Blog | PMHRN

A Simpler Way to Understand PTSD

by Alison L Miller, MSN, PMH-BC, RN, FAIS I was diagnosed with post-traumatic stress disorder in 1986, six months after my baby daughter and I almost died during childbirth. But that isn't when it started. If there was a DSM qualifier for PTSD that included "stacked" traumas, that's what I would be diagnosed with. Instead, they tend to call it "Complex PTSD." or cPTSD. Whatever it's called, it sucks to deal with. Like so many, my first batch of traumas started in childhood. I

4 days ago2 min read

The #1 Objective for Use of Restraints

One. Objective. Only. Restraints are to be used only as an intervention that helps the patient regain behavioral control in order to maintain patient and staff safety. Period. Drop the mic. That's it. There is no other reason allowed for using restraints on a patient. And the moment behavioral control has been regained, the restraints must come off. The patient does NOT need to have regained control over their emotions. They may still be angry or sobbing. But if they

Feb 82 min read

Narcissistic Personality Disorder

by Alison L Miller, MSN, PMH-BC, FAIS TEST TIDBIT TUESDAY Personality disorders tend to show up early in life (childhood) but are not diagnosed formally until after the age of 18, giving the child the chance to change their environment, and therefore their responses to that environment. But once an individual reaches 18, and there is a persistent--day in, day out, inflexible--pattern of behavior and thought that is considered unhealthy, dysfunctional, and/or aberrant, and the

Feb 32 min read

MAJOR DEPRESSION

FLASHCARD FRIDAY An astounding 14.5 million Americans have been diagnosed with major depression in the past 12 months. And I'll bet all the money in my wallet that that number is low, mostly because so many people never get diagnosed at all. Oh, and that's just the adult population. Count in the teenagers and that number zooms up to nearly 20 million. The prevelance over people's entire lifetimes goes into the stratosphere--an astounding 105 million Americans . The chanc

Jan 302 min read

Borderline Personality Disorder

At some point, the enormous committee that works on updating the DSM may decide that our understanding of BPD no longer supports it being labeled as a personality disorder. I hope that day is coming sooner rather than later, but I do think it's coming. We have strong evidence that childhood trauma—especially chronic interpersonal trauma and sexual assault—is a core component of the development of BPD. Yes, the field is split on whether that means BPD is misnamed, over-patholo

Jan 252 min read

Duty to Warn: The Tarasoff Rule

I had a patient one time--an active duty soldier--who, during my initial assessment with him, looked me square in the eye and said, "My buddies brought me in here because I'm going to kill our First Sergeant." His words were dramatic, but there wasn't a lot of emotion there. He was intense--very intense--but not in a rage or floridly psychotic. He was simply stating his intentions. He later told me that he "needed" to kill his 1SGT because his 1SGT was "dangerously incompe

Jan 162 min read