Before I begin my rambling I think you all deserve a med-school update.
I’ve been back for a week now and so far it’s been great. I’m working with a small team at the hospital that usually takes on 8-10 patients at most (in other words: it’s just me and the resident!). The resident is ridiculously nice, funny, likes to teach, she’s wonderful…in other words, everything you’d ask for in a resident (and she told me she also took a leave of absence, so she obviously inspires me). So far my only worry is that I’ve been a lazy-ass and have to study and my work is starting to catch up with me. I’m surprised to say I’ve liked pediatrics so far way more than I thought I would, but I think that’s mostly due to the experiences I’ve had since last year and my change in perspective.
I’m enjoying medicine again and that makes me happy. It gives me confidence.
And I made a goal for myself: I want to give the rotation my own mental/emotional health twist. I still get very anxious when I have to talk to patients or patient’s parents, so I’m trying to force myself out of my comfort zone by asking patients and their parents how they’re holding up emotionally-speaking. So far I’ve only done it with two patient’s moms, one of whom has already spent a lot of time at the hospital with her very sick child. I know most people aren’t willing to openly talk about what they’re feeling (especially with a total stranger), but I know it’s really hard for them to basically have to live at the hospital so long and so I just want to let them know that if ever they need to talk I’m all ears. I think everyone can agree that we all like to feel validated and listened to, especially when we’re going through a difficult time in life.
And so, like I said, it’s been great so far. I’m optimistic.
As for the rest of this post…
I saw R on Thursday. I’ve been having a lot of trouble anxiety-wise (not that I haven’t before) that’s being exacerbated by all the feelings relating to The Ex. I’ve tried to deal with this with as little medication as possible but lately I can’t stand it anymore and I feel I need the extra help so I can navigate therapy and daily-life smoothly. G agrees I need the help.
For now, R agrees that I have an anxiety problem but we have to explore it further to see what we’re going to do treatment-wise and exactly what it is. I’m just glad I finally got up the courage to explain to her just how much the anxiety is affecting me. Once you find yourself taping your curtains to your windows to avoid neighbors from looking inside your room and laughing at you then you know things are kind of going downhill.
Also, I told her about a pseudo-panic-attack-like-thing I had last Sunday. I tried to distract myself from all the depression-related pain by forcing myself to go to the movies with mom. However, the place was teeming with people, and that’s one of my biggest triggers. I couldn’t deal with all the people, I felt nauseous, felt like running away screaming….finally when it was time to leave I almost ran out of there. I hate that I can’t do mundane/daily-life things without the anxious thoughts consuming me.
So, I told R about all of this. She increased my dose of Prozac to 30mg, warning me that it can help with anxiety but it can also make it worse. She also mentioned how benzodiazepines are great for acute anxiety but she’s not all too keen on prescribing them. I agreed, and explained to her that I’m actually afraid of myself when it comes to benzos because I feel I have an addictive personality. She agreed, and she also mentioned how my being constantly surrounded by doctors who I can easily ask for a prescription at any moment is a risk factor. Ah, it’s like she read my mind. I chuckled when she mentioned this.
Finally, I asked her where I’m currently standing diagnosis-wise, what my labels are for now. Basically, I just wanted to know whether we’re on the same page so far.
I’m not a fan of labels, I don’t think I’ve made it a point on the blog before. This is what I think: If it’s causing you pain and/or problems, then it’s something worth looking into and helping you with. The name really isn’t as important as validating what the patient feels and recognizing that “it’s not just them”. Actually, I named this blog “Borderline Med” simply because BPD was a diagnosis M suggested and I wanted something catchy. I kept thinking something along the lines of the shows Boston Med and NY Med but the alternate option was Depression Med and that just sounded too….depressing.
Thankfully R shares this sentiment. She took the words right out of my mouth when she said that to her, labels can be helpful but she doesn’t place too much importance on them because they’re more of a practical tool insurance-wise and such. She explained how labels can change constantly and it’s more important to address the problem than to label it. I swear, I couldn’t have asked for a better psychiatrist to replace M.
So, finally, she told me her impression of me label-wise, to satisfy my curiosity and right to know. So, I present to you my diagnonsense for the moment, according to DSM-IV-TR:
- She didn’t mention depression because that’s pretty obvious, but to be precise she codes it under Major Depressive Disorder, recurrent, severe without psychotic features. And I think that’s spot on, so R’s been doing her job right all this time.
- Then she talked about anxiety, and how for now it’s just a “Not Otherwise Specified” kind of thing because we haven’t really gone into the nitty-gritty details of what the anxiety consists of. More on that when I get the chance to explore it with her.
- As for Borderline Personality Disorder, her opinion is I have a lot of traits. The way I see it is that I’m currently a “borderline-Borderline”. I agree with this, it’s been something I’ve been thinking for a while now. I think that when M met me I had stronger features of BPD and it was a bigger problem to address and worth labeling, but after so much time in therapy I’m glad to say I’ve gotten better and it’s not as bad as it was before.
- Nothing was mentioned about food problems. Might get around to asking her about it later, but again, it doesn’t really matter because I know I tend towards anorexia nervosa (and she knows this) and it really doesn’t need a label.
So those are my labels for the time being. I’m happy to say R, G, and I are on the same page in terms of what my problems are. That’s awesome.
And no worries, I’m not changing the blog’s name to Depression Med anytime soon.