Posts Tagged ‘anxiety’
November 19, 2012 | by Sadie Stein
August 28, 2012 | by Maureen Miller
According to every epidemiological study of medical-student mental health ever published, a large percentage of us suffer from, well, something. The discussion sections of these research papers generally propose we educate one another in mental hygiene. They suggest we should practice more “mindful medicine.” And, good students, we oblige. A medical student may not come into med school knowing how to handle a “high-functioning” anxious type in clinic, but the diagnosis doesn’t require an office pamphlet. It’s visible right there in the room.
At my school, we first learn to integrate this understanding of acute and chronic anxiety into clinical practice via the required six-week psychiatry clerkship. Six weeks of immersion in “ICU psychiatry,” the psychiatry faculty argues, is not enough time to master the management of anxiety disorders, but at least it is something. Third-year medical students spend six weeks on one inpatient psychiatry ward as well as several night shifts in a CPEP (Comprehensive Psychiatric Evaluation Program), the ER for the ill at ease.
In these settings you learn to triage threat and fear until you know from anxiety. There you learn the difference between anxiety and agitation. Panic-attack patients stay in the ER for a while for cardiac and thyroid workups. Anxiety in the CPEP counts as psychosocial stressors, or Axis IV on the DSM-IV: losing your edge, losing your family’s support, your job your benefits, your place to live. Maybe you will have an adjustment disorder on Axis I, or existential anxiety that keeps you off your axis. Agitation is losing your cool, and sometimes losing your hospital gown if you’re especially feisty. For anxiety there is benzos and SSRIs; for agitation, benzos and antipsychotics and sometimes four point restraints. They call the agitation cocktail a 5+2, for 5 milligrams of Haldol and 2 milligrams of Ativan, though I saw one “frequent flyer” get a 10+4.
March 30, 2012 | by Lorin Stein
I recently read Poets in Their Youth, by Eileen Simpson. Now I’ve taken to doubting my every turn. Am I a lout? A drag on my partner’s freedom and happiness? Am I going to drink myself into a coronary or into some sort of baking mishap? Is there anyway I can pretend that I won’t die cold and alone?
From your note it’s hard to tell whether you’re a poet or a poet’s main squeeze. Those are both high-pressure jobs and generally conducive to drinking. But take heart. For whatever reason, poets today—even good ones—are much less likely to walk in front of a car, or gas themselves, or even destroy their livers than poets fifty years ago. This makes them easier to live with, I imagine. (How could it not?)
Like, perhaps, more than a few of your readers, I am an anxious person. This anxiety manifests itself in a number of ways, but one of the most taxing is when it renders me extremely irritable. Feeling overwhelmed by a cornucopia of small tasks, I sometimes experience an actual skin-crawling physical discomfort as I attempt to slog through them—it’s nails-on-a-chalkboard all over if someone tries to talk to me or sends me an e-mail or if I even glance at any of my open tabs in Chrome. I have the feeling that reading should help—but all those tiny words on a page! It just makes me feel even more agitated. Do you have any particularly soothing books you could recommend? The book equivalent of a warm bath? (Obviously one can’t take a warm bath at work. Or at least not at mine.)
First, turn off your computer. You could have the calm of a lama, and you still wouldn’t be able to read a book and keep an eye on your e-mail. It can’t be done.
Now, are you able to sneak out of the office? If so, head to the nearest library. Really. In my last job I used to take the subway up to the Forty-second Street library whenever I could. One day I got busted by my editor-in-chief. He was doing the exact same thing.
If you can’t leave your desk, then close your door. If you can’t close your door, try earplugs or noise-canceling headphones.
Readers of this column know my opinion of the Jeeves books. They are gratinee for the soul. Kids’ books lower my blood pressure, too: Roald Dahl, Narnia, E. Nesbit’s Complete Book of Dragons. My grandfather, in his long final illness, swore by Trollope.Read More »