Are people getting worse in regards to mental health?
Im seeing more and more polypharm, substance use, benzos, inappropriate sleep meds, etc. Im also even seeing more late onset psychosis/bipolar and more rare disorders in general. Granted im a younger attending compared to a lot of people on here. What do you guys think? (Source: Student Doctor Network)
Source: Student Doctor Network - June 22, 2023 Category: Universities & Medical Training Authors: annoyedpsychiatrist Tags: Psychiatry Source Type: forums
Difficult case (schizoaffective, FND, and extensive allergy list)
Hi all. So I have a difficult case that I wanted to put to the group. I have a young ACT patient with schizoaffective disorder, bipolar type resulting in many hospitalizations and very bad destruction of property, in the years before I took over his care. Throughout those years, he was tried on a variety of antipsychotics (risperidone, olanzapine, haldol, prolixin, invega, etc), but each time would manifest "allergies", which he states (and are listed in his medical record) typically as...
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Source: Student Doctor Network - May 30, 2023 Category: Universities & Medical Training Authors: When is graduation again? Tags: Psychiatry Source Type: forums
Undiagnosed PTSD
Groundhog day in my consult clinic:
Pt has a history of either "depressionanxiety" or "bipolar".
I perform my evaluation.
Pt has textbook PTSD.
I discuss my findings with patient. Patient says something like "I've always suspected that but no one had ever [diagnosed me/confirmed that/talked to me about it]"
These are often satisfying visits because I can make a real difference (by getting them towards the right types of therapy and the right meds--including reducing antipsychotic use...
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Source: Student Doctor Network - May 19, 2023 Category: Universities & Medical Training Authors: Celexa Tags: Psychiatry Source Type: forums
More reasons to avoid antidepressants in bipolar disorder
(Source: BMJ Comments)
Source: BMJ Comments - May 2, 2023 Category: General Medicine Source Type: forums
MSW/MPH dual degree?
Hi all, I am currently a BSW student (just switched my major after deciding I want to pursue an MSW) in my last year. My school offers a dual degree MSW/MPH degree, and I was wondering if this is a beneficial route to take? I want to focus on the clinical side of social work surrounding mental health, and particularly I want to work with severe mental illness like schizophrenia and bipolar in adolescent populations (at least at this moment). My goal is to open private practice, but I am open...
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Source: Student Doctor Network - April 27, 2023 Category: Universities & Medical Training Authors: neurom Tags: Mental Health and Social Welfare Source Type: forums
Missing: Women, bipolar disorders, and evidence-based medicine
(Source: BMJ Comments)
Source: BMJ Comments - April 25, 2023 Category: General Medicine Source Type: forums
Techniques and Pearls for Bipolar Lumbar RFA
Doing my first one next week. Any pearls? Looked at the Chapman paper and it doesn't look too bad. (Source: Student Doctor Network)
Source: Student Doctor Network - March 20, 2023 Category: Universities & Medical Training Authors: oneforfighting Tags: Pain Medicine Source Type: forums
Drug monitoring in bipolar disorder needs to include alcohol and other drugs of abuse
(Source: BMJ Comments)
Source: BMJ Comments - February 16, 2023 Category: General Medicine Source Type: forums
Bipolar 1 Mania - Refusing Depakote and lithium, maxed on Zyprexa, thoughts?
I have a 60 something male with history of bipolar 1 disorder. Started on Zyprexa when they came in, is now sleeping and not receiving PRNs anymore. However, still very grandiose (knows several famous people, is writing a new Bible) and paranoid that his family is conspiring against him. Remains pressured and tangential. They are voluntary and up to 20 mg of Zyprexa, but refusing Depakote or lithium. Started Lamictal as they tolerated in the past but I know its not going to be as helpful for...
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Source: Student Doctor Network - February 10, 2023 Category: Universities & Medical Training Authors: FI-Prexa Tags: Psychiatry Source Type: forums
Discharge from practice while hospitalized
Is this an adequate practice discharge strategy.
A patient previously seen at a clinic serving relatively high functioning patients severely decompensates into a psychotic or manic episode and is hospitalized. The clinic calls the hospital to notify them patient is discharged from their clinic due to severity of symptoms and hospital will need to refer patient elsewhere for mental health follow up.
I can see both sides. It seems lame to dump someone who is now struggling more, with...
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Source: Student Doctor Network - February 2, 2023 Category: Universities & Medical Training Authors: nexus73 Tags: Psychiatry Source Type: forums
Lamictal augmentation for unipolar depression
Covering for an NP today and her overall diagnoses and management is driving me f*cking insane, doing things like diagnosing BPD as bipolar, and starting Lamictal for irritability.
Have seen multiple patients of hers with MDD only today, resulting in her starting low dose Prozac, Seroquel 25 mg QHS for sleep, and Lamictal AT THE SAME TIME.
Here are 4 patients of hers I saw today, all MDD:
Patient 1: Trintellex 10 mg once daily, Ritalin 30 mg once daily, Lamictal 150 mg
Patient 2: Prozac 10...
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Source: Student Doctor Network - January 27, 2023 Category: Universities & Medical Training Authors: yoloswagpoop42069 Tags: Psychiatry Source Type: forums
Examples of famous people overcoming mental illness/in recovery?
I am was looking for the "best" examples of famous people who have overcome mental illness, ideally ones that they have spoken about this publicly (and certainly not ones that didn't go on to succumb to their illness like Robin Williams, Marilyn Monroe etc etc) . I find these examples to be particularly salient to teenagers and appreciate any suggestions anyone has.
Looking for:
MDD
Bipolar D/o
Social Anxiety
Agorophobia
OCD (I use Howie Mandell with how he has changed on America's Got...
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Source: Student Doctor Network - January 20, 2023 Category: Universities & Medical Training Authors: Merovinge Tags: Psychiatry Source Type: forums
Podiatry Bipolar
In many ways podiatry has come a long, long ways. Residency training for all, with a much higher percentage getting good or great training.
As much as we justifiably knock the job market, there are mid size cities, often in fly over states where the majority of podiatrists are employed by ortho groups or hospital systems. If there is private practice it is usually not solo and a group with no mustache podiatrists. Sure they push Tolcylen, lotions, orthotics and laser toenail treatments to...
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Source: Student Doctor Network - January 8, 2023 Category: Universities & Medical Training Authors: icebreaker32 Tags: Podiatric Residents & Physicians Source Type: forums
Negligence accusation story.
Inspired by a recent ED forum post, I thought I would share my experience of negligence accusation. It never progressed to a lawsuit thankfully but took a lot of time and emotional toll. This occurred shortly after I finished residency.
Working inpatient psych, our team was consulted to see a woman in her early 50s who appeared frankly psychotic/manic. History from her husband notable for depression, and unclear history of possible hypomanic episodes on a few occasions over their 30-year...
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Source: Student Doctor Network - January 8, 2023 Category: Universities & Medical Training Authors: nexus73 Tags: Psychiatry Source Type: forums
Late onset bipolar
Patient in their 70s. Chronic cannabis user. Chronic depression, insomnia, anxiety, possible narcissistic personality traits. Over previous few months increased use of high potency cannabis products (e.g. 80% THC pen, flower marijuana soaked in cannabis oil). Manic episode emerges and leads to inpatient hospitalization. Dad had "bipolar", but best history I can get is dad was a heavy drinker and physically abusive, and had some good days.
Where do you put your money? This person has new...
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Source: Student Doctor Network - January 3, 2023 Category: Universities & Medical Training Authors: nexus73 Tags: Psychiatry Source Type: forums
