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Depression

Eh.

Took a hiatus. I’m sorry. But hopefully I’m back. Making no promises with my crappy schedule. But here I am. As I told one of my patients yesterday: let’s take it day by day, ok?

So. I did 2 months of psychiatry. I loved it, the hospital, the patients (mostly), the staff, everything. I felt stupid at first, then got the hang of it. Then on my last day I did an impromptu half hour teaching session about psychopharmacology with the medical students and I thought: well, I actually know more than I do. And that was awesome obviously.

But then I started medicine. A month of it. It’s been a week. Let’s just say I’ve found myself teary eyed in the bathroom or when I’m alone in the work room at random times. Yeah, it’s that bad.

And it’s not the team I’m working with. The team is great (except the attending, more on that below). It’s the fucking schedule. Minimum 12 hour shifts (that mostly turn to 13 or 14), 6 days a week. I bet you can guess which day of the week I have off, judging by the date on this post….and how frequent my potential posts will be.

The attending I started off with was good. He was chill and relaxed. The attending I have now is an overachiever. And I don’t bode well with that. I’m the chill type of person, by doctor standards, that is. No wonder I ended up in psychiatry, it’s the chill people specialty. I did enough overachieving during my teens. Ain’t nobody got time for that.

I feel stupid 24/7 and it’s taking a toll on me. Last time I did medicine was a year ago. “Rusty” is an understatement for my current status. It’s like I never went to med school and need a refresher course on everything. At least during my 2 months of psychiatry I felt marginally stupid but knew some things. Here it’s just straight up embarrassing every time I have to round on patients in front of the team, especially the attending.

My attending gave me feedback yesterday. He said nothing I didn’t know already, about my performance anxiety apparently having no reason to be as I seem more sure of myself, about how I should brush up on what my patients have to refresh my memory….but what really hit me was him saying “study on those topics even if it’s 2 minutes”.

Haha! Dude. SERIOUSLY?! I have no time to take my trash out in a whole week and my apartment stinks, let alone study. And let’s be honest, I don’t care about the topics. As terrible as that sounds. I just want to be done with these four weeks and marginally pass, setting the bar as low as possible so that the next psychiatry cointern that comes around doesn’t get treated like shit. I just want to know the basics so I’ll know when to recognize a medical problem in my psychiatry patients in the future.

Dude: just tell me what to do. And I’ll do it. Don’t expect me to be interested, though.

He did, however, reiterate something my program director has told me a few times before and something I’m proud of: that it shows I have good rapport with my patients. And really, as long as I know the basics and have good rapport with my patients, I’ll be set. No need for me to overachieve. It’s not like I have the time for it, either way. I’ll worry about studying for real when I get back to psychiatry and neurology rotations (and I’ll have the time for it).

So, medicine…it sucks and I would rather do 10 batches of laundry in a single day than do this for a prolonged amount of time (and trust me, I HATE doing laundry).

Yesterday I couldn’t take it anymore. A patient started masturbating as I was interviewing him. Yes, you read that right. Hello, trigger! Hello, feeling disgusted and used! And of course, nobody in the team gave a shit except the females. Then another patient’s family was driving me nuts with wanting special treatment for the patient.

And already my head had gone over to dark places because another patient was irritated with me when I went to talk to her. I found myself thinking about suicide, yes, solidly for the first time in a while.

I was able to manage the thoughts. But yesterday I couldn’t take it anymore. I got to my apartment at 9:30pm and just started bawling. How can anyone live through this? Why is this necessary? I just want to help people and lead a balanced life. Is that too hard to ask for?

I texted the Russian. And he got worried. He came over. Cuddled and held me while I cried like a baby and just let everything out of my chest. Everything including our current crappy relationship situation, or whatever it is, because both of us have shitty schedules and barely interact. Started crying even harder after I told him I didn’t want to get depressed again (he knows I’ve been depressed, although not in detail….I’ll get around to that when things are more stable between us).

And I guess I just needed a good cry and a day off, because today I feel better. I was able to finally clean my apartment.

I’m not depressed. Not yet. And I hope not ever again. But I know myself better than anyone else, and I know that if I don’t get enough sleep or enough balance in my life, I will fall down that slippery slope quick. And medicine is exactly the type of environment that depression festers in.

No wonder there’s so much physician suicide. But that’s nothing new to me, really. It’s just more tangible when you’re no longer a student and are actually in the front lines. I honestly think it’s unnecessary for one to work 14 hours straight, 6 days a week, and expect to be ON all those hours…sometimes having to skip breakfast or lunch. Nobody gets a sticker for toughing it out. What’s the point, then? My attending went so far as to make the medical students rotating with us come to hospital tomorrow, on a holiday. His reason? “Well, in my day, when I was a medical student…” Seriously dude? Times a-change. Get over it. I have to go because it’s my work, but the med students? Come on.

And…I’ve gotten more shit from my medicine patients in one week than I did from my psychiatry patients in 2 months. Oh the irony. Especially since people think psychiatry patients are “the difficult patients”. Pfffffft. Sure.

I try my best. I really do. And my intentions are good. But it’s difficult not to have your morale eroded quickly with so much crap going on.

And that, my friends, is my current “life”, for lack of a better word. Everyone keeps telling me it will be over soon, but soon isn’t soon enough. I want it to be over now.

And because I like to finish things on a lighter note: it seems things with the Russian are turning more solid/stable every day. His schedule is going to be better now, apparently. Can’t say the same for me, unfortunately. We’ll see what happens.

I’ve had a good two weeks working at hospital. Well, actually, this week was much better than the first, but you get the gist of it. I’m finally starting to get the hang of it again.

I’m working at a psychiatric inpatient unit. So far I like it a lot. My attending has given me good feedback, at least for having been only my first two weeks. We’ll see if I can keep it up.

I had three patients thank me this week, which felt great. Then I had a patient get significantly better. He said his symptoms were the mildest they had ever been for the past 3 to 4 years. And he thanked me profusely, even said his mood was “excellent”. And guess who changed his medications? Me (with my attending’s approval of course).

I still don’t feel quite like a doctor, but I’ll get there. My attending keeps reminding me to present myself as DOCTOR Dana. I keep forgetting the doctor part, haha.

And I still feel like an idiot frequently, but less so this week at least.

I have a lot in my head regarding my work so far. My feelings and thoughts are very convoluted. I’ll post more about that this weekend.

As for my own mental health… I’m in a very good place right now. Been able to keep it up. No extreme homesickness so far. However, I’ve been terribly crappy at taking my Prozac. I forget every other day, practically. And then I go to hospital and make sure my patients take their medications so they get better and reach some stability. Geez, can’t even do that for myself.

But I’m OK…right now. I’m just worried about this becoming a slippery slope. I don’t have a psychiatrist or therapist yet in the city that I adore, and I’m starting to get worried. It’s not that I need one right now (although I am running out of meds…shit), it’s that I don’t want to fall in the hole and then be forced to look for one. I’d rather prevent all that from even beginning to happen.

But I’m so lazy you guys! Right now I have time to see a psychiatrist or therapist, but I’m so friggin’ lazy to go and do it. I’m so tired by the end of the workday (and my workday really isn’t that long, to be honest), I have no energy for doctors’ appointments. My work in the unit seems simple, but the truth is I’m always moving and always doing something.

There’s never a dull moment or no work to do. I didn’t think I’d get physically tired so easily at first, but oh how wrong I was…

 

Finally, finally, FINALLY, I can post again!

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So much to say. So many things that have happened. Here goes…

I traveled with one of my best friends and had the time of my life. It hurt my pockets, but it was so worth it both for me as an individual and as a bonding experience. Also, it was an awesome self-gift with the money I don’t have, since…

I GRADUATED MEDICAL SCHOOL!

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I’m a doctor now. Still can’t believe it. I freeze over when people call me “doctor”, when I see the MD after my name, or when I have to state my job is “physician” (say what?!). You guys have no idea how long I’ve been waiting to change the description of this blog to “Part-time doctor, full-time patient”. Betcha didn’t notice that!

My graduation ceremony went great and my parents were so proud. I was so happy to see them like that, and I was so happy for myself…after all that’s happened I’m finally here. Couldn’t stop smiling that day.

And then I moved to the city that I adore. Yeesh, everything’s happened so fast. So far I haven’t gotten terribly homesick, but it’s bound to come (although I do feel a knot in my stomach whenever I think of my dogs). I love my apartment so far. It’s tiny, old, has its problems, and it’s rough around the edges, but it’s mine (rented, though) and I couldn’t love the location more.

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Bittersweet celebrations

The first weekend was the toughest. I always have trouble those first few days anxiety-wise when I’m in a new place. So much that I’m afraid of going out or even leaving the windows open (I’ve posted about this before, it happens a lot). However, when I’m hungry enough to pass out (because I’m too anxious to even get food), I usually go out because I have no choice. That’s when the anxiety starts going down. I’ve still got a bit of a way to go but I’m not afraid of going out on my own anymore. It’s always this way, a slow process. Eventually it’ll go.

I also began orientation for my program these past few days, and so far no red flags have popped up and I’m glad I chose the heart-mindblown program. The place feels like a good fit. We’ll see how it goes.

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She probably knows more about what’s to come than me

Also, I met my co-interns! I like them a lot so far. I think we’ll make great colleagues and if friendships arise then even better.

Meanwhile, my love life…always have to post about that, right? I’m actually in a good place right now. (Sorry for the TMI that’s coming…) I had a fuckbuddy for a while there back home. I know, me? A fuckbuddy? I never saw that coming. But it was actually a positive experience because there was only desire on both parts and it was quite clear that’s all we wanted and there was no chemistry other than sexual. Why was that good, you may ask? Because it helped me understand what it feels like to “like” someone, versus just feeling lust. Now I know the difference.

Which brings me to….The Russian. He’s back. I was expecting it to happen since we were texting for about a month and a half and I was moving to the city that I adore. What I wasn’t expecting was for it to happen so fast. And by “it” I’m not saying we’re dating. We’ve seen each other a handful of times so far and agreed we just want to see how things flow. Problem is, so far they’ve flowed all too well (…that’s not really a problem, though).

I won’t go into details here, but we’ve had one or two frank discussions where he’s been surprisingly vulnerable with me and I chose to believe him. He’s single now. However, I’m still testing the waters. He is too. No commitments for now, just proceeding cautiously. I’m well informed of the risk I’m taking. If things backfire, then I’ll learn my lesson and hopefully it won’t be disastrous.

But we’re both surprised about how smoothly things have gone and how there seems to be a certain chemistry that wasn’t there the first time around due to circumstances beyond ourselves (it was all uncertain, I was living back home, etc). I don’t know if that’s a good thing or bad. Then again, many things in life just “are”. I’ll go with that.

He’s actually helped me so far a lot with this transition. Having him invite me out the first week helped with my anxiety because it forced me to go out and about. And I told him about it, so he’s not completely clueless. Also I’ve encountered some unexpected issues that might delay my beginning residency as scheduled, and he helped me see another side to the problem and not take it personally (which is something I have trouble with). It calmed me down.

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He’s crazy. I’m crazy. It’s a perfect match!

So, this issue with beginning residency has to do with my obtaining a license to practice in the state. My program coordinator suspects it might have to do with some letters that got slightly delayed, but I’m paranoid and afraid it might be related to my taking a leave of absence in med school due to depression. I already provided a letter from my school, my own explanation, and a letter from G explaining that I’m good to go and doing wonderful…what more do they want from me?!

But that’s all I’m going to say about that. No need to spoil all the goodness with something that is far beyond my control. I figured: I matched, so I’m legally obligated to sign my contract (already did), I’m already here, and as far as situations go things could be much worse. So, hopefully, it’s all gonna fall into place. Better late than never.

And so, I’ve been doing a lot of adulting here. I’m at that point where “going out” means going to the bank to run errands.

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Adulting like a pro

And now the obligatory question: since I’m beginning a new stage, what’s happening to the blog?

Short answer: it stays.

Long answer: I’m beginning residency, which really isn’t a game changer. I’m still weirdo me, except I’ve got the title MD now after my name. Depression-wise I’m in a good place right now…and hopefully it’ll stay that way, if not forever, for a very loooooong ass time. Food-wise I’m kind of in a gray zone. Anxiety-wise, there’s so many things to obsess about irrationally right now. So, you can guess what my posts will focus more from now on when it comes to mental illness.

But I’m still here. Except this is all so new to me.

Grab the popcorn.

 

PS: I’m sorry if my comment replies are short and sweet. They piled up after so much time. Doesn’t mean I don’t appreciate them just the same!

 

Last night I realized I have about four weeks left here in my hometown (aka: the place I’ve been living in the past 21+ years).

Panic ensued.

Because…I’m moving away from here???

I’ve never known anything else. I mean, yes, I’ve lived in other places for a maximum of 2 months, but there was always a return date scheduled. And now I only have to buy a one-way plane ticket? No return? Nothing? Shit.

I’m not saying I don’t want it. I’m just saying I’m afraid. And I’m so afraid I don’t know what I want right now.

What have I gotten myself into??? Why wasn’t I a good girl and just stayed here to do my residency? Grass-is-greener-on-the-other-side complex, that’s why. That and wanting to do big things with my life…things I can’t do by staying here forever.

My med school BF told me: “About time you panicked. I’m surprised you hadn’t done so already.” I guess it’s good I’m panicking late in the game? Less time to get cold feet? But I know myself too well to know that even if I had only one day to mull it over, I would still get cold feet at some point. It’s a given with me.

So, this is natural, perfectly normal.

But god it feels horrible yikes!

Every time I look at my dogs my heart breaks. I don’t know when I’m going to see them again after June. And my parents? Geez. I’ve never lived without my parents. As much as I might complain about them and they might be downers for my mood, I still love them to infinity.

I’m going to live alone…..a…..l……o…..n…..e………

Double “shit”. No. Triple”shit”.

I mean, like I said, I’ve lived alone before. It always just had an expiration date on it. But now? Now it’s for realsies. Now there’s no turning back. Now it’s…

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Ok, I’ll stop now. That’s too much pressure. (But it’s the truth! *squeak*)

On a more serious note…I’m afraid for my parents. They’re not getting any younger. And I’m leaving now, just when they’re starting to show a decline in health (specifically my dad). I feel like I’m abandoning them, like the worst daughter ever. I’ve always lived with them and have always had them just…there….with me. And I’m afraid of….you know….leaving, and…stuff….happening to them while I’m gone…

And my dogs…oh my god…how am I going to live without my dogs?! No, seriously, they’ve been key in keeping me away from depression one too many times. I love them to bits.

I’m afraid of falling again into the depression hole. It’s a lot of changes. I’m afraid. Period. I’ve been excited and looking forward to having my new life, but I guess I hadn’t really *really* realized that I’ll be alone and my life and everything I know will be hitting a 180.

Crap. No wonder my face is looking like shit these days.

I’ve had a nasty flu for the past few days. Had to miss out on dance class today because of that, ugh.

Yesterday I finally received word on that teeny tiny apartment I was meaning to rent blindly. My application was accepted. All that’s missing now is my signing the lease forms and such. So it seems, I almost have a place to live in the city that I adore. That took a huge weight off my shoulders. For some reason I’d been working myself up so much over this apartment. It wasn’t letting me sleep.

In addition to that, yesterday I had the LEEP performed. It was quick and everything was fine. And hopefully it took care of everything and I won’t have to deal with this again. Hopefully the HPV infection won’t persist. But only time will tell.

I also saw R yesterday. It went well. It was kind of a farewell session, it being my next-to-last appointment with her. It was weird because I felt I didn’t have much to say. Back when I was in the hole, I always had something to say. But nowadays I sometimes feel I’m just narrating my day-to-day to G and R. And that’s really good, actually, because it means I’m managing on my own mostly and need less help from them. That’s progress. Lots of it.

So I spent part of the session reminiscing about how when I started seeing her everything was so different. I was terribly vulnerable, crushed, and needed help. R said she was proud of me and that she has no doubt in her mind about my excelling at whatever life brings me from now on.

We spoke about treatment, what I want to do and what she recommends. We agreed I’ve been in remission for quite a while now and could stop my Prozac. However, she recommends I should keep it up during this transition time going into residency and stop it 6 months after I’ve felt stable and well in the city that I adore. I agree and that’s what I’ll do. Stopping Prozac now is simply not an option.

In addition, R also said she wants me to keep going to therapy in the city that I adore. She said having the added support is not a bad idea during the transition time and that while training as a psychiatrist I will be faced with difficult situations that will potentially trigger me. She thinks having my own therapist will help not only me but my patients, as I can deal with countertransference issues with my new therapist. Plus, having my own therapeutic process is important if I’m interested in doing psychotherapy in the future. I agree with her 100%.

It’s weird, knowing my next appointment with her is my last. And it’s weird to think I’ll be going through the same thing with G at the same time. But I feel I’ll be ok. We’ll see what happens.

Well, enough rambling for today. I’m kind of out of it with this flu.

Gosh, all that residency paperwork got me going crazy. Didn’t mean to take a week off of posting there. Finally I have a decent break to write.

Well, I’m back home. That in and of itself helped a bunch in feeling better. It hurt to be in the same city as the most recent dude and not hear a word from him (I’ll call him Platonic dude from now on). So near yet so far, you know? But at home that’s the least of my worries since he’s far away and I can’t control that.

And so, I’ve kept myself busy by filling out paper after paper having to do with residency. I’ve also been busy apartment hunting from afar, although I wouldn’t exactly call it hunting since I’m so ridiculously easy to please and my only must-have requirements are appliances and good location. I already submitted my papers for a (really) teeny tiny apartment in exactly the place I want to live. I’ll be paying a shitload, but the city that I adore ain’t cheap and the apartment is EXACTLY where I want to live. Also, since my moods are very easily influenced by my environment that’s something I’m not willing to compromise in. All that’s left is receiving that “yay” or “nay” from the landlord. We’ll see.

Meanwhile, when it comes to food the past two weeks have been a crazy rollercoaster. I recently had an ear infection after a few days of back-to-back purging. I didn’t think much of it when it happened and I stopped purging for some days. But this past week I started purging again and now my other ear is infected. Odd, right?

However, I haven’t found any information on external ear infections and purging, only middle ear infections and vomiting (in toddlers). Either way, I don’t think it’s a coincidence. If there’s something eating disordered behaviors have taught me so far it’s that you always think what you’re doing to yourself isn’t “severe enough”. But oh how wrong we are…even the tiniest bit of purging or restricting wreaks havoc on our bodies. During the worst of my restricting in 2014 I had a kidney stone, then constipation and gastroparesis. Now that I’ve added purging to my behaviors both of my ears get infected out of the blue. Why else would an otherwise healthy twenty something female like myself have that happen to her?

Thankfully, I haven’t purged in 5 days. As soon as I started feeling the ear pain I’ve been more cautious of not reaching that point of no return where I feel full and want to purge. I’m not restricting, except maybe mildly. I’ve also been trying to be kind to myself and not body check as much. Also been keeping myself distracted. Trying to feel the love. Big things are a-coming in my life now.

I hope I’ll keep it up for as long as I can. I won’t count the days, though, that just makes me feel pressured.

Another thing that’s been helping is that I’ve kept my mind off men this week. I have to focus on me now and I know it. Plus, I have no prospects to look forward to here and I’m not remotely interested.

I spoke to Platonic dude the other day. I randomly texted him just to break the ice and make sure we’re on good terms, which we are. He confessed he was afraid of texting me in the aftermath and wanted to give me my space. I thanked him for being upfront about his feelings (or non-feelings) toward me. Also told him he’ll be my forever crush but I understand if he doesn’t feel we’re a match. It happens. He ended the conversation with “talk later”. But no, we haven’t. And we won’t. And I’m ok with that. It’s what I need.

I’m sure everyone who’s dated can relate to this, but it’s funny how after something doesn’t work out between you and someone you start noticing the itty bitty things that didn’t make you a good match. Platonic dude and I might seem like an incredibly amazing match on the surface, but it’s only after removing my head from the sand (or from somewhere else…) that I’ve accepted he’s right. It’s…details. Just details. Itty bitty details that make you go “crap, this won’t work”.

And the funny part? My gut felt this on the first date. I guess I let my brain get too much into it with time. That friggin’ gut feeling is always right.

I hope the gut is also right about the heart-mindblown program.

Yes. Yes it is. Let’s stay positive. It’s all a matter of how you see things.

When you’re hungry but you feel emotionally miserable so you decide to restrict/starve because you don’t want to keep feeding the monster (yourself).

That’s my current state.

It’s a mix of feeling great because I’m finally fucking restricting without my parents breathing down my neck, but at the same time feeling like shit because hunger sucks. But honestly, I prefer to starve myself than not doing it and then feeling sad AND fat.

It feels wonderful to starve while miserable. You know why? Because at least I’m getting skinny while miserable. (Yes, I’m fully aware of how horrible that sounds.) I don’t think my piece of shit body and the shit person that I am deserve the goodness of NOT feeling hunger.

To me, feeling hungry means emptiness. But a good emptiness. Empty of life, of soul, of anything that causes pain….I can focus solely on my hunger and how far I can take it, while ignoring the problems and fears in my life (solitude, changes, heartbreak, etc).

I’m always starving for something. Food, companionship, love….there’s always something. And right now I feel I deserve none of it.

Because this guy “dumped” me I now feel obviously very sad, but in addition I feel absolutely despicable, laughable, pathetic, and beyond disgusting. As a result, I don’t want anyone to pick and prod at me, not even myself. I want the disgust that is me to cease existing. And what better way to cease existing than becoming smaller as the seconds pass by and having your body slowly involuting while feeding off itself?

Somewhere in that argument there’s a big, gaping hole. I know it. But I can’t pinpoint it right now and I don’t really care either. I just want to be as cruel to myself as possible…because this guy “dumped” me, because I can’t hold down a romantic interest, because I’m fugly as shit…

I’m trying to explain something that doesn’t make any sense. Bummer. I’ll get back to it later.

In the meantime, I’ll just go to sleep….starving.

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