Psychiatrists or Medical professionals. Appropriate terminology to use in this situation.

KCT

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I'm asking for what professional terminology or phrase I could use to best describe the nature of the MC's condition.


Here is some background on the scene and the characters involved to give you a frame of reference. The MC is a fifteen-year-old girl who is recovering from the psychological shock of her father's sudden disappearance - possibly due to nefarious means. In the scene, the girl is attempting to describe to a friend what had happened to her as a result, and I need a phrase or the appropriate terminology to use to complete this sentence: "The doctor's said that I ____________."


The facts behind the situation are this. The girl learns that her father is missing, potentially murdered. She has nightmares that significantly impair her sleep for days on end. The girl lapses into a severe depression. Eventually, due to her deranged state, she steals some of her mother's prescription medicines and attempts to commit suicide. She recovers from the suicide attempt, but she continues to suffer periodic nightmares for a while. After a period of professional attention/therapy, etc., the girl is now in her mother's care.


I'm guessing that a professional would not have said to the girl, "You took a trip to looney land, and you didn't come back for a while." Rather they would've described her condition using the current medical terminology that best fit the situation.


What would you suggest is the best terminology to use that would reasonably encompass the girl's condition and complete the sentence? "The doctor's said that I ____________."


Thank you for your time and consideration, and I look forward to any comments or suggestions that you may wish to offer.
 

Karen Junker

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Not a doc, but was a social worker with some experience in working with clients with mental health issues. Suggest possibly 'Situational depression with suicidal ideation' -- but maybe you can look up some things online, like in the current version of the DSM V? http://www.dsm5.org/Pages/Default.aspx for what that stuff is actually called in a diagnosis.
 

Chasing the Horizon

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I'm not so sure about the suicidal ideation part, as an actual suicide attempt goes way beyond that, suicidal ideation being a normal part of the course of many mental illnesses and not emergent.

Otherwise, there's not really enough information in the OP to play guess-the-diagnosis. How long did the symptoms last? Were there psychotic symptoms or only severe depression? It's not unusual for a vague diagnosis like Mood Disorder NOS (Not Otherwise Specified) or Brief Psychotic Episode to be slapped on the chart in a crisis situation like that because there are minimum time periods during which symptoms must persist for a diagnosis like Major Depression to be made, and they have to bill the insurance company under some diagnostic code.

I'm not a professional either, just someone who has a lot of experience with the psychiatric system.
 

Literateparakeet

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What about PTSD? I'm not a medical person, but I have PTSD and those symptoms are very familiar to me.


Possible causes of PTSD

PTSD is a lasting consequence of traumatic ordeals that cause intense fear, helplessness, or horror, such as a sexual or physical assault, the unexpected death of a loved one, an accident, war, or natural disaster.

http://www.webmd.com/anxiety-panic/guide/post-traumatic-stress-disorder

Suicide

Posttraumatic stress disorder (PTSD) is frequently associated with suicidal ideation and suicide attempts.

http://www.ncbi.nlm.nih.gov/pubmed/23995037

Nightmares

Nightmares are one of the 17 symptoms of PTSD (1). Along with flashbacks and intrusive thoughts or memories, nightmares are one of the ways in which a trauma survivor may re-experience or relive the traumatic experience for months or years following the event.

http://www.ptsd.va.gov/professional/co-occurring/nightmares_and_ptsd_research_review.asp

Insomnia

Post-Traumatic Stress Disorder (PTSD) is a well-known cause of insomnia.

http://www.insomnia-free.com/ptsd-and-insomnia.html
 
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KCT

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Thank your for your reply's. I was wondering if I needed to say more about situation to make things clear. Unbeknownst to most everyone at that point in the story is that the girl was driven into drug-induced derangement by her mother to cover a murder that took place. The mother slips heavy drugs into her daughter's food and drink, and then claims to the authorities that she tried to commit suicide due to her father's disappearance. The doctor's believe the mother's story and assume the girl was severely depressed and had tried to commit suicide.


The girl, unfortunately, has no clear recollection of what had happened to her. Her memory of that period in time was lost in a drug-induced fog. The girl believes what the doctor and her mother had claimed happened to her. The nightmares she suffers have to do with something she may have seen while in a drugged state, but that is explained away by her mother as due to her depression. Later, the girl tries to explain what happened to her to a friend using the terminology the doctor used to describe her condition. I hope this helps.

I indicated in my first post the "facts" behind things to set up the situation, however, those facts are what the girl and the authorities believe at the time. So the doctor's diagnosis would be based upon that belief.


I wanted to use some relatively simple but accurate terminology that could be applied in this case without going into a lot of detail, if you get my drift.
 
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WhitePawn

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First off:
Syndrome/Disorder = long-term (ex: PTSD)
Reaction = short-term, transient (ex: Acute Stress Reaction, Grief Reaction)

If you go into your doc and ask for five days worth of sleeping pills just in case you have problems sleeping because your husband just died, for example, you'll get "Grief Reaction" in your chart. Acute Stress Reaction might work, I'd have to read to know though.

It is NORMAL not to have memory of a high-impact, high-stress event. Fact: Memory is NOT a tape recorder. If your brain is busy staying alive, checking out to avoid stress, or helping someone else at the point of impact, then you might not remember seemingly large details. Encoding requires attention. If attention isn't present, then encoding doesn't happen and thus the memory isn't formed. This is why some individuals go their entire lives not remembering a major stress event. (See: Princess Di crash)

We're adaptable critters, for survival. Sometimes that means the brain says, "Screw this", and shuts down awareness for a few.

The above is the simple approach, but medicine is rarely simple, continue reading if you want complication fodder outside of the technical stuff.

A politically charged topic in the industry is the to medicate or not to medicate regarding anything pediatric. Teens are pediatric. I'm not looking to take a side here, or to inspire tangential/emotional threads, I'm just offering up background noise to the character's situation. Whatever stance the author chooses to take, this question is going to loom regarding that fifteen year old.

Some professionals (and parents) believe that any indication of behaviors listed above require medication, possibly long-term. The other side says teens and kids are growing into their bodies and personalities and therefore should never be medicated until they hit their twenties. Again, not debating for or against either, just saying it's an omnipresent issue. Depression meds are an excellent, often argued, example.

Another conflict for you for the inpatient setting. When something high-stress occurs with a child, there is a high probability of parents arriving with BS of GoogleHead degrees under their arms. They then proceed to tell doctors and everyone else around them, those both degreed and experienced in medicine, what to do and how to do it. This is, by far, the best way to alienate the people taking care of the fifteen year old. This will invariably make the healthcare professionals in the situation: tight-lipped, angry, curt, overly polite, talk to the girl's family in overly calm and quiet voices, humor the parent with wide-eyed head nods, and so on. Tension all around. It's a thing that gets passed on in shift report, nurse to nurse, so each nurse coming in will know of any incidents that happened on prior shifts by word of mouth.

Anyway, I hope this helps.