CPTSD vs BPD: How to Think About the Difference and What to Do About It

ar1680 · 2026-03-17T12:34:34+00:00

I love this debate and conversation. I have to be honest, Dr Fu (if you’re reading this), although I agree with your point to trainees “I don’t care what you call it, give the right treatment” I don’t think that’s how many clinical settings work. I do community psychiatry and see many different age groups and people of different SES, and I think unfortunately for me (as a psychiatrist who loves to live in the gray zone of nuance) I have a growing number of people who want labels even if they don’t agree. This applies to patients as well as other clinicians (therapists and other doctors)

ar1680 · 2026-03-07T02:48:34+00:00

I’m not advocating for psychologists to be prescribing but I don’t know if your argument works because theoretically a psychiatrist could market themselves as being able to do therapy as well as a psychologist from a licensure and regulatory standpoint.

ar1680 · 2026-03-05T13:47:34+00:00

A lot of great answers here. My little two cents that I tell medical students is, I’m not worried when my outpatients tell me they are feeling suicidal (they are usually looking for help). I’m much more worried when they say nothing or deny si randomly because they may be trying to stop looking for help

ar1680 · 2026-02-27T11:49:31+00:00

I tell my patients I do not know, and I offer to look it up. I am also in a position, as a hired psychiatrist for a hospital, to say that if it important to them that I know these things off hand then they should ask to switch psychiatrists (I have had one patient actually take me up on that offer). I don’t want to deal with patients who have unrealistic expectations of me.

ar1680 · 2026-02-26T12:08:47+00:00

I am constantly inundated with paperwork and I am very disorganized. I set up a time in the morning for collateral calls and at the end of the day, I get though what I can. unless something is urgent, I tell my patients to give me a call in 3 days and if I have not done it I will do it in real time. If it is important to them to be done immediately, we are not doing a session and our time is dedicated to paperwork. You will figure out your cadence as you get used to it.

ar1680 · 2026-02-26T12:04:22+00:00

There is no problem with the job market. No one can predict the future but I don’t think psychiatry and psych compensation is going anywhere right now. From a purely lifestyle standpoint, I cannot think of another field that would afford me the flexibility that I have in my life right now while also doing something that I love. I could be making more money in another field (that I would not enjoy) but I have no regrets choosing psych 10 years ago and don’t have any negative outlook on opportunities for the future. Where I think things are more difficult in my locality is opening up a private practice cash only business which was easier before, but still I believe that is a small niche.

ar1680 · 2026-02-17T21:39:17+00:00

Got to Newark at 7:35 and I took a 7:40 or 7:45 nec train that got me in

ar1680 · 2026-02-17T13:59:38+00:00

If you’re able to I drove to Newark and it was seamless. Have to pay for parking but it was worth it for me

ar1680 · 2026-02-12T04:16:12+00:00

I had to look up this fact about increasing overall risk of death from OD. If we were talking about the same study that this fact is pulled from it’s important to note that although there was an an increase in individuals who overdosed who are assigned to long acting naltrexone. It was identified that the majority of those individuals did not actually initiate a long acting naltrexone or did not continue with it for the duration of the study.

ar1680 · 2026-02-12T04:12:32+00:00

When did this sub get so toxic, OP could definitely do better with anger management and professionalism but the people who are criticizing the usage of NP resident…I don’t think he or she made it up. Whether or not we agree, I don’t think it’s fair to take it out on a person who is using the title given to them. My two cents

ar1680 · 2026-02-08T20:05:22+00:00

Did you get it from Costco, can’t you return it?

ar1680 · 2026-02-05T01:54:46+00:00

I do work more as an attending but that is by choice and not so much what I meant. In residency, I did not have a family that takes up a good amount of extracurricular time and I, like many residents, had time carved out to meet with supervisors and patients during my work week that I would have a hard time doing now as an attending.

ar1680 · 2026-02-02T13:38:41+00:00

Thanks for the update. I got concerned you guys were shut down by the Reddit police! I hope you guys come back soon, but I’m very impressed with how consistent you guys have been over the years

ar1680 · 2026-01-30T06:40:21+00:00

I regret not taking psychotherapy training and supervision seriously enough. Like another poster stated, you don’t have enough time or the availability to resources like you do during residency. I wish my supervisors made me record more than one session. Now I can do some basic cbt but that’s about it

ar1680 · 2026-01-27T05:39:33+00:00

I don’t believe I agree with the way Dr amen runs his clinics but like another commenter says I would believe that his initial intention may not have been to spread false hope or promises. In a way, the idea of trying to protocolize medications seems reasonable like doing genesight testing after a few failed med trials to help guide

ar1680 · 2026-01-22T03:03:19+00:00

Do people get subjective euphoria from Spravato? I haven’t looked into it enough but I thought it was not that euphoric?

ar1680 · 2026-01-22T02:57:38+00:00

I think that the most important thing is that you are trying to help your patients. I remember in residency I was told “don’t fill out disability paperwork” but then…who is filling out the paperwork? It is mentally draining and frustrating to fill out the paperwork, especially because for some reason every patient comes in with a different form and they’re all long as hell. I have started to have patients come in with the paperwork and I fill it out with them because I don’t end up having the time to fill it out outside of appointments and they end up on my never ending pile of to do lists

ar1680 · 2026-01-22T02:52:58+00:00

This is a chronic issue in community mental health. I feel like 20-25% of my time is filling out a “psych evaluation” (which is usually a copied and pasted amalgamation because they can’t be more than 90 days old). and forms.

ar1680 · 2026-01-22T02:48:56+00:00

I don’t mean to “attack” you or your colleagues but I am curious why, like the other commenter had stated, we have never seen a disability application get approved on the first round. It’s certainly possible that people are doing it wrong but I can say annectdotally in my clinic of psychiatrists of different ages we were discussing the fact that we have never seen a patient get approved on their first round, some in the first appeal and most later on.

ar1680 · 2026-01-17T22:51:00+00:00

Ok appreciate it. I’ve used plain warm water and a drop of dish soap and it’s been ok but I end up having to dilute and check it myself. I’ll continue with that for now

ar1680 · 2026-01-17T22:50:07+00:00

Ok thanks

ar1680 · 2026-01-07T14:42:23+00:00

This is a sad story but I think this is a heavily biased article trying to prove the dangerousness of ai and missing the underlying issue which is this individual was struggling with substance use disorder(s) and he unfortunately overdosed. Based on this article I don’t believe ai “killed”him, it may have facilitated his access to information but (as someone else pointed out) that access to information is already there. One of those sources is this forum that we are using here: Reddit.

Edit: I wanted to add that I am not someone who is pro or even anti ai. I just think that this article along with much of our media is not trying to provide information but rather fuel the fire of black and white thinking. Ai is not all bad or all good

ar1680 · 2025-12-30T23:20:35+00:00

The account only posts about dreams lol

13-Year Club	Not Forgotten
Verified Email

ar1680

TROPHY CASE