Psychiatry – Day 20

Today was pretty quiet in the EDHU. The major learning point from today was benign vs debilitating psychosis. We had 2 older ladies, both presenting with some kind of psychotic episode/ decompensation. the difference was one of them was still able to function and carry out her daily activities and care for herself; the other was very disorganized mentally and so there was high concern for whether or not she could take care of herself.

I’ve been finding that the line between the two is very fine. Sometimes a simple word or brief phrase can make the difference that teeters the assessment to the patient being gravely disabled. Though my attending told me that even if a patient is able to hide their psychosis by saying all the “right things” in order to get discharged or whatever, that is an improvement and shows a recognition and understanding of what is socially/ culturally appropriate.

Part of me is curious what it is like to have hallucinations, to experience delusions. Pretty scary I imagine.


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