Is this a psych problem?

[anxiousMS]

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Not sure if this is the right place to ask this.. (seeing a psychiatrist is probably the best option.. i'd guess).

But I'm a MS4 and I'm wondering if i have a diagnosis of an anxiety disorder..

My problem is that I get extremely nervous during public speaking situations.. ie: giving formal presentations etc. Also, sometimes even presenting patients to my attending when I realize someone is listening (makes it hard for me to focus). I'm fine in informal presentations, presentations ot people im relatively close to (i still get nervous as heck.. but i can usually get through it in one peice), and presenting to attendings if its one on one. When I'm presenting I can feel my sympathetics firing like mad... tachy, dry mouth, not sure if im tachypnic.. but somtimes i get tingling.. so probably am... the biggest problem is that my mind goes blank and its very hard for me to concentrate on the task at hand. Sometimes even if im smoothly presenting a patient to an attending (not even a hint of being nervous), and i see someone else listening in, ill lose my train of thought and get nervous.. (i'm fine in social situations with strangers etc.. i can carry on a conversation with just about anyone)

I've always hated presentations, but i've just attributed it to 'fear of public speaking' like 50% of the population.. but its starting to interfere with my work.. I was put in charge of running a simulated trauma code today and i totally froze up.. even though i knew exactly what to do (ie: ABCDE) i couldn't really bring myself to say it.. my mind was all over the place.. like what should i do etc. (ive also had a few situations in recent presentations where although I was adaquately prepared, i couldn't really get through it without stuttering like crazy and then just reading the material from the slides .. very poor form)

I've tried to get through it by telling myself that its an irrational fear and that i'm well prepared.. but usually i go to pieces right before i present.

i've thought about the various treatments associated with this (ie: systematic desensitization, which ive tried on myself but its hard because its difficult for me to replicate the exact set of circumstances that'll make me anxious.. but maybe a pro has better ways).. maybe some beta blockers will help tone down my sympathetic drive when im working? So.. should i be seeing a psychiatrist for therapy or am i just paranoid?

thoughts?

 

[OldPsychDoc]

Not sure if this is the right place to ask this.. (seeing a psychiatrist is probably the best option.. i'd guess).

....
I've always hated presentations, but i've just attributed it to 'fear of public speaking' like 50% of the population.. but its starting to interfere with my work.. I was put in charge of running a simulated trauma code today and i totally froze up.. even though i knew exactly what to do (ie: ABCDE) i couldn't really bring myself to say it.. my mind was all over the place.. like what should i do etc. (ive also had a few situations in recent presentations where although I was adaquately prepared, i couldn't really get through it without stuttering like crazy and then just reading the material from the slides .. very poor form)

I've tried to get through it by telling myself that its an irrational fear and that i'm well prepared.. but usually i go to pieces right before i present.

i've thought about the various treatments associated with this (ie: systematic desensitization, which ive tried on myself but its hard because its difficult for me to replicate the exact set of circumstances that'll make me anxious.. but maybe a pro has better ways).. maybe some beta blockers will help tone down my sympathetic drive when im working? So.. should i be seeing a psychiatrist for therapy or am i just paranoid?

thoughts?

The fact that it's "starting to interfere with my work" is sufficient indication that you should see someone about it. All of your thoughts are in the ballpark--but anything more would be giving medical advice on the forum, which is verboten.

Hope you have access to a good professional!

 

[anxiousMS]

thanks. i guess ill go to the student health clinic and get a referral. as much as i've been exposed to health care at this point, i still hate to formally go through the proper channels myself. 😛

 

[OldPsychDoc]

thanks. i guess ill go to the student health clinic and get a referral. as much as i've been exposed to health care at this point, i still hate to formally go through the proper channels myself. 😛

Ahh--that is EXACTLY what makes health professionals so dangerous! We're lousy at taking the advice we would give our own patients! (In this case--find a good professional to help you.)