I fully understand the irony in someone like me posting about this, but I feel as though letting this out through text may be helpful.

I currently work as a mental health provider in an inpatient psychiatric unit. I see patients and counsel them on medications for anxiety, depression, mood lability, and psychosis on a regular basis. However… I’ve noticed my own anxiety escalating lately. The nature of this job entails having patients that are held under an involuntary commitment to the hospital, which I fully understand how this is distressing to patients…but I also understand the necessity. My anxiety lately has been more related to a larger proportion of patients becoming agitated/irritable regarding their forced hospitalizations. I’m used to having one or two patients with poor insight who become argumentative about their stay, but lately it has become a larger portion than I’ve handled. I do my best to reassure patients that the hospitalization is temporary and necessary to ensure their safety and success when they leave. I try to implement motivational interviewing to encourage the patients to see their issues and understand what changes would benefit them.

However, lately, my encouragement and reassuring demeanor have not been enough. I’m stressed. Burnt out with the nature of inpatient psych. In particular, one patient at the moment is extremely intimidating to me due to his physical size. If he wanted to, he could likely kill me. And these past two days he has become increasingly angry and his insight/patience are diminishing. Today, he demanded to leave. Despite explaining in great detail the ongoing concerns and that he was still involuntary, he argued. I sat there beside him frozen in fear. Eventually he did calm down, but I know it’s just a matter of time before this exact scenario happens again. And when I return to work after the weekend, I can only hope that his mood/head are in a better place.

That situation is just one of many that causes me such anxiety now. I can’t stop thinking about that patient when I’m away. It’s my weekend off, and I’m stuck here in bed, ruminating, catastrophizing different situations in my head. I sleep poorly. My diet is suffering. I question if what I do is right sometimes. I just want to help people, but less than a quarter of my patients have the insight to understand their need to receive help. The rest despise me, and I hate that the time and energy I put into their care is met with such anger. 

I’m a new provider, still learning the tricks of the trade to be both encouraging, yet stern. Perhaps there are no more tricks, and this is just what I should expect for my life. I’m at the point where I’m starting to regret this path, but I have no other career options to feasibly pursue at the moment. I feel stuck, hated, scared, and anxious. 

The funny thing about all of this being that I, of all people, should know exactly what to do to handle my anxiety. I know I need to make changes in my habits…practice some form of distraction techniques…utilize mindfulness to understand my intrusive thoughts…but at the end of the day, knowing that I will be back at a job where I’m hated will always keep me up at night.

But, writing this helped a little.