Every once in a while a guy will know something about women’s bodies that makes me go “ooooh OK that one’s actually really like kinsey 0 straight” instead of some other weird combination of interests that are approximately straight in a mostly possessive way. Sometimes I’ll hear “straight” guys talk about how gross vaginas are but then you hear a guy talking about pH balances and lactobacilli and it’s just really obvious which guy actually wants to be in one.

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…)

My parents told me it’s a hit list for when the fascists take over …but then they voted for the fascists.

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.

the only mental health thing I’m aware of being publicly available is commitments, and in most localities that requires an initial involuntary hold followed by evaluation and a hearing. and even that I think only counts for clearances, gun rights, and possibly licenses concerning public safety such as doctors, social workers, etc. rando employers should not be able to access that info afaik (this is a summary of the relevant part of the speech I give to patients when they ask if they want to change their status to involuntary and what the process looks like if the doctor disagrees that they need care, what their rights are in that situation, etc.). even with that idk that they can see what you were committed for just that you were. I’m not sure how hard they’d have to dig to get access to the mental health board evaluation that led to the commitment. I talked my way out of a commitment after an involuntary hold and have had a few incidents since where I even talked myself out of the hold to begin with and it never even affected me getting licensed (fellow cluster b PD here, hiiiii).

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.

a more useful question would be,“out of all the ways you could make money why are you thinking about this one?”

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.

I love dearmodern on YouTube and thrifted furniture

_beans

beans

beans

BEANS

BEANS

I began my psychiatric nursing career working as a behavioral technician on a unit for criminally insane men. I worked there for two years and was even promoted to lead tech in charge of making the assignments for all the technicians for the shift.

Other shifts and other units were sending staff members to the ER at least every few months related to aggressive incidents. Not us. Only thing was a guy had a stroke near when I was starting and while I think the job did do it to him, I think it happened over the many years before I worked there.

Two months before I left I sustained the worst injury I ever did at that job taking care of criminally insane men …I shut my own finger in a door.

I was rushing too much while grabbing hygiene / shower supplies for a guy one morning. Big heavy solid wood heavy latch and hinge with a long metal strike plate running top to bottom psych ward door. The tip of my finger swelled up twice as big, the nail turned black and eventually popped off. Looked weird as shit for a few months.

Meanwhile one time I was helping separate two guys where one was trying to bite the other guys face off and I kinda blacked out for most of it but I do remember seeing the other guys jaw working trying to gnaw at the guy I was holding. Anyway apparently there was a point where I was under both of them on the floor because like three people came into the restraint room while I was with face-bitey to ask how I was and as the adrenaline wore off it turned out I was a little scuffed up and bruised up…

But holy shit did shutting my finger in that door hurt so damn bad I legit thought I was going to lose the finger and it took over a month to heal!

Where tf was this when I was a kid?

Oh I know why, but how the specific dosages (like, actual numbers) are actually chosen sounds like more of an art than a science.

try this

…but also it’s not really helpful to me in patient care. I tend to find height and weight used separately more useful for patient care than the BMI and even then I don’t use them for much. The only time I really see a BMI that my brain does anything with is when it’s 40+ and at that point they’re almost certainly 300lb+ regardless of height and at that point the weight is still the most important piece of info I’m getting out of that section of the chart.

I think the highest BMI I’ve ever seen was 80something and at that point I’m more just telling the nurse version of a “big fish story” (that patient specifically is the one I use to illustrate the point of being given a patient with medical / mobility needs that is inappropriate to the type of unit I’m on and my efforts to give them some kind of safety and dignity being used by my administrators to justify continuing to leave them in that inappropriate environment, but that’s a story for another day).

The caveat is that I’m not really doing too much with metabolism other than with my catatonia patients, and with them it’s much more about keeping weight on than anything else. You actually very rarely see an acute eating disorder in inpatient psychiatry (if it’s worth hospitalizing them, they need to be on a cardiac monitor and have somebody nearby who actually knows what’s in the crash cart).

As an aside, while I did learn how to calculate a BMI in school, and most electronic medical records do it automatically and display it below the height and weight, most of the actual drug dose calculations either use weight directly (mg/kg) or use an even weirder and more complicated equation to estimate “body surface area” (BSA). You can google that equation but I neither need nor know how to calculate it (and again the computer does it for me). Other factors that seem to be used a lot for drug dose calculation are the age of the patient (both very young or very old patients often need less of something and get side effects more often), or specific diseases like kidney or liver disease can affect the dose too. How these specifically affect drug dosing is beyond me, but not being a doctor my best guesses are

• specific cutoffs / reccomendations for specific drugs and situations (these are likely looked up in lexicomp or UpToDate these days rather than memorized)
• “winging it”
• black magic

Most of what I’m using the height and weight for within my own specialty is actually clothing / equipment sizes so I can have everything prepped for a new admission, and estimating how much literal weight is gonna get thrown around if they show up ready to fight. It’s also helpful to know if medical is dumping another supermorbidly obese patient on us (they almost have to have psych issues to get that big, but they also almost always need mobility aids we don’t have).

Other things I would care more about:

• Can you get up and walk to the bathroom on your own and dress yourself?
• Can you make it up a flight of stairs?
• Are you physically able to do a job that supports you economically and feels purposeful to you?
• Can you dance and play games and walk to all the places you need and like to go to?
• Are you in pain very often?
• Are you likely to trip and fall or hit your head while doing any of those things?

BMI is associated with things like heart disease, diabetes, hypertension, etc, but with those things there’s also a bunch of other things like your specific sugar and fat and salt intake and your family history and what other medications you’re on or what other vices you have and current lab tests and whatnot so even there, like another user said, BMI is more useful at a population / public health level than it is an individual one.

I need to know your location to know what grass is ecologically appropriate to grow there. Wouldn’t want you growing an invasive species. Also need to know the layout of your water, soil, proximity to water, amount of shade, etc. Would be easiest for you to just provide your address so I can find the best grass location near you.

There is also the option to just not interact with things you don’t like on the internet. You can just not respond. You can block people that say things you don’t like. You can also make your own community that you moderate how you want to. Why are you demanding that someone else do work that you’re unwilling to do yourself?

Or you can go touch grass. If you find google maps data collection too invasive to find a local park with you can also try duckduckgo.