Psychiatry and bleeding disorders

I always wondered how Freud treated his patients with his unique strategy called "Psychoanalysis". Fortunately I am studying Psychoanalysis in depth these days. I am really excited and thrilled to know all the techniques used by Freud. I also believe that a person's past plays an important role in the development of psychopathology at the conscious level. When there are conflicts between the conscious and unconscious level we tend to see or find people with mental disorders. Frankly speaking I never wanted to pursue a career in Psychiatry or Clinical psychology but it was my destination. I always hated it and never wanted to deal with mentally ill patients. The field of mental health never allured or thrilled me. But it was my mamma who always ignited an aptitude towards Psychology and Psychiatry. I used to complain to my mamma that it is so difficult to deal with mentally unsound people as the manifestation of the psychiatric symptoms is absolutely different from diseases and disorders of other organ systems. I never realized that there were diagnostic classification systems developed for making diagnosis of various mental disorders. There are two major systems of classifications of mental disorders: ICD 10 (International classification of diseases) and DSM IV ( Diagnostic and statistical manual of mental disorders). I feel comfortable in using DSM IV TR to make diagnosis. It has details and descriptions of Psychiatric disorders in points which is easy to read and remember. ICD 10 on the other hand is very descriptive which I do not like. 

It is so unfortunate that Psychiatric disorders are not given importance by people and there are various taboos associated with Mental health profession. If someone considers to consult a psychologist or psychiatrist then the family members and friends think that the concerned person has become mad or has lost his/her senses. I do not know how to define normal and abnormal behavior in life. I can differentiate between deviant and normal behavior as per the diagnostic criteria but I cannot say that we all are sane or so called normal individuals. We have our own mental conflicts and confusions in life. Unfortunate are those who cannot deal with those mental conflicts and get a label of mentally ill person. Labeling a person with a particular mental disorder has been a controversial issue in the field of mental health. When a person gets a label of a psychiatric disorder then the attitude of the friends, family and colleagues changes. They think that the mentally ill person can harm them or cannot live life in a normal way. I feel pathetic to see the condition of the patients who are not given food and kept in isolation just because of their mental disorder. The understanding of mental disorders of the general mass is insufficient and has created many taboos for the afflicted individuals. There is a need to make others understand that mental illness is not communicable, it can happen to anyone and people who have mental disorder are not necessarily violent.  

I read about Mood and Psychotic disorders in my Bachelors. Both these mental illnesses always allured me. I think that it would be wonderful to estimate the number of cases of mood disorders in women with bleeding disorders. It is so unfortunate that there is hardly any effective literature available for the researchers to further research on unipolar depression or bipolar affective disorder in females with Von willebrand's or hemophilia or other bleeding disorders. It is really important to give appropriate psychological care to bleeders irrespective of their gender. But being a female with bleeding disorder, I am a little biased and think that females need more psychological support and professional help than their male hemophiliacs counterparts. The reason is simple of my belief  i.e, women are diagnosed late in their life, have little resources to deal with their bleeding episodes, there is denial by the family members as well as the medical professionals that can make the afflicted psychologically weak at times. I have personally experienced the need of a mental health professional at the times of crisis and confusion being a bleeder. Fortunately I have a mental health professional at my home who always gave me psychological support. She helped me when I felt low and doubted my abilities. It is fruitful to meet a counselor or psychologist when we are confused and want instant solutions for our problems. There is one major principle of counseling i.e, the solution lies within the person itself, it is the counselor or psychologist who guides the person to reach towards that solution. So I personally feel that psychological services are important for women with bleeding disorders and also for those without them.

Now I am madly in love with Psychiatry and have acquired the skills to help people with or without mental disorders. The beauty of being a mental health professional is that we treat/heal people who are facing challenging in living life in an effective manner as well as those whose behavior deviates from the normal. As I always say "there is no universal definition of madness or insanity and we all are not absolutely normal".

An unexpected visit to the hospital

Some things in life occur unexpectedly. But everything that occurs has a purpose behind its existence. Accepting it with an open mind helps in facing the reality and truth of life. The same principle is applied on health ailments according to me. Since Friday my lower abdomen is paining badly. I cannot get up from the bed because of my pain. This is why I could not attend my OPD today and decided to see a surgeon. I am not a kind of a person who avoids visiting hospital. I like the environment there and it teaches me how to carry the candle of hope when life seems to full of uncertainties. But today's visit to the hospital was unplanned. I was trying to ignore my pain thinking that it would subside on its own. Unfortunately the pain continued for more than three days to such an extent that I had to take an injection of painkiller. Then I seriously thought of going to a doctor. Sometimes we avoid our bodily conditions which become big headaches for us in the future. How unfortunate are those who cannot afford the cost of health care treatment. 

This morning I consulted a surgeon and he examined me. He advised an ultra sound and blood tests. I had to wait for an hour for my turn at the radiology department because there was a huge rush. I sat on a chair and waited for my turn. Ultimately my ultra sound and blood test was done. The ultra sound finding revealed that there is inflammation in my Ceacum (the first portion of the large bowel, situated in the lower right quadrant of the abdomen). My blood reports will come tomorrow. I am trying to ignore my pain so that I could do my work but my pain is really troublesome and severe. I hope my pain and inflammation will subside soon. I am keeping my fingers crossed.

A wonderful day at St. Stephen's

Today I met my team - mates after a long time. It was so nice to know that they missed me a lot. I could not attend my Psychiatry OPD because of my surgery. So I made my mind to go to the hospital and give them a surprise. Everyone looked lively, happy and cheerful. I must tell you that our Psychiatry department is all women's department. We have no male psychiatrist or clinical psychologist in our team. Being the only women department, we feel proud on our women power. It is so nice to see all the ladies at work and trying their best to provide the best treatment to all the patients. When I first joined St.Stephen's I was worried about the kind of team - mates I would work with. But I was given a warm welcome and accepted by everyone. Our department head Dr R is the most cheerful person I have ever met. She has charm which attracts the patients and her treatment is a miracle for them. Our clinical psychologist Dr S is a real sweet heart. She makes sure that I have my coffee on time. I do not like having coffee or tea but when she requests me to join her I am not able to say NO to her. On the other hand, Dr J is a very serious person by nature. She says that I am more like her in terms of clinical practice. She makes me sit with her during the therapy sessions so that I could learn. Dr J is fond of reading and you will always find a new book on her table. Her area of interest is addiction and adolescence disorders.

So I started my day by traveling in the metro train to reach my hospital on time. Dr S was amazed and happy to see after my surgery. I had my breakfast with her. Then our psychiatric social worker Miss A came and joined me and Dr S. By that time no patient poured in so we chatted for sometime. We discussed about the rebellious behavior of today's adolescents and how the parents can better deal with it.

While we were discussing this Dr R came and greeted us with a wonderful smile on her ever charming face. She was so happy to see me again in the department after my surgery. Ultimately Dr J came. She was having bad migraine today but she was enthusiastic to see her patients.

My first patient had depression because of various precipitating factors. He has no permanent job and has some financial problems. This patient is supposed to pay a heavy debt as he took loan for his daughter's wedding. His daughter's in laws did not take her to their home after she gave birth to a baby girl. I felt extremely sorry for that patient. Is it a crime to give birth to girls? I wish people realize the potential and importance of females and stop considering them less than males. It is so paining to know that we still come across such stories where giving birth to a girl is considered a crime. Is our country really making progress? God knows.

The second patient was an old lady of 75 years. She had some memory deficits and was hardly able to tell anything. Her son and grandsons were with her. It was really nice to see a close knit family. The grandsons were very anxious to know about their granny's condition. The support of the family is important in recovery of the patient's condition. The old lady is fortunate to have such loving people around her.

Then a lawyer practicing in the high court came to meet Dr R. She was her very old patient. The patient was diagnosed a chronic psychiatric illness many years and was prescribed treatment. It was so nice to see her doing well. She continued the treatment and felt much better. Dr R counseled her regarding importance of continuing the treatment as she was insisting to stop all the treatment modalities including cognitive behavioral therapy and medications. 

These three patients touched my heart. I hope that our patients do well in their life and recover.

I was tired after the OPD and everyone wanted me to have lunch with them. But I denied as I wanted to  write about today's experience. But Dr S wanted me to taste the sweets she made. She knows that I really like sweets. She makes wonderful Indian sweets with lots of sugar and milk. So, before leaving the hospital I had nice sweets made by Dr S. Our team has different food habits. Dr R and Dr S try to avoid sweets and junk food but they want others to have it and enjoy. Their wish is that I put on more weight. They say you are lean and we want to become like you. All crazy ladies. Both of them try their best to reduce their weight but fail to do so whenever they see Dr M's homemade cheese cakes. Dr M is a neurologist and a part of our gang. She makes wonderful cakes and pastries. So everyone waits for her treat. Dr M is herself a fitness freak. On the hand, I do not have anything during our coffee break unless and until Dr S persuades me. It is like a daughter mother relationship which I share with her. She is an excellent mentor and a very sweet person to gel with. Our department is never dull because of such wonderful ladies and their dedication to serve human race.

On the whole, my first day at the hospital after my surgery was really memorable and exciting. I will surely remember this day.

Cheers to our all women's team at St. Stephen's.