June 2019 – Page 3

Bzzzzzzzzzt.

“Hi there! You have been randomly selected as a winner of our draw! All we need is your credit card number-”

“For fuck sakes.”

Have you ever answered a robocall at four in the morning? You hear the ungodly buzzing of your device – turned on vibrate, so as “not to wake anyone” – and you’re sure it must be a family member in crisis, or a work email that can’t be missed. Instead, you are greeted by the disorienting sound of a fog horn and the robotic voice of the latest phishing scam as they tell you, “the Captain’s calling!,” and start wooing you with free cruise trips, with one catch. They need your social insurance number.

Fat chance.

The next day, you’re at work. You laugh with your colleagues about the Captain, and you realize the same thing happened to all of them as well, at some point. There’s a certain comradery in the shared psychological torture. That night you can’t get to sleep, and you wonder, “why am I so damn restless?!”

Hopefully, this exact scenario hasn’t happened to you, but I’d be willing to bet you have answered a phone call in bed at all sorts of hours in the morning. It’s a habit many (and probably most) of us do in our technologically driven society. While most of us realize that getting up numerous times a night isn’t allowing for the most restful sleep, many people often do not realize the deeper psychological consequences of bad phone hygiene.

In broad strokes, anxiety can be defined as a, “fear of uncertainty.” Which makes sense. Anxiety can be accompanied by several symptoms – concentration difficulties, fatigue, irritability, restlessness, and muscle tension. These symptoms are caused by an increase in the part of our nervous system that controls adrenaline, called our sympathetic nervous system. This is the part of the nervous system that allows us to react to uncertainty. In prehistoric times, the benefit from these functions is obvious. You want to be angry, on edge, and have tight muscles (and definitely do not want to be asleep) when the sabretooth tiger is attacking you. Today, these symptoms often cause us discomfort.

Smart phones are wonderful things. They allow access to hordes of information at any given time, and have allowed us to connect with each other on an unprecedented level. They have also allowed us to, unlike ever before, take work home to an entirely different degree. The expectation in many offices today is that emails should be answered immediately, regardless of the time of day (and even if you’re on vacation). In other words, smart phones, while wonderful, represent the endless possibility of something significant happening – a family death, a big deal, the Captain – at any given time, which requires our response. And we sleep with it. Ew.

Our smart phone addiction has contributed to a baseline feeling of uncertainty that in many of us turns on the adrenaline nervous system, and causes us the symptoms of anxiety. Bad phone hygiene, such as sleeping with your phone, and not setting limits insofar as when you will answer your phone, contributes greatly to the symptoms of anxiety, not just on the night of that inappropriate call, but for many nights to come.

Dr. Travis Barron is a resident physician in the Department of Psychiatry at the University of Toronto in Toronto, Canada.

“You have depression.”

“I think it may be bipolar disorder.”

“Borderline Personality is most likely.”

“Have you ever heard of Posttraumatic Stress Disorder?”

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You’ve been feeling down lately and you decide to see your doctor. They might refer you to a psychiatrist, or choose to diagnose you themselves. You might do this several times over your lifetime, and each time, you get a different answer. You go, “what the fuck?”

It’s a common conundrum.

In psychiatry, we do not have the luxury of many of the tests and tools used by other fields of medicine. In other words, we don’t have the luxury of x-rays and blood tests to aid in the diagnosis of the vast majority of illnesses we work with. What does that mean? As psychiatrists, we rely primarily on our clinical expertise, the histories provided by individuals and their families, mental status exams, and whatever collateral information is available to come to our conclusions.

After we have gathered all of the available information we arrive at a hypothesis, or best guess – don’t worry. We’re usually right! Psychiatric diagnosis is a finicky thing, because I’d be lying to you if I said I, or any other physician, had the ability to understand perfectly the inner workings of your mind and your own personal experience in an hour-long conversation. The point is, people are complicated, and what may appear as depression one day may come to reveal itself as posttraumatic stress disorder on another.

So what’s the point of seeing somebody, if their diagnosis may be fluid? We can help. Working with a mental health professional at times of difficulty can be an important resource, especially when in a publicly funded healthcare system such as Canada’s. Even if your diagnosis may evolve over time, our treatments are often (and usually) pointed in the right direction. The treatment for depression and anxiety are often the same, and the same is true for bipolar disorder and schizophrenia. Most importantly, regularly seeing a physician can be a rock during times of turbulence, and I would recommend that to anyone, regardless of diagnosis.

Dr. Travis Barron is a resident physician in the Department of Psychiatry at the University of Toronto in Toronto, Canada.

Month: June 2019

Living on the edge

One hundred diagnoses