any Psychiatrist or anyone related to this field on the forum? - Page 7

Originally posted by: anu rulz

I get your frustration but there is another aspect to it. My personal experience with many patients has been that when they come to a psychiatrist, they prefer to have medications rather than go through therapy. It's the same as with investigations - if a doctor asks for investigations, he is looting you and if he doesn't, then he doesnt know enough or is negligent.

If I recommend therapy, am told many times, they prefer to have meds than go through the longer and often more emotionally difficult process of thought or behavioral change. Then there is the aspect of what is appropriate. Therapy will not be effective if the patient has no or little insight or awareness - like in psychosis. If depression is severe, again the risk is too high to wait for therapy to be effective.

There are unfortunately many facets which need to be balanced in a risk-benefit analysis before deciding the treatment.

Now that I do agree with, it is true that many patients want meds itself, actually my best friend is pretty much the same though she didn't say it out loud but from the way she told me and the relief she felt with the meds it was obvious she was seeking that. All I am saying is while that is true, it is also true that many times doctors are quick to prescribe medication without even suggesting therapy to compliment the meds, again i am certainly not saying most i merely mean some.

But I get what you mean, if I really wanted to talk to someone I suppose I would go to therapy to begin with and then the therapist can diagnose if meds are necessary.

Confidentiality and other legal issues have been mentioned so I will just give my opinion.

There is absolutely no way a physician can supervise nor force all of his/her patients to follow a prescribed therapy once they leave their office/facility. In the privacy of their home, adults are responsible for themselves. They themselves or their personal care giver must reach out to the medical community or to their doctor when in crisis, that in turn triggers a reaction depending on the situation.

Please remember that for any temporary or chronic condition, medication is only one part of the therapy. Let's use diabetes as an example; a patient is diagnosed with it and is prescribed medication, but the physician will also tell the patient that medication will only be effective if they follow directions on it's use and a most important part of treatment is a life style change, that they have to follow on their own, like testing daily, keeping records, visiting the MD regularly, and a radical change in the food/drink they consume. All of it has to be combined, for treatment to be effective. Once all of that is followed, the doctor will then adjust or change the medication as needed so that the patient has a positive balance. Even following all requirements and the best care, individuals can still have a crisis caused by any triggers or simply because that is how illness affects all living organisms.

You can see how care has to be integrated in parts to make a whole, and how an individual has to be an active consistent participant in their care.

The problematic part is that a lot of individuals who are suffering from mental/stress/depression issues, temporary or chronic, unfortunately tend to stop taking the medications on their own or they throw it away after a care giver thinks they took it.. The reasons are many, like stigma, availability, miscommunication, they do not like the side effects etc... or as simple as they are unaware of the seriousness of their condition (anosognosia) or the patient feels better and decides they no longer need the medication. Noncompliance or refusing to take medication is one of the most serious problems in psychiatric care.

In defense of care givers, family, friends etc... I will tell you that no one can police a determined individual from self harm, just ask anyone who has had a substance addicted loved one and they will tell you how difficult it is to manage their care and recovery. That is why no one can really be blamed for the actions or choices an independent adult makes. No one really knows what goes on in the mind of an individual, and they can be effective in hiding what they are feeling, so that their care givers or family members let down their guard, there are a lot of emotions involved. Chances are that unbeknown to anyone but himself the tragedy had been prevented many times before and that the individual determined to end their life has had the thoughts and even attempted and failed many times before. It takes only one time to succeed.

I hope this is not too long an opinion and I commend you for your questions. It helps to keep sincere and constructive dialogs open.

Originally posted by: Moodyblue

I work as resident psychiatrist at a government hospital. The work load is massive, since many people consider psychiatry to be a branch where any case can be sent to and initial mental health evaluation takes anywhere from 60-75 minutes.

Usually in government hospitals, patients are never seen alone since history taking is quite important since you never know patient might be psychotic thus a close family member is required.

A high risk patient i.e. someone with suicidal ideation is taken quite seriously, admitted if with someone is with the patient and if patient is alone, patient is asked to bring family members if possible at the time and relatives are called informing the condition with admission advised but high risk patients rarely come alone . Many times , relatives refuse admission. 5/10 times, they are like ladke ki naukri chali jayegi and ladki ki shaadi nhi hogi, admission nahi karana.

You are so right about families...one of my relative got married to a brilliant girl. She was super nice in the beginning but later he realized she is suffering from mental illness. He was ready to support her for the cure.. but the lady was not at all ready to accept she had any problems.. her family on top tortured the boy for him suggesting a mental illness. The couple suffered for so many years.. There is real need to make awareness of mental illness.

@ Mages...OMG..😒.I can't even....I am so sorry that you had to go through all that...stay strong....my goodness...❤️🤗

and as long as u don't give out any personal details....its easier to talk to strangers and lift a little burden off ur mind..I hope talking here made u feel a little better..

Thankyou everyone for the inputs.❤️..this is such good information on this thread...👍🏼

As a medical student in America, one thing we are clearly taught is that patient privacy must always be respected. In the case of anesthesia that’s different, because the patient is informed prior to the medical procedure that they will need to bring someone to take care of them. If I’m able to make my own medical decisions as an adult, unless clearly authorized by me in an official written document, my own parents cannot collect my records or be given my information. The only exceptions to this would be if I were unconscious, or incapacitated, in which case parents, a spouse, or legally appointed medical power of attorney can make decisions. Sushant had depression, but would still be considered able to make his own decisions, and since they weren’t informed, you can guess that he didn’t give permission for that information to be shared. Had he been on suicide watch, or found to be incapable of rational thought and function, then they probably would have informed someone. Even then, it’s not a simple process to do that. Plus, if he’d stopped taking his antidepressants at some time during the lockdown, he probably didn’t even notify the doctor to begin with. As long as he kept refilling the prescription what would the doctor know?

Originally posted by: blue-ice.1

@ Mages...OMG..😒.I can't even....I am so sorry that you had to go through all that...stay strong....my goodness...❤️🤗

and as long as u don't give out any personal details....its easier to talk to strangers and lift a little burden off ur mind..I hope talking here made u feel a little better..

Thankyou everyone for the inputs.❤️..this is such good information on this thread...👍🏼

a warmth hug of friendship🤗

the regret is always there and the anger too that i was deprived of my father's love due to that deadly mental disease i don't want anyone to go through what i went through in my life or even sushant

mental disease awareness is definitely needed to educate people the basic symptoms and monitoring behaviour patterns and how to handle such patients as they expert in throwing away medicines and refusal in taking medicines this is the main problem

to be honest after seeing my dad suffering and reading about sushant and even saw some schizophrenic patients there is no cure for mental disease,the mind is very fragile and sensitive, one suffer such disease they loose themselves and its dangerous for them and also surrounded them such mental disease only can control but cannot cure them fully prolong medication can be the only cure

what is more dangerous is sucidal thoughts and when this disease occurs even if the person thinks positivity thoughts it still push towards negativity thoughts

Question to experts here.. how do we identify the mental illness in our relatives , friends whom we do not interact on daily basis? How can we help them if we don’t even know there is issue? The girl I was talking about was so warm and nice and so so brilliant, never thought she Was going through some challenges. She started blaming all the family later for not helping on small things.

Originally posted by: nema123

Question to experts here.. how do we identify the mental illness in our relatives , friends whom we do not interact on daily basis? How can we help them if we don’t even know there is issue? The girl I was talking about was so warm and nice and so so brilliant, never thought she Was going through some challenges. She started blaming all the family later for not helping on small things.

It's difficult when you dont talk to or see the person frequently. But things like saying our doing something out of character could be a clue - it need not mean being only sad or paranoid. Some take life decisions which they normally wouldn't, isolate themselves, stop taking interest in things they enjoyed, be irritable or angry or could be the opposite - talk too much, spend too much money, quit their jobs. Anything which for them is out of character. That could be a clue. Life events like marriage, birth, death, change of jobs, etc are often precipitating stressors. Lack of sleep for a few days like in a Jagran or something could trigger an acute episode. There are way too many triggers to actually list everything here - sorry. But it's quite often that mental health concerns are gradual and small things are noticeable when the family or friends who know the person intimately are around.

Originally posted by: Mages

a warmth hug of friendship🤗

the regret is always there and the anger too that i was deprived of my father's love due to that deadly mental disease i don't want anyone to go through what i went through in my life or even sushant

mental disease awareness is definitely needed to educate people the basic symptoms and monitoring behaviour patterns and how to handle such patients as they expert in throwing away medicines and refusal in taking medicines this is the main problem

to be honest after seeing my dad suffering and reading about sushant and even saw some schizophrenic patients there is no cure for mental disease,the mind is very fragile and sensitive, one suffer such disease they loose themselves and its dangerous for them and also surrounded them such mental disease only can control but cannot cure them fully prolong medication can be the only cure

what is more dangerous is sucidal thoughts and when this disease occurs even if the person thinks positivity thoughts it still push towards negativity thoughts

Aww Mages, your family has gone through such a difficult time. I know you mentioned not wanting to let your husband into this space but if their is someone else you trust, maybe you could speak about some of this and it could help get a bit of closure. This was quite a significant childhood trauma girl and we usually find it affecting our relationships in future if we dont find peace.

Originally posted by: anu rulz

Aww Mages, your family has gone through such a difficult time. I know you mentioned not wanting to let your husband into this space but if their is someone else you trust, maybe you could speak about some of this and it could help get a bit of closure. This was quite a significant childhood trauma girl and we usually find it affecting our relationships in future if we dont find peace.

sure someday will try to talk it out to someone but i guess the someone will be only mom and i swear she is very strong👍🏼