Interesting Observations as a Psychiatrist

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On vacation and there’s a bit of a lull now. Thought I’ll start something interesting and potentially fun.

What are some interesting things you have observed as a psychiatrist? This is open to residents and attending.

I’ll start with a few:

I have practiced in rich areas and poor areas. In the rich areas, the men were the primary breadwinners. The men cheating and moving to someone else was not uncommon. The women were more distraught if a relationship ended. In poor areas, men are the ones clinging onto the relationships. Some even attempted suicide when their women left. Often, the men had pretty much nothing going for them.

I grew up in an upper middle class household towards the latter part of my adolescence. I had no clue how many people were dependent upon the government. Since practicing in a poor area, I see there are people getting disability money since childhood. Sometimes the disability was self-inflicted such as due to drug addiction. They also get income based housing and Medicaid. They do not need to work at all as all their basic necessities are paid for. Commonly they spend their lives on alcohol and drugs.

Being a psychiatrist is useful for dating. For example, I’m getting very good at diagnosing high functioning autism. It’s eye-opening getting first hand experience of meltdowns and unmasking and sensory overload. Once I determine a woman has that, I nope the heck out of there. It’s a shame since some of them are pretty.

 

[Merovinge]

On vacation and there’s a bit of a lull now. Thought I’ll start something interesting and potentially fun.

What are some interesting things you have observed as a psychiatrist? This is open to residents and attending.

I’ll start with a few:

I have practiced in rich areas and poor areas. In the rich areas, the men were the primary breadwinners. The men cheating and moving to someone else was not uncommon. The women were more distraught if a relationship ended. In poor areas, men are the ones clinging onto the relationships. Some even attempted suicide when their women left. Often, the men had pretty much nothing going for them.

I grew up in an upper middle class household towards the latter part of my adolescence. I had no clue how many people were dependent upon the government. Since practicing in a poor area, I see there are people getting disability money since childhood. Sometimes the disability was self-inflicted such as due to drug addiction. They also get income based housing and Medicaid. They do not need to work at all as all their basic necessities are paid for. Commonly they spend their lives on alcohol and drugs.

Being a psychiatrist is useful for dating. For example, I’m getting very good at diagnosing high functioning autism. It’s eye-opening getting first hand experience of meltdowns and unmasking and sensory overload. Once I determine a woman has that, I nope the heck out of there. It’s a shame since some of them are pretty.

I work in an upper middle class area and live in a nearby upper middle class area. There are many families where the woman out earns the man (including my own!). I met a few trophy wives, but largely it's 2 income/2 professional households. I have met numerous SAHD's where the wife is a lawyer/doctor. I agree that in poorer areas the men are really struggling, it's impossible to look at current suicide data and think otherwise.

The idea that drug addiction is "self-inflicted" is a myopic narrowing of a very complicated issue. A country should be judged by how it takes care of it's most vulnerable and it's clear that we struggle with more addiction that other similarly resourced countries due to the poor job we do taking care of our most vulnerable. Trailer Park Boys aside, do you really think drinking $8 handles of vodka in a trailer park 7 days/week is somehow a great existence?

Being a psychiatrist is definitely advantageous for dating, although I think understanding countertransference is probably the most helpful bit rather than being remorseful about having to run away from attractive females who have high functioning ASD...

 

[FatherPsychiatry]

Being a psychiatrist is useful for dating. For example, I’m getting very good at diagnosing high functioning autism. It’s eye-opening getting first hand experience of meltdowns and unmasking and sensory overload. Once I determine a woman has that, I nope the heck out of there. It’s a shame since some of them are pretty.

Same. Definitely get some odd vibes from a girl, and after I overload their senses, I quietly grab my clothes and sneak out of their apartment!!

 

[calvnandhobbs68]

lol your first two things are actually sociological observations, has nothing to do with psychiatry or being a psychiatrist.

your last thing i don't even know.....

 

[Cath Up]

On vacation and there’s a bit of a lull now. Thought I’ll start something interesting and potentially fun.

What are some interesting things you have observed as a psychiatrist? This is open to residents and attending.

I’ll start with a few:

I have practiced in rich areas and poor areas. In the rich areas, the men were the primary breadwinners. The men cheating and moving to someone else was not uncommon. The women were more distraught if a relationship ended. In poor areas, men are the ones clinging onto the relationships. Some even attempted suicide when their women left. Often, the men had pretty much nothing going for them.

I grew up in an upper middle class household towards the latter part of my adolescence. I had no clue how many people were dependent upon the government. Since practicing in a poor area, I see there are people getting disability money since childhood. Sometimes the disability was self-inflicted such as due to drug addiction. They also get income based housing and Medicaid. They do not need to work at all as all their basic necessities are paid for. Commonly they spend their lives on alcohol and drugs.

Being a psychiatrist is useful for dating. For example, I’m getting very good at diagnosing high functioning autism. It’s eye-opening getting first hand experience of meltdowns and unmasking and sensory overload. Once I determine a woman has that, I nope the heck out of there. It’s a shame since some of them are pretty.

Echoing that viewing substance use disorders as "self inflicted" is a pretty surprising take from a psychiatrist. Read "In the Realm of Hungry Ghosts." In my experience most people with addiction issues have had horrible adverse childhood events giving them pretty understandable reasons to dissociate, escape, avoid, that were entirely outside of their control. People need to take agency at some point but we don't have to lose empathy to acknowledge that.

 

[TexasPhysician]

The main issue with much of these larger musings is that none of us have a huge sample size. I generally see more high producing females than males. Obviously substance abuse will negatively impact finances. Whether you start as low income or high income, substance abuse can equalize everyone financially.

I find it more interesting how niche trends seem to occur. For instance, I have these random evals occur where men come in to discuss infidelity (either side) and how to move forward. They don’t want a true psychiatric eval or meds. They are always 1 appointment and never schedule again. I don’t understand if I’m extremely effective at helping men process infidelity, so terrible no one returns, or why it keeps happening. A generic “friend” is how they find me. No where on my website does it state I enjoy infidelity counseling, male counseling, or anything related. I have 0 “therapy only” patients right now, so I don’t see why anyone would think I’m the person to call. Never has a female come in to discuss this issue with me from a therapy perspective. My colleagues state they aren’t seeing similar patients.

 

[Crayola227]

Echoing that viewing substance use disorders as "self inflicted" is a pretty surprising take from a psychiatrist. Read "In the Realm of Hungry Ghosts." In my experience most people with addiction issues have had horrible adverse childhood events giving them pretty understandable reasons to dissociate, escape, avoid, that were entirely outside of their control. People need to take agency at some point but we don't have to lose empathy to acknowledge that.

Ugh and the sheer number I know who not only had all that, but were straight up introduced to drugs from parents. Not sure what a 12 yo can be expected to do to prevent themselves being given a disease by a parent. Like I had friends the first time they ever drank, smoked cigarettes, or even used meth, was with a parent at a young age.

That's not everyone. But the number of folks that ended up where they are because one dumb mistake before their neurons were myelinated, theirs or even a doctor's or a parent's, compared to people who arguably should have known better and could be doing better....

It's admittedly frustrating when it seems like people aren't executing agency. Although some evidence exists agency is just a genetically programmed construct of the mind and an illusion, and just as subject to chemical transmissions as any organ. Hard to say.

It's never surprising to me that it's folks outside looking in with these conclusions. Yes, people are whiny and they do irrational stuff. Kudos to anyone of a privileged background looking from the outside that figures this all out anyway.

 

[Sushirolls]

7 posts in before "privileged" gets dropped.

RELEASE THE KRAKEN DEI !!!

 

[futureapppsy2]

I always question who are these people living comfortably off of SSI/SSDI--VA disability with a high rating I could see, but SSI/SSDI will barely cover anything in all but the cheapest locales.

 

[Cath Up]

7 posts in before "privileged" gets dropped.

RELEASE THE KRAKEN DEI !!!

Would you rather we pretend the world has no inequality and being born to any family gives you an equal chance in life? What else do adverse childhood events mean than a dearth of privilege?

 

[Sushirolls]

We need to stop looking at the world thru the lense of victimhood. As we look in the mirror, with these glasses on, we see ourselves as victims, too. We all lose in the Victim Olympics.

 

[Merovinge]

We need to stop looking at the world thru the lense of victimhood. As we look in the mirror, with these glasses on, we see ourselves as victims, too. We all lose in the Victim Olympics.

That's simply not true. I was raised by a single mom when my dad pissed off to another country, she unfortunately re-married an abusive man (and thankfully subsequently divorced). My ACEs score of 3 is good compared to a lot of kids I work with, but also not the 0 that a lot of my friends have. I have never seen myself a victim, how could I given that my life is better than 99.999% of human's throughout history and better than roughly 99.9% of people at this present moment? But I certainly do have different reactions and have had some problems that other people I know don't. Recognizing them lets me work on them. It's far more psychologically healthy to recognize actual problems that exist and overcome them then put one's head into the sand and pretend everything is perfect.

The idea that in the 1960's we didn't need to recognize the difficulties women and PoC had in society is so absurd that I wouldn't even know where to begin if that's your argument. Now are there ways/areas/movements that have overshot the mark? I would argue yes, but that's how societal change happens with pendulums swinging too far when they swing. Now we see the pendulum pushing back in the US and that's clearly also going too far with the Manosphere, ethnic based targeting etc.

If there's one thing that people ought to know spending time in the mental health space, it's that acknowledging reality is critical to every form of psychotherapy (certainly psychodynamic, CBT, and 3rd wave). It is the element that binds psychotherapy together. Of course how you choose to move forward from an accurate awareness of reality can vary, but you need to accurately understand a problem to solve a problem.

 

[calvnandhobbs68]

Sushi reminds me of like the reverse PC principal.

"DID YOU JUST USE A TERM THAT HAS SOMETHING TO DO WITH DIVERSITY BRO"??

 

[FlowRate]

Being a psychiatrist is useful for dating. For example, I’m getting very good at diagnosing high functioning autism. It’s eye-opening getting first hand experience of meltdowns and unmasking and sensory overload. Once I determine a woman has that, I nope the heck out of there. It’s a shame since some of them are pretty.

This would be better for a different thread, but I'm rather swayed by the idea that modern ultra-broad ASD is a useless concept. Honestly sounds more like you're running into anxiety difficulties/higher trait neuroticism rather than anything recognizable as "autistic" in a more classic (DSM 3 or 4) understanding of autism.

I think a flip side is I don't like when I start to feel like a therapist but some degree of emotional support is expected/appropriate in a relationship.

Not sure if this is much of an observation, but I have a handful of patients whose spouses (there's not a strong gender trend either way) sound like they developed very psychosomatically influenced "illness" and are now basically invalid and demanding significant caretaking from the spouse while being completely ungrateful. Just one of the "SLS" presentations I've seen that feels hopeless when the patient is very committed to their vows but their life is miserable because of the spouse.