I got it all wrong
The diagnosis is wrong
The gym does not help
Wednesday, January 13, 2010
Tuesday, January 12, 2010
Mood Indigo, p III
From The New York Times
Behind the promotion of Western ideas of mental health and healing lie a variety of cultural assumptions about human nature. Westerners share, for instance, evolving beliefs about what type of life event is likely to make one psychologically traumatized, and we agree that venting emotions by talking is more healthy than stoic silence. We’ve come to agree that the human mind is rather fragile and that it is best to consider many emotional experiences and mental states as illnesses that require professional intervention. (The National Institute of Mental Health reports that a quarter of Americans have diagnosable mental illnesses each year.) The ideas we export often have at their heart a particularly American brand of hyperintrospection — a penchant for “psychologizing” daily existence. These ideas remain deeply influenced by the Cartesian split between the mind and the body, the Freudian duality between the conscious and unconscious, as well as the many self-help philosophies and schools of therapy that have encouraged Americans to separate the health of the individual from the health of the group...
All cultures struggle with intractable mental illnesses with varying degrees of compassion and cruelty, equanimity and fear. Looking at ourselves through the eyes of those living in places where madness and psychological trauma are still embedded in complex religious and cultural narratives, however, we get a glimpse of ourselves as an increasingly insecure and fearful people. Some philosophers and psychiatrists have suggested that we are investing our great wealth in researching and treating mental illness — medicalizing ever larger swaths of human experience — because we have rather suddenly lost older belief systems that once gave meaning and context to mental suffering.
Behind the promotion of Western ideas of mental health and healing lie a variety of cultural assumptions about human nature. Westerners share, for instance, evolving beliefs about what type of life event is likely to make one psychologically traumatized, and we agree that venting emotions by talking is more healthy than stoic silence. We’ve come to agree that the human mind is rather fragile and that it is best to consider many emotional experiences and mental states as illnesses that require professional intervention. (The National Institute of Mental Health reports that a quarter of Americans have diagnosable mental illnesses each year.) The ideas we export often have at their heart a particularly American brand of hyperintrospection — a penchant for “psychologizing” daily existence. These ideas remain deeply influenced by the Cartesian split between the mind and the body, the Freudian duality between the conscious and unconscious, as well as the many self-help philosophies and schools of therapy that have encouraged Americans to separate the health of the individual from the health of the group...
All cultures struggle with intractable mental illnesses with varying degrees of compassion and cruelty, equanimity and fear. Looking at ourselves through the eyes of those living in places where madness and psychological trauma are still embedded in complex religious and cultural narratives, however, we get a glimpse of ourselves as an increasingly insecure and fearful people. Some philosophers and psychiatrists have suggested that we are investing our great wealth in researching and treating mental illness — medicalizing ever larger swaths of human experience — because we have rather suddenly lost older belief systems that once gave meaning and context to mental suffering.
White Coat, Mood Indigo
From New England Journal
"Although rates of depression among students entering medical school is similar to that among other people, the prevalence increases disproportionaly over the course of medical school"
"Why does being a medical student increase the risk of depression? Raymond believes that students’ coping strategies and
personal health deteriorate as they progress through medical school. Students “see themselves going into a very narrow tunnel,” she said. “A lot of the depression we see halfway through the [first] year — it’s a reaction to having constricted themselves down to studying these subjects in a very intense way. It’s pretty unidimensional.”
Symptoms of depression in medical students can be difficult to distinguish from the effects of the stress inherent in student life. Students often dismiss their feelings of despondency as a normal emotional response to medical school, where they live from test to test and don't take time for themselves.
"It's hard to ask about depression in medical students, because you ask about sleep, and all medical students aren't sleeping," explained Angela Nuzzarello, a psychiatrist and dean of students at Northwestern University's Feinberg School of Medicine in Chicago. "They are overwhelmed, they are working hard, and they aren't having fun socially. . . . Of course they are fatigued."
The emotional and academic challenges involved in becoming a physician wear on students. Their initial encounters with illness and death may unmask psychological vulnerabilities. Such encounters often resonate with unresolved episodes of loss or trauma in the student's past or come as a shock to those who have had little experience with death. The treatment of death as a part of the daily routine may appear cold and calculating to students, who may fear becoming emotionally detached. Some become overwhelmed by the emotional toll of caring for others.
Students may become depressed at any point in medical school, but Gartrell has found that the period of greatest distress occurs during the third and fourth years, when students rotate through the hospitals and clinics. "In the clinical years, there's just far greater commitment of time, plus as match pressure begins to emerge, it's an extremely stressful time for a lot of people," she said. Students are often separated from friends and classmates and must work with a constantly changing set of residents and attending physicians, which contributes to their sense of isolation. Gartrell said that many of the female students she sees are worried that the mounting demands of training and clinical practice will not allow them time to find a partner, marry, and have children. Haynes noted that the increase in sleep deprivation during rotations may also expose mood disorders."
"Although rates of depression among students entering medical school is similar to that among other people, the prevalence increases disproportionaly over the course of medical school"
"Why does being a medical student increase the risk of depression? Raymond believes that students’ coping strategies and
personal health deteriorate as they progress through medical school. Students “see themselves going into a very narrow tunnel,” she said. “A lot of the depression we see halfway through the [first] year — it’s a reaction to having constricted themselves down to studying these subjects in a very intense way. It’s pretty unidimensional.”
Symptoms of depression in medical students can be difficult to distinguish from the effects of the stress inherent in student life. Students often dismiss their feelings of despondency as a normal emotional response to medical school, where they live from test to test and don't take time for themselves.
"It's hard to ask about depression in medical students, because you ask about sleep, and all medical students aren't sleeping," explained Angela Nuzzarello, a psychiatrist and dean of students at Northwestern University's Feinberg School of Medicine in Chicago. "They are overwhelmed, they are working hard, and they aren't having fun socially. . . . Of course they are fatigued."
The emotional and academic challenges involved in becoming a physician wear on students. Their initial encounters with illness and death may unmask psychological vulnerabilities. Such encounters often resonate with unresolved episodes of loss or trauma in the student's past or come as a shock to those who have had little experience with death. The treatment of death as a part of the daily routine may appear cold and calculating to students, who may fear becoming emotionally detached. Some become overwhelmed by the emotional toll of caring for others.
Students may become depressed at any point in medical school, but Gartrell has found that the period of greatest distress occurs during the third and fourth years, when students rotate through the hospitals and clinics. "In the clinical years, there's just far greater commitment of time, plus as match pressure begins to emerge, it's an extremely stressful time for a lot of people," she said. Students are often separated from friends and classmates and must work with a constantly changing set of residents and attending physicians, which contributes to their sense of isolation. Gartrell said that many of the female students she sees are worried that the mounting demands of training and clinical practice will not allow them time to find a partner, marry, and have children. Haynes noted that the increase in sleep deprivation during rotations may also expose mood disorders."
Monday, January 11, 2010
Thursday, January 7, 2010
Storming
Hrm
" 'The art of any art is the art of obsession,' she said. 'This is not something that people in general tend to understand. They encourage you to be well-rounded, which bemuses me in a society that tends to reward the specialists – the obsessives – those who decided to excel at one thing instead of becoming good at a hundred or competent at a thousand.' "
In another note, the psychiatry professor ruminated outloud to the lecture hall full of med studnets,"Yes most of you have class C personality disorders, thats probably how you have got this far in your training."
per wikipedia:
Cluster C (anxious or fearful disorders)
Avoidant personality disorder (DSM-IV code 301.82): social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation and avoidance of social interaction.
Dependent personality disorder (DSM-IV code 301.6): pervasive psychological dependence on other people.
Obsessive-compulsive personality disorder (not the same as obsessive-compulsive disorder) (DSM-IV code 301.4): characterized by rigid conformity to rules, moral codes and excessive orderliness.
Debated with M the merit of 10,000 hours, while he casually took apart his electric keyboard and reconstructed it.
" 'The art of any art is the art of obsession,' she said. 'This is not something that people in general tend to understand. They encourage you to be well-rounded, which bemuses me in a society that tends to reward the specialists – the obsessives – those who decided to excel at one thing instead of becoming good at a hundred or competent at a thousand.' "
In another note, the psychiatry professor ruminated outloud to the lecture hall full of med studnets,"Yes most of you have class C personality disorders, thats probably how you have got this far in your training."
per wikipedia:
Cluster C (anxious or fearful disorders)
Avoidant personality disorder (DSM-IV code 301.82): social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation and avoidance of social interaction.
Dependent personality disorder (DSM-IV code 301.6): pervasive psychological dependence on other people.
Obsessive-compulsive personality disorder (not the same as obsessive-compulsive disorder) (DSM-IV code 301.4): characterized by rigid conformity to rules, moral codes and excessive orderliness.
Debated with M the merit of 10,000 hours, while he casually took apart his electric keyboard and reconstructed it.
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