A Psychiatrist's Mental Health Blog

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 assessment,  what comes

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

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 the

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.

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

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 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

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

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

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

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

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

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-This-Is-Now-Psychoanalytic-Psychotherapy-For-The-Rest-Of-Us-1.pdf PODCASTS: Podcasts are also useful in giving learners a

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

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

This is a case of a young man who had developed intense paranoia after using methamphetamine extensively.  While in my care, he was stabilized on medication, and he stopped using drugs.  I wish I could say it was because of addictions treatment that he stopped using drugs but it was

A 56 year old man, Roy, comes to see me after his family doctor raised concerns about his benzodiazepine use. He was taking 1 mg of Ativan most days, and when his panic attacks were particularly bad, he could take up to 4 mg. On top of this, he was

In these essays, I feature interactions I have had with my patients that I have found to be meaningful and thought-provoking. Any details about the patient’s identity have been modified to protect patient privacy and confidentiality. Part of what I love in the work I do are the insights

As someone trained in science, I thought how I cared for patients was related to how much knowledge and expertise I could cram into my brain.  In school, we were never praised for developing strong relationships with patients, but for how much medical minutiae we knew.  It is no wonder