April 20, 2017


The little ones are on Spring Break, which means I've had to adjust my sleeping schedule.  I now sleep in the evenings, go to work, then stay awake to do things with them.  It's been working out so far...its a nice change to stay up after work, and I'll admit that it's easier to fall asleep when it's starting to get darker out as opposed to brighter.  But this won't work when they're back in school, so in a couple of days, I need to return to my regular schedule.  I may shift back to this in the summer, we'll see.

I've been enjoying the last few days off.  I've caught up on sleep.  I'm spending time with the family.  I've turned down requests for work.  I'm just recharging the batteries, getting ready to once again tackle all of the Axis II that seems to have infiltrated the patient population.

The tough thing about personality disorders is that they are how a patient is wired, meaning that nothing is going to cure it.  Sometimes I do wish it was like psychosis, where a shot of Haldol will make the pink elephants go away...at least for a while.  Alas, it's not.  Medications may help them manage their symptoms, but the patients need some good old-fashioned therapy--usually CBT or DBT--to change how they think and respond.  But because they are wired this way, it's also incredibly hard to effect change.

All the Axis II can wear a nurse out after a while.

I'm debating if dealing with Axis II disorders is more exhausting than working with patients in mania.  Both can be challenging, frustrating, and have medications end up with little to no result.

But a manic patient with Axis II...now THAT'S a hurricane!

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