Legit have had paranoid patients making shivs or trying to start floods or fires and barricading their doors soap or lotion themselves up. The barricading isn’t usually an issue because most places I’ve worked have had swingstop doors but extracting them without getting them or us hurt always fucking sucks. Usually someone who’s spent time in the correctional system doing stuff like that with the soap or lotion but one dude was a combat veteran. That suuucked.

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Valerian root. It’s GABA active. Smells like either manure or freshly rained on soil though depending on your nose in a similar way to how cilantro taste varies between people. It’s what’s in sleepytime extra.

Guilty as minted.

I’ve noticed in codes I just have to step into the middle of the room put some bass out from my chest and point at people and give simple instructions (and these are psych codes so it’s usually “ALICE -> THAT ARM. BOB -> THE OTHER ARM. CAROL -> LEGS. DAVE -> GO GET THE RESTRAINTS.”

But then sometimes something very unexpected comes up like a very large patient dropping their weight into a weird position. So the important thing there is to hopefully come up with an idea quickly and give the simplest way possible to explain to everyone to move as a team. But sometimes someone else comes up with a good idea before me and then you go “CAROL’S RIGHT. ON THREE WE’RE GONNA ___.”

So. 0. Know what the fuck you’re doing enough that you’re respected as an authority figure.

1. Confidence in posture and voice.
2. Point and use simple instructions.
3. Confidence doesn’t mean ego. Recognize a good idea when you hear it and use it.

Probably not what you were asking but I hope it helps.

Every once in a while a guy will know something about women’s bodies that makes me go “ooooh OK that one’s actually really like kinsey 0 straight” instead of some other weird combination of interests that are approximately straight in a mostly possessive way. Sometimes I’ll hear “straight” guys talk about how gross vaginas are but then you hear a guy talking about pH balances and lactobacilli and it’s just really obvious which guy actually wants to be in one.

Well. Emotional swings like that can occur as part of a manic episode specifically. Mania just means the emotions come faster than usual, not that they’re good. Ppl w mania are actually frequently extremely angry, usually because they’re going a million miles an hour and don’t understand why everyone else won’t just keep. tf. up.

But yeah if op has always just been like that consistently without any ebb and flow over month’s / years then yes it points more towards a thought disorder. I used to have a really cool infographic from a textbook on the differential dx between borderline, bipolar, and adhd since they can all have very similar presentations or even just be comorbid in certain patients.

I’ve actually seen a good few patients who we all swore up and down were borderline then the meds would click into place and oh. Look at that you really were just bipolar. huh. (I say all of this having a childhood dx of ADHD, an adult dx of borderline, and a current psychiatrist who thinks I’m bipolar so…)

As a night shifter whose employer exclusively uses Windows, ty

Psych patients actually do this a lot. Some places I’ve worked actually have protocols for it that include stuff like having the bathroom locked and only unlocked for supervised use, or having the water only be cut on when the contents of the toilet have been verified (also helpful to have water shutoffs for psychogenic polydipsia because they WILL drink their way into a hyponatremic seizure and they dgaf if it’s from a toilet) but also for the flushing usually they’re limited to one set of clothes and bed linens, one towel / washcloth, and have to ask for small quantities of toilet paper as needed. Then they yell at you about having to ask you use the bathroom like they didn’t flood the unit three nights in a row. One time we didn’t catch it fast enough and some poor bastard on medical got leaked on. Motivations vary but the most common is wanting to feel in control of something and it can be difficult to try to find safe things for that kind of person to be allowed control over.

My parents told me it’s a hit list for when the fascists take over …but then they voted for the fascists.

Oh I legit notice a spike in mania cases this time every single year. Idk if it’s making people manic as much though as it is that they would also be manic in February but they’re too busy having seasonal affective depression instead. So the sun wouldn’t be making them manic so much as it’s just keeping them from getting depressed (which they’re already sensitive to with an affective disorder of any kind) and that allows for more mania.

Just because their corpses are there doesn’t mean their shit isn’t!

Funnily enough this was actually taught to me as a precipitating factor to constipation in a hospitalized patient. If they’re a coffee drinker and / or cigarette smoker at home, and their morning coffee + cigarette has been replaced with shitty weak hospital brew and a patch, their bowel muscles might forget they actually have a job to do. Not that you should encourage bad habits, but you might need to mindfully replace them with another laxative or in some cases just accept that people do things that are unhealthy and you’re not going to fix 20+ years of substance dependence in one stressful AF hospital stay. Still can’t let them actually smoke cigarettes but maybe some gum or a lozenge.

yes it’s very likely to either get torn apart by interpersonal tensions such as infidelities or economic power struggles or just devolve into a new age cult of some kind, and usually some combination of all three from what I’ve seen of those kinds of communities.

working in psychiatry for as long as I’ve had, the people I admire most are actually the ones who are just decent every single day. the ones who know everybody’s kids names and remember everybody’s birthday. I don’t know how they do it. I became the person who helps pull apart people trying to bite each other’s faces off because idk how to remember birthdays and I was hoping it would be something people appreciate but day to day it actually really isn’t and the reason why becomes obvious pretty quickly. the people who make the biggest difference in people’s mental health are people who know how to plan a good Friday night get-together and how to follow up when they haven’t heard from one of the invitees for two weeks in a row.

the only mental health thing I’m aware of being publicly available is commitments, and in most localities that requires an initial involuntary hold followed by evaluation and a hearing. and even that I think only counts for clearances, gun rights, and possibly licenses concerning public safety such as doctors, social workers, etc. rando employers should not be able to access that info afaik (this is a summary of the relevant part of the speech I give to patients when they ask if they want to change their status to involuntary and what the process looks like if the doctor disagrees that they need care, what their rights are in that situation, etc.). even with that idk that they can see what you were committed for just that you were. I’m not sure how hard they’d have to dig to get access to the mental health board evaluation that led to the commitment. I talked my way out of a commitment after an involuntary hold and have had a few incidents since where I even talked myself out of the hold to begin with and it never even affected me getting licensed (fellow cluster b PD here, hiiiii).

I have borderline personality and premenstrual dysphoric disorder. I was so unmanageable as a teenager (and twice a month since my cycle was coming every two weeks) that my fundie parents put me on birth control at 14 years old.

also helps to plan difficult conversations if it’s something that can wait a few days or that could wait a week but you know you need to do it sooner rather than at the end of the week when she won’t be able to respond as charitably. me and my husband keep track of each other’s hypomanias and depressions for similar reasons.

I think we should make all work legal for the worker. They can be here, they can receive wages, their kids go to school. as As long as they don’t commit any crimes just let them exist, whatever.

…but hiring someone without a visa should be extremely illegal. Like decades in prison illegal. Should fix the rampant human trafficking pretty quickly. A lot of these employers do it because they don’t have to worry about treating the workers fairly. They should be terrified of illegal workers telling on them. And after they’re done telling on one human trafficker let them go find another job and tell on him too. If we were tossing people in prison for hiring illegal immigrants their job market would dry up immediately and the problem would resolve very quickly.

people need to think more about who is actually benefiting from illegal immigration and go after those people. because it’s not some lower than minimum wage laborer, it’s his employer who found someone who’s too scared to tell OSHA that the sharps bin is overflowing and APS that meemaw has been sitting in her own shit for three days. Immigrants aren’t taking my job, sketchy employers are trafficking human beings in who are willing to be paid less while being abused and who will be too scared to say anything about the really scary shit they’re being made to do and watch.

a more useful question would be,“out of all the ways you could make money why are you thinking about this one?”