Okay, okay, the title does sound weird. But it was the first piece of advice we were told during our psychiatry course. Actually, it’s a piece of advice given to patients with anxiety disorders during therapy, but somehow it aptly applies to being a second-year medical student too.
It’s funny, they say that during the second year, med students tend to become hypochondriacs. Particularly during psychiatry, the line between normal and abnormal is so hazy that it’s often difficult to identify an illness from normal behavior. I guess that’s why so many people live with a mental illness and often go untreated.
For the past three weeks, we’ve been inundated with clarifying this blurred line, using the DSM-5 to pull out particular distinctions between shizoaffective, schizophreniform, and schizophrenia.
But words do not clarify as much as actions. Each week, we interview inpatient psychiatric patients. We don’t know what to expect (not even the professors know who we will interview until the morning of), which means we have to be ready for anything, from a mild depression to a severely schizophrenic patient.
And with this course, mental illness starts to become clearer. Even during preceptor visits in family medicine, I see more prevalent mental illness and how it affects patients’ physical conditions. Interestingly, most mental illness is encountered and treated during primary care visits. I guess that’s why it’s so important to be appreciating psychiatry as a necessary medical practice that is applied across specialties.
A few pieces of advice I’ve picked up in appreciating psychiatry:
- Blurred lines are good. Patients don’t conform to clear-cut diagnoses.
- Take the time to appreciate patient encounters just as much as appreciating the textbook for psychiatry. Seeing it, and being a part of the experience is essential in delineating how mental illness plays out.
- Listen intently. Sounds obvious, I know. But often patients don’t have the language to convey what they truly mean. Also, patients often use a hidden language, where their meaning comes out when they try to answer questions, and for some reason, shame and guilt make it difficult to express.
I, personally, have no interest in pursuing psychiatry, but I see how valuable it will be in any field.