, I am managing VERY well now due to medicine and therapy, but ugh. This stuff is the damn pits.
Omg yes.
I just talked with my mom about how there's a history of alcoholism on her moms side of the family. But me and my sisters have healthy relationships with alcohol, so I highly doubt it's genetic addiction and would be money it's more likely their way of coping with PTSD/trauma and the strong family history of undiagnosed autism and adhd 🙃
Also somehow it's always the alcoholics and drug addicts who draw the short end...they often seem annoying when all they need is someone to just actually care. Seen this way too many times... and they always have the craziest stories! Nobody just wakes up one day thinking: Oh well this whole life thing just isn't working for me...I'm gonna be an addict instead! There's always a story.
There are people who are careful ruling out physical conditions for behavioral issues, and there are people who are just trying to knock off some consults off their list. You usually turn into the second kind with enough over work
The temptation to be the latter example is real, especially as your consult list grows to an obscene amount!
I was only ever given to psych so I fought for my physical health and it has since destroyed my mental health. But I am physically now able to go get help for my mental health. It's a a strange world we live in
Glad to hear everyone else has the same issues with Pyschs. I went through a ludicrous amount over the years before finding one that wasn't immediately just attacking every issue *but* my mental state.
I didn't get diagnosed with autism until I was an adult because my childhood doctors said my autism symptoms were down to me being overweight and anxious
You put honest things on here. I suffer from mental illness and alcoholism. And you are the only one I've seen actually address it in the realist way
This skit reminds me of my consultation-liaison service days in the hospital. In my training I was taught to rule out any possible underlying organic etiology before assuming a case was a psychiatric issue. Sometimes psychiatric providers start at the opposite end and when no psychotropic medications seem to be making a dent then they start backtracking and looking at organic causes which isn’t good medical practice IMO.
Hey, I just gotta say, it sucks that so many people have been thrown to the wayside by psychiatry, it is very nice and refreshing to see people speaking up about their experiences. I was forcefully sedated a while back not more than 6 minutes after a four point restraint was called, and yet I’m constantly told that “forced sedations only happen as a last resort or when you’re in danger of hurting yourself or others!” There was no way they could have exhausted every possibility in those 6 minutes. There was no way I could have hurt myself or anyone else.
The way the medical system handles mental health issues is damaging and we need to start talking about it. I’m so happy to see it happening here
I went through DTs with hallucinations, tremors, paranoid behavior, etc for almost two weeks when I quit drinking.
Yeah I was gonna say, withdrawal takes longer than 5 days. Dude is still dealing with it at that point.
This also works the other way around 😅
It happens more often the other way around. Psychs and other doctors ruling out physical conditions before slapping on mental illness labels? Total fantasy.
As a lab person, I literally said "But that's not-" at the same time, and I love it. the normal for an AST is
I mean 5 days out is still prime time for withdrawal. No way you're going to get a psychiatrist to see someone until you can demonstrate SEWS have been 0 for >24 hours without meds. Or initiated delirium precautions because let's face it, SEWS every 4 hours for days = excellent setup for delirium in patients who are already halfway there from withdrawal+cirrhosis. Then it's a brief interview, "yep, depression, anxiety, and delirium. Get them out of the hospital and schedule an outpatient intake in, oh, 6 months is the next opening we've got."
I think calling it “prime time” is a little too strong. It’s within the realm of possibility maybe
@@Doc_Schmidt you're right, prime time was an exaggeration. I should have said still within the time frame for acute withdrawal. I've had patients start to experience seizure-level withdrawals while still intoxicated or as late as 7 days later. Neither are as common as people who start to display symptoms after 24-96 hours. Both outliers are dismissed by nurses and providers because it's not within the standard timeframe. If they don't get treated they just hang out there for days and get labeled as a drug seeker, difficult, belligerent, or untreated psychotic patient. Give them a benzo for agitation (or surgery) and they're magically more engaged, vitals are better, and they're less difficult to work with. For 4-12 hours depending upon the benzo.
@@faeriegal713 Not to mention that I have had patient that aren’t even legally SOBER until it’s almost 24 hours after last ingestion.
psych consult here- refer to social work for dc to a co-occurring program after stabilizing acute psychosis.
yw.
there isn’t a quick fix, this is a long-term situation, but people want a quick fix. and when it doesn’t get the quick fix and the social services program/staff simply don’t exist, people just blame us and say we don’t care.
So you just gaslight us and blame us instead? 😅
As a psych consult, I advise you to be extremely careful when you diagnose a pt. You could be bead wrong, and ruin that life.
@@Doc_Schmidt Honestly…trying to push for a psychiatrist to diagnose a patient who has 2 or possible 3 organic causes seem incredibly ill advised and can lead to misdiagnosis that will haunt the patient for the rest of their lives. Overprescription, dismissiveness of somatic and psychiatric symptoms as being related to the misdiagnosis, the stigma of the label of the illness.
Alcohol withdrawal, hepatic encephalopathy, Wernicke’s encephalopathy are all diagnoses that should be excluded prior to consideration of primary psychiatric diagnosis. Not to mention investigation for an insidious neurological cause.
I’m not saying that an eventual psych consult isn’t a consideration…but seems a bit premature because he is experiencing active withdrawals. Stabilization of active organic issues prior to jumping to pursue a presumptive psychotic disorder is very reasonable.
Personally, if I were the nurse, I would advocate strongly for my patient not to be labelled with anything until the psychotic symptoms persisted passed resolution of the rest of the symptoms.
Seems to me this is more a case of the American system to get everything dealt with in a hurry when some things will take some time to sort out.
I mean the line “we just think it’s different” isn’t very descriptive is it? No, we have collateral from family that he experienced delusions like this during periods or abstinence in the past or anything…just a gut feeling?
@@Doc_Schmidt that doesn’t seem very fair given I was highlighting the absolute crisis happening in MH/SUD right now.
@@Doc_Schmidt Really??? That's what you heard? It wouldn't have occurred to me to blame a gastroenterologist for the lack mental heath and social work resources that make it so difficult to provide adequate care for these individuals, but maybe I just missed it because I agreed with the comment. I also have to say that my heart just sank when I saw your costume for the psychiatrist: you made him look like an idiot and a slob, which is not typical of you. I felt so defensive that I decided I needed to stay out of the comments until I saw this one - from you, of all people. There are definitely things that "Psych" needs to improve, but this . . . is disappointing.
It took moving from a neurologist to an epileptologist to fully understand the impact my PTSD was having on my epilepsy stability and switching me to a medication to help with both. He was the first to coordinate with my therapist.
When i was hospitalized for a heart palpitation, the hospital refused yo allow me to discharge until i saw a phych due to my past mental health.
Basically held me prisoner for 2 days longer then medically needed until i saw her. And she gave me a 20 min appointment, checked a box, and discharged me.
Now im 3 grand in debt and pissed.
American hospitals suck..
I tried a new therapist when I moved and the first one I went to was not a match.
“What are your current diagnoses, if any?”
“Anxiety and Depression. I routinely have panic attacks. I was diagnosed with these conditions over 12 years ago. Id also like to talk about attention issues.”
Half an hour later (only asking me to describe the depression- not panic attacks/anxiety or attention issues):
“So from what I’m seeing today you do not have anxiety or ADHD. Your symptoms all stem from your depression.”
And now Im hoping when I get the courage to go to the next one they aren’t as dismissive.
I'm so sorry. Its already so hard to reach out and then they won't even listen...I hope it works out for you and you are heard, you deserve to be heard.
Refer to dual-diagnosis clinic...hahaha good luck finding that!😄😡
It's so frustrating. I work in Optometry and it has heavily taught me that the one part of the body doesn't act independently of another. We work with pretty much every medical specialty (bc often times we see the first signs because warning signs often show up in the eyes first) and that's what taught me to address my medical issues as a unified thing. I have hormone imbalance issues so I see my PCP for that but I also have ADHD and anxiety. I was diagnosed with depression but that was mainly bc of the hormone imbalance. Regulate hormones, decreased depression. Anxiety and ADHD were the opposite. It was causing insomnia and a lot of body pains and headaches. Treated the ADHD and anxiety, decreased body pains and headaches. That's why in hospitals with regular patients, the patients are assigned a TEAM of med professionals.
When even mental health professionals don't take mental health seriously. As someone who developed chronic pain as a kid from being severely traumatized via emotional and psychological abuse and was just told that it's probably growing pains, not that they would've even checked for anything even though I was at the nurse complaining about it every week. After 16 years of abuse I finally made it to therapy and my chronic pain has left for the most part through working on my mental health.
There is always an underlying condition, never met an addict without trauma/PTSD and/or ADHD/ADD/autism mixed with depression & anxiety. ❤ I’m 10 days sober today. The people I’ve met in rehab were so broken, but always kind. It shouldn’t be like this. Please help them.
Sounds about right even in the UK 🙄
It took nearly 17 years under the care of the mental health services, in and out of different pointless therapies, under the care of a psychiatrist eventually but have tried basically every medication i could... Still only got half assed dignoses, some out of date and incorrect, other important ones missing due to lack of interest be the mental health services and also due to a complete lack of treatment for a specific disorder countrywide... But psychiatrist finally hit the "oh thank god!" medication combination and ive been so much better for a few years now! Issues not cured but dialled from 99 down to 1 in a swift introduction of venlafaxine for depression but it didnt work, it more or less took my severe anxiety (generalized and social) down to about 5 from 99... With anxiety stabilised and 6 months for me to convince myself it would be ok... Lithium 🤷🏻♀️ life saver! Last 3-4 years have been so stable and even though things arent great, its not unbearable like it was and always had been.
Then after a year on lithium my thyroid just gave up working (thanks lithium 😒 but whats one pill? I'll give you that one...).
Then another year and loads more health issues appear including hallucinations but not mental health related ones... There is a difference and i know both, even my psychiatrist saif theres no way is was psychological! Does any other medical professionals believe the psychiatrist!? Do they heck! 😒 I did get brain MRI and saw neurologists who refused to listen or address the symptoms i was having, they kept making up symptoms or twisting things to their messed up thought processes. No every to fight them or complain so discharged myself... Twice... Literally hundreds of symptoms, body is failing, unable to leave house, unable to even function...
Then 1 year ago almost out of nowhere i got a diagnosis of Stage 3 Chronic Kidney Disease (took them 1.5 years worth of bad tests to decide it was an issue... Once it was a major issue and too late to prevent 🤦🏻♀️). The rate at which my kidneys are failing amd refusing to stop mean that, failing some miracle, my kidneys will both be in failure in a year... Give or take. On a new blood pressure medication but two weeks and readings still bad. Dose increase soon i guess. If it doesnt work... There is literally one one blood pressure medication for me to try... Nobody... Not one person is anything other than dismissive of my theory that my high blood pressure isnt causing the kidney trouble (lithium is also high contender but its also my lifeline so not worth coming off either way), my BP is so resistant to everything that im honestly wondering if we havent got it the wrong way round... Something in my body is forcing my BP up... And BP isnt going down because we havent addressed the root cause 🤷🏻♀️
Have had so many tests that i feel like a pincushion but nothing significant apart from kidneys in years of testing. Then suddenly a 24h urine test came back really high... Noradrenaline? Something like that... Now im having redo the test to confirm because the result could be suggesting of an adrenal tumour 🤦🏻♀️
It is honestly never ending and having to fight and demand i get the right treatment has exhausted me. Now im so exhausted that im just like... Phhht 🤷🏻♀️ whatever. I no longer care.
Yeah well... Welcome to Merica
I am non medical. Love these videos, makes me smile. Thank you so very much Dr.Schmit.
Thank you for watching!
@@Doc_Schmidt You are so welcome. You are doing great as you have made a wonderful difference making educational and comedic videos. Thank you so very much. Much love and happiness for you family too.Kindest regards from here in England. I am about to visit doctors for blood pressure check!!!!
I work in Drug and Alcohol.... we are thankfully staffed with specialist Addiction Psychiatrists who provide hospital consult liaison services. Mental health swats away so many patients ☹️
We learned that we should always start with the assumption that any substance abuse is a coping mekanism and look for a psychiatric reason. There is also off course a cultural element, but we should always remember that body and mind are not seperate.
I mean the patient could probably use some therapy lol but other than that, make sure the withdrawal is taken care of and anything else. Prolonged alcohol consumption that caused cirrhosis of the liver and caused hallucinations takes a while to reduce and cease. Like. More than 5 days lol
This made me so angry. Phsyc is disheartening. I was misdiagnosed with BPD. Turns out opposy doodle, it was ADHD. So, got medicated for ADHD, and symptoms became manageable. I now have medical trauma because of it.
The thing is…the Dr Schmidt in this scenario is actually the one likely pushing for the incorrect diagnosis…this psychiatrist is the one doing the right thing in advocating that the immediate organic causes are treated before trying to dismiss his symptoms as a psychiatric diagnosis. Withdrawals can absolutely persist to 5 days and delirium is not an uncommon feature.
@@sallycinnamon5370 what’s the underlying cause though?? What if it was bipolar disorder?
@@littlebrownjug1683 Then it should be investigated after the organic causes are ruled out and have resolved. Particularly when they are time-limited like alcohol withdrawal. I know this might shock the American healthcare system…but you actually don’t need to kick a patient to curb the minute they are physically able if there is something psychiatric ongoing.
I’ll flip that back on you…what if this this man doesn’t actually have psychosis but instead had a temporary delirium but now is discharged on medications with significant side-effect he doesn’t need and a diagnosis of bipolar or psychosis NYD that he actually doesn’t have that causes future medical doctors to mistreat his future withdrawals as manic psychosis instead of clinical withdrawals.
What is potentially more harmful? Starting unnecessary psych meds on a patient that doesn’t need them while he is in delirium or deferring psychiatric diagnosis until organic causes are no longer a consideration. Or he comes in with hepatic encephalopathy and they attribute it to a psych presentation and he doesn’t get the appropriate medical treatment. What if he’s developed Wernicke’s encephalopathy and they try to treat it like bipolar instead of the degenerative condition it actually is and he doesn’t get the supports in the community that he needs.
Way too real. One of the reasons why a lot of people HAVE to lie to some of their doctors. In some fields the wrong word will get you down the wrong lane really really fast :
Not making many friends at work, are we??!¿😹
From the CL Psych perspective, this is "my patient has no psychiatric history and half a dozen risk factors for delirium, we think it's acute-onset schizophrenia. Can you please take over care?"
And then I've seen the opposite:
ER Doc: Hey psych, I've got a co--
Psych: Recommendation is Inpatient in a psychiatric center to be evaluated by the inpatient staff.
ER Doc:... I..... ok....
DUDE!!’ This was the SAME conversation I had with my psychiatrist when I requested to be tested for adhd!! He’s like you have depression and anxiety…. Good luck 🍀
This is so real it's scary 🥲
This sounds exactly like my ex, who exhibited the same behavior for the same reason. He would talk to an imaginary woman called Eva. In the end he died a few years later, never really getting treatment, no matter how hard I tried.
Another fun one is once you get the diagnosis every other doctor will refer you back to psychiatry who will do nothing. Joint pain? Anxiety. Headaches? Anxiety. Fatigue? Depression.
Uno reverse
Cool
Honestly such an odd validation knowing doctors egos cause them to even gaslight eachother with lazy DX’s that don’t fit or fully explain the symptoms.
You have to be careful with such things. I've been dumped in the "psycho" bucket because of the symptoms my PHYSICAL illnesses cause me. So they just told me from day 1 I was crazy rather than doing ANY tests for physical illness.
I hate dealing with psychiatrists. Got turned away from FIVE CLINICS because they refused to take on a patient with ADHD. (They’re only profession that can legally prescribe ADHD meds in my country)
When I finally did get through to one, she spent 30 minutes asking me a whole bunch of census-type questions, listened to me describe my ADHD symptoms for all of 30 seconds before she prescribed me stimulants and said ‘see you in six months.’
Good luck getting anything out of them.
Detox him and ship him home! Duh! He couldn't possibly be drinking to cope with his underlying depression and anxiety. The alcoholism is the only issue here
Are married psych consults different?
👏🏻
Yeeeeaah, this one hurt a bit.
No no no
Bam! Another right on vid
Actually alot if mental health issues ARE caused my physical issues. For example narrow spinal cord which is pretty common, can mess up the way the cerebral spinal fluid circulates, causing physical symptoms (which can be so bad it creates emotiona in mental health imbalance) or it can cause mental health symptoms like experiencing hallucinations, irritability, and an over all stress response both mentally and physically.