Thursday, September 12, 2013

Day 2401: On psychosis

While on the phone with a dear pal of mine today, I had an interesting thought on psychiatry. Well, two interesting thoughts.

1) I may not want to do psychiatry, but seeing it has pushed me more toward a possible career in family medicine.

2) Psychosis is one of the most rewarding ailments to treat in psychiatry. I currently have two psychotic patients on my child/adolescent psych service. One is purely psychotic, which doesn't bode well for her future as an adult. She sees things that aren't there, hears voices that no one else hears and is quite paranoid. My second patient had something resembling a first-psychotic break. It may have been substance-induced, but boy was it a doozy of a psychotic episode. Hearing things. Seeing things. "Flipping out," as the patient put it. BUT. When you give these psychotic patients the proper dose of the proper medicine, it is amazing to see how quickly these patients improve. Kid #1 is showing very slow improvement each day, but improvement nonetheless. Kid #2 is looking really good and will most likely go on to lead a fairly normal life.

Psychiatry isn't all mumbo-jumbo and talking about feelings. It's a pretty fine art to differentiate between depression or a medical condition causing depression (like hypothyroidism) and other things of that nature. Psychiatry isn't for me, but it has been an interesting rotation to be a part of.