Mid-school Crisis (PMHNP)

[indomie23]

HeIlo! I am going through a mid-school crisis in my PMHNP program, and wanted your advice. I am in Psychopharm and Psych-patho, and I cannot shrug off the thought of mental illness and psychotropic medications not being concrete concepts for me. I am often reading in my textbooks that there is inconclusive evidence to a medication's proven efficacy on a disorder, and there is a large risk for misdiagnosing due to overlap of symptoms. I am torn whether these psychiatric disorders are part of the natural process of a person actually coping/developing, and if psychotropics cause more harm than good, and if there really is a true difference between placebo and medication. I understand the need for psychotropics in acute, severe situations to manage a patient, but I guess I am more skeptical about outpatient treatment in more stable patients.

I think I want to continue in this program, but it's difficult with these thoughts I have. Any advice? TIA!

[Dale DNP, ADN, BSN, MSN, DNP]

Your concerns are valid and I think the same way. The truth is, other than acute care medicine, a majority of people taking medications could avoid them if they chose lifestyle interventions instead. There is lots of evidence to support the connection between mental health and lifestyle changes. If you have the opportunity to listen to podcasts, The Institute of Functional Medicine has some really good ones on this topic. Also, there are books written by psychiatrists that espouse the value of functional medicine assessment in the pursuit of proper mental health treatment. I, myself, can't imagine how any area of medicine can take a one-size-fits-most approach without first doing a full nutritional and biopsychosocialspiritual assessment. Now, if we can collectively figure out a way to spend more time initially with patients and have insurance cover this and the nutritional testing....we could take the field in a much healthier direction.