Well. Emotional swings like that can occur as part of a manic episode specifically. Mania just means the emotions come faster than usual, not that they’re good. Ppl w mania are actually frequently extremely angry, usually because they’re going a million miles an hour and don’t understand why everyone else won’t just keep. tf. up.

But yeah if op has always just been like that consistently without any ebb and flow over month’s / years then yes it points more towards a thought disorder. I used to have a really cool infographic from a textbook on the differential dx between borderline, bipolar, and adhd since they can all have very similar presentations or even just be comorbid in certain patients.

I’ve actually seen a good few patients who we all swore up and down were borderline then the meds would click into place and oh. Look at that you really were just bipolar. huh. (I say all of this having a childhood dx of ADHD, an adult dx of borderline, and a current psychiatrist who thinks I’m bipolar so…)

As a night shifter whose employer exclusively uses Windows, ty

deleted by creator

Also I’m specifically a gnostic / esoteric Christian at this point so the obligatory:

If I’m gonna believe some wildass shit I might as well really go for it you know?

I wish there were more Christianity comms (I’ve got some Bible shitposts too) but pretty much all of them get brigaded / downvoted by people who don’t even follow the subs and by all appearances don’t know what a block button is.

yes it’s very likely to either get torn apart by interpersonal tensions such as infidelities or economic power struggles or just devolve into a new age cult of some kind, and usually some combination of all three from what I’ve seen of those kinds of communities.

working in psychiatry for as long as I’ve had, the people I admire most are actually the ones who are just decent every single day. the ones who know everybody’s kids names and remember everybody’s birthday. I don’t know how they do it. I became the person who helps pull apart people trying to bite each other’s faces off because idk how to remember birthdays and I was hoping it would be something people appreciate but day to day it actually really isn’t and the reason why becomes obvious pretty quickly. the people who make the biggest difference in people’s mental health are people who know how to plan a good Friday night get-together and how to follow up when they haven’t heard from one of the invitees for two weeks in a row.

I think we should make all work legal for the worker. They can be here, they can receive wages, their kids go to school. as As long as they don’t commit any crimes just let them exist, whatever.

…but hiring someone without a visa should be extremely illegal. Like decades in prison illegal. Should fix the rampant human trafficking pretty quickly. A lot of these employers do it because they don’t have to worry about treating the workers fairly. They should be terrified of illegal workers telling on them. And after they’re done telling on one human trafficker let them go find another job and tell on him too. If we were tossing people in prison for hiring illegal immigrants their job market would dry up immediately and the problem would resolve very quickly.

people need to think more about who is actually benefiting from illegal immigration and go after those people. because it’s not some lower than minimum wage laborer, it’s his employer who found someone who’s too scared to tell OSHA that the sharps bin is overflowing and APS that meemaw has been sitting in her own shit for three days. Immigrants aren’t taking my job, sketchy employers are trafficking human beings in who are willing to be paid less while being abused and who will be too scared to say anything about the really scary shit they’re being made to do and watch.

Also, psych nurse protip - this is how you use this to talk someone out of a panic attack. Use the above conversation template plus the following nonverbals / paraverbals:

• start by reducing stimuli (think five senses!). Reduce the noise and lights, and try to get away from any particularly offensive smells or sensations.

• you can try to get the crowds and stimuli out of the area, but it will probably be easier to move the person panicking. Getting crowds of people to do things is very tricky. It’s usually just easier to move the one person.

• talk at about half to a quarter of your usual speed and volume

• use common English words (no SAT vocab). Enunciate clearly, and don’t use more than one conjunction / more than two ideas per sentence. Their brain can’t chew / digest as much as all at once.

• Do not stand directly in front of them and especially do not corner them. If you feel unsafe you can still stay closer to the door than they are but try to stand slightly to the side to give them line of sight to it.

• if you want to practice / really up your game, learn to deepen your pitch slightly / resonate / speak from your chest while still keeping your volume down. Imagine James Earl Jones reading a meditation script on YouTube. This has an added benefit if you work with seniors, most age-related hearing loss is in the upper pitch ranges.

my usual answer when I’m suspecting some kind of boundary-pushing behavior is “well you can ask…” …but I have to hear out my psych patients, you don’t owe strangers the same obligation.

_beans

beans

beans

BEANS

BEANS

I just got certified to teach mental health direct care workers to talk people down and how to safely restrain people when they are still posing a threat to themselves and others and that’s a goal I set almost a decade ago and it’s really taking some time to set in that I actually did it. I went from spending 3 hours on a state hospital floor with my back locked up with EPS after getting twice the normal agitation meds to teaching in under 10 years. What the fuck.

I mean he’s doing better than my parents.

right now? you’d have to find me first, and I doubt that it’s worth it for you. There’s also other logistics you would have to figure out that also probably wouldn’t be worth it for you.

at my place of work? The environment is so controlled that you just… probably won’t succeed. Most people also don’t even notice the stuff I’m actually doing to maintain my safety. The biggest thing is before the patient is even on the unit making sure there’s nothing in the environment they can hit me with that would really hurt. One advantage I’ll admit I have over the cops is that I’m 99.99% certain that no one in the environment has a gun (the 0.01th time was the night the ER really fucked up*). But there’s also no corded devices, no IV poles or oxygen tanks to hit me with. Even stuff wide / long enough to get some leverage with like a dinner tray is made of styrofoam. Even the shitty coffee is lukewarm instead of boiling (sorry but I do what I gotta do).

Most people also don’t notice that if they’re even anxious I’m usually between them and the door or even if I’m letting them have a sightline to it for their own peace of mind I’m still closer. If they’re actually mad I’m definitely between them and the door and whether or not they can see them I have at least one person for backup right outside the room, possibly 2 or more. I’m really just not that worried about it and I’d rather focus on what I can actually practically do to resolve the problem. Is there some comfort measure I can help with like warmth, cold, food or water? I’m not giving you a steak dinner for cussing me out but I can probably do peanut butter crackers and some water if you’re just hangry. Do you wanna talk about your legal status and what the judge is actually going to look for while deciding whether or not to commit you? Do you just wanna yell at somebody for fifteen minutes? I can do most or all of that with some detail-based caveats.

If none of that works and you’re actually trying to hit me or even yourself (but talking does work like 85-90% of the time) there’s always haldol and if that doesn’t work I’ll try geodon and so on and so forth down a decently long list of options until you’re either better able to control yourself or unconscious. If I have to lock you in a room or strap you to a chair until it hits I can do that too (the paperwork sucks tho). If you’re on something real wild like PCP and can’t be sedated without respiratory collapse you’ll probably have to be detoxed in an ICU probably strapped to a bed and possibly intubated. But the confidence that I have the resources to handle most of the possibilities and that I have people to call if I can’t makes it a lot easier to not overreact to being called slurs and just focus on what the actual safety risks are in the situation and what actually needs to be done to resolve the problem.

On the street? When I’m not in my scrubs I dress like a hobo and it’s very obvious that whether or not I’m actually a tweaker (unless you count caffeine which is technically a stimulant) I’ll probably lose a fight but I also will be taking either a testicle or an eyeball with me and you may or may not get a choice. Again, probably not worth it for you, probably not even worth interacting. Most people don’t interact beyond polite mutual acknowledgement of our existences. My scrubs only barely cover my overwhelming feral raccoon aura.

Here’s real footage of me when admin comes through with our traditional consolatory pizza and cookie offerings:

Have some pride! It’s only an insult if you let it be!

~ Sincerely, a certified redneck <3

Yeah but last week the mean bitchy old Lady at my job who’s mad nobody works as hard as her (it’s because she works too damn hard) who I thought hated me told me she’s surprised that I’m only 30 because I have a lot of wisdom and I’ve never been more honored. It almost makes it OK that caffeine gives me hangovers now and I need a nap before I do the dishes on my day off.

I was actually really waiting for the wisdom to kick in and while I don’t really feel like it’s kicking in people are starting to listen and they trained me to teach the “how to talk people out of hitting you” class and I’m actually pretty hyped for that.

I feel like the specific price is something you figure out after you figure out how much it costs to run the thing and no, I had not gotten that far yet. How much do your accounting services cost?

Tbh this is as far as I’ve ever gotten with this idea but I appreciate the tip if I ever did actually try to implement it! Edit: had to look it up but probably actually. My fuzzy original thought was one of the many services my various employers have used to verify my license, but these seem more consumer focused which is probably better suited to this use-case.

Obviously. You’d only use it if you specifically wanted to back up what you were posting with a medical license or status as a public figure or whatever. This isn’t a service targeted at the average shitposter.

I’ve thought it would be cool to run a $1 monthly paid mastodon server where your username has to match the credit card used to pay. + maybe other stuff like verifying degrees, medical licenses, etc so that people with such things can have a verified presence with which to interact with the rest of mastodon.