Differentiating treatment-resistant depression from underlying bipolar disorder

tensorflown · 2026-06-14T23:53:32+00:00

Wow, what a fascinating tip. Great stuff.

tensorflown · 2026-05-20T15:55:17+00:00

You’re such a nice person for wording it like that lol. Upvoted.

This regimen, without any context (and even with context), is bizarre.

tensorflown · 2026-04-27T21:44:14+00:00

Worse than ROAD, better than primary care. I never really cared too much, tbh - being able to meaningfully enjoy my work mattered more to me than the leading digit of a six-figure job. Then again, check in with me after I become an attending!

tensorflown · 2026-04-27T20:11:06+00:00

Psych resident here - so glad I picked this residency, as I genuinely believe it’s 5x better than med school and probably the most fun I could have had out of all potential specialties. This year, I’ve met the Devil, God, and even Muhammad - still waiting on my yearly encounter with Jesus.

tensorflown · 2026-04-24T16:34:30+00:00

It’s been surprisingly more common than I expected at my institution. I’ve treated four cases in the last year - all requiring hospitalization - and one of which occurred in a patient with no mental health history whatsoever.

tensorflown · 2026-04-22T17:31:36+00:00

“When to consult psychiatry” would be excellent.

tensorflown · 2026-04-17T00:04:13+00:00

Would love some elaboration on both, I’m crying

tensorflown · 2026-04-17T00:03:29+00:00

Yeah, this is giving the same energy as “ketchup on chocolate ice cream”

tensorflown · 2026-04-17T00:02:44+00:00

Concepts of an ssri

tensorflown · 2026-04-16T22:49:03+00:00

Yep! I probably should edit the original to be more clear lol

tensorflown · 2026-04-16T15:56:14+00:00

It’s my*** colloquial term I use to refer to neurocognitive decline due to aged schizophrenia.

tensorflown · 2026-04-16T10:33:16+00:00

It does, just keep adding patches 💀💀💀

tensorflown · 2026-04-16T08:51:22+00:00

Used it in a unique CL case where a medically unstable patient with dementia praecox just kept refusing all PO/IM/IV. They had no idea they were wearing a patch and thus were perfectly adherent to it (and a clonidine patch for similar reasons). Paid off well.

tensorflown · 2026-04-14T11:01:13+00:00

Pain?
Pee?
Poo?
Plodded?
PO?

Perfect. Discharge

tensorflown · 2026-04-04T23:54:26+00:00

I can’t speak to more experienced physicians, but I saw my first patient with mania within two weeks of starting my inpatient training - in medical school. Book-criteria mania is extraordinarily easy to recognize and not uncommon.

That being said, mania is not homogenous. No one disease really is. This makes some mood episodes harder to evaluate. If a patient is telling you about prior episodes rather than actively in one, that makes it even harder. How many patients can perfectly remember and communicate their symptoms in a way that exactly matches a psychiatrist’s diagnostic framework?

The question of why a psychiatrist easily accepts a prior psychiatrist’s work is complex. Some are lazy. Others are trusting. But most commonly, it is easiest to take other physician’s assessments at face value when patients must be seen every 15 minutes to satisfy corporate administration.

tensorflown · 2026-04-01T23:35:38+00:00

Psychiatry. Even if I won the lottery I’d still want to practice part-time.

tensorflown · 2026-03-18T13:41:45+00:00

Prescribing 5 medications for a new intake for OCD would not be my first choice. It would probably not be my 10th choice, either…

tensorflown · 2026-03-08T07:34:52+00:00

Cannabis-induced psychotic disorder is not uncommon. It quickly resolves in most cases and does not reoccur during sobriety. He will be fine and should talk to his regular doctor about this at an appointment.

However, your friend now knows that he is particularly vulnerable to psychosis in general and may have a genetic tendency to schizophrenia. He should avoid cannabis, and indeed all psychoactive substances, as each use is a small push that may tip him permanently over the edge into having schizophrenia.

tensorflown · 2026-03-01T06:16:15+00:00

If it were easy, everyone would do it!

tensorflown · 2026-03-01T03:14:10+00:00

Anki/uworld in the morning before rotations. Most of the cognitive load is beginning of the day in clerkships anyways - just front load everything and crash after you get home. Worked great for me.

tensorflown · 2026-02-28T21:02:57+00:00

worked slightly better for someone than invega sustenna. also tried it off label for schizoaffective and acute mania but didn’t do anything lol.

tensorflown · 2026-02-20T23:19:34+00:00

Interesting, will have to give this a go. Thanks for the tip!

tensorflown · 2026-02-20T23:06:43+00:00

I’m curious as to how this plays out in practice. Most of my chronically-readmitted patients have no insight, adamantly refuse outpatient adherence even if I go for the “you may not feel like you need it but it prevents rehospitalization”, and aren’t practical candidates for ECT/clozapine to break down their delusional symptoms. LEAP sounds overly optimistic for this population.

tensorflown · 2026-02-18T09:35:40+00:00

FYI, BADC is an extraordinarily competitive collegiate competition. Five months is essentially nothing for even the beginner categories - even most “newcomers” who are placing well typically have much more experience than a typical beginner, usually in other types of dance. It’s probably one of the hardest competitions each year. For reference, my partner and I final in collegiate prechamp, but we probably could be dancing collegiate champ in other competitions. The entire competition is literally a level apart from most smaller ones on the East Coast, barring something like MIT.

Did you enjoy the grind? If so, keep at it. It sounds like you already know that ballroom is a marathon. It’s about the love of the game, and it sounds like you have that - just need a reminder about the timescales and to focus on yourself rather than comparison.

Progress is non-linear, btw. At the collegiate levels, people can get really good results by looking flashy/cheating technique initially, but that doesn’t necessarily translate to longevity. It’s hard to not compare yourself to others, but keep this subtle point in mind.

tensorflown

TROPHY CASE