Psychiatry
This is week two of my Psychiatry rotation. I have been very fortunate to be able to do this rotation away from Stanford. It is very unusual to be allowed to complete a core rotation at another institution but folks have been very supportive of my attempts to live in the ATL with my husband and nurture our relationship status post 4 years long distance.
As for Psychiatry, I am learning that the human psyche is an amazingly complex entity capable of affecting the body in profound ways. While I have always believed in the mind-body connection I am now utterly convinced there is very little separation between our mental health and physical well-being.
Yesterday I learned about conversion disorder, a type referred to as pseudoseizures. Please, Lord, never let me suffer from a conversion disorder. Conversion disorder is when a person converts a subconcious thought or emotion into a physical symptom, typically something pseudoneurological. What does this mean? For many of us, this may be that belly ache we got when we didn't want to go to school one day. For others it can mean something much more debilitating.
Yesterday, conversion disorder meant that the patient I was caring for could not walk despite a completely normal neurological and physical exam. There was no reason she could not walk other than the influence of her mind on her body. As I helped the patient stand, her right hand began to shake uncontrollably. And, when we settled her gently into bed the trembling worsened. Slow breathing exercises quieted things briefly. But, they began again. They spread form her right arm to her right leg. Then to her left arm and left leg. For the next 15 minutes , tearful, with eyes shut, each limb trembling and jaw clenched she lay there. She was able to respond to my questions and had normal vital signs. However, she was utterly unable to control her shaking. She was having what is sometimes called a pseudoseizure. Watching her shake uncontrollably, it did not seem possible that this could be a manifestation of a subconcious process and that something wasn't physically wrong with this human being. How could our mind and body collude in such seemingly violent ways?
When conversion disorders are diagnosed early and patients accept the diagnosis and work on identifying the underlying psychological stressor there is hope that they can be controlled. However, if patients do no accept that this is not a physical condition or if health care providers do not realize the underlying cause is not a neurological condition but a psychological manifestation this disorder can be more debilitating than true epilepsy.
I'll never underestimate the power of the mind over the body.
As for Psychiatry, I am learning that the human psyche is an amazingly complex entity capable of affecting the body in profound ways. While I have always believed in the mind-body connection I am now utterly convinced there is very little separation between our mental health and physical well-being.
Yesterday I learned about conversion disorder, a type referred to as pseudoseizures. Please, Lord, never let me suffer from a conversion disorder. Conversion disorder is when a person converts a subconcious thought or emotion into a physical symptom, typically something pseudoneurological. What does this mean? For many of us, this may be that belly ache we got when we didn't want to go to school one day. For others it can mean something much more debilitating.
Yesterday, conversion disorder meant that the patient I was caring for could not walk despite a completely normal neurological and physical exam. There was no reason she could not walk other than the influence of her mind on her body. As I helped the patient stand, her right hand began to shake uncontrollably. And, when we settled her gently into bed the trembling worsened. Slow breathing exercises quieted things briefly. But, they began again. They spread form her right arm to her right leg. Then to her left arm and left leg. For the next 15 minutes , tearful, with eyes shut, each limb trembling and jaw clenched she lay there. She was able to respond to my questions and had normal vital signs. However, she was utterly unable to control her shaking. She was having what is sometimes called a pseudoseizure. Watching her shake uncontrollably, it did not seem possible that this could be a manifestation of a subconcious process and that something wasn't physically wrong with this human being. How could our mind and body collude in such seemingly violent ways?
When conversion disorders are diagnosed early and patients accept the diagnosis and work on identifying the underlying psychological stressor there is hope that they can be controlled. However, if patients do no accept that this is not a physical condition or if health care providers do not realize the underlying cause is not a neurological condition but a psychological manifestation this disorder can be more debilitating than true epilepsy.
I'll never underestimate the power of the mind over the body.