Can I go into psychiatry if...

[despair]

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I'm a psychiartric patient myself? (schizoaffective?) my reasons for going into psychiatry are that I want to help people like myself...

 

[whopper]

I salute you for wanting to go into the field for a noble reason.

However, I think you're going to get more problems than pats on the back by telling programs you have schizoaffective DO. The same stigma that hurts psychiatric patients from getting work, ironically & hypocritically, is alive & well within several residency programs that are devoted to healing these same people.

I wouldn't say all programs have this issue, but several of them do.

For your own benefit, someone spoke at a NJPA (the NJ chapter of the APA) who is a practicing psychiatrist & she has bipolar. She spoke of the stigmas & prejudices she had to face in her career. I wish I had her name but if you want to contact the NJPA, give a description of this person, I think they'll refer you to her.

 

[Faebinder]

Schizoaffective DO is a level harder than bipolar in my eyes. How well controlled are you? Do you feel your judgement about human emotions/actions is not impaired? You have to ask yourself if you are really going to help the patient or just defend them / treat them with a low of countertransferance from your condition that might not be in their best interest because you can "understand" how they feel.

 

[whopper]

Schizoaffective DO is a level harder than bipolar in my eyes.

True.

If someone with a psyche disorder goes for residency, the program has every right for the safety & welfare of patients to make sure that a resident with an chronic illness can still deliver quality care. Schizoaffective DO of course--well its certainly a situation where someone has to make sure that the person with it can deliver "standard of care" care.

 

[Shalom77]

Here's a couple links with names of psychiatrists who are open about their mental illness - one of whom has schizoaffective disorder.

http://pn.psychiatryonline.org/cgi/...IRSTINDEX=50&minscore=5000&resourcetype=HWCIT

http://pn.psychiatryonline.org/cgi/...FIRSTINDEX=0&minscore=5000&resourcetype=HWCIT

There a book about UK doctors with mental illness. I don't know how good it is - not having read it - but it looks interesting.

http://www.radcliffe-oxford.com/books/bookdetail.aspx?ISBN=1+85775+887+0

To answer your question. A person with schizoaffective disorder or another psychiatric disorder can be a psychiatrist. Whether YOU can given your illness and other personal strengths and weaknesses is a slightly different question which requires a lot of self-honesty and reflection to figure out. It's not really something any of us internet folks can answer for you.

 

[Effervescent]

Some previous posts related to the topic:
Developing a psych disorder as a psych resident?
Personal Experience
"Have you ever been in Psychtherapy, doc?"

Shalom77: Thanks for YOUR links, I hope to check them out.

 

[despair]

I actually have schizoaffective disorder and borderline personality disorder. I know. TOUGH. I hope I can deliver the same quality of care to my patients. Right now, I am still in the process of stabilizing myself but am in the process of considering career options. I think am stable enough to consider career options sanely and rationally at the moment.

Will the stigma be as tough as I think it will be? Will I be a good clinician once I overcome my own obstacles? I know only I will be able to answer these questions. But I was hoping for some objective view on the matter.

 

[Faebinder]

Borderline personality? Sigh, you are really better off in another field. I'm just being honest.

Family Medicine and Internal Medicine do some basic psychiatric treatments.

How far in medical school are you?

 

[despair]

I'm in second year med school...

Really? Aww... I was hoping for some encouragement, but then again, I was asking for objectivity.

 

[HCE]

I'm in second year med school...

Really? Aww... I was hoping for some encouragement, but then again, I was asking for objectivity.

If you are detrmined to go into psychiatry, you may want to consider going into research and writing. You bring a unique perspective on the issues which could enhance the field.

 

[Shalom77]

Will the stigma be as tough as I think it will be?

The stigma will probably be worse than you think it will be.

Right now, I am still in the process of stabilizing myself ... Will I be a good clinician once I overcome my own obstacles?

The issue is that medical education progresses quite rapidly and healing and recovery from the problems you describe usually progresses at a much slower pace. So perhaps the better question is can you be a good clinician while dealing with your "obstacles"?

You'll get a taste of this on your psychiatry rotations - and can try to extrapolate somewhat from your experiences to what it would be like doing a residency/practicing as a psychiatrist while struggling with your mental health issues.

There are number of issues including:
1) Can you be objective and effective when dealing with patients with issues similar to your own.
2) Are you able to be a consistent reliable presence with your patients. (I'm not quite sure quite how to phrase this.)
3) What are the aspects of psychiatric practice that trigger your own emotional/psychological issues - and are you able to cope with those challenges without your own mental health suffering?

Another thing to consider is that you might not be ready to be a psychiatrist in the near future - but there's always the possibility of working in another area of medicine and then later going back to do training in psychiatry. That's not an easy road - but it might be a better option than going into psychiatry before you are ready from a mental health perspective.

Ultimately, while I understand the desire to help people like yourself -
you also need to ask if doing so as a psychiatrist is what's best for your patients.

Also consider that people with mental illness also have higher rates of other medical illnesses and often get inadequate care for such. There's definitely a great need for non psychiatrists who are sensitive to the needs of and advocates for patients with mental illness in other medical settings. So are there are more ways to help people with similar illnesses than being a psychiatrist.

But I was hoping for some objective view on the matter.

A reasonable opinion on the matter requires much more information about you than would be wise to for you to provide on the internet. You'd be better off discussing this with someone who knows you and whom you trust is your advocate and not prejudiced. And perhaps in addition, particularly if you do decide you want to go into psychiatry, following Whopper's advice and trying to contact and speak with a psychiatrist who has personally dealt with a similar issue. I'm not trying to discourage you, I just think it's difficult to provide either encouragement or discouragement when all you know about a person is a psychiatric label.

Keep an open mind about potential specialties during your clerkships. It's different getting the opportunity to see things in practice (no matter how limited that perspective is), than how you imagine it will be before you have much if any exposure.

 

[despair]

All I can say is I HOPE. I hope I can deal with my patients. I hope I can heal in time. I hope that in my practice, anything that might trigger anything in me will allow me to face challenges in myself consistently and without bias. I know it will be difficult.

Thank you to everyone for pointing it out to me that perhaps psychiatry may not be the best bet for me. Perhaps something less stressful and less personal may be the road for me to take.

 

[MDhasbeen]

someone in my program was openly bipolar. they had a manic episode once over the 4 yrs. program seemed supportive of them from what they told me, though this person has taken more than the standard 4 yrs to finish residency. plus sleep deprivation was one of their triggers, so make sure you strongly consider low call programs if you're going to go through with your plan in any specialty.

 

[despair]

Thanks for the support, I'll my psychiatrist even suggested that I go into neurpsychiatry when I discussed this with him. He thinks I can handle it, provided I keep myself out of the hospital.

 

[Shalom77]

Thank you to everyone for pointing it out to me that perhaps psychiatry may not be the best bet for me.

That's not what I was trying to say. And I only see one person saying that.

The point of your clerkship and any other psychiatry rotations is so that you can make a decision based on some practical knowledge not just hope. I just listed some things to consider asking yourself as you go through your rotations. I make no presumptions about your answers. And if something is an issue - a follow-up question might be what can I do to overcome this - or is this likely to change in the next couple years. Your answers to these questions may also vary depending on the type of psychiatric practice you are interested in.

Good luck!

 

[nancysinatra]

There are number of issues including:
1) Can you be objective and effective when dealing with patients with issues similar to your own.
2) Are you able to be a consistent reliable presence with your patients. (I'm not quite sure quite how to phrase this.)
3) What are the aspects of psychiatric practice that trigger your own emotional/psychological issues - and are you able to cope with those challenges without your own mental health suffering?

Ultimately, while I understand the desire to help people like yourself -
you also need to ask if doing so as a psychiatrist is what's best for your patients.

All prospective psychiatrists should be asking themselves this question--not just those who have been labeled with a psychiatric diagnosis. And furthermore, NOT having a mental illness is no guarantee of reliability, objectivity, or effectiveness.

 

[nancysinatra]

Borderline personality? Sigh, you are really better off in another field. I'm just being honest.

Isn't BPD theoretically treatable? We are sending people off to DBT with these big admonitions about all the hard psychotherapy work they're going to need to do for themselves--if the patient is motivated, then aren't they supposed to get better and then be functional? For those who have been effectively treated, is there some sort of "relapse" phenomenon? Again, if the patient is motivated, wouldn't that just be a treatment failure?

It also seems to me that this is a good example of something I mentioned in a different thread awhile back--for Axis II problems, it is extremely easy to just see the label of "personality disorder" and want to give some commentary back to the person about how they should live their life. Isn't that tantamount to giving medical advice over the internet? (Faebinder, I don't mean your question in particular, just this general subject.) EVERYONE in medicine has an opinion about what borderline people should or should not do, it seems.

 

[Faebinder]

Isn't BPD theoretically treatable? We are sending people off to DBT with these big admonitions about all the hard psychotherapy work they're going to need to do for themselves--if the patient is motivated, then aren't they supposed to get better and then be functional? For those who have been effectively treated, is there some sort of "relapse" phenomenon? Again, if the patient is motivated, wouldn't that just be a treatment failure?

It also seems to me that this is a good example of something I mentioned in a different thread awhile back--for Axis II problems, it is extremely easy to just see the label of "personality disorder" and want to give some commentary back to the person about how they should live their life. Isn't that tantamount to giving medical advice over the internet? (Faebinder, I don't mean your question in particular, just this general subject.) EVERYONE in medicine has an opinion about what borderline people should or should not do, it seems.

Just like nothing is impossible in life... it is not impossible for it to happen.. but life is not about doing the impossible...will the OP end up practicing psychiarty correctly? Will the patient with borderline personality manage to have traits that the OP will ignore because he/she feels transference? We all feel transference with some patient's but to feel positive transference with borderline personalities is a bit dangerous. Potentially disasterous... why court disaster? The OP has worked too hard and suffered med school and deserves a safer future. (E.g. just imagine the lawsuit of a patient with borderline vs. the op... the fact that she/he is borderline as well will comes out... even if she is treated it would be a disaster. Remember it's not longer if you will get sued.. it's when will you get sued.)

 

[despair]

Isn't BPD theoretically treatable? We are sending people off to DBT with these big admonitions about all the hard psychotherapy work they're going to need to do for themselves--if the patient is motivated, then aren't they supposed to get better and then be functional? For those who have been effectively treated, is there some sort of "relapse" phenomenon? Again, if the patient is motivated, wouldn't that just be a treatment failure?

It also seems to me that this is a good example of something I mentioned in a different thread awhile back--for Axis II problems, it is extremely easy to just see the label of "personality disorder" and want to give some commentary back to the person about how they should live their life. Isn't that tantamount to giving medical advice over the internet? (Faebinder, I don't mean your question in particular, just this general subject.) EVERYONE in medicine has an opinion about what borderline people should or should not do, it seems.

about borderline personality disorder being treatable... I remember a lecture about personality disorders a few weeks back and our professor said that a "cured" borderline will actually become a narcissistic PD. I'm not so sure that's true... or better... but hey, I don't know..

 

[sunlioness]

Thank you to everyone for pointing it out to me that perhaps psychiatry may not be the best bet for me. Perhaps something less stressful and less personal may be the road for me to take.

Don't make life decisions based on advice given on a message board. There are plenty of good psychiatrists who have their own personal histories that drew them to the field. Some people can do it and do it well. Some people can't. And I don't think anyone on an internet board can tell you which of those you are. That's something you need to determine by looking within your own self and through relationships with trusted mentors and treatment providers who know you and your whole situation.

Good luck with whatever you decide to do. 🙂

 

[sunlioness]

We all feel transference with some patient's but to feel positive transference with borderline personalities is a bit dangerous.

Why? It could be helpful actually to have a doctor who will listen and understand where they are coming from vs one who will try to avoid them at all costs. Borderlines oftentimes get really crappy care just because their treatment providers find them to be so frustrating and try to avoid them. To the point that in psychiatry, calling someone a "borderline" is pretty much an insult.

Yes, borderline coping skills are really really frustrating. And yes, boundaries need to be set. But those coping skills are there for a reason and underneath all that frustrating behavior is a person in a heck of a lot of pain.

about borderline personality disorder being treatable... I remember a lecture about personality disorders a few weeks back and our professor said that a "cured" borderline will actually become a narcissistic PD. I'm not so sure that's true... or better... but hey, I don't know..

That has to be one of the most ridiculous things I've ever heard.

 

[despair]

Isn't BPD theoretically treatable? We are sending people off to DBT with these big admonitions about all the hard psychotherapy work they're going to need to do for themselves--if the patient is motivated, then aren't they supposed to get better and then be functional? For those who have been effectively treated, is there some sort of "relapse" phenomenon? Again, if the patient is motivated, wouldn't that just be a treatment failure?

It also seems to me that this is a good example of something I mentioned in a different thread awhile back--for Axis II problems, it is extremely easy to just see the label of "personality disorder" and want to give some commentary back to the person about how they should live their life. Isn't that tantamount to giving medical advice over the internet? (Faebinder, I don't mean your question in particular, just this general subject.) EVERYONE in medicine has an opinion about what borderline people should or should not do, it seems.

about borderline personality disorder being treatable... I remember a lecture about personality disorders a few weeks back and our professor said that a "cured" borderline will actually become a narcissistic PD. I'm not so sure that's true... or better... but hey, I don't know..

 

[Shalom77]

Isn't BPD theoretically treatable?

In this longitudinal study which admittedly excluded those with comorbid schizoaffective disorder, 40% remitted by 2 years and 88% had remitted at the 10 year follow-up.

Some of the factors associated with an earlier remission are probably characteristics that a medical student would have:

history of childhood competance, history of vocational competence, age younger than 25, conscientiousness, and perhaps others.

http://ajp.psychiatryonline.org/cgi/reprint/163/5/827

about borderline personality disorder being treatable... I remember a lecture about personality disorders a few weeks back and our professor said that a "cured" borderline will actually become a narcissistic PD. I'm not so sure that's true... or better... but hey, I don't know..

That has to be one of the most ridiculous things I've ever heard.

I agree.

Here's an abstract about Axis II Comorbidity in patients with borderline personality disorder from the same group. I don't have access to the full article - but their conclusion:

CONCLUSION: The results of this study suggest that axis II disorders co-occur less commonly with BPD over time, particularly for remitted borderline patients. They also suggest that anxious cluster disorders are the axis II disorders which most impede symptomatic remission from BPD.

http://www.ncbi.nlm.nih.gov/pubmed/...nkpos=1&log$=relatedarticles&logdbfrom=pubmed

Edit: I also agree that there's nothing wrong or dangerous with having positive countertransference towards patients with borderline personality disorder. People with this disorder are usually quite aware of the negative countertransference of many providers which I agree does lead to worse care and often psychological harm. The other side to this is that sometimes patients are inappropriately labeled as borderline just because a care provider finds them difficult and not because they actually meet the criteria for the disorder.

 

[despair]

Isn't BPD theoretically treatable? We are sending people off to DBT with these big admonitions about all the hard psychotherapy work they're going to need to do for themselves--if the patient is motivated, then aren't they supposed to get better and then be functional? For those who have been effectively treated, is there some sort of "relapse" phenomenon? Again, if the patient is motivated, wouldn't that just be a treatment failure?

It also seems to me that this is a good example of something I mentioned in a different thread awhile back--for Axis II problems, it is extremely easy to just see the label of "personality disorder" and want to give some commentary back to the person about how they should live their life. Isn't that tantamount to giving medical advice over the internet? (Faebinder, I don't mean your question in particular, just this general subject.) EVERYONE in medicine has an opinion about what borderline people should or should not do, it seems.

about borderline personality disorder being treatable... I remember a lecture about personality disorders a few weeks back and our professor said that a "cured" borderline will actually become a narcissistic PD. I'm not so sure that's true... or better... but hey, I don't know..

 

[michaelrack]

Isn't BPD theoretically treatable? We are sending people off to DBT .

The symptoms of BPD are treatable - suicidality, impulsivity, etc. It is hard to change the core deficits- sense of emptiness, lack of stable identity.

 

[Shalom77]

The symptoms of BPD are treatable - suicidality, impulsivity, etc. It is hard to change the core deficits- sense of emptiness, lack of stable identity.

Although those are the most persistent symptoms, it still seems that for a significant percentage of people even those core symptoms remit over time.

http://ajp.psychiatryonline.org/cgi/reprint/164/6/929

Regardless of the statistics though - they tell you nothing about the prognosis of any one individual or that individual's ability to keep any residual symptoms from interfering with their professional functions - which is why I don't think one can give advice one way or the other on the basis of a label alone.

OP, I heartily agree with this advice. 👍

Don't make life decisions based on advice given on a message board. There are plenty of good psychiatrists who have their own personal histories that drew them to the field. Some people can do it and do it well. Some people can't. And I don't think anyone on an internet board can tell you which of those you are. That's something you need to determine by looking within your own self and through relationships with trusted mentors and treatment providers who know you and your whole situation.

 

[despair]

Thank you everyone for taking time to reply. I guess, in the end, it all boils down to me, doesn't it. I'll work with my psychiatrist on this one. Thank you.

 

[tr]

If you can get through college and med school with whatever handicaps you have, you can definitely get through psychiatry residency. The hardest part is over.

It would be your own judgement call as to whether you might feel things were getting too personal in your profession.

 

[despair]

Hey, thanks... Maybe I can. I'm just worried that since I am already emotionally labile, that I may impose countertransference on my patients.