“I feel stressed!! I’ve got to find a way to deal with this stress!” I popped off these words several times before I ended the call with a close friend. I specifically chose a rotation I felt I could deal with stress with ease. Why do I feel so burned out?
Just like a prequel to a good movie, I had to find a way to get your attention. Sorry I have been unavailable on my blog for quite some time. I know I’ve lost a lot of my readers. I promise to make it to you guys in the upcoming months.
I would like to inform you all I have started a 6 month rotation in Psychiatry; – a branch of medicine devoted to the diagnosis, prevention and treatment of mental disorders.
Just into a month of my rotation, I have encountered several divergent people. From manic people who can talk for an hour before taking a breath, to depressed people who utter single letters of the alphabet in between sobs. I have interviewed people who flew insults at me just at the sight of my lab coat, to those who threw kisses at me just because they loved my glasses. There are several times I have questioned myself if this specialty was actually meant for me? I have asked interminably if God was leading me in the right direction. Or it is just me being stubborn trying to prove a point?
As I take my seat in the consulting room, a week into the start of my rotation. A referral form is handed to me. “Referred as a case of hysterical aphonia, please assess and manage accordingly” Trust me! I almost left the consulting room. What weird diagnosis was this? Time check 1:00pm
Staring at me with dilated eyes, was a middle-aged woodwork carpenter who doubled-up as the father of a teenage girl – the patient in question.
“Daddy, what brings you to the clinic?” I muttered, hiding my nescience right at the back of my head with a smile.
“My daughter has lost her voice. She was seen at the ENT department and referred to your facility for treatment” He shouted. It seemed someone was expecting a miracle that day. Can I get an Amen?
A quick scan at her revealed a dark short-haired girl in glasses who mostly avoided eye contact by looking down; the only remarkable finding on visual assessment. Quickly, she handed me a note. I assumed someone was giving her number out already.
The note read “Can I talk to you privately?” I threw a no-look at her father and handed the paper back to her. A low pitched shrill voice answered “Vivian” when I asked of her name.
I motioned to the door as I asked the father to excuse us, pulling my chair forward with intent ears to listen to the story as it unfolds…like a napkin.
Vivian was a brilliant student who had recently gained admission into high school. Her father’s job was in ataxia, rendering him unable to provide the needs of his children, of whom Vivian was first born. He had to par down by relocating to a place of residence he could afford. His marriage was down-rocketing. There were numerous occasions she met her Daddy crying behind closed doors.
Fast forward to school, her name was all over the place. A school chaplain! Handwritten letters written by her boyfriend were intercepted by other students in the school. These letters tarnished her image as the school chaplain as it outlined the numerous sexual escapades with other students in the school; which were untrue.
Her sleep patterns were affected. She would spend a lot of time studying at night when she had to be asleep. Reasons for this adjustment were to isolate herself so she could avoid jesters from her dormitory mates and also to substitute for her inability to concentrate during the day.
She could not go around the school to evangelize again; something she loved to do and with ease. She lost interest in previously pleasurable activities such as singing in the choir and listening to music.
Taking a good look at her, I noticed how prominent her clavicles were, so I asked if she had lost weight? “Considerably” she replied, while she kept looking down. She revealed there were days she could go without taking food because the dining hall was a ‘no-go-area’ for her. Her ‘chop box’ was so empty and spacious she could even sleep in it.
She then began to question God and ask why all these were happening to her; her father’s job worsening his relationship with his wife. The school issues? Hard nut to crack! She begin to have feelings of extreme guilt and worthlessness thinking ‘Life was a complex maze full of intertwining endings with no exit point’
Next up, Research methods came into play. Recipes to take her life came in different flavors. A dish served cold! There were numerous occasions she would think of going to stand at the apex of her building at school and just drop down like a bomb – exploding as she scattered her desperate call for help all over the school. However she would not do this for the fear of God and going to hell.
One fateful night, she decided to end it all; by taking a bottle of bleach she found in the kitchen. However her throat began to sting so badly after a few gulps, abruptly terminating her mission. She then drank water with the attempt of diluting the poison and returned to bed.
She woke up as mute as a feather. Any word she attempted to produce went down her throat. A deep sense of guilt dawned on her and she regretted her actions. Was this enough to prevent another action of attempting her life?
Her father brought her to the hospital oblivious of her daughter’s attempt on her own life. The suicide notes hiding in her locker, her tear-stained glasses, the dark shroud smiling under her eyes and her dopamine – deprived brain.
I finally penned down the diagnosis of Severe Depression as I motioned her father back into the consulting room.
I started antidepressants and encouraged she underwent a session of cognitive behavioural therapy with a psychologist. I had to double up as the psychologist when my attention was drawn to their financial constraints. I took her contact number and bid her farewell to report the next week; educating her on the side effects of the medications and the need to report frequently for review. Time check 3:02pm
Depression is a common and serious medical illness that has to be treated just like other conditions such as hypertension and diabetes. During a depressive episode, a person can feel unremitting sadness and hopelessness. Most people suffer from a loss of pleasure, referred to as anhedonia, a state in which activities and intellectual pursuits that were once enjoyable are no longer enjoyable. This symptom can further lead to social withdrawal as they decide to while away time in their isolation.
People who are depressed tend to make more negative comments, make less eye contact, are less responsive, speak more softly, and speak in shorter sentences than people who are not depressed. In addition, people who are depressed may feel less energetic than usual or feel tired or fatigued even when they don’t physically exert themselves.
When in the grip of depression, people often feel worthless or guilt –ridden, may evaluate themselves negatively for no objective reason, and tend to ruminate over their past failings.
The more severe the depression, the longer the episode is likely to last. About two thirds of people who have a major depressive episode recover from the episode completely and return to their previous level of functioning.
The deaths of a loved one, loss of a job or the ending of a relationship are difficult experiences for a person to endure. It is absolutely normal for feelings of sadness or grief to develop in response to such situations. But being sad is not the same as being depressed.
Fortunately, it is also treatable. Before the diagnosis or treatment, a health professional should conduct a thorough evaluation which includes an interview and a possible physical examination. Blood tests can exclude other causes of depression.
The most disastrous consequence of depression is suicide. It is a stated fact that women attempt to commit suicide about three times more often than men but men succeed in killing themselves more than women.
There are a number of things people can do to help reduce the symptoms of depression. This includes regular exercise, getting quality sleep and eating a healthy diet.
If you experience symptoms of depression, the first step is to see a psychiatrist. Talk about your concerns and be evaluated fully because depression is a treatable disease.
Thanks for reading!
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