Category:

Psychiatry

Back to Work

After returning from a week-long vacation, I dreaded the pile of catch-up work and voicemails waiting for my much-needed attention. I assumed that I’d be in vacation-mode and perform sluggishly on my first day back, but surprised myself at how easily I resumed my normal routine. Even more surprising was noticing the level of comfort I had while interacting with new patients whereas in the past I’d be concerned about whether or not my patients would feel connected to me or question my knowledge being a mere resident instead of a full-fledged Psychiatrist. One word to describe this new-found feeling? — Confidence. Confidence may come easily for some, but for me (and most, I assume), it required self-evaluation and rising after feelings of inadequacy and failure. Once that feeling is obtained, savor the moment the way you savor a great vacation.

November 17, 2010 1 comment

Psychiatry Travel

Vacation Time

written by freudandfashion

One thing I’ve mastered during residency is the timing of vacation and making the most of those few days of freedom. Four months without vacation is far too long, one month intervals is too soon, but a vacation every 2.5 months comes out to be just right. I’m at the point of yearning for some much-deserved time off, which I plan to spend soaking up sun to boost my Vitamin D and eating/shopping/partying in one of my favorite cities. My key to surviving residency incorporates a balance of combining work, relaxation, and fun, because the former can easily dominate over time, resulting in high anxiety, struggles to get up in the morning, a shorter temper, less sleep, and less people wanting to be around me.

November 1, 2010 0 comment

Psychiatry

Pill Pusher

written by freudandfashion

I have a simple theory that I like to follow when it comes to psychotropic meds: “Simple is Better.” Pretty straight-forward.

When I inherit a new patient with a list of meds the length of the Declaration of Independence AND they’re still depressed despite all the designer brand name drugs at their disposal, I don’t think it takes a medical degree to figure out that something’s not right.

Question 1: Question the diagnosis. Question 2: They’re still depressed—what the heck am I supposed to do about it?

Whereas most might seek comfort in adding yet another miracle drug to the list, I was inspired by one of my Attendings and made a goal to venture in the opposite direction of the less anxiety-provoking intervention and instead take a medication out (slowly, of course, before withdrawal throws them into a far worse state) and maximize the therapeutic benefit of a truly helpful medication at the same time.

And, the outcome? Well, it’s worked out in many of my patients thus far. Maybe my warmth and reassurance helps as well. Only thing I need now is the research to show it (my next residency venture).

Image via ramoscentral jpg

October 23, 2010 3 comments

Psychiatry

Just Breathe

written by freudandfashion

{driving on I-395 in Miami}

Two things that annoy me on a daily basis: drivers who tailgate and drivers who drive too slow. Being from California, I’ve learned to drive aggressively and posess a constant level of road rage. I never thought a driver who followed traffic laws existed until I moved to Oregon where the average person makes full 3-second stops, drives below the speed limit, and is shockingly courteous towards other drivers. Now that I’ve lived here for over a year, I admit to some appreciation for the overly-cautious driver though I constantly find myself in a tense, angry state every once in awhile. On my way to work today, I noticed my tight grip on the steering wheel and my frequent glares at a speeding car through my rearview mirrow. I felt my neck muscles tense and head start to feel heavy before I realized that I just needed to relax and BREATHE. Take a deep breath…and another deep breath…then switch to the next lane and simply let the driver go. Breathing sounds like a simple solution to high anxiety situations though plenty of people, including myself, have to remind ourselves to do so. I wanted to attach a video demonstrating the diaphragmatic breathing technique, but the videos online have a cheesy 1980’s vibe. I’ll find one eventually, or make my own.

Tip of the day: Next time you go into anxious or angry mode –remember to breathe!

October 19, 2010 1 comment

Psychiatry

RFF: Residency Friends Forever

written by freudandfashion

Is it rare to have a class of residents who actually like each other and get along? When I moved away from home, the residents in my class were not just peers– they became my family. When one member leaves, you get hit with a sense of loss that affects you far more than you could’ve imagined. When more than one member leaves, you try even harder to keep your support system from falling apart even further, only to hope and find comfort in believing that life circumstances have led them to a better path. I’m fortunate to have formed wonderful friendships with amazing people over the course of one year, but will definitely last a lifetime. C’est la vie.

October 16, 2010 3 comments

Psychiatry

Almost There

written by freudandfashion

{as a not-so-stylish intern during a 30-hr night on-call}

Rough day today. Sometimes when I get a second to relax at work, I wonder where time has gone. Four years of college, one year of academic research, four years of medical school, four years of residency training — 13 years of life devoted to a career. Thirteen years of life spent accumulating knowledge and learning how to best care for others. Thirteen years of life spent possibly neglecting loved ones, events, activities, experiences, and myself. Balancing priorities in life is necessary, but definitely challenging. Anybody who has mastered the art of balancing priorities receives my respect. I’m slowly getting there…finally, after 11.25 years filled with sleepless nights, feelings of self-defeat, confidence-boosters, and affirmation that sacrifice is worth achieving the ultimate goal. One year and eight months left until freedom.

September 30, 2010 4 comments

Psychiatry therapy

Dark Light

written by freudandfashion

{Sunset in Waikiki}

Goodbye, Summer. Shorter days, raindrops on the window, dirt splattering onto my cream-colored slacks…just a few initial signs of gloomy Oregon weather. I’m already preparing for my period of weather-dependent laziness that starts around this time. I teach my patients some of the following simple strategies to feel a daily sense of accomplishment…or shed light on barriers towards accomplishing your goals (mine would be dark, rainy weather, which I documented here/):

1. Make a realistic daily task list, and check them off with pride as you complete each one.

2. Set a goal for the day, and if not accomplished, then write the reason why.

3. When you get overwhelmed, feel like you have no energy, or notice yourself making excuses not to complete a task, do something simple for 15 mins that brings you out of lazy-mode (take a walk, short run, read, journal, etc.).

What techniques do you find helpful? Please share before I turn into an even bigger couch potato this Fall.

September 18, 2010 0 comment

Psychiatry

You’re Crazy

written by freudandfashion

{My sister, aunt, and I on Christmas 2008}

The idea of giving a fake cell phone or earpierce to a person with Schizophrenia who can’t control talking to the voices inside their head in public seems like an ingenius idea. I have an aunt diagnosed with Schizophrenia and I get extremely defensive when people stare at her in public. Perhaps that’s why I get mad when people gauk at people they don’t know on the street and immediately label them as “crazy.”

I encourage you to think twice before you call a random person “crazy” or “psycho.” You don’t know what they’ve been through and you probably don’t care where they’ve been, but technically you care enough to immediately judge them for not fitting in with social norms.

What’s the definition of “normal” anyway? I think the more important term to look up and utilize is empathy.

September 14, 2010 3 comments

Psychiatry therapy

Leave It Behind

written by freudandfashion

When a patient dwells on a thought to the point of feeling extremely anxious and overwhelmed, I sometimes teach them to approach those thoughts with the following metaphor: Grab onto [the thought] briefly in your hand, then let it go like a feather. Perhaps I need to practice more of what I preach. I have several complex patients who require contant monitoring and found it difficult NOT to think about a few of them during recent trips out of town. Did I prescribe too high of a dose? Will my patient be suicidal and land in the ER? Will my supervisor think I was an idiot for giving that medication? No doctor is perfect, but I do need to learn how to leave work behind (for the sake of maintaining my own sanity).

September 8, 2010 3 comments

Psychiatry therapy

Canine Saviors

written by freudandfashion

{with our family dog, Sanka}

I remember trying to hold back tears as I watched the Oprah episode that highlighted the Puppies Behind Bars program (see video below). I have two legally-blind aunts, so my family felt extremely fortunate when given the opportunity to adopt a career-change dog that was initially trained as a guide-dog for the blind. There’s a strong connection between the calming, healing effects a pet can have on a person’s health, especially after witnessing my dad’s health improvements since adopting our yellow lab, Sanka. The process of certifying your dog as a therapy dog varies among states, but I’ve seen dogs certified by submitting a letter from a doctor or through a professional trainer. Even more proof that dogs truly are a (wo)man’s best friend!

[youtube=http://www.youtube.com/watch?v=7pK-enFgSLA&feature=related]

September 2, 2010 4 comments

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