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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Squiggles on November 18, 2007, at 20:11:23
I'd like to know why doctors do not
go after their seriously psychotic or
suicidally depressed patients to help
with medication or treatment; instead of
waiting for the suicidal, sometimes shy
and introverted, or psychotic patient
to meet them at the next appointment.
Is this the way psychiatry works everywhere?
Maybe it's a legal obstacle? I know that
vets, dentists, home cleaners, telemarketers
and hairdressers, car mechanics make far
more frequent update calls.I seriously don't get it. Maybe i am
missing parts of the puzzle, due to lack
of information.Squiggles
Posted by yxibow on November 19, 2007, at 2:51:06
In reply to Righteous Raving Loon or just Raving Loon, posted by Squiggles on November 18, 2007, at 20:11:23
> I'd like to know why doctors do not
> go after their seriously psychotic or
> suicidally depressed patients to help
> with medication or treatment; instead of
> waiting for the suicidal, sometimes shy
> and introverted, or psychotic patient
> to meet them at the next appointment.
> Is this the way psychiatry works everywhere?
> Maybe it's a legal obstacle? I know that
> vets, dentists, home cleaners, telemarketers
> and hairdressers, car mechanics make far
> more frequent update calls.
>
> I seriously don't get it. Maybe i am
> missing parts of the puzzle, due to lack
> of information.
>
> SquigglesLegal -- a doctor maintains a confidentiality and essentially a do no harm / voluntary patient relationship unless they actually believe that a patient is in immediate threat of harm to themselves, others, or abuse to children or elders. "Seriously psychotic" nor the other terms are not DSM diagnoses. If a doctor believes harm is imminent then they will likely transfer an outpatient relationship to an involuntary hold which can be renewed, all of the above depending somewhat on your state's laws.
Posted by Phillipa on November 19, 2007, at 12:36:33
In reply to Re: Righteous Raving Loon or just Raving Loon » Squiggles, posted by yxibow on November 19, 2007, at 2:51:06
Don't know what the laws are there but can you commmitt someone for 72 hours there like here for observation? Phillipa
Posted by yxibow on November 20, 2007, at 0:31:33
In reply to Re: Righteous Raving Loon or just Raving Loon, posted by Phillipa on November 19, 2007, at 12:36:33
> Don't know what the laws are there but can you commmitt someone for 72 hours there like here for observation? Phillipa
Yes, and can follow with a 15 day hold for some period of time, I don't know all the laws.
Posted by Squiggles on November 20, 2007, at 8:01:36
In reply to Re: Righteous Raving Loon or just Raving Loon » Phillipa, posted by yxibow on November 20, 2007, at 0:31:33
> > Don't know what the laws are there but can you commmitt someone for 72 hours there like here for observation? Phillipa
>
> Yes, and can follow with a 15 day hold for some period of time, I don't know all the laws.
That may be a good thing in case of emergency -
agitated depression or mania for example. One hopes that this isn't a police procedure with some of the really heavy-handed tactics that
have happened in arrests and prison incarceration. Mentally ill people living on the street for example, or people on medication but
forgetting and withdrawing, and
acting off in an airport are often confused for
terrorists and may be tasered. Semi-voluntary would be best; asking the person to be escorted
to a hospital or clinic, sedated and observed in collaboration with doctor or relative.
This is for extreme suicidality-- i think it may
save a life.Squiggles
Posted by Squiggles on November 20, 2007, at 15:24:11
In reply to Re: Righteous Raving Loon or just Raving Loon » Phillipa, posted by yxibow on November 20, 2007, at 0:31:33
The spinning waltenschauungs i sometimes
refer to are some of the strange paradoxes
i've been through; they're usually vacillations
of the "cognitive dissonance" type or a
reinterpretation of facts that stick to the
necessity of the moment-- but accepting the
facts. I think historical events are full
of this kind of thing-- politicians or historians
look back and rewrite history according to present propaganda or world events or wars, for example.Right now, my latest SW (for spinning waaltenschauung) is whether a dx (not mine)
has been wrong all along, and something far
more critical has been the problem which will
change my life and perspective. If the dx
is wrong, i will have to give up a lot (too
personal to say what but a big chunk of my life).
If i am right, and my pro-med belief turns out
to be correct, it will still be problematic but
not as devastating.Either way, i am preparing myself for "the truth", regardless of having to give up my pet 'medication for mental illness' theory, and much more. There is no alternative really.
Squiggles
Posted by Phillipa on November 20, 2007, at 18:20:35
In reply to Strange paradoxes in psychiatric dx (SWs), posted by Squiggles on November 20, 2007, at 15:24:11
Squiggles don't understand what your're saying that you will have to stop your med too????Phillipa
Posted by Squiggles on November 20, 2007, at 18:44:34
In reply to Re: Strange paradoxes in psychiatric dx (SWs) » Squiggles, posted by Phillipa on November 20, 2007, at 18:20:35
> Squiggles don't understand what your're saying that you will have to stop your med too????Phillipa
No... sorry the message is a bit nebulous;
i would love to get off my meds; there may even
have been a misdiagnosis in my case; i often said
i may have sufferred from unrecognized benzo
withdrawal or post-traumatic stress. But even
if all that were true, i cannot get off my medication after such a long time. My doctor dares
not try it, and when i have inadvertently tried the
results were really bad. So basically, i live AS IF i have bp; i cannot prove that i do or i don't have it now-- doesn't this have religious overtones? LOLNo, i am referring to another similar situation, which may infact have been successful. It turns your whole life around the life of others.
I don't doubt that there are such cases, but i think they are very hard to prove or disprove. I think we don't have an acid test.
Squiggles
Posted by yxibow on November 22, 2007, at 16:13:56
In reply to Re: Righteous Raving Loon or just Raving Loon, posted by Squiggles on November 20, 2007, at 8:01:36
> > > Don't know what the laws are there but can you commmitt someone for 72 hours there like here for observation? Phillipa
> >
> > Yes, and can follow with a 15 day hold for some period of time, I don't know all the laws.
>
>
> That may be a good thing in case of emergency -
> agitated depression or mania for example. One hopes that this isn't a police procedure with some of the really heavy-handed tactics that
> have happened in arrests and prison incarceration. Mentally ill people living on the street for example, or people on medication but
> forgetting and withdrawing, and
> acting off in an airport are often confused for
> terrorists and may be tasered. Semi-voluntary would be best; asking the person to be escorted
> to a hospital or clinic, sedated and observed in collaboration with doctor or relative.
> This is for extreme suicidality-- i think it may
> save a life.
>
> Squiggles
>Hospitals for legal reasons and to not interfere with staff have limited visiting hours, this is just a matter of fact.
A hold doesn't have to be and has faded away from (at least here) putting people in isolation booths or strapping people down provided 1) The hospital is fairly modern, 2) The patient voluntarily agrees to take calming medication ad 3) The staff don't think the patient is in an immediate danger to themselves or the other patients on a shared wing (e.g. someone on PCP)
Posted by yxibow on November 22, 2007, at 16:18:26
In reply to Re: Strange paradoxes in psychiatric dx (SWs), posted by Squiggles on November 20, 2007, at 18:44:34
> > Squiggles don't understand what your're saying that you will have to stop your med too????Phillipa
>
> No... sorry the message is a bit nebulous;
> i would love to get off my meds; there may even
> have been a misdiagnosis in my case; i often said
> i may have sufferred from unrecognized benzo
> withdrawal or post-traumatic stress. But even
> if all that were true, i cannot get off my medication after such a long time. My doctor dares
> not try it, and when i have inadvertently tried the
> results were really bad. So basically, i live AS IF i have bp; i cannot prove that i do or i don't have it now-- doesn't this have religious overtones? LOL
>
> No, i am referring to another similar situation, which may infact have been successful. It turns your whole life around the life of others.
>
> I don't doubt that there are such cases, but i think they are very hard to prove or disprove. I think we don't have an acid test.
>
> Squiggles
>
>I ultimately don't have to take medication, nobody has to, they can refuse advice or go AMA as an outpatient. But I'm stuck in a major loop of circles and circular thinking because Seroquel allows me to be functional day after day yet it also exacerbates a tic that may likely have been caused by it. I also don't relish the remote possibility of TD so I may end up taking Clozaril as a choice, which may actually improve things but is a dangerous undertaking. So I can understand the frustration of not being able to get off of ones medication for fear of becoming not functional. I'm only lucky that I still have living parents who are trying to support me back to some semblence of normality knowing that nobody will ever be perfect.
This is the end of the thread.
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