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Psychiatry Stigma

Discussion in 'Psychiatry' started by fj25, Nov 26, 2005.

  1. fj25

    fj25 Member
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    Hello Everyone,
    I am a MS3 considering going into Psychiatry. I feel that there are several stigmas against psychiatrists. Which include that they are weird or have some psych disorder themselves. I havent done Psych yet so I do not know if this is true.
    Has anyone encountered this or is just one of those "things" that has no basis but people just love to say.
    I think if i end up liking Psych the stigma wont other me.


    Another question,
    Do most patients with a benign disorder, like anxiety/depression tend to get better or do we medicate them for long periods of time?
     
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  3. mosche

    mosche Senior Member
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    Re: Psychiatry stigma

    There may be a few people who hold such stereotypes; however if they have a stereotypical idea of a psychiatrist, they will have a sterotypical notion of pathologists, dermatologists, surgeons, radiologists, Family Practice physicians, etc.... Every specialty has its own particular stereotype, and every physician in said profession will at some point do something (however minute) that will entrench that stereotype. Not intentionally, per se, but people who view the world through stereotypes will selectively ciphon your actions to fit their preconceived notions of what you are or ought to be!

    Therefore, choose your profession based on what you want to do; not on what others think, say, or do. For the next twenty (+) years, you will wake up, and go to work with the choice that you will be making in the next year or so; so, choose wisely!

    Re: Patients

    Many do get better, many don't -- depends on the individual and the population from which the patient comes. For instance, an indigent population will have fewer success stories (though they will likely be more dramatic) than does a wealthy suburb population. Again, this is a stereotypical answer, and will have many exceptions. OPD and Anasazi are probably in a better position to answer this question than I am.
     
  4. OldPsychDoc

    OldPsychDoc Senior Curmudgeon
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    Thank you for the referral.
    First off, anxiety and depression are not "benign"--both can be terminal diseases left untreated. In the "suburban" piece of my practice, I do see people who have a single major depressive episode or a panic disorder bad enough to cause them to seek medical help, and who get better after a relatively small intervention (6 mo SSRI, some brief cognitive/supportive therapy) and who will go away and not be seen again. I'd say it's a minority of my patients, though. By the time their PCP has sent them to a psych doc, they've already gotten complicated (with substance abuse, personality disorder, or polypharmacy) and it takes some time to sort them out.
     
  5. Anasazi23

    Anasazi23 Your Digital Ruler
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    Stigmas abound across the wonderful world of medicine. All are absolutely true and may never be argued against: (I'll recite some of those medical specialties recognized by the SNOBS) [SDN Network Of Board-certified Specialties]

    The following is satirical:

    Anesthesia: lazy, good for nothing work-skirters that couldn't hack a surgical residency. You probably have a best-friend anesthesiologist or gas resident. They love to smoke pot, will often give you some for free, and never seem to be concerned with life in general...except making sure they grab the lastest edition of Car & Driver to read while they nap behind the paper napkin that separates them from a more prestigious career. Their dark side is dark indeed, however, as they will actually kill a nurse anesthetist on sight.

    Dermatology: Depending if you're male or female, you're either a pretty-boy silver-spooned wuss or a stuck-up "Clueless" inspired vain female looking to make as much money with as little work as possible. Dermatologists are an interesting lot, as they conceivabllye know the most about medicine, as entrance to their specialty takes a combination of highest grades and most frequent delivering of sexual favors to those in power. Yet, they amazingly have only 2 treatments in their entire medical arsenal. They can be found in their white labs on weekends, working on their personal zit-cream product line saleable to hysterical pre-prom borderlines and neurotics.

    Family Medicine: Bottom 1/25th of the class, unable to match into absolutely any other specialty, including interventional parasitic radiooncology. Family practitioners are resourceful folks, unabashingly working for an average salary of $18,249. They don't mind driving AMCs, and take delight in the exhaustiveness of their extensive specialty-referral database, which allows them to refer with surprising success, any disease or condition that they are unqualified to treat themselves.

    Neurology: Intellectual elitist, "know everything but do nothing" suit-wearing stiffs. Neurologists take pride in not knowing how to write prescriptions. In the rare instance that they decide to actually just treat a migraine complaint instead of sending for MRI, CT with and without, PET, fMRI and SPECT scans, they have to walk next door to the family practice clinic to remind them how to write the damned thing. Never mind the fact that they can virtually reverse the symptoms and potential life-stealing pathogenesis of your Aunt Elsie's stroke. They really do treat nothing....ever. Sad, really. When you think about it. All that work in medical school for nothing. As catharsis for their ineptitude in treating medical conditions, they engage in the sadistic practice of sticking dozens of tiny teflon-coated needles into people's skin in an attempt to measure "nerve conduction velocity" or some such mumbo-jumbo nonsense; the results of which, if abnormal, they can do absolutely nothing about. Thus the viscious cycle continues.

    Neurosurgery: Those who simply don't mind doing 18-year residencies. The money sure is great though! You'll have the nicest Porsche of any other 70 year-old on the block!

    OB/GYN: Females, or questionable males that have no seemingly apparent problem giving 4/5ths of their salary to malpractice premiums and who, were it not for 3:30am deliveries, enjoy watching Law & Order, since it gives them tips on how to defend themselves in court. Contrary to popular belief, OB/GYNs spend 4/5ths of their time in malpractice defending why they delivered that shoulder dystocia to a jury of below 90 IQ unemployed people on welfare.

    Ortho: They're not as narrow-minded or "hoo-RA!" for ortho as people make them sound. Sure, they invented the "sweet spot" (that central secret location on the mediastinum that allows you to simultaneously listen to heart sounds, hear murmurs, lung sounds, and bowel sounds without moving the stethescope). But, they have the benefit of forgetting virtually any medical knowledege they obtained throughout medical school!

    Pathology: Ah, yes. They are borne in the fiery pits of Mordor...slaving over their microscopes at all hours, arguing amongst both themselves and the other bridge trolls whether that is a normal variant of a fruiting body. They are completely unable to interact with any of the "above grounders" and have the pale drow skin and knurled hand bones to prove it.

    Pediatrics: Perhaps the most altruistic of all medical professionals. They have an uncanny ability to deal with the most annoying people on the planet: neurotic mothers. Known to be able to get blood from a stone, (ask about the heel-prick-and-squeeze technique), they are in actuality the blackest-hearted unsympathetic souls in medicine. This is due in no small part to having the dubious distinction of the lowest paid residency of them all...except for family medicine (see above). Of course, they are simply happy to be there at all, considering they were unable to match into any other specialty.

    Psychiatry: By far the oddest and most bizarre of all medical specialists. Their behavior, mode of dress, chosen hobbies and misshapen children cause many to wonder if psychiatry and psychiatrists are part of the medical establishment at all! Brilliant yet inept at the same time, they are both fascinating and incredibly annoying at the same time. They are often compared to the prototypical "mad scientist" bent on world domination. Never taking a breath from constant analysis of all their spouses friends, and even their loved ones themselves, they are always on the search for eternal enlightenment. Ironically, they appear to lack any ability whatsoever to have introspection into their own horrid selves.

    To answer the poster's original question, there is a joke: How do you tell the difference between a psychiatrist and a psych patient? The psychiatrist is the one with the keys!

    Radiology: What can we say that hasn't been said? Radiologists are one of the few specialties that realized early enough in their medical careers that patients are subhuman creatures that should not be approached, talked to, or thought about at any time - ever. As such, they are content to resign themselves as overpaid dark-room denizens that have actually been seen running in terror from patient contact. The medical world wonders what will happen when teleradiology destroys the comfortable infrastructure that radiologists are used to. Will they be force to provide floor consults for radiology study approval? The thought has already put many in therapy with the mad-scientist psychiatrists described above.

    Surgery: Everyone is familiar with the surgeon subtype. More interesting is the surgeon who exists in bizarro world. There, they are actually cute and approachable creatures, known for their altruism, patience, and their warm and approachable personalities. They can be found in homeless animal shelters, donating their time and energy nursing abandoned kittens to health, and in soup kitchens dressed in raggy clothes, so as not to reveal their true identities. Don't let their infantile O.R. scalpel-throwing tantrums fool you. Actually, yeah, nevermind. That's actually how they are.



    Studies indicate that the longer you medicate someone, the longer the period of euthymia. The sooner you stop the medication, the sooner the relapse. This is a complicated topic, however, as one must consider all depressive and anxiety disorder variants, such as bipolar depression vs. unipolar, and variations of anxiety disorders themselves, and the severity of each.
     
  6. Poety

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    Isn't Sazi the best? :D
     
  7. mosche

    mosche Senior Member
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    :thumbup: :thumbup: :thumbup:
     
  8. Solideliquid

    Solideliquid Members Only
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    BPE

    Best.Post.Ever.
     
  9. Anasazi23

    Anasazi23 Your Digital Ruler
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    Oops, sorry Liquid. I accidentally edited your post when I meant to edit my own. That's what 4:50am will do to ya.
     
  10. fj25

    fj25 Member
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    Thanks for the replies. I am aware that whatever I go into I need not care about what other people think but that's easier SAID then DONE. I try very hard not too.

    By the way, I did not mean to minimize anxiety or depression by calling them 'benign', what I meant by that was in comparsion to psychotic/schizophrenic patients.
     
  11. Poety

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    Don't worry fj25, but I would definitely suggest that before you specialize you decide which stigmas you can deal with and which you cannot - this will be your life. And as part of medicine, its our duty to also teach other specialties - so you have to be very comfortable and secure in whatever you choose.

    I don't like the stigma either - but I've come to realize that the stigma doesn't override my love of psych OR the fact that the more I'm practicing, and good at what I do, the more respect I get - regardless of which specialty you'll find this across the board :)

    GOOD LUCK! We hope you'll join us!

    edit: and I want to add: psych is the BEST SPECIALTY because all we do is laugh half the day away :D
     
  12. Poland

    Poland As strong as me
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    I am working in pre-pharmacy, but I have thought alot about counseling; not so much pysch doctoring but behavorial support through counseling or other means like social work. I am not afraid to admit that I have had my own struggles and could definetly relate to my patients then, now, always. I would not be afraid of the stereotypes, it is inevitable that we each fit into one in life. I agree with the poster saying that it is a good field. It would be filled with things for those who enjoy an understanding of the way people work, and etc. I hope to find out more about exploring this field in pharmacy practice.
     
  13. willow212

    willow212 Senior Member
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    To the OP:

    My misguided younger self (before I did my psych rotations in med school) did think psychiatrists were "weird". Why? I think that I was in "medical mode" and wasn't used to hearing a doctor comment on how a patient behaved and thought.

    At that time, I thought it was a little judgemental to be pointing about "negative" things about a patient, and I didn't see how it would help with treatment. Now, of course, I see that we do it because we care about the person getting better, and (gasp!) can actually TREAT patients by knowing this info.

    So I can see how the stigma comes about (at least partially), but through my own experience, I've found that the people in this field may be "weird", but they're also "wise".

    P.S. Anasazi - loved your satirical specialty descriptions. Can't wait to have misshapen children of my own. :p
     
  14. Anasazi23

    Anasazi23 Your Digital Ruler
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    Some of the strangest doctors I know are in IM, cardiology, and surgery. They've got the psychiatrists beat by a long shot. We're talking very weird here.
     

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