Posted by
Message
td01241
Georgia Fan
Savannah
Member since Nov 2012
15691 posts

Further examination of Mental Health fallout from country’s situation
Originally posted on PT and request admins move but not much interest there. Hoping for some more insight on what others are seeing here and if it is inline with me or something different.

As this thing drags on I think its important to periodically keep ourselves aware of other areas of health impacted by Covid and all its wrought. For context I practice in Georgia, although not in the city of Savannah where I live but nearby, although due to the nationwide low numbers of psychiatrist I get patients from about a 50 mile radius and our wait time fluctuates around 9 weeks. This is also in State that has been full on open for months now.

1) Covid itself is rarely a primary or even secondary trigger or reason for patients seeking help
2) The average age of patients has increased somewhat significantly and most because inability to provide for family, loss of business, or lack of outside activity
3) Suicide and overdose rates have risen although not by what I would call a significant amount, but in my judgement could possibly be related to lockdowns, not getting social interaction mentally ill people generally need, and inability to get the proper care rapidly enough
4) While anxiety and depression is generally one of the most common patient types, these have exploded and for once in my life wouldn’t be opposed to GPs handling more of these to ease loads
5) Increase in Alcoholism, and addiction to Benzodiazepines and Opiods, leading to an increase in inpatient care in some cases

A few positives:

1) Much less patients are abusing their own medication, I have come to attribute this to people realizing that in this current climate they will need it and are actually interested in getting better
2) More patients being open to therapy and techniques to help manage problems without relying solely on medication
3) More patients being willing to alter currently existing Med regimens started by another doctor

These things tell me things have deteriorated for enough people their interest in getting well trumps anything else. I know this is just my experience but interested in takes.

ETA: This is solely what I’ve seen in my area, and realize some national trends may not be exactly in line. Interested to know if any other providers are seeing similar things.

Would also be interested in a physician in a field qualified to expound on if serious physiological conditions like high blood pressure, heart disease, etc have seen similar differences. Some of my stimulant patients who have vitals tested at monthly visits have seen concerning increase in blood pressure outside of their norm and others.

Also, our practice has put in a way we can help reach patients at the back of the line possibly needing immediate care. Friday afternoons one person rates to zoom calls with those identified. A terrible time in history to have a shortage of psychiatrist all across the country.
This post was edited on 10/18 at 1:45 pm


jimbeam
USA Fan
University of LSU
Member since Oct 2011
65272 posts

re: Further examination of Mental Health fallout from country’s situation
I was assured this would not be an issue


td01241
Georgia Fan
Savannah
Member since Nov 2012
15691 posts

re: Further examination of Mental Health fallout from country’s situation
I’m young and haven’t been practicing but barely over a year and for the first time ever a patient on 4mg of Xanax a day immediately agreed when I suggested we taper and overhaul his Med regimen. Could be a one off but the man could’ve been in such a bad place he’d have done anything.


Replies (0)
Replies (0)
30
td01241
Georgia Fan
Savannah
Member since Nov 2012
15691 posts

re: Further examination of Mental Health fallout from country’s situation
No doctors to way in about seeing similarities or to drop some info on physiological responses possibly outside norm?
This post was edited on 10/18 at 2:01 pm


fishfighter
LSU Fan
Baton Rouge
Member since Apr 2008
39345 posts
 Online 

re: Further examination of Mental Health fallout from country’s situation
C19, no problem here. ALS, big problem that is kicking my mental state. Yes, I am ready to just end it, but will not.


Replies (0)
Replies (0)
140
HammerJackFlash
LA-Monroe Fan
Member since Sep 2018
456 posts

re: Further examination of Mental Health fallout from country’s situation
quote:

No doctors to way in about seeing similarities or to drop some info on psychological responses possibly outside norm?


Taking a toll on everyone. People are stressed and pissed off. Coming from not a doctor, but from someone who simply looks around and observes.

It’s not rocket surgery.


td01241
Georgia Fan
Savannah
Member since Nov 2012
15691 posts

re: Further examination of Mental Health fallout from country’s situation
No need to be rude my man. Changing demographics for symptoms unusual to them, average age increase per patient, increase in referrals, more suicide and drug addiction, inpatient hospitals at capacity for longer periods than ever. It’s Covid I understand. But if I remember correctly Georgia has been opened fully since July, how come we haven’t seen a shift back even if slightly?


blueboxer1119
LSU Fan
Baton Rouge
Member since May 2013
1998 posts
 Online 

re: Further examination of Mental Health fallout from country’s situation
This seems like a political issue.

Can an admin explain why this can be posted on the OT and Hunter Biden can not?

Serious question.


td01241
Georgia Fan
Savannah
Member since Nov 2012
15691 posts

re: Further examination of Mental Health fallout from country’s situation
It’s political only tangentially because of Covid. It’s more a medical issue than anything. We opened Georgia fully in July and the pendulum hasn’t swung back.


blueboxer1119
LSU Fan
Baton Rouge
Member since May 2013
1998 posts
 Online 

re: Further examination of Mental Health fallout from country’s situation
quote:

It’s political only tangentially because of Covid. It’s more a medical issue than anything. We opened Georgia fully in July and the pendulum hasn’t swung back.


So it is a political issue though.

Seems like admins just hate the idea of people talking about Hunter Biden.


TD SponsorTD Fan
USA
Member since 2001
Thank you for supporting our sponsors
Advertisement
td01241
Georgia Fan
Savannah
Member since Nov 2012
15691 posts

re: Further examination of Mental Health fallout from country’s situation
I also dismissed Covid as reason in the very first point I made. Well the worry of Covid at least. The trends I see are troubling i’m only trying to ascertain if anyone else sees them. Tried Reddit first got banned for downplaying a pandemic
This post was edited on 10/18 at 2:08 pm


Earthquake 88
LSU Fan
Mobile
Member since Jan 2010
2096 posts

re: Further examination of Mental Health fallout from country’s situation
I would think the alcoholism and drug abuse would go up. Turn on the news it’s doom and gloom. 30 plus million I believe were laid off. The inability to provide for my drive me nuts. Having said that in Alabama you can find work if you want to. It might not pay as well as say a salaried professional position but at least it pays something. My circle of friends scattered all across the country are more concerned with excessive weight gain than popping pills and drinking more. Now politics have people on edge though but I avoid talking about that subject with people in general.


tigergirl10
Member since Jul 2019
2776 posts

re: Further examination of Mental Health fallout from country’s situation
quote:

Georgia has been opened fully since July, how come we haven’t seen a shift back even if slightly?
There are still a lot of people unemployed in Georgia. At the end of September, Georgia was ranked 6th out of 52 (including DC and Puerto Rico) for highest unemployment at 10.1%. Louisiana is 5th.
LINK


BeerMoney
LSU Fan
Baton Rouge
Member since Jul 2012
5880 posts

re: Further examination of Mental Health fallout from country’s situation
I know I’ve been drinking more. Working from home sucks. Better than not working at all like many unfortunate people. But still, sucks with uncertainty of future. Also working out more than ever just to get out of the house. So I look good just don’t feel good.

Politics. Just can’t wait for the election to be over for better or for worse. Can’t stand it anymore.


Replies (0)
Replies (0)
53
td01241
Georgia Fan
Savannah
Member since Nov 2012
15691 posts

re: Further examination of Mental Health fallout from country’s situation
I agree alcoholism going up really isn’t a shocker. But when you have someone who takes 6mg of Klonopin a day plus 30mg Oxycodone 4 times a day while pounding beers that’s a pretty big issue. This is pure conjecture but I’d say it’s more likely than in the past alcoholics aren’t solely sticking to alcohol. Further, looking at this through the lenses of a wide open state like I was, the big question is why have we not even seen the slightest swing back in former direction?

Coincide this with my point about patients misusing their own medication at an actually much lower rate, that leaves a whole subset of people out there who are not getting help. Rehabs are full. Many doctors who have the credentials to write suboxone/subutex scripts for opioid addicts are at their max (I’m not at max but I rarely write them although I have much more recently.) I assume methadone clinics have never been more packed as it is essentially a very strong long last government supplied opioid for less than what maybe 2 Percocet cost a day. I know of only two psychiatrist specializing in addiction in Savannah and both are booked 6 months out. I feel like we maybe failing these people.


Replies (0)
Replies (0)
10
td01241
Georgia Fan
Savannah
Member since Nov 2012
15691 posts

re: Further examination of Mental Health fallout from country’s situation
Thank you for the statistics that could certainly be a part in what I am seeing coupled that with coming out of long period of hibernation with increased risk of developing an addiction, and the depression/anxiety of what many have suffered could definitely be playing a major part of what I’ve been seeing. Yet on the other hand like I listed under my positives I’m seeing more patients operate exactly as the medication dictates than I ever have. Perhaps increased desire to actually turn things around beating desire to take a 30 month supply in 10 days or sell it.
This post was edited on 10/18 at 2:34 pm


Replies (0)
Replies (0)
00
WeeWee
USA Fan
Member since Aug 2012
31259 posts

re: Further examination of Mental Health fallout from country’s situation
quote:

Would also be interested in a physician in a field qualified to expound on if serious physiological conditions like high blood pressure, heart disease, etc have seen similar differences. Some of my stimulant patients who have vitals tested at monthly visits have seen concerning increase in blood pressure outside of their norm and others.


I'm a family med PGY-2 in WV. In the outpatient clinic I'm seeing a lot of covid induced anxiety and depression in my patients that didn't have MDD or GAD prior to covid. I'm also seeing a lot of drug seeking behavior because of covid induced anxiety. I'm prescribing a lot of meditation and exercise to help with it. I'm not writing any scripts for benzos for new anxiety unless the pt was my patient before covid and I am comfortable they are not drug seekers. I have not really seen a lot of change in compliance with follow-ups. My patients that were compliant before covid are still compliant and their HbA1c, BP, and other stats are about the same as they were before Covid. With the exception of weight, I would estimate that most of my patients have seen a 5-8lb weight gain on average. The patients that were noncompliant before are still noncompliant but now they just use covid as an excuse. Of course resident clinics have high noncompliance with follow-up appointments and medications general so that might be skewing my observations.

Inpatient population has not really changed. Still a lot of CHF exacerbation, ACS rule-outs, and IV drug abuse associated infections. I have seen a lot more "repeat customers" for the IV drug abuse infections because drug use appears to be increasing (just my subjective observation). The biggest thing that I have noticed has been with increased mental illness in the elderly that are self isolating or living in nursing homes. I have had 2 patients that were self isolators that have had to be hospitalized because of suicide attempts. The stress from the isolation was what tipped those 2 over the edge.

With all that being said, I think that the mental health aspects of covid will last much longer than covid. Covid induced anxiety and depression will turn into GAD and MDD. Plus the benzo abuse, drug abuse, alcohol abuse, etc will keep getting worse and then take years to fix if it ever does get fixed.


saint tiger225
LSU Fan
San Diego
Member since Jan 2011
17397 posts

re: Further examination of Mental Health fallout from country’s situation
quote:

Tried Reddit first got banned for downplaying a pandemic
What a bunch of idiots over there. That place is truly lost. If you don't agree with what everyone else agrees with (which is the dem platform), then you're banned or comment gets removed. That place only tolerates group think.


SaintsTiger
Member since Oct 2014
138 posts

re: Further examination of Mental Health fallout from country’s situation
quote:

I'm a family med PGY-2 in WV. In the outpatient clinic I'm seeing a lot of covid induced anxiety and depression in my patients that didn't have MDD or GAD prior to covid. I'm also seeing a lot of drug seeking behavior because of covid induced anxiety. I'm prescribing a lot of meditation and exercise to help with it. I'm not writing any scripts for benzos for new anxiety unless the pt was my patient before covid and I am comfortable they are not drug seekers. I have not really seen a lot of change in compliance with follow-ups. My patients that were compliant before covid are still compliant and their HbA1c, BP, and other stats are about the same as they were before Covid. With the exception of weight, I would estimate that most of my patients have seen a 5-8lb weight gain on average. The patients that were noncompliant before are still noncompliant but now they just use covid as an excuse. Of course resident clinics have high noncompliance with follow-up appointments and medications general so that might be skewing my observations.

Inpatient population has not really changed. Still a lot of CHF exacerbation, ACS rule-outs, and IV drug abuse associated infections. I have seen a lot more "repeat customers" for the IV drug abuse infections because drug use appears to be increasing (just my subjective observation). The biggest thing that I have noticed has been with increased mental illness in the elderly that are self isolating or living in nursing homes. I have had 2 patients that were self isolators that have had to be hospitalized because of suicide attempts. The stress from the isolation was what tipped those 2 over the edge.

With all that being said, I think that the mental health aspects of covid will last much longer than covid. Covid induced anxiety and depression will turn into GAD and MDD. Plus the benzo abuse, drug abuse, alcohol abuse, etc will keep getting worse and then take years to fix if it ever does get fixed.



Are you seeing good results with this, doc? Do you have a general opinion on the sam-e, probiotics, b-12 stack? I've been taking that for a while with great results and no side effects. Well I taper off sometimes. A couple years ago I went to see an integrative psychiatrist because of depression and anxiety. At the time I was already doing plenty yoga and meditation with some good results but the symptoms were still there. She ordered labs done and said my neurotransmitter counts were low and that I wasn't methylating. I was expecting a prescription, but her opinion as a former VA psychiatrist who used to prescribe prozac, valium, etc. was that they didn't work long term and caused guaranteed side effects. She's also a certified yoga teacher and treats patients with yoga, meditation, and talk therapy. I was already doing a lot of that so she just recommended the sam-e stack. Changed my life!


SFCATiger
LSU Fan
Marin County
Member since Aug 2006
924 posts

re: Further examination of Mental Health fallout from country’s situation
quote:

What a bunch of idiots over there. That place is truly lost. If you don't agree with what everyone else agrees with (which is the dem platform), then you're banned or comment gets removed. That place only tolerates group think.


Kind of like the conservative, pro- Trump position on the poli board I guess.


Replies (0)
Replies (0)
89
first pageprev pagePage 1 of 3next pagelast page

Back to top

logoFollow TigerDroppings for LSU Football News
Follow us on Twitter, Facebook and Instagram to get the latest updates on LSU Football and Recruiting.

FacebookTwitterInstagram