While I was on my psychiatry rotation, I had a lot of difficulty discerning the difference between normal bereavement (grieving from a death) and adjustment disorder caused by a heartbreak. Everyone laughed at me and only gave me the explanation that death is so much worse. Umm, yeah I understood that, but my point was that patients suffering from both will have similar symptoms, and I also argued that in both, there's a loss of someone in your life and you still go through all the stages of grief to get over it.
Denial - "This can't be really happening."
Anger - "Why did this have to happen to me?! Its not fair!"
Bargaining - "I'll do anything to have more time with you. Just come back to me."
Depression - "What's the point to life without that person? Who cares?"
Acceptance - "I guess I'll be okay, and there are things to look forward to without that person here."
Maybe it all just seemed too similar for me for my exams. I'm sure DSM-IV (the psych book of diagnostic criteria for every disorder) probably is more specific, and I honestly don't remember what it said. Those books are still sitting in my med school apt. However, all I remember is being really really confused since almost everything going on in a person's head is the same in both.
Maybe this is why I'm not cut out for psych. Too many shades of gray when it comes to people and their psychiatric well being. Who's to say going through the bereavement like states isn't normal for a person who had their heart crushed? There's just so much overlap. I guess I like a lot of things with clear cut answers. History of alcohol abuse and LFTs elevated over 500? Acute alcoholic hepatitis. Done. TSH has sky rocketed through the roof and you're cold, constipated, and balding? Hypothyroidism. Done. Right lower quadrant belly pain, nausea, vomiting, fever, constipation? Appendicitis, let's get you into CT and then surgery. Done. Everything in psych is so fluid and even the criteria can be bent a little. Differential diagnoses are often listed as "rule out _____ disorder," and often times, there's not really a test that can be done other than watching and waiting to see how long these symptoms continue. I didn't like that. So I decided no psychiatry for me even though it was really interesting.
Until the next one then.
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COUNTDOWN TO GRADUATION: 10 DAYS!!
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