Am I just burning out?

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Specializes in telemetry, med-surg, home health, psych.

Maybe I am just getting tired and need a break....I don't know but it seems to me that too many people are being admitted for "Bi-Polar" disorder when it looks like a case of bad behavior, poor judgment or "medicated" with the wrong mixture at the time......

what in the world did all these people do before this diagnosis???

Now your see it on TV all the time....if you have these symptoms, you could be bi-polar....etc. etc.....heck, we can all relate to some of these symptoms....anyone agree with me or am I just in need of a break?

I don't know if "over-dx" is any worse than what it used to be. Fortunately, over the years it appears that ETOHics and other Addicts are more frequently diagnosed with CD and not mistaken for Bipolar Disorder as often as they used to be. I've got major concerns with the frequecy of ADHD dx.

This indeed may be a sign to inventory your self-care activities, after 20+ years in the field compassion fatigue can be frequently underdiagnosed, especially by those of us with it.....take care.:smokin:

Specializes in critical care; community health; psych.

Some if it is for payment. With a dual dx, admissions are covered for payment. There are also the behavioral "patients" who have been given the choice of inpatient psych treatment vs. jail. We've seen the cops drop them off in the parking lot and watch long enough to make sure they get inside. So we give them a dx, mpulse control disorder, SAD, BP manic. The facility gets paid and stays in business and we keep our jobs though we may get a little battered in the process.

They're personality disordered, just wired that way. Meds won't help them change. They need miracles or incarceration courtesy of the department of corrections.

It's easy to get burned out with the criminals posing as patients. Other than them, we see really sick people.

Specializes in acute care then Home health.

Yeah, I think bipolar disorder is like the newest and coolest thing to have. I've seen some "real" bipolar patients and it is obvious when they are in the manic phase. These people are the real deal. However most people that go around labeling themselves as "bipolar" are probably looking for an excuse for their bad behavior or trying to come up with a valid reason to smoke some mary jane.

Specializes in telemetry, med-surg, home health, psych.
Yeah, I think bipolar disorder is like the newest and coolest thing to have. I've seen some "real" bipolar patients and it is obvious when they are in the manic phase. These people are the real deal. However most people that go around labeling themselves as "bipolar" are probably looking for an excuse for their bad behavior or trying to come up with a valid reason to smoke some mary jane.

My sentiments exactly......or needing the Dx so ins. will cover...as one post suggested.....I just get tired of these people and have little compassion for them....thanks everyone....needed to vent....

Specializes in Med-Surg, Geriatric, Behavioral Health.

Primary Axis II wannabe Axis I's can be very trying on one's nerves at times.

A primary Axis II diagnosis forces a person to look at him/herself (they don't want to do that...they often want to blame others instead). So, many may wish "to shop" for that Axis I. An Axis I diagnosis may seem like a way out to them, in their being held responsible (a dirty word)...so, for some, it is coveted and pursued. However, we do no service to them by encouraging this pursuit. It is much more honest and therapeutic to point them to/back to a counselor...then wish them well.

Also, not uncommon, an Axis II equating an Axis I diagnosis with "keys to the candy." Not true, but many try. They can be the most draining...and the most entitled. They need to be shown the door.

Malingering...attempting to get an Axis I diagnosis as a "get out of jail free card" can also wear on you. For some/many, you see it for what it is. For some/many, jail is treatment. Sorry, nice try, but "no pass go."

Agree.

Sometimes, a break from their behavioral (personality) games can be very refreshing.

Your own peace of mind is.....priceless. Sometimes, a break is warranted or needed.

Specializes in Med-Surg, Geriatric, Behavioral Health.

They're personality disordered, just wired that way. Meds won't help them change.

So true.

It is personality.

You can't change that via meds.

Possibly it may be dampered a bit, but not changed.

And often, meds or not, it takes a lifetime to mellow out on its own.

Specializes in telemetry, med-surg, home health, psych.

I think that often the "wrong mixture of meds" get them in this position to begin with................too many prescribed meds, I have seen them come in with so many different meds from the same doc.....no wonder they are confused and have a disorder.........

Specializes in Med-Surg, Geriatric, Behavioral Health.

I agree...a primary Axis II misdiagnosed, mistreated, and placed on tons of meds often begs for trouble later. For it begs the question: "So, what are we medicating?" "What are we treating?"

The same applies for an Axis I.

Otherwise, an iatrogenic condition may just present itself. Yes, that can/does happen. It results from poor/mishandled treatment.

Starting from scratch may be called for....peeling back some of these meds like peeling back the leaves of a cabbage. Is it a true Axis I we are treating/mistreating here?....or is it a primary Axis II inappropriately treated/not treated at all? Or is it an iatrogenic condition?

The diagnosis should guide the course of treatment....not the treatment guiding the diagnosis.

Unfortunately, many clinicians forget this basic rule.

Specializes in Med-Surg, Geriatric, Behavioral Health.

A diagnosis is only as good as the diagnostician...many who diagnose stink at it, but many are quite good at diagnosing too.

Then what logically follows: treatment is only as good as the clinician who provides it...some stink at this, but many are quite good in providing this service to others as well.

Specializes in telemetry, med-surg, home health, psych.
I agree...a primary Axis II misdiagnosed, mistreated, and placed on tons of meds often begs for trouble later. For it begs the question: "So, what are you medicating?"

The same applies for an Axis I.

Starting from scratch may be called for....peeling back some of these meds like peeling back the leaves of a cabbage. Is it a true Axis I we are treating/mistreating here?....or is it a primary Axis II inappropriately treated/not treated at all?

The diagnosis should guide the course of treatment....not the treatment guiding the diagnosis.

Agree.

Exactly....if we could stop all the meds (psychotic) give them a month to see the true person then go from there it would sure eliminate a lot of the guessing and misdiagnosis that we see all the time....

Specializes in telemetry, med-surg, home health, psych.
A diagnosis is only as good as the diagnostician...many stink, but many are good.

Then what follows afterward: treatment is only as good as the clinician who provides it...some stink, but many are good.

Amen.......

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