I'm wondering

ageless · May 3, 2006

borderline...definately

pacmrc · May 3, 2006

i worked with several schizophrenic clients and it was exhausting for me- their meds were not controlling their delusions or hallucinations and it was very tiring trying to talk with them and keep them in reality.

lisabeth · May 3, 2006

Thanks. I can imagine both would be very difficult. We watched a film on Schizophrenia and that really shocked me. I think that is very sad. I could not believe the way they would be talking and nothing made any sense. I think it would take a long time to be able to say things like that that just made no sense at all. I imagine that disease would be totally devastating. I dont know much at all about borderline personalities. Our book discusses them, but not in great detail. Our teacher worked with outpatients, so she didnt get to see a lot of some of the situations.

I appriciate your replies.

Thunderwolf, MSN, RN · May 3, 2006

Actually, in outpatient psych, you tend to see MORE not less of the different psychiatric illnesses. The exception could possibly be the outpatient offices strategically placed to cater mostly to the "walking worried", not inner city.

MarkRN · May 3, 2006

What is the hardest Psychiatric disorder to work with? We are studying all of them right now, and I really am curious. I am sure each one has some very real challenges.

From my experience, many nurses find patients with borderline personality dosorder, antisocial personality disorder, and substance abuse disorders the most difficult to work with.

lisabeth · May 3, 2006

Actually, in outpatient psych, you tend to see MORE not less of the different psychiatric illnesses. The exception could possibly be the outpatient offices strategically placed to cater mostly to the "walking worried", not inner city.

I dont know. She probably saw a lot of most everything, but none of some things.

karynfrances · May 5, 2006

people with personality disorders are very challenging. sometimes working with schizophenia patients can be like walking into a party where everyone is drunk to some degree and you are the only sober one there!! manic patients can be extremely tiring, and if the ward is predominately filled with depressed patients one can go home very low.

lisabeth · May 5, 2006

people with personality disorders are very challenging. sometimes working with schizophenia patients can be like walking into a party where everyone is drunk to some degree and you are the only sober one there!! manic patients can be extremely tiring, and if the ward is predominately filled with depressed patients one can go home very low.

All of the replies have helped answer my question. Thanks. I have always been interested in Psychology and trying to figure out what the different issues are. I know some people can be helped, and I guess that would be very rewarding to know you were able to help, but I guess it would be just as discouraging to see some who were unresponsive to your efforts.

DREAM_KEENNA_RN · May 6, 2006

From my experience, many nurses find patients with borderline personality dosorder, antisocial personality disorder, and substance abuse disorders the most difficult to work with.

hi sir mark ... well, i was just wondering ... how'd u say that patients with bordeline disorded are one of the most diffucult cases to work with? im just curious coz i kinda have this disorder ... =)

Thunderwolf, MSN, RN · May 7, 2006

Learn more about the personality disorder(s) and you will understand.

In my previous practice, I found the true Narcissists more trying at times.

Here are a couple links for you.

http://emotional.healthcentersonline.com/personalitydisorders/personalitydisorders.cfm

http://www.4degreez.com/misc/personality_disorder_test.mv

On Narcissists:

Quick Summary:

Narcissistic personality disorder is characterized by self-centeredness. Like histrionic disorder, people with this disorder seek attention and praise. They exaggerate their achievements, expecting others to recongize them as being superior. They tend to be choosy about picking friends, since they believe that not just anyone is worthy of being their friend. Narcissists tend to make good first impressions, yet have difficulty maintaining long-lasting relationships. They are generally uninterested in the feelings of others and may take advantage of them.

Symptoms of Narcissistic Personality Disorder:

Requires excessive praise and admiration
Takes advantage of others
Grandiose sense of self-importance
Lack of empathy
Lying, to self and others
Obsessed with fantasies of fame, power, or beauty

Additional Information:

Narcissism is most often found in men and is often diagnosed with other mental disorders.

http://www.4degreez.com/disorder/narcissistic.html

On Borderline PD:

Quick Summary:

Borderline personality disorder is characterized by mood instability and poor self-image. People with this disorder are prone to constant mood swings and bouts of anger. Often, they will take their anger out on themselves, causing injury to their own body. Suicidal threats and actions are not uncommon. Borderlines think in very black and white terms and often form intense, conflict-ridden relationships. They are quick to anger when their expectations are not met.

Symptoms of Borderline Personality Disorder:

Self-injury or attempted suicide
Strong feelings of anger, anxiety, or depression that last for several hours
Impulsive behavior
Drug or alcohol abuse
Feelings of low self-worth
Unstable relationships with friends, family, and boyfriends/girlfriends

Additional Information:

Borderline personality disorder was so-named because it was originally thought to be at the "borderline" of psychosis. The disorder is relatively common, affecting 2% of adults. Women are much more likely to suffer borderline than men. Nearly 20% of psychiatric hospitalizations are due to borderline. With treatment, patients are often able to see their symptoms improve.

Treatment involves therapy in which the patient learns to talk through his or her feelings rather than unleashing them in destructive and self-defeating ways. Medication may be helpful, and treatment of any alcohol or substance abuse issues is required. Brief hospitalization is sometimes required, especially in cases involving psychotic episodes or suicide threats or attempts.

http://www.4degreez.com/disorder/borderline.html

CharlieRN · May 7, 2006

I personally like borderlines. Not that they are not anoying, and draining to work with, but they are so clearly injured people trying to recover their sense of self worth, that I can cut them some slack. (Not trust them, cut them some slack.)

The most difficult patients for me are those who are physically threatening to me. Paranoia in any form is dangerous but combined with mania it is really scary.