Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Djohaal]

So yesterday was world awareness day for suicide prevention. I noticed a lot of threads here are about mental health. I'm a psychiatry resident so I might be able to offer some advice. Insight about mental disorders sometimes is difficult and proper orientation is helpful.
As an example of myself, I started with depressive episodes eight years ago at the beginning of medical school. Several episodes later and a suicide attempt only this year when I started studying the stuff myself, I found a psychiatrist and the proper diagnosis of bipolar mood disorder was made. I never had response to medication and my suicide attempt was during treatment with an antidepressant.

[ChairmanPoo]

speaking of which... let's talk about the intense, absurd pressure inflicted on physicians, resident physicians and medical students, and it's consequences.


According to this article the US alone loses 400 doctors yearly to suicide. The writers note that down as the yearly output of at least "one entire medical school". (IMO that number is closer to the yearly output of TWO medical schools.) And that's without even counting morbidity and indirect mortality of other related conditions.
On top of that the article goes on to state

Depression is even more common in medical students and residents, with 15-30% of them screening positive for depressive symptoms.

Which is kind of a no-brainer, given that resident physicians tend to far more easily end up being the butt of the department (even in countries with reasonable labor laws this happens, let alone in places where such a thing is nonexistant). As such, if your average physician is around three times as likely to kill himself, it follows that his average indentured serv resident is going to have a worse lot.


The whole thing stinks even from an economical POV. Training a physician is lenghty and expensive. To have so many people fall due to suicide and burnout goes beyond the pale, from both a human and economical point of view.

[Djohaal]

Residency has shifted from a learning place to one of labor exploitation. In my country (Brazil) law sets the maximum (and ironically) the minimum weekly hours to 60. At the same time you receive a meager salary. I'm making 640 dollars per month with current conversion rates, which isn't so hot given our inflation is out of control thanks to those socialistoid labor party idiots.

I'm fortunate that since our psychiatry department is mature enough to see that is bullshit we have more reasonable 40 hour weeks, even though that is somehow illegal. Some services (esp surgery and intensive care) have residents working over 100 hours per week here. On top of that given the meager salary you'll need a secondary job to help with your income. And still, this is on a public hospital were supposedly there's no labor exploitation interest. Private hospitals are authorized here to set up residencies, on those the routine and responsibilities can be much more brutal.

We are considering creating a service to provide care to our residents and medical students. We have an average of one suicide in medical school and residency every 2-4 years; this year something curious happened, our interconsultation resident was called by a neurology resident, the reason wasn't because of some patient, the resident himself was in quite bad shape.

[ChairmanPoo]

Here, and, for that matter, theoretically in all Europe, law establishes that regular workhours plus shift duty cannot exceed 48 weekly hours on average. In practice, I am pretty much always beyond sixty, and compared to some specialities at my workplace I am getting off relatively lightly. It's not infrequent for residents to get pressured into staying after a night shift, despite the fact that those hours are unpaid and uninsured, and it's unhealthy and illegal. As if pulling all-nighters wasn't bad enough.

And still, this is on a public hospital were supposedly there's no labor exploitation interest

I think there is. Having a ready source of cheap educated professionals is a big way to save bucks, to begin with. Also, hospital managers and heads of department are likely to pressure resident physicians first, as they are far more vulnerable than other people.

[Djohaal]

Hence the Supposedly. With bunny ears.

[That Wolf]

Can we pm my problems?
I dont mind you and toady seeing them but the rest will think im "criminaly insane"

[Il Palazzo]

As a psychiatry resident, shouldn't you be advising people NOT to get psychiatric advice on the internet?

[Urist McScoopbeard]

Can we pm my problems?
I dont mind you and toady seeing them but the rest will think im "criminaly insane"

Be careful what you say, man. There's not really any doctor-patient confidentiality on the internet.

[That Wolf]

Is it against the law to murder a rapist, pedo, sick fucks? yes of course.
But I want to do it all the time, seek them out kill them. Nothing fancy though, just kill it.
Yeah sure I understand everything has emotions and feelings but when we break the 'law' dont we forfit most our rights?
So if you forfit others emotional reactions or feed on the negative, shouldnt that be a self forfit of ones own emotion?
Agreed that my own thoughts of this matter are contridictary, but am I wrong to want to stop the wrong? or am I wrong to KNOW it happens and not attempt to prevent what I am able to?

[Urist McScoopbeard]

Is it against the law to murder a rapist, pedo, sick fucks? yes of course.
But I want to do it all the time, seek them out kill them. Nothing fancy though, just kill it.
Yeah sure I understand everything has emotions and feelings but when we break the 'law' dont we forfit most our rights?
So if you forfit others emotional reactions or feed on the negative, shouldnt that be a self forfit of ones own emotion?
Agreed that my own thoughts of this matter are contridictary, but am I wrong to want to stop the wrong? or am I wrong to KNOW it happens and not attempt to prevent what I am able to?

I think that most people would agree with you, but the way the law works... as soon as you make one exception, even if it was the morally right decision, it unravels entirely and you're opening up society to a lot of moral degradation and the potential of even greater evils.

[i2amroy]

I think that most people would agree with you, but the way the law works... as soon as you make one exception, even if it was the morally right decision, it unravels entirely and you're opening up society to a lot of moral degradation and the potential of even greater evils.

Honestly I think the big problem that the law has with the idea necessarily that what you are doing is necessarily morally wrong, but rather that you aren't the appointed person to carry out such decisions and actions. Police officers, judges, lawyers, and so forth are all people that have passed the requirements needed to be allowed to carry out their specific jobs, essentially being given a "moral license" to decide upon their certain, limited, aspect of crime and punishment. On the other hand a random person most likely hasn't completed those requirements (I'm assuming you aren't a lawyer, judge, police officer, or executioner in your country) so there is no guarantee that what they believe to be a transgression and appropriate punishment actually match what the agreed upon definitions and punishments are, as well as the fact that by you acting like that you are concentrating jobs that are normally split among several people (such as the judge, jury, and executioner) into a single person, greatly increasing the chance of abuse.

[Trapezohedron]

Let's give you a standard case of dismotivation and not-being-able-to-give-a-fu with my life.

i am stuck in a rut, trying my best to help. My best isnt enough. People think I'm not doing my best. So they ask me to do even more, at the expense of my mental health. There's college oral defense waiting, and family thinks I'm lying about a lot of things even if I had not lied to them about said things in a very long while. (there is no point nor a reason to lie so why)

these people think shouting at me is going to make me better, and ultimatums are issued almost everywhere demanding to give things my all thinking that I am not. And they are right, because I also have thesis to do, I only have 100% capacity and theyre asking for 200%.

and so they shout and demean me and think i am not responsible enough. I probably am not, if only because i have loose ends that i feel so strongly to bypass and break before i can proceed. it's called university.

and i want to killcmyself because it is admittedly thr better choice. if they hate me for everything i do ten hate me for the last time so you dont have to later.

[Djohaal]

Suicide ideation is always a red flag, specially if you have plans or are executing them already. You should seek a healthcare professional (preferably a psychiatrist) to unravel your situation (a psychiatry interview is rather complex and I'm not going to make it over a forum) and see what is potentially treatable by medication and what is a better case for psychotherapy. Lithium is often prescribed to prevent suicide as there is evidence that it can independently of the disorder, reduce the risk of suicide.

Food for the thought: are you not giving all your potential and that is making you depressed, or you developed an insidious depression that now cripples your producitivity?

[Trapezohedron]

we can say its both because if i fail i get scolded and insulted at, while they wish i was a person they envisioned and not the me today.

i have spent my waking moments trying to appease them but it seems like i always screw something up and then suddenly i am the worst failure ever.

so i believe i am such.

[sprinkled chariot]

I would suggest coming to psychologist or psychoteurapist rather then visiting psychiatrist at all.

Spoiler (click to show/hide)

I dont know, how it is in your country , but in Russia going to psychiatry for survey ends up with being placed in tiny room with 10 more people, rising up in 5 hours of morning because of insanely bright lights being turned off, this is followed by medical personnel running in and yelling something like useless idiots/ shits rise up. Then  you have to leave the room and it is CLOSED until the dinner ends, so you have to roam uselessly in 60 metre long 5 metre wide corridor, unless you somehow persuade medical personnel to obtain you some books( this gets you some sympathy, so you are treated not as shit, but as underhuman being) .
During night there is another light turned off, bright enough to read, also doors are always open, so every hour someone gets into damn room  for INSPECTION)
All this is combined with medical personnel constantly yelling at everyone/ threatening to tie up to the bed/ to give nasty injections and making you to clean, what they are actually paid for cleaning( like cleaning shit after those mentally-ill people, who cant rise up from the bed) or doing rather unpleasant things like  moving cadavers to morgue, tying  raging persons to the bed, etc)
There are fucking steel rods on the windows, so it is quite prison feeling. And once you are in, you are not out in 30 days, until the doctor makes a decision on you.
Also you better dont tell ( to psychiatrist), that anything is bad, because this ends up with cheap galoperidol( aka, It is painful to think it all, or when you read the second sentence on the page, you cant remember, what was in the first sentence. This is how those, who get it describe the feelings) or getting really really bad diagnosis

Toilet is big room with 6 toilets( not toilet rooms), so everything is public. is closed for 1/3 of the day, and everyone has to use one bucket for 70 people, and there is observational room, those inside dont have the right to leave it until getting permission of the medical personnel, there is no toilet there, and doctor may not to release person out of it and tell something like shit in your pants

Showering is performed once per week, it is quite public and there is always wide opened window in the bathroom, so med-personnel can enjoy smoking, while you freeze during washing and catch cold.

So you better dont get in at all.