Psychiatry, Uncategorized

You Should Know Correct Mental Health Terminology (OCD and Bipolar are not what you think they are)

I am SO bipolar.

Everyone messes up basic mental health terminology. Why is this important? Well, I feel that using the terms in casual way only serves to further trivialize and stigmatize mental health disorders and people who suffer from them and impedes the education of others about appropriate mental health terminology. It trivializes the disease and those suffering from it to use these terms incorrectly.

With that being said, here are a few common mistakes:

I am so OCD.

Usually said in reference to being a “neat freak” or being really particular about the way you want something to be, such as wanting your desk or room organized a certain, specific way, color coding your closet, or alphabetizing your music collection.

This is not OCD

It’s actually closer to OCPD (Obsessive Compulsive Personality Disorder), but it’s not really that either. OCD is when you have an obsession (i.e. “There are germs on my hands, I have to wash them off”) and a compulsion (washing hands repeatedly) and act on these obsessions and compulsions repeatedly to the point that it interferes greatly with your life. Like, you can’t function at work because you’re too busy washing your hands all day. Common variations of OCD include washing, counting (even/odd numbers, stairs, switches, etc), and checking behaviors (have to check all the locks in the house 5 times, every time).

Being really neat or particular is closer to OCPD. OCPD is a “personality disorder” (terrible name, but that’s a different blog) in which people are SO particularly about the way something is that it interferes with their life. For example, someone spends so much time formatting a spreadsheet so the columns are exactly the right width and color that they never finish it and their boss gets mad. Repeatedly, so they get fired. Or someone is SO particular about the way their things are that they can’t keep friends or relationships because they’re constantly yelling at people for messing up their stuff.

If it’s not interfering with your life, it’s not OCD or OCPD. Lots of people do little things that are OCD or OCPD-like. I used to alphabetize my CD’s (when CD’s were a thing). Not OCPD, but maybe an OCPD trait. I tend to keep my thermostat set on even numbers. Not OCD, but maybe an OCD-like behavior. No big deal. Unless it takes over your life or causes you problems.

OMG, I am so bipolar!

“Bipolar” does not mean mood swings.

Say it again with me. “Bipolar” does not mean mood swings. Well, it kind of does, but not the kind of mood swings people usually talk about when they talk about bipolar disorder. What people generally mean when they say they’re “so bipolar” is that they get angry often and/or easily. But that’s not bipolar disorder. Bipolar disorder is a biologic mood disorder in which a person has experienced at least one manic episode at some point in their life.

What’s a manic episode?

Remember Charlie Sheen when he was “winning” (video)

I don’t know if Mr. Sheen was having a manic episode, or if he was on drugs, or was “acting” or doing a publicity stunt, but regardless, that is similar to what a manic episode LOOKS like. The person is very elevated, on top of the world, not needing to sleep, grandiose (I’m winning, I have tiger blood, etc), talking really fast or not letting other people get a word in edgewise, compared to their usual way of talking…and all of this goes on for at least 7 DAYS straight (often longer without treatment) and represents a marked change from their usual behavior.

The bipolar part comes from the fact that they have some of these “up” episodes, then they’ll have horrible depressive episodes. The textbook case is a manic episode, then a depressive episode 6 months later. The “rapid cycling” variant means 4 mood episodes in a year, not many episodes a week or a day. (Note: there is some professional debate about whether other “types” of bipolar might exist that last less than the 4 days required for Bipolar Type 2, but there is no official DSM diagnosis for manic episodes lasting less than 4 days.)

Anyways, I hope that next time you start to say you’re “so OCD” or “bipolar”, (at least without an accurate doctor’s diagnosis), that you will pause to consider using different terms and perhaps take a minute to educate those around you about the real diseases and terminology. Let’s stop mistaking OCD for OCPD, Anger for Bipolar Disorder, and move towards a society that is educated and compassionate about mental illness.

Uncategorized

Why I Founded Treehouse Child Psychiatry

There is currently a severe shortage of child psychiatrists nationwide.  Charlottesville is no exception.  Many patients are waiting months to years to see a doctor.  Take a look at this map:

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All the areas in dark blue have ZERO child psychiatrists.  As you can see, that’s most of the country.  Even areas in red, the best ranking, have severe shortages.  Los Angeles, for example, only has 7 child psychiatrists per 100,000 children, about half of Charlottesville’s 14 per 100,000.

Also, even the best count of child psychiatrists are not accurate. These are typically done by reviewing the number of active license holders in a state. Unfortunately, many doctors have moved or retired, but still hold active licenses.  Also, a very large percentage of child psychiatrists (possibly > 50%) work less than 40 hours a week.

My hope is that my practice, Treehouse Child Psychiatry, will help with this shortage.  Having grown up in Charlottesville, I care deeply about my community and want to help children in our area grow up free from the struggles of mental illness. I hope to do my small part to alleviate the severe shortage of mental health providers for children in our area and appreciate your support as we begin this journey.