Psych and thoughts

It's finally the "holidays" (with an EOPT and pros both coming within the next 6 weeks) after 1 month in psychiatry.

My initial thoughts before entering psych was: Great. Psych. That was probably my differential for every presenting complain that didn't make sense to me.

Upon entering psych: This place is a madhouse. I'm probably going to go mad if I stay here long enough!

Well, 1 month has past. Admittedly, I still have my bias against these specialty - probably a major reason is because I simply cannot understand the plight they are going through (and there the doctors are saying that empathy is a very important part of the communication process).

How am I to empathise with them when I fail to understand what they are going through? Do I imagine the same voices that they hear, or imagine the torment they go through when they are infested with thoughts of germs and diseases? Or am I supposed to fake my empathy right in front of them while keeping that straight face?

Yes, I can understand some of the depressed patients, maybe the anxious ones too - surely all of us have went through periods of depression or anxiety, it's just how severe it was. But how am I to understand the delusional people? "There is somebody after me. They are spying on me. I don't know who but I'm very sure they are doing it" And they say it with such conviction that you would think they are telling the truth - if not for the fact that they are right there in the psychiatry ward.

Struggles with patients aside, the psych content itself has given me much insight about.. well, life. Life in general. It can get quite funny how we start diagnosing ourselves and others during lectures as we spot the uncanny similarities between psychiatric disorders and ourselves or people around us. And of course, the usual occupational hazard where everything around us is somehow related to hallucinations and delusions just because this is the psych posting.

Truth is, everything around us IS related to psychology - just that psychiatry focuses more on diagnoses and medication rather than psychology per se. There is always this concept of a spectrum between normal and pathological. Pathological could be defined by the standard DSM-IV criteria or ICD-10 that is being thrown around the wards, lectures etc. But what actually is normal? How is normal defined? If being normal just means not abnormal, then it is simply contained by the definition of pathological that in the first place, has been defined by other humans/psychiatrists themselves.

Going back to how we tend to relate school content to ourselves, it can sometimes be quite scary if we think about situations we are going through in life - could I be going through a major depressive disorder? Could I have a personality disorder rather than just the traits? The list of questions goes on. It even extends to people around us - are they suffering from a disorder, should I recommend them to seek treatment?

Or put it another way, again at the original question: how can I be certain that this current phase of my life can be considered normal? Am I over-reacting to the stimuli around me or is this actually deemed to be a normal response?

On a related, or perhaps rather unrelated note, I did think about something: How does all this fit together when you bring God into the picture? There are patients saying: Mary and Joseph told me to jump; they pushed me off the building. Others are saying: The voices tell me to jump, but the voice of Jesus tells me that these voices are evil - do not listen to them!

It can be quite confounding (for lack of a better word) when we try to delineate what makes a hallucination versus the true voice of God Himself. It makes a world of difference - one guy has schizophrenia which needs to be treated, while the other may very well be receiving visions from God or words of Knowledge and Wisdom. How then, are we able to differentiate these two? A fleeting thought comes to me: If I do hear the voice of God, I may actually be going mad. Or more optimistically speaking, I'm starting to hear God's voice for real.

Perhaps these thoughts are churned out by my mind which tends to go into a whirlpool of questions whenever left idle - which means all I ever do with my life is play and think about these questions. Not very productive indeed.

But sometimes, I find these questions can help to understand ourselves better, it can sometimes help to understand others better. Though I may not necessarily find answers to all these questions, I suppose it is good enough if it helps me to perceive things better in various situations. Whether it is myself, my loved ones, my patients, or even people unrelated to me.

~Just another Sunday night rambling just because I feel like penning out my thoughts~