Neat case in the E.R. yesterday…
I was paged and asked to come to a local E.R. to assess a 14-year-old “manic” female. Well, I was prepared for most anything, including an inaccurate initial assessment by the medical staff. Believe me, in the world of E.R. psych, it happens all the time.
When I walked into the room I met a young lady, who presented very well, and her mother. And I could immediately tell she wasn’t at all manic. Oh, she was talking in a very animated and rapid manner. But she was also very fidgety, breathing way up in her chest, sighing frequently, and rapidly blinking her eyes.
It was obvious she was suffering from some pretty intense anxiety and I learned she’d had a nasty panic attack at home, which led to her mother bringing her to the E.R.
Well, she shared her recent history, and all of the symptoms were there. To name a few; she frequently hyperventilates, experiences that smothery feeling we know all too well (that’s actually what pushed her over the edge today), finds it very difficult to sit still, feels as though she’s “going nuts,” has some problems sleeping, and so on.
Given my history of anxiety we immediately connected. And as I explained what she was experiencing, and why, I threw in a few morsels from my past.
What a joy it was to see the anvil being lifted from her shoulders as she came to know she wasn’t “going crazy,” and that others experience her confusion and distress.
Well, as we were wrapping things up I gave her some counseling referrals and encouraged her to explore her traditional patterns of thought, and how they contribute to her symptoms. I also mentioned a medical examination, with blood work, would be a good idea. She and her mother were so into it. They “got it.”
This is the kind of early intervention panic attack and anxiety sufferers need the most. And I was glad the E.R. doc had the insight and compassion to call for a psych consultation (even if he missed the diagnosis), as opposed to coldly ordering a benzo and “streeting” her when she calmed down.
This young lady has so many years ahead of her. And now she has a leg-up on a potentially very cruel demon.
Neat case for sure…