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A little bit of the psychiatry experience


Fist off A&E was an amazing experience. I do not regret any bit of it. Was it overwhelming? YES! There was so much to take away although I gained lots of experience that's helping me now. When I started with A&E I thought I was going to continue with it as a specialty but as a woman and hoping to start a family, more time and energy is needed to raise a family so I decided to take a more subtle path (Family medicine)

Psychiatry happens to be my first rotation and  I chose psychiatry to start with because I wanted something calm and I love the psychology path of it. As you know I love to talk to people and see changes so Psychiatry is a good opportunity with that. Although it is for a short time but It should help.

Mental health is something lots of people take for granted. With advances in technology and information, mental health has now become a relevant part of medicine. Just like physical health, mental health is something that should be taken rather seriously as we know lots of people suffer from mental health problems especially in this part of the world.

My experience so far

I started psychiatry about 4 months ago. I work most times with old age psychiatry patients and on call days I work with adult mental health patients.
Cases I have come across with adults (18-64years) are Depression, anxiety, self harm, Borderline personality disorder, Schizophrenia. Its amazing how the symptoms vary and how this patients present in different ways. Lets look at the case of a 28years old presenting with self harm. He feels depressed, feels lost amongst his peers and feels he isn't being heard, he has managed depression for a period of time and can't cope with it anymore so he decides to harm himself  by using a blade to cut himself multiple times. This may be to seek more attention or may be the only way out of how feels at that time.  Its funny how these patients do this effortlessly, feeling no pain at all. I personally can not even prick myself with a pin so for me it was strange to see this happen at the first instance but seeing so many of them I got used to the idea that these people are actually unwell. The interesting part of dealing with such patients is treating them and seeing them get better. To be honest it may be difficult sometimes because this patients are within the age where they still have enough strength and man power. They can become violent, very aggressive and as you know it can also be difficult to change their mind-set, but when you get the treatment right, you begin to see changes. Some times they get aggressive, agitated and require to be in the psychiatry intensive care unit(PICU) or even in isolation.
The psychiatry wards for young adults have no access to materials or equipment that can be used for self harm. Doors, toilets, cabinets have no handles and from the medical point of view they have no IV cannula insitu, they only take medications orally or intramuscularly. If they need IV medications then they will be transported to the hospitals where those facilities are available.

With older patients (65- 100+years), it is totally different. Symptoms vary from dementia to depression, anxiety and schizophrenia just like the younger ones. The interesting part of this is that most of them are harmless, not very aggressive and almost like babies again so interacting with them is really fun and interesting for me. You get to appreciate life more when you hear their stories and life experiences. Painting a typical scenario of an 85years old lady who has totally lost her memory, unable to carry out day to day tasks, incontinent, not able to recognise familiar faces, unfortunately lives alone. Neighbours including the community health care team get worried about her wellbeing then decide to send her to hospital for management. In hospital she may be calm or possibly act aggressive on first few days of admission while she adjusts to the new environment, she may reject medications as she thinks she isn't unwell, wanders and paces on the ward. Looking after such patients could be easy at same time difficult it just depends on how she presents and if medications are working to keep her more settled. With patients refusing medications, you will be surprised that that are given their medications covertly, meaning medications are mixed with food or drinks. This is interesting because it reminds me of my childhood. When older patients act aggressive it is easier to hold them down or talk to them compared to a strong agile 40 years old man being agitated and aggressive.

Psychiatry in general is an interesting specialty although lots of people see the aggressive part more but it is something quite interesting to do and if you feel stuck about what specialty to go for and you are someone that likes to interact with patients and you love to work at a calm pace, then this is absolutely for you. No time pressure, less acutely ill patients, choice of medications are at your discretion and experience.



Hope you like psychiatry now.

Cheers
Mute


About Mute Akpomedaye

Mute Akpomedaye
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