Aug 29, 2015
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Throwaway account here. I am an MS4 applying to psychiatry this cycle. From my rotations in psychiatry, I was aware of the emotionally taxing nature of the work, but I thought that I could handle it. However, my family has had a small tragedy this month and my parents, who have been married for more than 30 years, are likely going through a divorce as a result. I live at home for financial reasons and have a good relationship with both parents. Trying to emotionally support each of them at this time is exhausting. I am worried that I am becoming depressed. I feel excessive guilt and I am isolating myself from my friends and SO because I am just such a downer to be around.

I was somewhat emotionally drained by my psychiatry rotations, but it was manageable. This is not. I can't live like this, and it is making me doubt whether I have what it takes to be a psychiatrist. I guess what I need to know is this: are things different when it's your own family? Thanks for any insight.

pre-emptive EDIT: I will probably seek professional help if things get worse. What I am asking here is whether dealing with this professionally is easier than dealing with it personally. I would think so, but based on how badly I am handling this, I don't want to take any chances.
 

wolfvgang22

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Personal tragedies are usually tougher to deal with than patient tragedies, because it's personal. With patients you may have a treatment team of nurses, other doctors, a therapist to help you.
Basically, surround yourself with your own treatment team if you can - family, friends.
You can make it.
 

Shikima

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Personal tragedy is always hard to manage, it's personal. When working with others, you're not emotionally caught up in their personal circumstances - you may relate to the feelings, but they're not yours to own.
 
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Dharma

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Sorry to hear you're going through a tough time. Like all things, this too shall pass.

But remember: THE PATIENT IS THE ONE WITH THE DISEASE.
 
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jettavr6

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No matter what specialty you go into, personal tragedies are in themselves, emotionally draining. Good luck to you.
 

TikiTorches

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Sorry to hear you're going through a tough time. Like all things, this too shall pass.

But remember: THE PATIENT IS THE ONE WITH THE DISEASE.
Doesn't mean it doesn't effect you.
It's hard to leave the job at the job...
 

notdeadyet

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I guess what I need to know is this: are things different when it's your own family? ...
God, yes.
What I am asking here is whether dealing with this professionally is easier than dealing with it personally. I would think so, but based on how badly I am handling this, I don't want to take any chances.
Yes again. There is no comparison.

You will learn quickly to separate your work life from your professional life. It's called "boundaries" and you can't be any kind of psychiatrist without learning how to set boundaries very quickly. Boundaries are how psychiatrists are able to deal with very depressed people quite frequently without becoming depressed themselves.

You don't have these same boundaries when it comes to family. You intentionally let them get very close to you. So it hurts when there are trajedies and traumas at home.

Seek help if you think you need it. It can't possibly hurt and may very well help a great deal.
 
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Dharma

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What specifically does he say that applies here?
House Law #4: THE PATIENT IS THE ONE WITH THE DISEASE. True, it's just a novel, but I have found that keeping that in the back of my mind while remaining compassionate helps keep me mindful of how easy it is to absorb other's problems. I've heard numerous attendings in different fields (including psychiatry) mention this quote actually.

But this is not in reference to our own troubles and suffering.
 
May 9, 2015
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Another MS4 here. I felt the same way after my first 2 months of Psychiatry - loved it but just felt so drained. Things eventually turned around for me as I learned to better protect myself, to use positive and healthy defenses, and really just worked with better and more supportive treatment teams (I know this will be a hit or miss in residency but once you're practicing you will have some say in who you seek out for support, who you hire, etc. hopefully). If you love Psychiatry, don't let your personal experiences dissuade you, they're exactly that - personal (as opposed to professional). In my limited experience, people who become psychiatrists aren't impervious to emotional changes, mental health problems, and exhaustion - rather they're frequently the medical students better attuned to recognizing these states in others and (sometimes) themselves and wanting to do something about them. If it were the former we wouldn't always be monitoring ourselves for counter-transferences!

Best of luck getting through a tough time. I hope to run into you on the interview trail this fall!
 

Achillees

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Another MS4 here. I felt the same way after my first 2 months of Psychiatry - loved it but just felt so drained. Things eventually turned around for me as I learned to better protect myself, to use positive and healthy defenses, and really just worked with better and more supportive treatment teams (I know this will be a hit or miss in residency but once you're practicing you will have some say in who you seek out for support, who you hire, etc. hopefully). If you love Psychiatry, don't let your personal experiences dissuade you, they're exactly that - personal (as opposed to professional). In my limited experience, people who become psychiatrists aren't impervious to emotional changes, mental health problems, and exhaustion - rather they're frequently the medical students better attuned to recognizing these states in others and (sometimes) themselves and wanting to do something about them. If it were the former we wouldn't always be monitoring ourselves for counter-transferences!

Best of luck getting through a tough time. I hope to run into you on the interview trail this fall!
Seconded. Well said.
 

Dharma

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Thanks for the reassurance, everyone. I am feeling better after a few days and after reading your replies.



And thanks for this. The Fat Man is a great American.
No problem boss. And yeah, although fictional (somewhat?), I agree, he is. Anyhow, glad you're feeling better. We all ride the roll coaster at some point. Life baby!
 
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I would also add that you seem to be demonstrating that you have what it takes.
  1. You have an emotional response to a distressing life event. Patients appreciate human doctors.
  2. You are concerned that the emotional response could impact your ability to provide effective care. Patients appreciate caring doctors.
  3. You are taking steps to cope with the emotional response by reaching out to colleagues for support. Patients appreciate doctors who use healthy coping mechanisms. Well, a lot of them kind of like the docs who drink their sorrows away too, but that one can cause other problems. :)
From my perspective as a psychologist who has seen some bad psychiatrists, it sounds to me like you have the makings of of a good psychiatrist.
 

thoffen

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I'm sorry for the strain you've been through lately.

As everyone has pointed out, personal life and professional life are two entirely different things. Your ability to cope with distress in personal life is an important skill to have in order to work with patients, less so to cope with their distress and more so to be accurately empathetic and model better defenses for patients / teach them skills (depending on therapeutic orientation). However, the most important skill is the ability to set and maintain appropriate professional boundaries. That, coupled with ability to process and utilize countertransference reactions are how you remain stable and enjoy exploration of the mind as a psychiatrist. To some extent these skills are innate, and to some extent they are taught. I would recommend consulting with psychiatry attendings you are familiar with to get a better sense for your abilities in these areas.
 
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