Mentally Ill Psychiatrists

[InimicusTempi]

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Hi everyone. I'm a pre-med student who is seriously considering psychiatry. I also happen to have bipolar II disorder. I'm depressed most of the time (and yes, on occasion suicidal); this has impacted my grades as the depression has interfered with my ability to think and my motivation to study. I also have had hallucinations and strange beliefs that may or may not have been delusions (believing that everyone hated me, believing that I wasn't 100% human,etc). I don't think my disorder is too severe; I've never been hospitalized, for instance.

Given the information I've given you, do you think that I'll be able to handle the pressure of medical school, etc.? Psychiatry is my dream career. I really would not like to give up on the idea of becoming a psychiatrist, but I worry that my illness will interfere with my ability to do so.

Also, do you personally know any mentally ill psychiatrists? Are they good doctors? Does their illness affect your perception of them?

Thanks.

 

[notdeadyet]

Personally, IT, I would be very hesitant to recommend medical school to someone who is depressed most of the time and occasionally suicidal. Medical school can put mentally healthy folks through the wringer. I'd be very reluctant to recommend it to someone who is actively fighting depression and suicidal thoughts. I'd particularly not recommend it to folks who have difficult times motivating to study.

Maybe I'm sounding harsh, but we had two suicides amongst students at my medical school during the 4 years I was there. I'd strongly recommend not doing medical school until you had your depression and mental health under better management.

And if that isn't possible, always keep in mind that there are many ways in which you can devote your life to treating the mentally ill in careers that aren't as challenging to your own mental health as medicine is.

 

[peppy]

I agree that medical school is a very emotionally taxing experience. One big problem with medical school is that if you were to end up having any problems along the way and had to take a leave of absence, then it could really hurt your chances of matching into a good residency program (or depending on the situation might even jeopardize your chances of matching into a residency at all, which is a big problem). For the degree to be useful at all, you need a residency program.

I'm not the type of person who will tell anyone "You can't do it". However I would strongly encourage you to talk to your doctor about if there is anything else that can be done to optimize the treatment of your disorder to be sure that you're in the best possible state of mind before you go to med school, make sure you have some supportive family/friends to help you cope, and have a good plan for how to get some help if you do feel like you're becoming overwhelmed or suicidal.

What is it that appeals to you about being a psychiatrist? Maybe we can suggest some other ways to be involved in that aspect of things that is not so time consuming and stressful.

 

[loveoforganic]

Personally, IT, I would be very hesitant to recommend medical school to someone who is depressed most of the time and occasionally suicidal. Medical school can put mentally healthy folks through the wringer.

Just for the current medical student perspective, I will add a resounding agreement with this. I could not in good faith recommend med school to anyone with a history of depression unless it has been controlled very well for a LONG time. And I would still be guarded about it with a firm recommendation to establish a good relationship with a mental health provider proactively. Transitioning into med school has easily been one of the most stressful prolonged periods in my life, and I know that doesn't only hold for me - I know many individuals who have developed new mental health or behavioral issues since starting school. As peppy said though, there are many careers that share common ground with psychiatry, where the training process isn't quite as unbearable.

 

[digitlnoize]

Hi everyone. I'm a pre-med student who is seriously considering psychiatry. I also happen to have bipolar II disorder. I'm depressed most of the time (and yes, on occasion suicidal); this has impacted my grades as the depression has interfered with my ability to think and my motivation to study. I also have had hallucinations and strange beliefs that may or may not have been delusions (believing that everyone hated me, believing that I wasn't 100% human,etc). I don't think my disorder is too severe; I've never been hospitalized, for instance.

Given the information I've given you, do you think that I'll be able to handle the pressure of medical school, etc.? Psychiatry is my dream career. I really would not like to give up on the idea of becoming a psychiatrist, but I worry that my illness will interfere with my ability to do so.

Also, do you personally know any mentally ill psychiatrists? Are they good doctors? Does their illness affect your perception of them?

Thanks.

I have to agree with everyone else. While my school hasn't had any suicides, med school is tough. You will often be sleep deprived, which can really wreck havoc with your mood...

I wouldn't "give up" per se, but instead focus on getting yourself better. It's definitely not something to attempt until you're ready, if ever. I agree with the previous advice to seriously consider other careers in mental health. Social workers, psychologists, PA's, NP's, nurses, etc etc. Not that those training programs are a walk in the park either, but they're easier than med school and residency.

If you had been stable for quite some time, it might be a slightly different story. Many people might disagree with me, but I don't think controlled mental illness should preclude anyone from being a doctor, anymore than any other medical condition should...

 

[upright]

Mental illness is rampant in medicine. Anxiety, depression, addiction, personality disorders. Welcome to the party.

 

[tryp]

I have a mood disorder with episodes of severe depression and I am finishing up MS1 in the top 10% of my class. I anticipate that clerkship could bring issues but I am confident I can handle it and so is my doctor.

But the only reason I am doing it is because my condition is under control - I am on a stable medication regimen, I take my meds, I go to therapy, I go to group therapy and I literally do absolutely everything under the sun to keep myself euthymic. I am not episode free, but I am well enough to do my work without interruption or requiring accommodations.

Talk to your doctor. It's not out of the question, but you have to jump hurdles that someone without a chronic health condition will not, and you will have to make sacrifices and work your ass off.

 

[deleted103644]

You might be better off going for a Psy.D.

There are definitely plenty of psychiatrists with mental issues, but as others have said medical school itself might be tough to get through.

 

[whopper]

I'd recommend getting your bipolar disorder under control first and get a solid medication regimen before considering medical school. Further, if you are passionate about this field there are easier routes such as being a NP or physician's assistant.

Having a whacked out sleeping schedule-and that WILL happen to you in medschool and residency will likely exacerbate your bipolar disorder, not to mention the level of incredibly terrible stress it puts on your mind and body.

 

[Iwillheal]

I don't appreciate the suggestion, as made by digitlnoize and others, that going for a PhD in psychology is somehow easier than medicine. It's not! The fact that the acceptance rate for psychology PhD programs is lower than for medical school should tell you a little about the kinds of people who make it and the kinds of expectations that there are. Yes, the lifestyle is less stressful in terms of sleep schedule. You also don't do any calls. But you deal with people's mental health issues. And that's MORE stressful than dealing with a patient's purely medical issues. I know little about medical school and I am not saying that it's all relative and all that. Medical school is indeed stressful. Maybe the time pressure is a bigger source of stress in medical school. Maybe it's the rote memorization. Or the whole medical school culture, which can be brutal. I simply don't know. From acceptance rates alone, a masters degree or alternatively a Psy.D. degree would be easier. But still, though the OP may have less workload, s/he may end up getting traumatized from dealing with suicidal patients. If his/her mental illness is well under control, that's a different story. Unfortunately, mental health issues are different from physical disabilities. There is stigma, lack of understanding, etc. Not as easy to disclose, to get support, etc. Must be careful.

 

[snarfer]

Given the information I've given you, do you think that I'll be able to handle the pressure of medical school, etc.? Psychiatry is my dream career. I really would not like to give up on the idea of becoming a psychiatrist, but I worry that my illness will interfere with my ability to do so.
Also, do you personally know any mentally ill psychiatrists? Are they good doctors? Does their illness affect your perception of them?

Thanks.

I've met docs, in various medical fields including psychiatry, with variants of anxiety, depression, asperger and ADHD. And no they are not great physicians. This is not limited to psychiatric illnesses alone as one of my classmate went into GI with a h/o ulcertative colitis. He rarely works now due to complications from the disease, which he thinks is due to neglect of care during residency/fellowship training.

So yes, medical school is tough but internship/residency/fellowship training is also known to increase risks to various illnesses (multiple sclerosis, myasthenia gravis, depression, etc..). It's difficult to take 1-2 days medical board exams with poorly controlled UC or ADHD.

Psychiatry research maybe a viable option after medical school or a PhD program. It's stressful as well but with less intensity. good luck!

 

[whopper]

I don't appreciate the suggestion, as made by digitlnoize and others, that going for a PhD in psychology is somehow easier than medicine. It's not!

The training is certainly different. Is it easier? IMHO that cannot be answered because it's an apples to oranges thing. Medschool certainly requires more hours--hard hours, but it's about taking in obscenely huge amounts of data and spitting it out. Psychology grad school is about being able to make new material to advance the field while being heavily trained in statistics and testing modalities.

In fact I'd go as far as to say medical training is far too dependent on shoving data in and using multiple choice tests. The only thing a person apparently needs is that skill to become considered a hot commodity medical student while things such as research, good clinical skills, devotion to healing, etc, are things most professors don't seem to give a damn about.

I've seen medstudents that couldn't do what psychology grad students do, but were great at multiple choice tests. That's why I'd refrain from saying one is easier....but in terms of lifestyle I would say that it is likely it'd be more friendly on someone with bipolar disorder because the likelihood of you having a balanced life is far more likely in that field. I don't consider that a criticism of psychology, I'd consider that a complement to that field.

Ultimately, I don't want anyone to walk away from their dream, but the reality is that some people go into a field and realize it didn't live up to their dream or it really wasn't the best road for them. Again get your bipolar disorder under extremely good control first.

 

[billypilgrim37]

Yes, the lifestyle is less stressful in terms of sleep schedule. You also don't do any calls.

You don't seem to recognize this as a pretty huge deal. The best way to destabilize someone with a psychiatric illness is to disrupt their sleep schedule. The best way to disarm previously healthy coping mechanisms is to disrupt a sleep schedule. If you've never worked 30 hours in a row trying to pay attention to life-threatening details (and nobody except folks in the military do anything equivalent, typically), then you can't really comment on what it's like or how disruptive it is to psychiatric illness.

But you deal with people's mental health issues. And that's MORE stressful than dealing with a patient's purely medical issues.

Given that you've never taken care of medical patients, and that you're on a forum of people who mostly have taken care of both, you seem to be the least qualified to make that statement. For one, the idea of dealing with medical problems does not involve dealing with LOTS of mental health problems simply isn't correct. "Mental health issues," which I will henceforth call "psychiatric illness," as I don't know what "mental health issues" are, are among the most prevalent medical problems. And medical problems are, by and large, comorbid. Folks with psychiatric illnesses have greatly elevated rates of a variety of physical illnesses, and plenty of medical illnesses (among the most prevalent, heart disease, cerebrovascular disease, diabetes) have common psychiatric sequellae. One of psychiatry's greatest functions is to help our colleagues give appropriate treatment to patients with psychiatric illness and personality pathology.

A psychiatry resident will have many more hours of patient exposure with on average much sicker patients than psychologists or psychology students. So, if we do want to say that patients with psychiatric illnesses are more stressful to treat than patients with medical illnesses (a pretty heterogenous group, and a useless comparator), psychiatrists have more of that stress, typically experienced with more disrupted sleep schedules.

I have massive respect for my psychology colleagues. They are brilliant, they work very hard, they know tons of things I don't know. They have tons of stress in their life, enough that we share much more in common that we do with folks not in health specialties. They don't have anything to prove. But they understand that their training was a well-paced marathon, while ours was a series of frantic sprints, and the latter is much more chaotic and stressful than the former.

Medical school and residency would be much more disruptive to someone with a psychiatric illness than psychology training. That's not saying that psychology training is somehow easy, unimportant, or in any way lesser than psychiatry training. Both are difficult paths and should be considered very carefully by folks with unstable psychiatric illness.

 

[digitlnoize]

You don't seem to recognize this as a pretty huge deal. The best way to destabilize someone with a psychiatric illness is to disrupt their sleep schedule. The best way to disarm previously healthy coping mechanisms is to disrupt a sleep schedule. If you've never worked 30 hours in a row trying to pay attention to life-threatening details (and nobody except folks in the military do anything equivalent, typically), then you can't really comment on what it's like or how disruptive it is to psychiatric illness.

This is more what I was trying to say. If you look, you'll notice that gave the disclaimer that I wasn't trying to say the other careers were easy, but the time and sleep demands of med school (and more importantly, residency) are not to be overlooked. It can be pretty brutal at times.

More importantly, just the marathon aspect of it can get challenging. 4 years of college, 4 years of med school, 4 years of residency...it gets to you after a while...

 

[billypilgrim37]

More importantly, just the marathon aspect of it can get challenging. 4 years of college, 4 years of med school, 4 years of residency...it gets to you after a while...

Hey, you're bonking up my race-running metaphor!

 

[Iwillheal]

I apologize I snapped. I was incorrectly implying that doing long shifts and calls is the same as being up all night studying in grad school, which happens more often than not, especially in certain periods in one's training. But you're right, it's quite different. And interrupting one's sleep schedule continually is a sure way to destabilize a mentally ill individual. Heck, I don't have a major mental illness and I usually come down with cold/flu and/or anxiety/depression right around the exam period (when my sleep schedule is terribly hectic.)

It's just that I work in a medical setting and I'm just tired of certain people thinking people go into psychology because they can't get into medicine. I was accepted into a program that had a 8% acceptance rate. The associated medical school here accepts 15% of applicants. That does not mean, of course, that psychology students are more brilliant. But I usually make reference to it whenever I hear someone says, Oh, you failed organic chem? Well, I guess you could always go for a PhD in clinical psych. Or: You get stressed easily? Oh, well, there is always clinical psych. Of course, I have so far been referring to PhD in clinical psychology from respected and APA accredited schools. There is much greater range in quality of education in clinical psychology than in medicine. Certain Psy. D. programs do indeed deserve the mockery.

 

[whopper]

But they understand that their training was a well-paced marathon, while ours was a series of frantic sprints, and the latter is much more chaotic and stressful than the former.

I'd say our training is more along the lines of a marathon with fartleks (yes that is a real word). Having to run at a marathon pace with the occasional equivalent of a guy pulling a gun on you and telling you to sprint in the marathon, then when you outrun the guy with the gun, get back to jogging the marathon, another guy comes out with a gun and starts chasing you again.....

All for the full run. It wasn't until 3rd and fourth year of residency where I felt my schedule was that of a human being again.

As a buddy of mine put it, in medschool, after the first year, there is a light at the end of the tunnel. It's coming from a train that's going to run you over.

 

[splik]

I can only assume that Iwillheal was talking about how it wasn't easier to get into a PhD psychology program. The point is the psychiatry route is potentially more stressful. For psychiatrists and psychologists most have ignored that depressed people don't usually crumble at the slightest bit of stress, and no exposures are inherently stressful, only potentially so. The interpretation of the exposure by the individual is the major mediator of how stressful the exposure is, even if there are some which most would experience significant stress and would regard as 'stressful' or even traumatic.

The point is there just are more potential stressors as a medical student and resident. The hours are longer, there is a lot more to learn, the culture is more unforgiving, the very hierarchical nature means the junior ranks have little power, there are some thoroughly unpleasant characters working in medicine, the workload is more intense, you have to deal with medical and psychological issues (unless you are not very good and ignore the latter), the schedule is more disorienting in terms of hours worked, the decision-making more agonizing. If you think psychology is more stressful than medicine, perhaps you are in the wrong field.

I personally love the stress and did not feel burn out during intern year (though that maybe a whitewash with the passage of time). However there were some really tough and draining circumstances - it is physically demanding running around the hospital, being on your feet, and mentally draining telling patients and their families they are going to die. Some decisions I agonized over like giving a treatment I knew could cause a patient to stroke out (his worst fear), but he was bleeding out all over the place and he couldn't make the decision on his own so I took it out of his hands, and bore the agony he once did about the difficult decision.

I cannot tell you how **** I felt the first time I saw a patient die (he was younger than me and had been shot) or how scared I was I had discharged a patient who I had a dream about had papilloedema I had missed on fundoscopy post-head injury! There were times I hugged my patients or relatives thinking I might need this more than they did! Or how incompetent I felt when I managed to overfill a lady will renal failure with fluids to push her into pulmonary edema - and confused to be congratulated by the ICU staff who felt that I was right to have been aggressive with fluid management. Oh and that pager is like being in shackles, constantly reminding you that you are just a slave, and sometimes it just won't stop! You begin to fantasize about destroying it...

Now there are stressful situations in psychiatr/psychology ... 'was it right to let that suicidal patient go home', 'was the borderline patient just goading me or did she really mean it this time?', 'is that malingerer going to do something just to spite me', 'why is he rejecting everything I have to offer', 'why is the patient here at all', 'why am I here at all!?', or thinking just how horrific the lives of some of the patients are and how little you can actually do to change there lives and the entrenched nature of their problems. But even then, most of the situations fraught with risk are dealt with by psychiatrists not psychologists.

I have a great deal of respect for clinical psychologists, and for the training model which I think psychiatry could learn a lot from, but is it more stressful? Psychologists have high autonomy and don't have as great demands placed on them - I think not. Nursing on the other hand - you couldn't pay me to do that. I think nursing is a lot more stressful in many ways than being a doc..we like to joke that they sit around stuffing their faces with chocolate etc., but they have high demands placed on them and little autonomy that makes it challenging - this is less true for nurse quacktitioners but there you go..

 

[twright]

Hi everyone. I'm a pre-med student who is seriously considering psychiatry. I also happen to have bipolar II disorder. I'm depressed most of the time (and yes, on occasion suicidal); this has impacted my grades as the depression has interfered with my ability to think and my motivation to study. I also have had hallucinations and strange beliefs that may or may not have been delusions (believing that everyone hated me, believing that I wasn't 100% human,etc). I don't think my disorder is too severe; I've never been hospitalized, for instance.

Given the information I've given you, do you think that I'll be able to handle the pressure of medical school, etc.? Psychiatry is my dream career. I really would not like to give up on the idea of becoming a psychiatrist, but I worry that my illness will interfere with my ability to do so.

Also, do you personally know any mentally ill psychiatrists? Are they good doctors? Does their illness affect your perception of them?

Thanks.

I would agree with all of the prior recommendations against pursuing medical school and residency at this time. Medical school need not necessarily entail sleep deprivation in the first two years if you manage your time well, but during your 3rd and 4th year clerkships you will be expected to take overnight call. Few psychiatry residency training programs do not require overnight call (and I would suspect those that do not are more competitive on average than those that do, all else being equal), so you are looking at a period of at least 6 years during which your sleep will be substantively disrupted. All of this assumes you obtain an attending position that does not entail any home/pager call.

There could be many psychiatrists with mental disorders, but because of prevailing stigma this information is generally not known publicly. The few prominent ones who have outed themselves have done so generally only after achieving prominence. My guess is that it is possible to have a fulfilling career even after being outed, but that career is unlikely to entail clinical work in your chosen profession. Elyn Saks is not practicing law -- her time is focused more on writing and teaching. Kay Redfield Jamison is not practicing psychology -- her time is also focused more on writing and teaching.

 

[upright]

Nursing on the other hand - you couldn't pay me to do that. I think nursing is a lot more stressful in many ways than being a doc..we like to joke that they sit around stuffing their faces with chocolate etc., but they have high demands placed on them and little autonomy that makes it challenging - this is less true for nurse quacktitioners but there you go..

^I'm onboard your nursing argument. Prior to starting rotations I thought nursing was a chill job where you made decent money. After having started rotations, I'd literally rather go gay for pay that do their job for a living.

A) working with doctors in a basically subservient role would be a nightmare
B) patients are generally gross

 

[billypilgrim37]

It's just that I work in a medical setting and I'm just tired of certain people thinking people go into psychology because they can't get into medicine. I was accepted into a program that had a 8% acceptance rate. The associated medical school here accepts 15% of applicants. That does not mean, of course, that psychology students are more brilliant. But I usually make reference to it whenever I hear someone says, Oh, you failed organic chem? Well, I guess you could always go for a PhD in clinical psych.

A better retort might be, "Oh, so your research failed, huh? Maybe you should go to medical school."

Acceptance rate data is fairly hard to interpret. The barrier to APPLYING to psychology grad school is pretty small. Basically, take the GRE, and you're qualified to submit an application. That of course won't be a successful application, but it still winds up in the denominator at some places. Plenty of psychology applicants don't really understand how unqualified they are for a ph.d. program, or they are applying for a less competitive psy.d program, and "what the heck, I might as well sent an application to these fancy places too."

However, just to apply to medical school, you have to complete all those pre-requisites and take the MCAT, which unlike the GRE, you can't really just decide to take and go take it. If you impulsively decide you want to go to medical school, it will take you 1-2 years of science classes and then studying for the exam. Compare that it to the LSAT, which you can decide to take in April and take the exam in August and do well on it.

So, as whopper said wisely, the problem is that we're comparing apples to airplanes. The sort of skills that will make you successful in these programs are fairly different, the applicant pools and processes are very different, and the things you do to prepare are very different.

I went to college with plenty of people who I thought were idiots who went to medical school, and some of them wound up doing quite well. I knew a few folks from my psychology minor who wound up going to psychology ph.d. programs (accredited, decent ones), and I also thought some of them were pretty dumb, but they weren't any dumber than some of the idiots that still got into medical school. So it's not all that valuable to talk about what the bare minimum is for entry into these fields, because at the margin, there are some total *****s who get in, and there are some pretty smart people who for some reason struggle to get in.

We wouldn't compare which specialty was better at shooting blindfolded half-court shots, and sometimes I don't think that would be any worse a selection process than we have now.

 

[kugel]

We wouldn't compare which specialty was better at shooting blindfolded half-court shots, and sometimes I don't think that would be any worse a selection process than we have now.

Surgery: just throw the ball with all your might. It will eventually hit something and then you can begin to figure out where to throw the ball. If you eventually sink a basket, the more damage to arena, the more you're thought to be a hero.

Medicine: throw the ball just a little ways, then next time throw it just a smidgen farther, and keep doing that until you hit the backboard. Then tell people that there are no miracles and that hitting the backboard is the best that can be expected, and trying to sink the basket will more likely end up causing damage. It is better to learn to optimize function at this stage and learn to live life to the fullest with only hitting the backboard.

Neurology: Can diagnose your faulty technique within 10 seconds, but it doesn't matter because there is little we can do about it.

Pediatrics: Wear a funny tie. Sometimes throw a toy basketball instead, just to cause distraction. Kneel down to the level of the ball. Then suddenly stick a pin in the ball and try to get it to launch itself at the basket.

Psychiatry: just keep handling the ball until it wants to leave.

 

[InimicusTempi]

Thank you everyone for your replies. I knew before that it would be foolish to attempt med school while depressed, but I hadn't realized how foolish. I have two years before I'd apply, so I'll work really hard during this time to get better.

My psychiatrist knows that I have an interest in medicine, and he encourages me to go for it. However, I worry that his opinion is not as objective as a stranger's, which is why I posted this question.

I have considered careers in social work and clinical psychology. Clinical psych particularly appeals to me because I want to do research. However, I feel that I could offer more to my patients as a psychiatrist.

Thanks again.

 

[billypilgrim37]

Remember, we don't know you. You should be careful, that's all.

 

[Iwillheal]

OP, something bothersome about your last post. With all due respect, if I were you, I'd weigh your psychiatrist's opinion well above those of a bunch of strangers who know very little about you. Unless you don't trust your psychiatrist. A mental health therapist needs to be honest and realistic. It would be irresponsible of such a person to encourage you to pursue something that would be detrimental to your health. If you have doubts, get a second opinion. But generally, try to base your opinion on your own assessment of your abilities, and that of people who know you well, want the best for you, and can be objective. Best of luck.

 

[FLpk1girl86]

Hi everyone. I'm a pre-med student who is seriously considering psychiatry. I also happen to have bipolar II disorder. I'm depressed most of the time (and yes, on occasion suicidal); this has impacted my grades as the depression has interfered with my ability to think and my motivation to study. I also have had hallucinations and strange beliefs that may or may not have been delusions (believing that everyone hated me, believing that I wasn't 100% human,etc). I don't think my disorder is too severe; I've never been hospitalized, for instance.

Given the information I've given you, do you think that I'll be able to handle the pressure of medical school, etc.? Psychiatry is my dream career. I really would not like to give up on the idea of becoming a psychiatrist, but I worry that my illness will interfere with my ability to do so.

Also, do you personally know any mentally ill psychiatrists? Are they good doctors? Does their illness affect your perception of them?

Thanks.

You can do it but do not mention mental illness to your school, in your personal statement, or anywhere else, i've had friends who had problems with their schools because of this.

 

[whopper]

I'd consider the psychiatrist's opinion among perhaps an academic adviser who truly are considering this seriously. I can think of a lot of doctors who'll say go for it or not based on a very gutt-reaction more based on their own personal experiences than what's best for you.

I don't think it's fair to compare difficulty with what route is better. If that was truly the case then we all should enter a concentration camp or volunteer to have our hands cut off. Medical school certainly in most circumstances will require much more difficult hours but again I know plenty of medstudents who couldn't come up with a decent grad-school thesis.

I've said this before, if you compare the AAPL journal (forensic psychiatry) with the journal Law and Human Behavior (forensic psychology), it's the psychologists who have more interesting articles with them actually showing papers with validity and coming up with conclusions, disproving something or adding something to the available data pool, while AAPL is more about lit-reviews, or someone saying we need a better test while the psychologists are actually coming up with the better test. Then when you actually see a decent article in AAPL where it actually comes up with something new, more often than not it's from a psychologist!

 

[Ceke2002]

I've been in a similar situation to you, Inimincus, I got into an undergraduate nursing degree, with a view to eventually pursue medicine, but decided not to go ahead with it for a number of reasons, not the least being the fact that I was nowhere near stable enough mentally to take on the level of stress doing a University course would have entailed. I am a lot better these days (hooray for a good psychiatrist, and proper medication), and I've thought about going back to do the course, but then I have to be honest with myself and admit that in my case 'a lot better' doesn't necessarily equate to 'can now seek a career in medicine' (maybe one day, who knows). I think you're definitely right to keep working on your self before anything else, all the best whatever happens. 🙂

 

[aphenomenon]

A little off topic, but I'm interested in self-disclosure among the mental health professions. What "famous" or well-known psychiatrists/psychologists/etc. do we know have self-disclosed?

Marsha Linehan, for one, disclosed having borderline personality disorder

 

[Cinnameg]

I'd say our training is more along the lines of a marathon with fartleks (yes that is a real word). Having to run at a marathon pace with the occasional equivalent of a guy pulling a gun on you and telling you to sprint in the marathon, then when you outrun the guy with the gun, get back to jogging the marathon, another guy comes out with a gun and starts chasing you again.....

All for the full run. It wasn't until 3rd and fourth year of residency where I felt my schedule was that of a human being again.

As a buddy of mine put it, in medschool, after the first year, there is a light at the end of the tunnel. It's coming from a train that's going to run you over.

I love this analogy. Whopper, you're very entertaining. 🙂

One thing I've noticed is that people in medicine tend to put down any choices that lead to less working hours -- psychiatrists have reasonable working hours, and we get a lot of resentment from medicine and surgical residents in the form of implications that we are lazy. It's a great defense for their chosen lifestyle: instead of working crazy hours because they are, well, willing to take a lot of abuse with very little thanks, they are working crazy hours because they are good people, good doctors, and more dedicated to their jobs and better at their jobs than people who work less. As we psychiatrists are trained as doctors first, it makes sense that some of this culture would rub off on us and we would then pass along some of that attitude and defensiveness of our own choices (excessive debt, brutal night shifts, lower salaries and lower respect than our MD colleages in other specialties) on to PA's, PsyD's, NP's, etc. The fact is, a job is a job, and if you're being paid to do it and you do it well these social comparisons should take a back seat. I'm very glad when an inpatient unit has PsyD's and social workers as part of the team, they add a lot of knowledge and expertise that I'm not going to get from medical or psychiatry residency training, and so what if their debt is lower and their hours are less? It doesn't reflect on their value as people; a job is a job, and I have mine and they have theirs.

Back to the original question of the thread: as a pre-med, it's too soon to tell if your mental illness is going to get in the way of medical school. LOTS of things get in the way of medical school, and we can't go around telling every person who has, say, a time-consuming marriage, a baby, rheumatoid arthritis, migraine headaches, or a dog that whatever they have going on is going to be too much of a distraction to do well in medical school. That's just ridiculous. Life happens, problems happen, and they happen as much in medical school and in residency as before, and those spouseless/babyless/dogless/healthy people who enter medical school with no indication of problems could have disaster strike them at any point. If the questioner is able to get through pre-medical courses without repeating more than, say, one of them, is able to do enough research and extra-curriculars to be a competitive applicant to medical school, is able to do well on the MCAT, and gets into medical school, who are we to say that s/he can't then be a good doctor? I had classmates in medical school get cancer, fall into depressions, have babies, lose parents and have to take time off, and they all graduated and got into residency programs.

But, to the questioner: consider working one or two years after you complete your undergraduate degree. Taking a little extra time working in, say, psychiatry research, or as a mental health worker on an inpatient unit, will help your application, help you figure out if this is what you really want to do, and also help you work on your health and assess your own personal limits. I took two years off between college and medical school, worked as an in-home behavioral therapist for autistic kids and in an intensive outpatient psychiatric treatment program (like a day program but with home visits and an interdisciplinary team), and while it is occasionally bothersome to be 2-3 years older than my colleagues, overall those two years off were extremely valuable, helped my application, and reinforced that this is what I want to do with my life.

Good luck. 🙂

 

[whopper]

One thing I've noticed is that people in medicine tend to put down any choices that lead to less working hours

I've noticed that a lot of medstudents tend to be masochistic and equate working ineffectively hard with superiority. Some cited they would not go into psychiatry because that was for wimps and they were gunning for surgery. Emphasis on ineffective. Working hard in an effective manner is a good thing IMHO.

Wimps? I still had to work 80 hours weeks on occasion and IMHO anyone working over 40 hours a week is above the norm for a population. Further to have to worry for USMLE while working more than full-time would be something that the overwhelming majority could not handle.

But if these people want to be a gluttons for punishment let them. If not being able to pay for your bills on time because you're working 100 hrs a week, no love-life for years-leaving these people to go with the "band of the hand," and almost running over a kid as you fall asleep behind the wheel of your car somehow makes you a better person, you go right on believing that because that only left more spots for people like me who went into psychiatry.

 

[deleted103644]

I've noticed that a lot of medstudents tend to be masochistic and equate working ineffectively hard with superiority. Some cited they would not go into psychiatry because that was for wimps and they were gunning for surgery. Emphasis on ineffective. Working hard in an effective manner is a good thing IMHO.

Wimps? I still had to work 80 hours weeks on occasion and IMHO anyone working over 40 hours a week is above the norm for a population. Further to have to worry for USMLE while working more than full-time would be something that the overwhelming majority could not handle.

But if these people want to be a gluttons for punishment let them. If not being able to pay for your bills on time because you're working 100 hrs a week, no love-life for years-leaving these people to go with the "band of the hand," and almost running over a kid as you fall asleep behind the wheel of your car somehow makes you a better person, you go right on believing that because that only left more spots for people like me who went into psychiatry.

I don't think many people rule out psych for the reasons you're giving.

Personally, not to pull a Tom Cruise, but I thought far too much of the specialty was simply made up. Having to learn DSM IV diagnoses for the shelf was the biggest joke in medical school.

There are legitimate uses for psychiatry (particularly psychopharmacology for mood disorders and schizophrenia), but far too much of the specialty is BS or glorified social work. Maybe the DSM V will make things better, but I'm not holding my breath.

 

[whopper]

Having to learn DSM IV diagnoses for the shelf was the biggest joke in medical school.

No offense taken. If you found it easy for you, good for you. I know plenty of people, very left brain thinkers such as engineers who went premed who told me they just couldn't get into the different mindset of psychiatry.

but far too much of the specialty is BS or glorified social work.

Hey if the field is not for you it's not. As I tell some other doctors who believe psychiatry is BS, fine by me so long as you don't send me a consult, after all why should they need my services if the field is BS? Unfortunately the same docs end up asking me for one while having an apparent amnesia of their psychiatry-bashing when they need help. If you find it glorified social work-hey fine, send the patient to a social worker, not me.

I do actually find quite a few psychiatrists BS. That's a reason why I went into forensic psychaitry, a field where in a court of law you have to back up what you say with evidence. It's another reason why if you read my posts, I occasionally tear into some aspects of what I believe to be poor psychiatry such as the heavy prevalence of people misdiagnosed as having bipolar disorder.

I don't think many people rule out psych for the reasons you're giving

Oh yeah sure, I agree with you. Some people actually pick surgery because they actually like it. I'm not being sarcastic. Whatever the field is,if someone is passionate for it, they should go for it. I'm just pointing to a segment of medstudents, and I don't think a desire for self-punishment should be the reason to go into a field, nor a field that can offer a more balanced lifestyle a reason to avoid it. Some people want to be in a field that is more structured and with more specific physical science grounding it. That's fine too.

 

[deleted103644]

Hey if the field is not for you it's not. As I tell some other doctors who believe psychiatry is BS, fine by me so long as you don't send me a consult, after all why should they need my services if the field is BS? Unfortunately the same docs end up asking me for one while having an apparent amnesia of their psychiatry-bashing when they need help. If you find it glorified social work-hey fine, send the patient to a social worker, not me.

To be honest, it's often a lot harder to get a social worker than a psychiatrist inpatient.

 

[whopper]

Being that social workers make a small fraction of what psychiatrists make, there is a nation-wide shortage of psychiatrists but not social workers, you could go to the administration and ask them to fire all the psychiatrists in the hospital and replace them with social workers. Tell me what happens and what their response is after you do this.

Not that I'd agree with this, but if you believe this, follow your logic to what would end up saving a hospital system millions a year.

 

[deleted103644]

Being that social workers make a small fraction of what psychiatrists make, you could go to the administration and ask them to fire all the psychiatrists in the hospital and replace them with social workers. Tell me what happens and what their response is after you do this.

To be honest, I would. I don't think social work gets reimbursed much if at all.

 

[whopper]

You would? What do you mean you "would." Just do it. How hard is it to start going to the right people in the hospital,. drop them an email, call them up? It'd take minutes. Again I don't agree with you but if you believe this put your money where your mouth is.

Then do it. Stop ranting here. Follow your logic. Tell me what happens. You got a solution, make your voice heard. Just let me know what happens afterwards. I'd even ask you to video record it so I can see it. Put the video on this forum.

Do a lecture in the hospital and openly declare your opinions.


Again I don't agree with you, but IMHO the medical school and the hospital administration ought to know the the feedback and opinions their students are developing based on the curriculum they're being taught. If medstudents get the opinion that psychiatrists do something that social workers can do, I don't think the medschool's doing it's job right. They ought to know it so they can fix the problem.

 

[deleted103644]

You would? What do you mean you "would." Just do it. How hard is it to start going to the right people in the hospital,. drop them an email, call them up? It'd take minutes. Again I don't agree with you but if you believe this put your money where your mouth is.

Then do it. Stop ranting here. Follow your logic. Tell me what happens. You got a solution, make your voice heard. Just let me know what happens afterwards. I'd even ask you to video record it so I can see it. Put the video on this forum.

Do a lecture in the hospital and openly declare your opinions.


Again I don't agree with you, but IMHO the medical school and the hospital administration ought to know the the feedback and opinions their students are developing based on the curriculum they're being taught. If medstudents get the opinion that psychiatrists do something that social workers can do, I don't think the medschool's doing it's job right. They ought to know it so they can fix the problem.

Don't want to fight (and didn't mean to agree to your statement "all").

Most hospitals could use far more social workers. If that came at the expense of a couple psychiatrists, so be it.

Most of my psych rotation consisted of titrating anti-psychotics, waiting for spots to open in state psychiatric hospitals or rehab, or for mood stabilizers/anti-depressants to kick in.

 

[whopper]

Well I'm not trying to fight either. I'm being a bit polemic too. Just that from my experience if someone's got this opinion, I figure they should just take it to it's logical conclusion. While I don't agree with you, I actually do think that logical conclusion would lead to some good so long as you posed your opinion diplomatically.

If I were teaching a psychiatry course and a student told me he thought my entire lecture was BS, I'd want to know why and question whether I was teaching the material right. I still think you should bring this up. I'm getting the impression that the psychiatry dept didn't do a good job in giving you a good experience though that's merely a theory.

You'll get no argument from me that a lot of stuff in psychiatry, in fact all of medicine is highly theoretical and would benefit from more empirical data and study. A lot of medicine operates on Edward Jenner's cowpox vacccination paradigm that he knew the thing worked but didn't know why.

 

[deleted103644]

The closest I've gotten to talking about this with a psychiatrist was a discussion about how the DSM is seriously flawed.

I also think that a lot of psych pathologizes things that are within the normal range of human behavior.

And interviewing kids in the inpatient ward made me furious. For many of them, I'd sooner lock up their parents than the children.

 

[sunlioness]

And interviewing kids in the inpatient ward made me furious. For many of them, I'd sooner lock up their parents than the children.

And there, in a nutshell, is why I didn't go into C&A.

I don't agree that social workers can do everything a psychiatrist can do. For that matter, I also don't think a psychiatrist can do everything a social worker can do. Very different fields, with a lot of overlap, both very necessary. But a lot of my frustration with working in mental health, I'm finding, comes from trying to find solutions/answers/treatment for individuals when the things causing the problem/distress operate at a systems level. I can't give people a job when they don't have one and are facing losing their home. I can't make psychotherapy affordable when insurance doesn't cover it or it does, but with crazy co-pays. I can't give people a childhood transplant with well-adjusted parents and a stable nurturing environment. I can't even make my current state of residence have resources (like community treatment team) that I took for granted in the state I trained in.

But still, I agree with Whopper. If psychiatry is BS, I'm okay with that. Just don't consult me.

 

[deleted103644]

Wasn't saying social work can do everything psych can, just that a lot of social work is dumped on psych because there aren't enough social workers (or the ones there are lazy).

 

[AcronymAllergy]

Wasn't saying social work can do everything psych can, just that a lot of social work is dumped on psych because there aren't enough social workers (or the ones there are lazy).

A good social worker is seriously a godsend. I've worked in places where both extremes of the continuum were available, and it can lead to a stark contrast in the overall atmosphere of the department (particularly with respect to how confident the other providers are in referring patients to their on SWs, and their knowledge of what the SWs can actually provide).

I don't know that I'd go so far as to say there's a shortage of social workers, though. Perhaps a shortage of well-trained social workers in certain areas, or a shortage of social workers in particular hospitals due to hiring structures and restrictions, though, for sure.

As for pathologizing normal behavior--it can and does happen, but it's not supposed to, and "clinical judgment" is meant to be the ultimate gatekeeper in preventing it from occurring. Ultimately, if the behavior is causing significant and prolonged distress to the individual, then one could make the argument that it's no longer necessarily "normal" in many cases. And many "normal" behaviors can of course become pathological (i.e., grieving in and of itself is normal; grieving heavily for a decade is not). Beyond that, in general, no one goes to see a psychiatrist, psychologist, etc., because they're doing too well. So if someone walks through your door, you generally know they at least think something's wrong enough for them to visit a professional and risk the potential stigma associated with mental illness. This means there's probably something worth at least addressing, even if it doesn't warrant a diagnosis or formal treatment.

Oh, and much like a good social worker, a good psychiatrist is also a godsend.

 

[whopper]

The closest I've gotten to talking about this with a psychiatrist was a discussion about how the DSM is seriously flawed.

I also think that a lot of psych pathologizes things that are within the normal range of human behavior.

And interviewing kids in the inpatient ward made me furious. For many of them, I'd sooner lock up their parents than the children.

I actually agree with you on this. I've written this on the forum before. I seriously believe that 10 years from now, people will look back at the psychotropic medication administration on children and see that the situation is seriously screwed up.

I do think some children have benefited from psychotropic medication but the reservation to give one should be way more than it is now.

And I also agree that some providers are too quick to pathologize anything. Again I'm thinking maybe the doctors in the dept where you're at school weren't doing their jobs well.