In the last few weeks I have been thinking about the way Anorexia affects some girl very severely. In our clinic most will recover after one year but a handful develop a chronic course with more preoccupation with anorexic thinking, voice hearing and a more depressive experience.
In the last few months I have been involved in teaching medical students because in the next 10 years I would like to give back some my learning through clinical experience back to the next generation of students and doctors. My wife and I are both doctors and we have looked back on our younger selves with compassion in relation to our witness of suffering, sickness and death of our patients. I feel a need to protect doctors from the future trauma they will face as hospital doctors.
The assumptions are that
In my professional role I have had to assess the risk of suicide for over twenty years. A holistic understanding of the young person is required in terms of their personal life, education progress and life at home, in addtion to the features of depression and anxiety disorders. In the forensic setting there is additiona emphasis on the risk a young person might posse to others in terms of offending behaviours.
Recently I was reading a blog entitled www. wiring the brain.com by Professor Kevin Mitchell of Trinity College, Dublin.
In the Victorian era the study of the skull contours was linked to theories of the emotional life and character of that person, giving way to a language of understanding the mind.
After Freud there was a great expansion in our language in understanding the mind in the modern age in relation to the great social and technological changes.
Young people frequently present to us in the context of the breakdown if their parents' relationship.
It can be a very sad time and have an enduring emotional impact on a young person for many years.
We have all been under pressure during the Coronavirus pandemic that causes the potentially fatal disease covid-19.
Just under 1 million people have died from this disease and we hear of a resurgence of the virus within different national populations. The disruption to life around the world has been profound, with the impact of bereavements, poverty, economic hardship, people not being able to work in certain sectors like the airline industry and children not being able to go to school for several months.
After a person has committed suicide, everything stops. We can no longer see them and our relationship with their relatives transforms somewhat. We share their pain and suffering, which they carry on long after the coroner's inquest into their lives.
Relatives will feel anger and sadness, which never seems to end. They have to face life without their lives one, often not knowing what they left. Other family members and friends may find this loss is too much.
There is always hope and there is always a way back in life, even in this present age.
I will outline some of the thoughts I have in relation to antidepressant drug prescribing for young people wit severe depression.
A depression care pathway is enclosed to help show the path a young person might take through a child and adolescent mental health service.