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Slogging in mental health clinics not a very fun and ideal thing to do... Finally endured till a 1 week leave starting tomorrow :)
Sometimes, I don't know if I'm treating myself and the patient's family or the patient himself.
Of course, those with the mood disorders like anxiety or depression (excluding manics) will feel genuinely better with treatment. However, in patients with psychosis like schizophrenia, who in the first place may not have insight to their illness, i tend to wonder if they actually prefer living in their world of voices/hallucination than the real world.
The 2 types of schizophrenic patients i come across are: 1) the blunted (because of the medicine), obedient patient, who will follow anything/prescription offered. They'll say they are comfortable, getting well, not hearing voices etc. Then obediently accept any treatment we institute to them. Of course, these patients are our darlings since they make the sessions easy. Some of them also volunteered that they really felt uncomfortable when they had hallucinations and are happy that they are well now.
2) the no insight, not compliant, resistant to treatment patient. These are the patients i'll start thinking that the actual patients are the family members or the doctor. The patient usually says "i'm not sick, i don't need medicine!!" No matter how one will try, they'll persevere that nothing is wrong with them. So they'll not take their medicine or resist everything else one can offer like depot injections. They often behave strangely and disrupt the lives of their loved ones. Usually the patients require admission to the wards, only to return few months later with another relapse.
I'm wondering if they actually enjoy their world more, since if they become alert to the real world again, they'll need to worry about their livelihood/money/meals etc. And if being 'unwell' is that uncomfortable, why won't they want treatment? Admitting them will relieve their family of constant worry and caregiver stress. It'll also relieve the doctor of the paronoia: whether they'll commit a crime or suicide if they leave the clinic status quo. So? Are we treating the patient or the family/doctor?
Well anyway, most likely i'm not cut out to be a psychiatrist. Really admire them for handling the patients tirelessly for years. I would have suffered from burn out..
Guess i'll continue the trip blog for now :) still got more than half to cover...
Slogging in mental health clinics not a very fun and ideal thing to do... Finally endured till a 1 week leave starting tomorrow :)
Sometimes, I don't know if I'm treating myself and the patient's family or the patient himself.
Of course, those with the mood disorders like anxiety or depression (excluding manics) will feel genuinely better with treatment. However, in patients with psychosis like schizophrenia, who in the first place may not have insight to their illness, i tend to wonder if they actually prefer living in their world of voices/hallucination than the real world.
The 2 types of schizophrenic patients i come across are: 1) the blunted (because of the medicine), obedient patient, who will follow anything/prescription offered. They'll say they are comfortable, getting well, not hearing voices etc. Then obediently accept any treatment we institute to them. Of course, these patients are our darlings since they make the sessions easy. Some of them also volunteered that they really felt uncomfortable when they had hallucinations and are happy that they are well now.
2) the no insight, not compliant, resistant to treatment patient. These are the patients i'll start thinking that the actual patients are the family members or the doctor. The patient usually says "i'm not sick, i don't need medicine!!" No matter how one will try, they'll persevere that nothing is wrong with them. So they'll not take their medicine or resist everything else one can offer like depot injections. They often behave strangely and disrupt the lives of their loved ones. Usually the patients require admission to the wards, only to return few months later with another relapse.
I'm wondering if they actually enjoy their world more, since if they become alert to the real world again, they'll need to worry about their livelihood/money/meals etc. And if being 'unwell' is that uncomfortable, why won't they want treatment? Admitting them will relieve their family of constant worry and caregiver stress. It'll also relieve the doctor of the paronoia: whether they'll commit a crime or suicide if they leave the clinic status quo. So? Are we treating the patient or the family/doctor?
Well anyway, most likely i'm not cut out to be a psychiatrist. Really admire them for handling the patients tirelessly for years. I would have suffered from burn out..
Guess i'll continue the trip blog for now :) still got more than half to cover...
posted by KwangHow at
10:23 PM
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