Sarah Chan

Featured

The Promises and Pitfalls of Psychedelics

There has not been a mental health subject that has gotten more attention in recent years than psychedelics. It seems like they are a cure for everyone. In the medical literature, we are seeing positive results in many patient populations, from treatment-resistant depression, to drug addiction and post traumatic

In Therapy: The Patient stops Flirting

What had me thinking about this patient's flirting at all was when it stopped.  It is so strange that while it was going on, I did not feel like talking about it or writing about it.  Isn't it interesting how secrecy can be part of attraction

personal

Looking Forward. Looking Back. Where am I?

Where am I? I am coming to terms with the limitations of my training in being able to manage the mental health crises that walk through my doors every day. Where am I? I am actively seeking out different psychiatric education and mentorship that better reflect my own experiences in

It is Time We Begin to Matter

Ahmed was referred to me for a chronic deep depression. He had always lived in the shadow of his father, and this continues even after his father passed 10 years ago. His father was a very respected and revered man at the local temple. People often sought his advice and

parenting

Turns out I am an Intensive Parent. Here is My Experience So Far.

I am on vacation with my two children. They are 5 and 7 years old. As I enter into this stage of parenting what becomes more clear is that when you give your children what you did not have, they do not appreciate it like you would hope. They have

Talking To Depression: Do Not Give Up

Warning, this article mentions suicide. In real-world clinical practice, depression is the most common complaint.  Because of how it has entered into the mainstream, it is also the most non-specific complaint and has come to represent a catch-all term that can mean many things.  After a thorough

Chronicles in Therapy: Can I be Forgiven?

I had a patient, Marie, with severe physical impairment and depression, tell me the impact this has had on her relationship with her son. She admits she was absent mentally and emotionally for most of his childhood and sees his current disrespect for her as punishment for this. She has

On Call Psychiatry: A Review of Some Cases

Of note, this article does mention and discuss suicide I was on call recently over the weekend.  What this means at the hospital where I work is that I go into the psychiatric emergency unit for 830-9am to review any admissions that took place overnight.  The staff on call

It is OK to Not Feel Good - A meditation ...of sorts

It does not mean you are broken. It does not mean you are depressed (though check with a therapist or doctor if you are concerned about this). It does not mean you need medication. It is ok to ask yourself what brings you joy. It is ok not to know.

A Patient Flirts in Therapy

When a patient starts to flirt with me, I think, "here we go." I know it is flirting when the person who is persistently depressed starts to laugh more in sessions and may slip in a dirty joke or two. I can tell the person is flirting when

Some thoughts after an Autism Conference

Thought #1) The title of the conference was "Is this Autism? Recognizing the less obvious presentations of autism". It was taking place at the Royal Ottawa Hospital, our tertiary care mental health hospital. I had registered because I thought this was going to be about diagnosing autism in

The Mental Health Care System of My Dreams

The mental health care system of my dreams would take into consideration three facts the current system does not: 1. Mental health diagnoses change over time and mental illnesses are chronic in nature 2. Mental health care workers can only do their jobs when the care is voluntary, in other

The Madness of Mixing Medications and Therapy, a Mess Unique To Psychiatry

She came in wanting several sessions to discuss the death of her dear pet. She took care of him until the end and struggled with how the decision to put her dog down was made and the procedure itself. She was rattled to the point of needing to take time

Good Psychiatry: Treatment Recommendations

This is the final installment of a series where I describe what a patient can expect when seeing a psychiatrist for the initial consultation. The case formulation (where the psychiatrist explains his clinical impression and the rationale) dovetails perfectly into the conversation a psychiatrist will have with the patient about

My Ambition and Psychiatry

I have recently had to go through a big shift professionally. I had believed there was a reward for working my hardest and striving to be the very best psychiatrist I can be. This fueled me to work long hours, make personal sacrifices and drive myself as hard as I

I reflect on Ambition

Beware of wishing for and being driven to have what our society may paint as a universally good trait. Ambition is one that is deserving of some scrutiny. What is it to be ambitious? Is it simply to be the best? It can be, in areas where skill can be

She Finds Peace

Finding peace is one of the most common wishes I hear from patients. A wish I used to blow past in my appointment with patients because of how vague, overly simplistic and unattainable it sounded, much like the wish to be "happy". I hope it comes as no

case formulation

Examples of Case Formulations

Patient names and details have been changed for confidentiality. Case formulation #1: Catherine is a 35 year old woman who experienced her first depression in university after a break-up. She tells me her depression resolved on its own. She had a relapse in 2020 when she found out her

good psychiatry

Good Psychiatry: The First Meeting, Giving Patient Feedback using The Case Formulation

This is the second installment of a series where I describe the care I offer to my patients. After I have asked all the questions needed for the initial assessment, the next task (in the same appointment if possible) is to come up with my case formulation. A case formulation

For Learners to Psychodynamic Therapy, Start Here

The following two articles are written by Psychodynamic psychotherapist Dr. John Shedler. I like them for their brevity and their plain, easy-to-understand language: https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf https://jonathanshedler.com/wp-content/uploads/2023/02/Shedler-2022-that-Was-Then-

Getting Back up After a Difficult Case

The appointment started off like any other. He is a challenging patient in that he does not say much in our appointments, but he was showing up and requesting to be seen and so I took this as a sign that he found me somewhat helpful. Buoyed by that, even

good psychiatry

Good Psychiatry: The First Meeting

This is the first in a series where I hope to describe the care I offer to my patients. I have thought a lot about what it is to provide good psychiatric care, because interestingly, I do not believe I was trained with this in mind. In my time as

therapy

Therapy is...NOT a place to assign blame

I am seeing a young woman who has recently ended a long-term relationship.  She tells me how within weeks of this relationship ending, despite making a promise to herself that she needed time to be single and on own, she found herself in another romantic relationship. She was perplexed

bipolar

Consider Bipolar depression when antidepressants are not working

One of the most common presentations to a family doctor or psychiatrist is for symptoms of depression. These symptoms include feeling low in mood, but also having sleep and appetite changes, low energy, poor concentration and a lack of interest in things that would normally bring joy like hobbies and

Time

Time is such a funny thing. We are told it is our most valuable resource, and I agree. It took my turning 40 to realize the true value of the time we have on this planet, made more precious given the state of things. In conversations I have with people