I’m a week into my psychiatry rotation (three more weeks until third year is over!) and man have I learned a ton! I’m rotating in the inpatient unit at a hospital for children and adolescents. So just as if someone came to the hospital for a COPD exacerbation or a heart attack, our patients have had some sort of mental/psychiatric breakdown that landed them in our hospital. They suffer from long term conditions like depression, bipolar disorder, personality disorder, schizophrenia, etc. Many of them have anger issues and problems with authority which makes it especially difficult to deal with. There were like 3 fights my first morning, I was definitely overwhelmed.
Compared to my patients, I grew up in a sanctuary. I had a 2-parent household with siblings that were fully mine. My parents loved me and supported [most of] my endeavors. I got teased in school like everyone but never actively bullied on a regular basis. And most notable, I never knew anyone who committed suicide. The problems that most of the patients battle stem from the inability to say all of those things. They’ve seen and dealt with more trauma in their 14 years than I ever will in my lifetime–and it’s taken a huge toll on their mental health. One of the more common disorders I’ve seen is depression with psychosis. The patient meets criteria for clinical depression but also have auditory and visual hallucinations. In most cases, when the patient gets triggered (usually by loud noises or yelling), the voices start/get louder. These voices they hear tell them to commit suicide or self-harm or harm other people. We teach them all kinds of coping mechanisms to help them stay strong against them, but eventually they get out of control and that’s when trouble starts.
Thankfully there is medication available to help get their illness under control. In the long run, its likely for many that they will come off of medication and only need to do therapy in order to stay stable. For some, especially with their home situations, they will need to be on anti-depressants/anti-psychotics life long. It’s that whole thing about nature vs. nurture. I’m sure there are kids growing up in the same environment and same social class but don’t suffer from mental illness because of their loving parents, siblings, and friends. One of my patients called her mom the day after a suicide attempt and her mom said she didn’t care. I mean what??? This is real life y’all I can’t make this stuff up. I tried to tell her to find strength in God and trust Him to deliver her, but I don’t think I got anywhere unfortunately.
So this first week has definitely been a reality check. It’s not just in the movies and tv shows. There are hundreds of teenagers across the country suffering from mental illness and before I know it, some of them will be my patients. I’m grateful to have been exposed to it at the level that I have so I can develop some techniques along the way that can help me. I’m definitely looking forward to another week at this site and then I’ll move on to the main hospital when I’ll be seeing adults.
I’d encourage anyone who has younger siblings, cousins, family friends, etc. to check in on them and see how they are doing in school. Ask them directly about any issues they are having and listen to them and read between the lines. Something as seemingly simple as teasing, or having a friend that gets teased a lot in school, can plant seeds of insecurity that manifest later in life as mental illness or self-harm. It can be invisible until it’s too late.
Have a wonderful week 🙂