I'm so glad that someone who works in mental health has decided to review this episode. Wilson is really the MVP of friend standards since it was his idea to talk House into voluntarily checking in to the psych ward. I can't wait for the next one.
Trivia - Lin Manual Miranda was writing Hamilton during the filming for this episode he was stuck on the King George songs and asked Hugh Laurie for his input and he just said "you'll be back."
As an absolute Musical fan, especially Hamilton and an absolute House fan and a big fan of LMM, this made me absolutely really happy. Also, Alvie made me kinda really enthusiastic because I tend to mirror behaviour of people I like. Apparently I really like Alvie. End product: Really happy, enthusiastic me with my brain running a mile a minute. 🙂🙂
Dude “everything runs” is one of the most perfect way of describing opioid withdrawal that I’ve ever heard, still a bit of an understatement but it’s an accurate description of what to expect during opioid withdrawal, in addition to feeling like you’re dying and not being able to sleep or even sit still for 10 days.
Yes! Every orifice runs like Niagara Falls. All you want to do is try to sleep but you constantly have to vomit or stumble to the bathroom. Maybe you make it. Maybe you don't. You can't even bring yourself to give a single fuck. F'ing misery!
I think there are three, somewhat related, things that TV shows consistently get wrong about hospitals, assuming they’re not being portrayed as a hellscape straight from the 19th century. The first is a tendency to give each patient a different disorder. Some mental illnesses are more common than others. For example, you would probably have more patients dealing with depression than shown here. The second is that not every patient is constantly presenting symptoms. Some patients are going to seem normal, either because they’re farther along in their treatment or because they’re in a calm environment away from their primary stressors. Finally, and in my opinion the most troubling, is the tendency of TV to give psych ward patients no personality beyond their illness. The people in this show are “the paranoiac”, “the suicidal woman”, “the delusional guy”. Every person with a mental illness also has relationships, jobs, hobbies, likes, dislikes, opinions, and those facets of their personality don’t disappear the moment they check into a hospital. It seems to be an issue with any character who has any sort of disability, and it’s really something Hollywood, and frankly we, should work on.
Good points, but I think there are also the limitations on narratives imposed by audience attention. There's a point at which a drama becomes a quasi-documentary that, frankly, no-one's really interested in watching (even documentaries have to be skillful with the editing in order to keep eyeballs). I'm not saying you're not right; I'm just noting that it's not always that simple, and Hollywood, as powerful as it is, is ultimately at the mercy of its customers. If you can't get people to pay for it, either directly or via attention to ads, no-one's gonna pay you to make it, and film people gotta eat, too (especially in LA; cost-of-living's insane).
Mental health, specifically has come a LONG way since 2000. Let's be real: even up until 20 years ago, most hospitals (mental or otherwise) were mostly shitholes. I would know, I was in one as a kid. It was a NIGHTMARE. It was exactly what you said it wasn't - every patient constantly presenting, almost every single patient with differing disorders, and pretty much no personality to speak of because most of the kids were so heavily sedated. I was there because yay, racism! A juvie psych ward is scarier than anything I've ever seen since.
I literally can’t tell you how incredible this comment and the replies to it made me feel. You rarely see civil discussions in comment sections about anything, but especially about subjects like this. And you are bringing up some truly important points that a lot of people might look over. I know it’s silly, but this made my day! It’s the little things in life, ya know?
also with forcing oral medication, I'm no doctor but I would imagine in that kind of situation, you would want to keep your hands away from the teeth in case someone is a biter
There is an episode from Scrubs that said a line that was more or less "And from that day on, Rex was forever the guy with only 4 finger tips in his hand" so yeah....
Yeah, right??? On top of having to forcefully hold them down, AND hold open their mouths, they're kicking and breathing and huffing and puffing- that simply wouldn't work. But its entertaining tv though.
100%, in restraints you're always watching for limbs that can fly up, biting or spitting. Also shoving something in someone's mouth can be even more distressing e.g. if the person has trauma from past assaults
Maaan, this episode gives me an another perspective. I watched this really long time ago, and I did not really know anything about biipolar. Now I have been diagnosed with it, I understand Al more and more. Thank you for the review!
The message of the episodes is also the right message, both thematically and for setting expectations for people with mental health struggles. House’s release doesn’t happen when he is happy, exactly the opposite. It’s at one of the lowest points for House. But that’s the point: it wasn’t about making House happy. It was about being comfortable connecting to other people, and being able to cope if/when those connections cause us pain.
I went to rehab to get off oxy. They managed it so well, I barely felt any withdrawals. Emotionally I was hurting really bad, but physically, I was comfortable. They managed my withdrawals with subutex and it worked very well. It took me 10 days to get off the drug. I’m still tryin g to learn to deal with my emotional baggage. But I’m off drillings 9 years later.
About pushing tablets into mouth, my biggest concern would be losing a finger. About urine test, Hal was taking the same things House was, because House gave all his medicine to Hal. Hal took his own medicine and House medicine, if anything then the pee had some extra :D
i always thought shared rooms were a bit weird too and not helpful. i ve been in a ward with single rooms and a ward with shared rooms. and the psych ward with single rooms was actually better for me with my symptoms. most wards in the us are shared rooms. which sucks.
The cynic in me thinks that the shared rooms are a cheap way to prevent successful suicides. You don't need as much staff to check on patients if there's always another patient around who can get help when someone is doing something dangerous.
@@inspiredby624 i also think it’s a way to allow more people to get into the psych ward so as to avoid having to keep suicide risks in the Emergency Department or referring them to the outpatient clinics that have more discretion in rejecting patients ( I was in an outpatient clinic where a girl was asked to leave because she brought a book and read it during group therapy).
I work in a crisis center, which has a triage with individual rooms, a 24 hr observation unit with reclining chairs surrounding the outside wall and a central windowed room with clinical staff(doctors, nurses and case workers), and technicians and peers on the floor interacting with patients. If continued assessment indicates, there is a second floor with hospital type psych ward with individual rooms. I certainly hope there are no psych wards operating anything like what's depicted in this episode.
@@felixflax19 I'm sure there are good-hearted people doing exactly that, ie making the best of limited resources with a good-faith intention to care for people, but, overall, I still gotta imagine the primary motive is "profit". If you really just wanted to help vulnerable people (thinking of the system holistically here), there are much better ways to do it. Ideally, you'd also start investing upstream in care that could keep people from reaching the point of wishing to kill themselves to begin with. The best way to deal with any emergency is to do your best to ensure it never happens (boy, are we going to be finding that one out the hard way. Hold onto your butts). Can't imagine it's necessarily great for the room-mates of extremely distressed people, either. They've got no training for that sort of thing, and they have problems of their own. I can kinda understand the group-therapy thing, if I've the full picture. Someone who has no interest in engaging in their therapy can't really be helped against their will, and keeping them in the group deprives others of that spot while also undercutting the commitment and progress of other members. If you've ever been in one of those group school projects where one kid decides to just be a cynical sabotaging dick when you're trying to brainstorm, you probably know what I mean.
@@inspiredby624 That's probably part of it, but I'm gonna go with "stack as many patients in there as you can to maximize revenue and minimize cost" as the likely primary reason. The level of consideration given to psych patients anywhere has rarely been great (to put it extremely mildly), but, as usual, America's privatized care system adds a whole other layer of dysfunction that exacerbates all the others (highest costs in the rich world for the worse outcomes, by far! Nice bonuses for insurance execs and the politicians they buy, though).
As an American who's been in a "shared room" psych ward where my "roommate" made me feel genuinely unsafe physically and sexually... it's a weird practice to me too. If we're deemed unfit to be around basic society, why should we be expected to room with another random person who's just as crazy as we are? Also, the "reality" in the USA is that all these different types of people would absolutely be grouped together on one ward, unless you're somehow able to pay to be in a very expensive place.
Enjoy your videos so much, and always learn something from them! As someone who has voluntarily admitted myself twice before, I always look for representation in film/TV shows about settings like this and especially about recovery options and outpatient follow-up. It's always interesting to see how it's portrayed, and I can't help but feel some connection to it.
Your description of bipolar disorder is probably the best I've ever heard it explained. I sometimes struggle to get people to understand what it's like living with bipolar disorder.
If you've never been there, it's impossible to understand. People can be supportive but it's SO different when you live it. My brain is basically an amusement park meets circus, meets a riot. It never shuts up. It lessens the pinball machine of thoughts bouncing in my skull but it never goes away.
I recently watched The Fall, and the final series includes a lot of medicine, from A&E, trauma surgery and intensive care to forensic psychiatry. It’s set in Northern Ireland in 2015 so might be more relatable to your practice. The acute trauma management stuff seemed pretty accurate (to my Barry trained third year med student eye!) but I’ve done very little on psychiatry and barely anything in forensic psychiatry so it might be an interesting one. It’s quite a hard watch, and they really get you to sympathise with the “bad guy” so it might be a bit much for your channel but I was quite impressed by their attention to medical detail.
My favourite episode from House is where he diagnosed Korsakov’s syndrome because a patient gives a different history to two separate medical students without even meeting the woman 😂 That said a episode also helped me solve a PBL case (Partial Androgen Insensitivity Syndrome) so who’s the worst really?
Flight of Ideas... I LOVE you. People get annoyed because I interrupt them, if I don't say it now, it's gone. I'm on to another thought by the time I'm "allowed" my turn in a conversation.
I get the impulse and the reasoning behind it, but the problem is that everyone feels like that, to some degree. Your interruption to express the thought you might lose may be causing them to lose the thought they were in the middle of expressing for the same reason. I'm bad with this, so I started carrying a notebook. You'd be surprised how little you have to write to get you back into whatever the thought was at a later time, whether that's 30 seconds in the future or hours. Shorthand helps, though you tend to quickly develop a personal version, anyway.
Thank you for acknowledging the unethical way House is made to withdraw from opioid medication. This is also seen in the movie 28 Days which saw characters with addictions to everything from heroin and other opioid drugs placed in a rehab facility without any titration regime and it definitely wasn't medically or psychologically advisable.
I'm in the US and both times I was hospitalized, I had my own room. The worst was the second time I went and there was construction on the floor, remodeling. Not so great when you're in severe pain and having flashbacks to car crashes. Still, incredibly helpful to go.
These videos are made so well you can tell he knows what he's doing he says a lot but does it concisely and make sure that there isn't any downtime in the video where he's talking but isn't really saying anyting love it keep up the good work
Thank you so much for doing this episode! I have been looking everywhere to see if anyone covered it. I appreciate all the work you do! Can't wait for part 2❤ Also the Matrix may be before my time but it is one of the most phenomenal movies out there, can't wait for part 4 this December 👀
Really loving this channel, and how well you explain every condition you analyse. Thank you for taking the time to do it. If you're interested, I would love to hear your thoughts on an episode of The West Wing called "Noel" where Josh Lymen sees a psychiatrist. It is set weeks after he was shot during an assassination attempt on the president. It's a day to day office environment where he begins to get increasingly aggressive to the staff around him without understanding why. Looking forward to part 2 of House!
2:15 what you said is on point… I have a few friends who were addicts and did IV drugs and others who were on pills. They were used to doing a certain amount, then went through the process of getting sober. After this, when they relapsed they did a “small” dose (what barely would have kept them from being sick the month before), then they literally overdosed and passed away from that same amount. It’s important to tell people who are getting sober about this effect. Everyone feels like they will never relapse and feels like a million bucks a lot of the time after getting over opioids and feeling the freedom of not being dependent. Then if they get tempted and haven’t had their doctor make this risk clear and explain that they might relapse and if it happens their tolerance will be so much less it can be dangerous. I guess nobody wants to say “congratulations in your sobriety but just in case you do drugs again…” Another thing is to let someone know that even if they slip up it does not mean that it’s all over and they are back to it full time because they failed. Very good insight Sir!
I just wanted to comment on 0:22 when he only gave House the description of '' groggy and drowsy'' and not ''in complete and utter agony'' when talking about withdrawal was a massive mistake. The rest of the video was was quite nice and accurate though :)
I would love love love to see more House MD episodes, both for the psych comentary as well as the medical ethics commentary because that show was just one malpractice suit after another. There's an episode I believe is from S7 in which a woman loses her memory and House explains the case to Dr Nolan
I love this! And I do rewatch House MD every once in a while. I think it's overall a really good show. So, I'm watching around 7:30 now and you are talking about pressured speech and flight of ideas as symptoms of mania. I was wondering how you differentiate that from for example someone stressed out with ADHD and verbal impulse control issues? Is that hard, or are there some key things to separate the two?
@@trayas2272 well that would be the obvious one, but I am myself, wondering about the characteristic and how different conditions would present pressured speech etc. Not just how often or when it happens. Also, with ADHD, it isn't all the time. Some people with ADHD don't even have this symptom.
@@naomid5806 it’s probably the intensity of those characteristics in a manic episode rather than ADHD. It’s a manic episode that usually causes a bipolar person to be hospitalised and diagnosed, their behaviour crosses the line to something which puts them at risk.
Its very common in Australian mental health facilities to have two or four beds in each room and although there will be some single rooms they're usually reserved for certain patients
Opioid withdrawal is a hell like no other. It's basically the flu on meth. You're so exhausted but you can't stop vomiting and diarrhea. The shakes and sweating. The entire body pain. Absolutely horrible.
You have no idea how much I rolled my eyes when House was talking to that man with anorexia. As a trans man with an eating disorder, the stereotype that only girls get eating disorders particularly bothers me
Love the insight on this. Obviously with TV and film there is a lot of storytelling that treats some real-world matters with some shorthand, but it's nice getting a professional's insight to know that the production isn't just 100% making it up as they go. What are your favorite fictional medical shows/films?
As someone who worked on a psych ward i feel compelled to say that we would a: not medicate someone immediately, esspecially not if theyre self-admitted and b: if we were to give someone oral medication like this it would be a tablet that starts melting on your tongue so you cant stash the meds and we would check if you tried to anyway
Explaining what it feels like to withdrawal is impossible. It’s absolutely horrific, it honestly can feel like you’re being ripped apart. I’ve been forced cold turkey here in Australia so many times. It’s so so not a good experience. As a disabled person, doctors are like ‘you’ll have this forever, you’ll be right’. Okay, well how about you go through it instead of me… so many doctors have been wrong about my body which caused my health to get so much worse and permanent now.
I know me. If someone called my family or friends and said refuse help and they did. When i get out i will never associate with any of them again. I understand the point, I do. IMO i would feel completely abandoned by them all.
psychiartic nurse here. I'm working in a forensic ward. If we are unsure about a patient taking his meds and liquid is not available, the patient has to sit with us for about 15 minutes. Can he vomit it up afterwards, sure, but we hope that part of the meds have been absorbed by then.
As a psych nurse, I'm betting the second pill with the Haldol was cogentin or benadryl to prevent eps. Their mouth checks were lacking if he cheeked that long. We do 2 to a room in my hospital on all units unless we have reason to block like sexual aggression and certain forms of psychosis. We do psych icu, kids, general population and high functioning/ military but all disorders are mixed.
Oh, also - do they use Haldol gel in the UK also? I think most places in the U.S. tend to use that, they yell "HIT THEM WITH THE GEL" if someone's "freaking out" on a ward like that or a nursing home. But it *really* sucks if the nurse/CNA/whoever happens to get the gel on their arm or something while administering it, and then they fall out too 🤣
Slightly off-topic but I had a feeling that was Lin-manuel Miranda and I was correct! 😃 As someone who is bipolar (and a theatre kid) I think he did an excellent job doing both verbal and physical signs to tell that someone is manic and just kind of all over the place. His repetitive comments & thought patterns, quick cadence, jerky movements, constant talking. Well done!
Oh the joys of being sectioned. I don’t know if it’s the same in the UK and US but here (in Australia) you can sign yourself in and then be detained if you try to discharge and the doctors don’t think you are safe enough. And for sure that would be an IM Haldol and seclusion situation 😂😂
Im in the USA and once had a friend call 911 for me during a psychological crisis. I went willingly and checked myself in, and a few days in to my visit they had me come in to a conference room with a judge present and basically explained that the state of California (where I was at the time) allowed a judge, under reasonable medical advice, to order a psyche detention for up to 12 days. I knew I was in a bad way and told them I was fine with staying, but I'm not sure if they actually did order that I remain or if they were just intending to if I didn't consent. Either way in that state the government does have certain leeway to intervene on behalf of the patient
Hello Dr Elliott Carthy. You are the latest medical professional that I have subbed (I first found Dr. Mike, and now you) I find it fascinating to dive in to every bit of info you tell us 'your viwers' about being a psychiatrist. And I am one of the the many who loved your reaction videoes on the 'Always Sunny' series. There is a second reason why I very much enjoy your videos. My best friend is half way through medical school and he has chosen psychiatry as his speciality after aswell. I am actually the cause of him choosing to take this path because when we met I was a mess, (I just didn't now how much of a mess I was) he made me feel safe and so, I trusted him with the deepest darkest experiences that I have had in my life, he helped me through it and I am a very different person today because of him, in my time of need he was always ready and is still today ready to 'lend me his ear' should I need it, but i don't have the same need now as I did. I realize I am rambling on a little here but I just wanted to share this with you. Oh and again, I thoroughly enjoy your videoes. Keep up the greatness
I've spent plenty of times in psych wards, some of them not voluntarlily, and I was mostly a model patient. Combination of mania and involontary comitment? I was actually once ejected from my ward, doctor in charge cussed me out. I would give my left testicle for the chance to apologize to one of the girls I vented my spleen at, she didn't deserve it, and as crazy as I was I should have been better.
16:18 Older? I take mirtazapine and I have dry mouth all the time. In my case, that is a good thing because I usually drink only about 1L of liquid per day. Now I drink 3-4L per day.
After 7 days, I couldn't even do group anymore. The dramatic change you make after 3 group sessions a day & 5 behavioral meds, I just HAD to get out, it honestly was probably a bad idea and a sign I should have stayed another week or so. A girl kept ruining group to a point that a few of us complained she was interrupting our treatment. Also meet a dude who told me one of the most insane medical stores I have ever heard. Oh there was also a CIA/color guy! He said he was 54 and from Russia. Both were obviously not true, it was so believable I didn't even notice till after I got out. Wild times.
@@abbyhuntley3171 case in point self medicating in the first place. It's an area that still needs a lot more research but the little that has been done strongly suggests that self medicating is a leading cause of opiod addiction among physicians and primary care practitioners.
Stupid question, but how do you treat delusions? I worked in Alzheimer’s care and we were told when someone was hallucinating or acting delusional, not to feed into it by saying “nothing is there” (sometimes the hallucinations were people). We were supposed to be empathetic and say that we will see what we can do, etc instead.
@@DoctorElliottCarthy That’s what I figured. I would love to see a video about the topic. Plus, Alzheimer’s/dementia delusions are very different than delusions due to mental illness (I hate that phrase. We should call it something else, like mentally diverse or whatever. Mental illness implies insanity or derangement, imho).
This 2-parter is my favorite part of the series (and I was OBSESSED with this series growing up). I had already liked it, but when I was committed myself, this set of episodes was one of my major comforts. The place I was in was very abusive to me and basically everyone else there. I can definitely say that my life would be much worse without it.
In the scene where House beats up Alvie, I remember the shot on the TV showing the scene from Family Guy where Stewie was doing the same to Brian (this one is creeper, btw)
You're a pretty sweet guy for only noticing and commenting on the fact that a patient might aspirate on the pills you try to force down their throat. I was thinking more, "good luck not getting your finger bitten off."
Opioid withdrawal was the worst thing I’ve ever been through. I’ve broken my leg, broken my foot in three places, torn my ucl (requiring Tommy John surgery) and I would rather go through any of those again rather than go through withdrawal again. It’s absolutely miserable.
Is that why you endes up on them. A ton of drugs for a broken leg haha fucking america drs trying tonget you addicted and any american happy to get addicted. Since the symptom never needs those drugs
There's one where he's literally tripping on Vicodin and mental disease or something like that and it's a really heartfelt episode till you realize that it's all in his head
Yeah, and House managed to switch urine samples with Hal. Except Dr Nolan had switched House onto sugar pills because he knew House would cheat, and his positive test result was proof of it.
My doctors in the US gave me 1 month to get off diazepam and hydrocodone to be in a chronic pain program. I didn’t know what dependency could be capable of and I was a pre-Med. I thought I was dying and now I understand it was dangerous to have me taper off that fast. I have taken biopsychology and anatomy physiology courses, where I’ve learned what’s actually happening. How do they not teach us the severity of these medications and Down regulation when they are prescribing? All medications should really be explained in detail. It’s like a soul contract to grow a dependency. I’m so fortunate I was never addicted.
That's deplorable to cut off in 1 month, what POS drs. Those meds are really hard to get in Australia, esp opiates over the long-term. I have severe, chronic pain too and other meds don't work, plus I get terrible side effects (like anti-depressants - just a way for drs to avoid prescribing opiates; also anti-inflams don't work anymore). I'm lucky that my GP cares and takes the risk in prescribing me (not that I'm an addict) but am terrified I could be cut off at any moment (pain without meds is 9-10/10, with em is still an unacceptable 4-6/10).
Try Mirtazapine cold turkey and London grade air pollution.. Histamine flare and blew out my lung function to 25%. My previous lung tests 125% normal. Normal and I would have been dead. One of the many reasons I'm suing the No Hope Service.
Man, I just realized how much I relate to Alvie. I have depression and flight of ideas and was on medication for a while but became miserable when everything slowed down.i guess after too long of not being on medication it just feels more normal than everything being slow and boring.
As someone who spent a week in the psych ward in the US, some of that was accurate and some wasn't. People are divided in the psych ward according to age and gender, but I don't think at our hospital that they had separate places for people. Teens didn't cross over anything with adults and had a different schedule for everything. Everyone has a roommate until someone leaves and the staff had to clean and change over that half of the room for someone new. In America, there's a higher need for psychiatric inpatient stay than there is staff and beds and the moment you are on the path to stabilization, you will be checked out that day or the next. Crazy people are mixed in with those who are suicidal, those who go days without sleep, and those who just need a med adjustment. Anyone with severe symptoms or needing long-term care have to go to specialized facilities, and I cannot give information on what they are like. They give meds the way you described and not the way they show on this clip. I think they did it this way for drama, but they stick you in the but with a needle for a quick knockout when someone is violent. They call it booty juice here. Don't know what the technical term is. I was newly diagnosed with Bipolar and the PSYCH APRN and Neuropsychologist were too obsessed with treating my mania and not enough time looking at my medical history and listening. The med they put me on caused a week of insomnia, and it wasn't mania keeping me up. Every other drug gave me a bad reaction and the one they kept me on caused throat closure and drooling before I was finally believed and taken off a med triggering my asthma. I had to beg for my inhaler and no one was allowed any pills until scheduled times of the day. They wouldn't even give me something when I had diarrhea. I had a roommate that tried to kill herself and another that was in and out of comorbid diagnosis. I couldn't sleep and everything she was on made her sleep all day. A man down the hall kept yelling fire as he thought his room was burning, and another guy kept banging his head against a wall before his roommate threatened him and they both got kicked out. When people get violent, security guards come down and aid the nurses in separating people. Sometimes they get to stay and other times they don't. It all depends on the situation. But, shows like house like to exaggerate for drama before looking for accurate depictions. At the very least, it is entertaining. * Just to clarify, men and women aren't entirely separated. Their quarters are and no one may enter another room other than their own without some sort of punishment and possibly getting sent to another facility. Everyone basically chose who to associate with kind of like high school. They put me there because of insomnia lasting over six days and no meds curing it. I got a Bipolar diagnosis before I even knew what it was. All I knew was some of it is like the movies and some wasn't that bad. I was at a good facility where the staff was sweet and half didn't want to leave that early. Couldn't tell who was crazy and who was on the wrong meds. All I know is unless you were violent, sick, or confined to your room for some reason - you had to interact with people you used to have preconceived notions about. Many were kind people who were struggling. After developing a psychiatric disability, I felt bad for judging people and casting them aside as crazy. Most of the psychiatric patients had been through some sort of trauma or abuse to end up where they did. It's east to judge from the outside when you don't know why they act the way they do.
I actually take Haloperidol for Tourettes syndrome. I'm just glad that I don't have the very vocal type of Tourettes; just spasms. It's bearable unless I haven't slept a lot for a while :)
The worst thing about the inaccuracy of urine drug screens is that the people being subjected to them are, by nature, extremely likely to have their own claims dismissed as lies. I have been on methadone maintenance for twelve years. FOUR TIMES over the years I’ve had urines come back with false positives. Two times it was for drugs I have no interest in and had hardly ever touched my whole life! But every time, the assumption has been that I was lying, with everyone assuring me it was the only explanation, because the test can’t be wrong. But I *know* the test is wrong, because I *know* I hadn’t done the drug. And even if the chemistry of the test is infallible, the humans administering them, labelling them, reading the little strips, entering the data into the computer, etc etc etc certainly aren’t. There’s a thousand ways it can go wrong, but everyone instantly defaults to “the patient is lying”. Which can ruin people’s lives!
Speaking for Australian psych wards, there's no way House would have been given that haloperidol - as a voluntary patient, he couldn't be forced to take any medications against his will (unless they slapped an involuntary order on him after the fact). Instead, he'd just be kicked out and the other patient encouraged to press charges 🤷
True but in Australian psych wards they can and often do switch a patient from one medication to another whether it really is best for the patient or not and usually because of the way they've been taught to regard certain medications as more or less harmful than others. A loved one had been evaluated by psychiatrists and prescribed Alprazolam for panic disorder that was part of C-PTSD yet in a psych ward that was changed to diazepam. That switch caused a big increase in both panic attacks and anxiety and a few days later upon release their usual medical practitioner returned them to Alprazolam.
@@Adara007 like you're not wrong, a very intentional part of all hospitals is that medications are changed by the doctors without much/any negotiation with the person who will actually be taking them (and any person who just asks for a basic explanation before taking a new drug gets labelled by the whole team of nurses and doctors as difficult). That's a very different situation to forcing someone to take medication against their will, as was depicted. Involuntary treatment is either intensely regulated by state/territory-specific mental health acts, or by duty of care for life-threatening medical illnesses. Old mate arcing up in the late stages of his admission for substance withdrawal is transparently behavioural, and would not be covered by either.
That is one thing I didn't understand about this show when it came to House's rehab. The show spoke about methadone like it was evil (in a later episode) and it never mentioned Subutex even though its been available since 2002.
I hate when people use "dependency" rather than "addiction" just to be more polite. They are two different things. One is more physiological the other is phycological. People with an addiction may not have a dependency and people with a dependency may not have an addiction though often both are present. Withdrawal symptoms are from the addiction side.
Having rewatched House several times and from what I can remember about the editing techniques used on occasion through the series, I think the opening scene was actually a jump back and forth between House drying out, and then the immediate time after that when he was on a strict regime with no opioids and still railing against been there. I don think he was actually going back and forth between been locked up and drying out, been let out then been locked up again - at least I'm not sure that's what the writers were doing based on the style of storytelling we usually saw.
I'm on withdrawals from codeine and I can't stop shivering and sneezing. And it feels like someone has smashed me in the pelvis, arms and legs with a sledgehammer...
It might be a little out of left field, but could you react to "Pickles vs. Rehab | Metalocalypse". A musical clip from an episode of Metalocalypse where a band member goes to rehab for alcohol dependence.
pls react to one day at a time, especially the one called "hello penelope" in season two, it talks a lot about depression and the way her therapyst tried to help her.
I’ve never actually thought about it that way. Yes it’s bad if you relapse, for psychological reasons and because you’ve just undone all of your progress. But I never even considered that you’ll have a lower tolerance if you start again! That’s interesting asf❤
I spent five years attending group therapy in a casual setting. I'm Bipolar (don't ask which type, since my symptoms vary so much, I don't really fit in any of the established categories). Our regular group had several Bipolar, a couple of Autistic, one PTSD, several with Major Depressive Disorder, two paranoid schizophrenics, and one with a pretty severe personality disorder. It was fun and therapeutic.
Ive had a few psych stays (in the US) and it has always been shared rooms. I felt so bad for the people who had difficult roommates. Thankfully all of my roommates were pretty nice and well behaved.
I'm so glad that someone who works in mental health has decided to review this episode.
Wilson is really the MVP of friend standards since it was his idea to talk House into voluntarily checking in to the psych ward.
I can't wait for the next one.
Edit gee thanks for the likes
Trivia - Lin Manual Miranda was writing Hamilton during the filming for this episode he was stuck on the King George songs and asked Hugh Laurie for his input and he just said "you'll be back."
As an absolute Musical fan, especially Hamilton and an absolute House fan and a big fan of LMM, this made me absolutely really happy. Also, Alvie made me kinda really enthusiastic because I tend to mirror behaviour of people I like. Apparently I really like Alvie. End product: Really happy, enthusiastic me with my brain running a mile a minute. 🙂🙂
That's such a good tidbit to know! Can't wait to tell my dad- he loves Hamilton, House, and trivia!
What makes this especially funny is that Hugh Laurie previously played George III's son in Blackadder.
Dude “everything runs” is one of the most perfect way of describing opioid withdrawal that I’ve ever heard, still a bit of an understatement but it’s an accurate description of what to expect during opioid withdrawal, in addition to feeling like you’re dying and not being able to sleep or even sit still for 10 days.
Yes! Every orifice runs like Niagara Falls. All you want to do is try to sleep but you constantly have to vomit or stumble to the bathroom. Maybe you make it. Maybe you don't. You can't even bring yourself to give a single fuck. F'ing misery!
Are we not going to talk about Bipolar Roomie being played by Lin-Manuel Miranda? Dude's a fast talker, it was a good choice.
Amazing choice.
I could relate a little too much
Also amazing that he's playing a guy who thinks he's the greatest (because of the mania) when in actuality he is extremely talented.
Right?!? I’m screaming at the TV right now
was this before or after In the Heights? (the play)
I think there are three, somewhat related, things that TV shows consistently get wrong about hospitals, assuming they’re not being portrayed as a hellscape straight from the 19th century.
The first is a tendency to give each patient a different disorder. Some mental illnesses are more common than others. For example, you would probably have more patients dealing with depression than shown here.
The second is that not every patient is constantly presenting symptoms. Some patients are going to seem normal, either because they’re farther along in their treatment or because they’re in a calm environment away from their primary stressors.
Finally, and in my opinion the most troubling, is the tendency of TV to give psych ward patients no personality beyond their illness. The people in this show are “the paranoiac”, “the suicidal woman”, “the delusional guy”. Every person with a mental illness also has relationships, jobs, hobbies, likes, dislikes, opinions, and those facets of their personality don’t disappear the moment they check into a hospital. It seems to be an issue with any character who has any sort of disability, and it’s really something Hollywood, and frankly we, should work on.
Good points, but I think there are also the limitations on narratives imposed by audience attention. There's a point at which a drama becomes a quasi-documentary that, frankly, no-one's really interested in watching (even documentaries have to be skillful with the editing in order to keep eyeballs).
I'm not saying you're not right; I'm just noting that it's not always that simple, and Hollywood, as powerful as it is, is ultimately at the mercy of its customers. If you can't get people to pay for it, either directly or via attention to ads, no-one's gonna pay you to make it, and film people gotta eat, too (especially in LA; cost-of-living's insane).
Mental health, specifically has come a LONG way since 2000. Let's be real: even up until 20 years ago, most hospitals (mental or otherwise) were mostly shitholes. I would know, I was in one as a kid. It was a NIGHTMARE. It was exactly what you said it wasn't - every patient constantly presenting, almost every single patient with differing disorders, and pretty much no personality to speak of because most of the kids were so heavily sedated. I was there because yay, racism! A juvie psych ward is scarier than anything I've ever seen since.
I literally can’t tell you how incredible this comment and the replies to it made me feel. You rarely see civil discussions in comment sections about anything, but especially about subjects like this. And you are bringing up some truly important points that a lot of people might look over. I know it’s silly, but this made my day! It’s the little things in life, ya know?
also, the number of dimwits, and those who are merely socially unacceptable - using the psych ward as a social dustbin - does not come across
I think the other person is right, in that what is realistic is not always what is entertaining.
I love this! I've never watched the episode, but I work in mental health and study psychology and always appreciate how well informed your videos are
Thanks so much 🙂
also with forcing oral medication, I'm no doctor but I would imagine in that kind of situation, you would want to keep your hands away from the teeth in case someone is a biter
There is an episode from Scrubs that said a line that was more or less "And from that day on, Rex was forever the guy with only 4 finger tips in his hand" so yeah....
Yeah, right??? On top of having to forcefully hold them down, AND hold open their mouths, they're kicking and breathing and huffing and puffing- that simply wouldn't work.
But its entertaining tv though.
100%, in restraints you're always watching for limbs that can fly up, biting or spitting. Also shoving something in someone's mouth can be even more distressing e.g. if the person has trauma from past assaults
Maaan, this episode gives me an another perspective. I watched this really long time ago, and I did not really know anything about biipolar. Now I have been diagnosed with it, I understand Al more and more.
Thank you for the review!
The message of the episodes is also the right message, both thematically and for setting expectations for people with mental health struggles. House’s release doesn’t happen when he is happy, exactly the opposite. It’s at one of the lowest points for House. But that’s the point: it wasn’t about making House happy. It was about being comfortable connecting to other people, and being able to cope if/when those connections cause us pain.
I went to rehab to get off oxy. They managed it so well, I barely felt any withdrawals. Emotionally I was hurting really bad, but physically, I was comfortable. They managed my withdrawals with subutex and it worked very well. It took me 10 days to get off the drug. I’m still tryin g to learn to deal with my emotional baggage. But I’m off drillings 9 years later.
About pushing tablets into mouth, my biggest concern would be losing a finger.
About urine test, Hal was taking the same things House was, because House gave all his medicine to Hal. Hal took his own medicine and House medicine, if anything then the pee had some extra :D
i always thought shared rooms were a bit weird too and not helpful. i ve been in a ward with single rooms and a ward with shared rooms. and the psych ward with single rooms was actually better for me with my symptoms. most wards in the us are shared rooms. which sucks.
The cynic in me thinks that the shared rooms are a cheap way to prevent successful suicides. You don't need as much staff to check on patients if there's always another patient around who can get help when someone is doing something dangerous.
@@inspiredby624 i also think it’s a way to allow more people to get into the psych ward so as to avoid having to keep suicide risks in the Emergency Department or referring them to the outpatient clinics that have more discretion in rejecting patients ( I was in an outpatient clinic where a girl was asked to leave because she brought a book and read it during group therapy).
I work in a crisis center, which has a triage with individual rooms, a 24 hr observation unit with reclining chairs surrounding the outside wall and a central windowed room with clinical staff(doctors, nurses and case workers), and technicians and peers on the floor interacting with patients. If continued assessment indicates, there is a second floor with hospital type psych ward with individual rooms.
I certainly hope there are no psych wards operating anything like what's depicted in this episode.
@@felixflax19 I'm sure there are good-hearted people doing exactly that, ie making the best of limited resources with a good-faith intention to care for people, but, overall, I still gotta imagine the primary motive is "profit". If you really just wanted to help vulnerable people (thinking of the system holistically here), there are much better ways to do it. Ideally, you'd also start investing upstream in care that could keep people from reaching the point of wishing to kill themselves to begin with. The best way to deal with any emergency is to do your best to ensure it never happens (boy, are we going to be finding that one out the hard way. Hold onto your butts).
Can't imagine it's necessarily great for the room-mates of extremely distressed people, either. They've got no training for that sort of thing, and they have problems of their own.
I can kinda understand the group-therapy thing, if I've the full picture. Someone who has no interest in engaging in their therapy can't really be helped against their will, and keeping them in the group deprives others of that spot while also undercutting the commitment and progress of other members. If you've ever been in one of those group school projects where one kid decides to just be a cynical sabotaging dick when you're trying to brainstorm, you probably know what I mean.
@@inspiredby624 That's probably part of it, but I'm gonna go with "stack as many patients in there as you can to maximize revenue and minimize cost" as the likely primary reason. The level of consideration given to psych patients anywhere has rarely been great (to put it extremely mildly), but, as usual, America's privatized care system adds a whole other layer of dysfunction that exacerbates all the others (highest costs in the rich world for the worse outcomes, by far! Nice bonuses for insurance execs and the politicians they buy, though).
As an American who's been in a "shared room" psych ward where my "roommate" made me feel genuinely unsafe physically and sexually... it's a weird practice to me too. If we're deemed unfit to be around basic society, why should we be expected to room with another random person who's just as crazy as we are?
Also, the "reality" in the USA is that all these different types of people would absolutely be grouped together on one ward, unless you're somehow able to pay to be in a very expensive place.
Enjoy your videos so much, and always learn something from them! As someone who has voluntarily admitted myself twice before, I always look for representation in film/TV shows about settings like this and especially about recovery options and outpatient follow-up. It's always interesting to see how it's portrayed, and I can't help but feel some connection to it.
Your description of bipolar disorder is probably the best I've ever heard it explained. I sometimes struggle to get people to understand what it's like living with bipolar disorder.
If you've never been there, it's impossible to understand. People can be supportive but it's SO different when you live it. My brain is basically an amusement park meets circus, meets a riot. It never shuts up. It lessens the pinball machine of thoughts bouncing in my skull but it never goes away.
Awesome to see you're reacting to House again, can't wait for the next one!
I'm so excited to see you reviewing/reacting to this episode! There's so much to unpack in this storyline.
I recently watched The Fall, and the final series includes a lot of medicine, from A&E, trauma surgery and intensive care to forensic psychiatry. It’s set in Northern Ireland in 2015 so might be more relatable to your practice. The acute trauma management stuff seemed pretty accurate (to my Barry trained third year med student eye!) but I’ve done very little on psychiatry and barely anything in forensic psychiatry so it might be an interesting one. It’s quite a hard watch, and they really get you to sympathise with the “bad guy” so it might be a bit much for your channel but I was quite impressed by their attention to medical detail.
YEEESS I love that show!!!
My favourite episode from House is where he diagnosed Korsakov’s syndrome because a patient gives a different history to two separate medical students without even meeting the woman 😂
That said a episode also helped me solve a PBL case (Partial Androgen Insensitivity Syndrome) so who’s the worst really?
I am so glad you are reacting to these episodes. As ever, your insight is clear and interesting. Thanks so much
As a pharmacology PhD student I’m very happy to see you have a copy of Rang and Dale 😄
In addition to the choking hazard, shoving pills down an agitated patient's throat also means you're likely to get your finger bitten!
"...On different wards with more specialized services."
Those didn't exist during my hospitalizations.
Unfort it's still a postcode lottery here about access to things like eating disorder wards or autism wards
I know you’re not allowed to play the audio at the beginning because of copyright but Radiohead’s No Surprises absolutely makes that first scene
I know. Its so annoying that I had to take it out but I couldn't get it past the copyright otherwise 😞
@@DoctorElliottCarthy it’s ok because when I see the visuals of that scene, the song plays in my head anyway 😊
Flight of Ideas... I LOVE you. People get annoyed because I interrupt them, if I don't say it now, it's gone. I'm on to another thought by the time I'm "allowed" my turn in a conversation.
Thank you, god yes. I constantly interrupt without meaning to, and even my bipolar partner hates it. I don't even realize I'm doing it.
That's something I have a tendency to do, also.
I get the impulse and the reasoning behind it, but the problem is that everyone feels like that, to some degree. Your interruption to express the thought you might lose may be causing them to lose the thought they were in the middle of expressing for the same reason.
I'm bad with this, so I started carrying a notebook. You'd be surprised how little you have to write to get you back into whatever the thought was at a later time, whether that's 30 seconds in the future or hours. Shorthand helps, though you tend to quickly develop a personal version, anyway.
Thank you for acknowledging the unethical way House is made to withdraw from opioid medication. This is also seen in the movie 28 Days which saw characters with addictions to everything from heroin and other opioid drugs placed in a rehab facility without any titration regime and it definitely wasn't medically or psychologically advisable.
I'm in the US and both times I was hospitalized, I had my own room. The worst was the second time I went and there was construction on the floor, remodeling. Not so great when you're in severe pain and having flashbacks to car crashes. Still, incredibly helpful to go.
These videos are made so well you can tell he knows what he's doing he says a lot but does it concisely and make sure that there isn't any downtime in the video where he's talking but isn't really saying anyting love it keep up the good work
House's roomie is Hamilton? SWEET!
Thank you so much for doing this episode! I have been looking everywhere to see if anyone covered it. I appreciate all the work you do! Can't wait for part 2❤
Also the Matrix may be before my time but it is one of the most phenomenal movies out there, can't wait for part 4 this December 👀
Really loving this channel, and how well you explain every condition you analyse. Thank you for taking the time to do it.
If you're interested, I would love to hear your thoughts on an episode of The West Wing called "Noel" where Josh Lymen sees a psychiatrist. It is set weeks after he was shot during an assassination attempt on the president. It's a day to day office environment where he begins to get increasingly aggressive to the staff around him without understanding why. Looking forward to part 2 of House!
2:15 what you said is on point… I have a few friends who were addicts and did IV drugs and others who were on pills. They were used to doing a certain amount, then went through the process of getting sober. After this, when they relapsed they did a “small” dose (what barely would have kept them from being sick the month before), then they literally overdosed and passed away from that same amount.
It’s important to tell people who are getting sober about this effect. Everyone feels like they will never relapse and feels like a million bucks a lot of the time after getting over opioids and feeling the freedom of not being dependent. Then if they get tempted and haven’t had their doctor make this risk clear and explain that they might relapse and if it happens their tolerance will be so much less it can be dangerous.
I guess nobody wants to say “congratulations in your sobriety but just in case you do drugs again…”
Another thing is to let someone know that even if they slip up it does not mean that it’s all over and they are back to it full time because they failed.
Very good insight Sir!
I just wanted to comment on 0:22 when he only gave House the description of '' groggy and drowsy'' and not ''in complete and utter agony'' when talking about withdrawal was a massive mistake. The rest of the video was was quite nice and accurate though :)
I would love love love to see more House MD episodes, both for the psych comentary as well as the medical ethics commentary because that show was just one malpractice suit after another. There's an episode I believe is from S7 in which a woman loses her memory and House explains the case to Dr Nolan
1:32 YOOOOO House totally does use Methadone at some point, he stops taking it because his being pain free messed with his ability to be a doctor.
lol that was fun to watch, looking forward to seeing part 2.
Did you see part 2? 6:24
I love this! And I do rewatch House MD every once in a while. I think it's overall a really good show.
So, I'm watching around 7:30 now and you are talking about pressured speech and flight of ideas as symptoms of mania. I was wondering how you differentiate that from for example someone stressed out with ADHD and verbal impulse control issues? Is that hard, or are there some key things to separate the two?
I was wondering the same thing around this time. 🤔
A manic episode with bipolar is episodic, ADHD is all the time.
@@trayas2272 well that would be the obvious one, but I am myself, wondering about the characteristic and how different conditions would present pressured speech etc. Not just how often or when it happens. Also, with ADHD, it isn't all the time. Some people with ADHD don't even have this symptom.
Mostly because ADHD doesn't lead to inhibition, grandiose ideas or really any manic symptoms.
Especially in adults.
@@naomid5806 it’s probably the intensity of those characteristics in a manic episode rather than ADHD. It’s a manic episode that usually causes a bipolar person to be hospitalised and diagnosed, their behaviour crosses the line to something which puts them at risk.
This episode is so brilliant, cinematic, and emphasizing how EVERYTHING is different from the seasons of the show before. It was a shock.
Shared bedrooms are still very common in wards, there were 3 people to a room in the ward I had a stay in (north west england for context)
I know, it such a postcode lottery as to the type of care and the precise conditions
Its very common in Australian mental health facilities to have two or four beds in each room and although there will be some single rooms they're usually reserved for certain patients
Opioid withdrawal is a hell like no other. It's basically the flu on meth. You're so exhausted but you can't stop vomiting and diarrhea. The shakes and sweating. The entire body pain. Absolutely horrible.
You have no idea how much I rolled my eyes when House was talking to that man with anorexia. As a trans man with an eating disorder, the stereotype that only girls get eating disorders particularly bothers me
I mean… that’s the point of the scene.
He’s trying to make the people upset.
Love the insight on this. Obviously with TV and film there is a lot of storytelling that treats some real-world matters with some shorthand, but it's nice getting a professional's insight to know that the production isn't just 100% making it up as they go. What are your favorite fictional medical shows/films?
As someone who worked on a psych ward i feel compelled to say that we would a: not medicate someone immediately, esspecially not if theyre self-admitted and b: if we were to give someone oral medication like this it would be a tablet that starts melting on your tongue so you cant stash the meds and we would check if you tried to anyway
Gotta think another risk with trying to give oral medication especially in a violent person is biting
You would be spot on
I found myself really enjoying your explanations. Thank you! Well done.
Explaining what it feels like to withdrawal is impossible. It’s absolutely horrific, it honestly can feel like you’re being ripped apart. I’ve been forced cold turkey here in Australia so many times. It’s so so not a good experience. As a disabled person, doctors are like ‘you’ll have this forever, you’ll be right’. Okay, well how about you go through it instead of me… so many doctors have been wrong about my body which caused my health to get so much worse and permanent now.
Sucks doesn't it, hope you're getting some treatment at least. We don't deserve to suffer just because there's incomplete knowledge of our conditions.
I know me. If someone called my family or friends and said refuse help and they did. When i get out i will never associate with any of them again. I understand the point, I do. IMO i would feel completely abandoned by them all.
psychiartic nurse here. I'm working in a forensic ward. If we are unsure about a patient taking his meds and liquid is not available, the patient has to sit with us for about 15 minutes. Can he vomit it up afterwards, sure, but we hope that part of the meds have been absorbed by then.
As a psych nurse, I'm betting the second pill with the Haldol was cogentin or benadryl to prevent eps. Their mouth checks were lacking if he cheeked that long. We do 2 to a room in my hospital on all units unless we have reason to block like sexual aggression and certain forms of psychosis. We do psych icu, kids, general population and high functioning/ military but all disorders are mixed.
Oh, also - do they use Haldol gel in the UK also? I think most places in the U.S. tend to use that, they yell "HIT THEM WITH THE GEL" if someone's "freaking out" on a ward like that or a nursing home. But it *really* sucks if the nurse/CNA/whoever happens to get the gel on their arm or something while administering it, and then they fall out too 🤣
Slightly off-topic but I had a feeling that was Lin-manuel Miranda and I was correct! 😃 As someone who is bipolar (and a theatre kid) I think he did an excellent job doing both verbal and physical signs to tell that someone is manic and just kind of all over the place. His repetitive comments & thought patterns, quick cadence, jerky movements, constant talking. Well done!
Can't wait for episode 2!!
Thank you for understanding the license taken for story and humor. Most other professional reactions focus on those and not the broader veiw.
Oh the joys of being sectioned. I don’t know if it’s the same in the UK and US but here (in Australia) you can sign yourself in and then be detained if you try to discharge and the doctors don’t think you are safe enough. And for sure that would be an IM Haldol and seclusion situation 😂😂
Im in the USA and once had a friend call 911 for me during a psychological crisis. I went willingly and checked myself in, and a few days in to my visit they had me come in to a conference room with a judge present and basically explained that the state of California (where I was at the time) allowed a judge, under reasonable medical advice, to order a psyche detention for up to 12 days. I knew I was in a bad way and told them I was fine with staying, but I'm not sure if they actually did order that I remain or if they were just intending to if I didn't consent. Either way in that state the government does have certain leeway to intervene on behalf of the patient
Hello Dr Elliott Carthy. You are the latest medical professional that I have subbed (I first found Dr. Mike, and now you) I find it fascinating to dive in to every bit of info you tell us 'your viwers' about being a psychiatrist. And I am one of the the many who loved your reaction videoes on the 'Always Sunny' series. There is a second reason why I very much enjoy your videos. My best friend is half way through medical school and he has chosen psychiatry as his speciality after aswell. I am actually the cause of him choosing to take this path because when we met I was a mess, (I just didn't now how much of a mess I was) he made me feel safe and so, I trusted him with the deepest darkest experiences that I have had in my life, he helped me through it and I am a very different person today because of him, in my time of need he was always ready and is still today ready to 'lend me his ear' should I need it, but i don't have the same need now as I did. I realize I am rambling on a little here but I just wanted to share this with you. Oh and again, I thoroughly enjoy your videoes. Keep up the greatness
Thanks for sharing and really glad you like the channel 🙂
I've spent plenty of times in psych wards, some of them not voluntarlily, and I was mostly a model patient.
Combination of mania and involontary comitment? I was actually once ejected from my ward, doctor in charge cussed me out.
I would give my left testicle for the chance to apologize to one of the girls I vented my spleen at, she didn't deserve it, and as crazy as I was I should have been better.
The reason house is taking pills is because he lost a part of his leg when doctors wanted to amputate. Now he is in constant pain.
16:18 Older? I take mirtazapine and I have dry mouth all the time. In my case, that is a good thing because I usually drink only about 1L of liquid per day. Now I drink 3-4L per day.
“They said give 5mg of haloperidol, And he had two tablets… Haloperidol doesn’t come in 2.5 mg tablets”--> you made me laugh so hard. BUT so true lol
Good stuff, appreciate your perspective.
After 7 days, I couldn't even do group anymore. The dramatic change you make after 3 group sessions a day & 5 behavioral meds, I just HAD to get out, it honestly was probably a bad idea and a sign I should have stayed another week or so. A girl kept ruining group to a point that a few of us complained she was interrupting our treatment. Also meet a dude who told me one of the most insane medical stores I have ever heard.
Oh there was also a CIA/color guy! He said he was 54 and from Russia. Both were obviously not true, it was so believable I didn't even notice till after I got out.
Wild times.
In series 5, House tries methadone himself and ODs 😬
You’d think a doctor would know how to avoid that.
@@matthewgallaway3675 yeah but an addict doesn’t always think with their rational mind
@@abbyhuntley3171 case in point self medicating in the first place. It's an area that still needs a lot more research but the little that has been done strongly suggests that self medicating is a leading cause of opiod addiction among physicians and primary care practitioners.
No, he didn't. He dozed off in his chair and forgot how to breathe: a side effect of methadone, apparently
@@segaiuolo oh yes of course 😅
When I was in a psychiatric hospital there was two people in each room
Stupid question, but how do you treat delusions? I worked in Alzheimer’s care and we were told when someone was hallucinating or acting delusional, not to feed into it by saying “nothing is there” (sometimes the hallucinations were people). We were supposed to be empathetic and say that we will see what we can do, etc instead.
Not a stupid question at all. One for a whole video at some point. In short, if its truly delusional, challenging it won't work
@@DoctorElliottCarthy That’s what I figured. I would love to see a video about the topic. Plus, Alzheimer’s/dementia delusions are very different than delusions due to mental illness (I hate that phrase. We should call it something else, like mentally diverse or whatever. Mental illness implies insanity or derangement, imho).
There were four people in the room I was in on the psych unit. Only having to share with one other person would have been a treat.
This 2-parter is my favorite part of the series (and I was OBSESSED with this series growing up). I had already liked it, but when I was committed myself, this set of episodes was one of my major comforts. The place I was in was very abusive to me and basically everyone else there. I can definitely say that my life would be much worse without it.
In the scene where House beats up Alvie, I remember the shot on the TV showing the scene from Family Guy where Stewie was doing the same to Brian (this one is creeper, btw)
You're a pretty sweet guy for only noticing and commenting on the fact that a patient might aspirate on the pills you try to force down their throat. I was thinking more, "good luck not getting your finger bitten off."
In all the mental hospitals I've been in use a 50mg of Thorazine and 50mg of Benadryl mix for injections.
You should review The Sopranos! It’s about a mafia boss seeing a psychiatrist for mental health issues and it’s such a good show!
Haha I just finished watching this season and I thought you would get a kick out of this episode
Opioid withdrawal was the worst thing I’ve ever been through. I’ve broken my leg, broken my foot in three places, torn my ucl (requiring Tommy John surgery) and I would rather go through any of those again rather than go through withdrawal again. It’s absolutely miserable.
Is that why you endes up on them. A ton of drugs for a broken leg haha fucking america drs trying tonget you addicted and any american happy to get addicted. Since the symptom never needs those drugs
There's one where he's literally tripping on Vicodin and mental disease or something like that and it's a really heartfelt episode till you realize that it's all in his head
regarding the urine test, I haven't watched the episode in a while but wasn't house giving all the drugs he was supposed to take to Hal?
Yeah, and House managed to switch urine samples with Hal. Except Dr Nolan had switched House onto sugar pills because he knew House would cheat, and his positive test result was proof of it.
My doctors in the US gave me 1 month to get off diazepam and hydrocodone to be in a chronic pain program. I didn’t know what dependency could be capable of and I was a pre-Med. I thought I was dying and now I understand it was dangerous to have me taper off that fast. I have taken biopsychology and anatomy physiology courses, where I’ve learned what’s actually happening. How do they not teach us the severity of these medications and Down regulation when they are prescribing? All medications should really be explained in detail. It’s like a soul contract to grow a dependency. I’m so fortunate I was never addicted.
That's deplorable to cut off in 1 month, what POS drs. Those meds are really hard to get in Australia, esp opiates over the long-term. I have severe, chronic pain too and other meds don't work, plus I get terrible side effects (like anti-depressants - just a way for drs to avoid prescribing opiates; also anti-inflams don't work anymore). I'm lucky that my GP cares and takes the risk in prescribing me (not that I'm an addict) but am terrified I could be cut off at any moment (pain without meds is 9-10/10, with em is still an unacceptable 4-6/10).
Try Mirtazapine cold turkey and London grade air pollution.. Histamine flare and blew out my lung function to 25%. My previous lung tests 125% normal. Normal and I would have been dead. One of the many reasons I'm suing the No Hope Service.
Man, I just realized how much I relate to Alvie. I have depression and flight of ideas and was on medication for a while but became miserable when everything slowed down.i guess after too long of not being on medication it just feels more normal than everything being slow and boring.
Youre a walking, talking encyclopedia!! I could watch you all day.
Lol your sarcasm. Love it. You think that'll work in a mental Ward. Bless him. Died laughing.
As someone who spent a week in the psych ward in the US, some of that was accurate and some wasn't. People are divided in the psych ward according to age and gender, but I don't think at our hospital that they had separate places for people.
Teens didn't cross over anything with adults and had a different schedule for everything. Everyone has a roommate until someone leaves and the staff had to clean and change over that half of the room for someone new. In America, there's a higher need for psychiatric inpatient stay than there is staff and beds and the moment you are on the path to stabilization, you will be checked out that day or the next. Crazy people are mixed in with those who are suicidal, those who go days without sleep, and those who just need a med adjustment. Anyone with severe symptoms or needing long-term care have to go to specialized facilities, and I cannot give information on what they are like.
They give meds the way you described and not the way they show on this clip. I think they did it this way for drama, but they stick you in the but with a needle for a quick knockout when someone is violent. They call it booty juice here. Don't know what the technical term is. I was newly diagnosed with Bipolar and the PSYCH APRN and Neuropsychologist were too obsessed with treating my mania and not enough time looking at my medical history and listening. The med they put me on caused a week of insomnia, and it wasn't mania keeping me up. Every other drug gave me a bad reaction and the one they kept me on caused throat closure and drooling before I was finally believed and taken off a med triggering my asthma. I had to beg for my inhaler and no one was allowed any pills until scheduled times of the day. They wouldn't even give me something when I had diarrhea. I had a roommate that tried to kill herself and another that was in and out of comorbid diagnosis. I couldn't sleep and everything she was on made her sleep all day. A man down the hall kept yelling fire as he thought his room was burning, and another guy kept banging his head against a wall before his roommate threatened him and they both got kicked out.
When people get violent, security guards come down and aid the nurses in separating people. Sometimes they get to stay and other times they don't. It all depends on the situation. But, shows like house like to exaggerate for drama before looking for accurate depictions.
At the very least, it is entertaining.
* Just to clarify, men and women aren't entirely separated. Their quarters are and no one may enter another room other than their own without some sort of punishment and possibly getting sent to another facility. Everyone basically chose who to associate with kind of like high school.
They put me there because of insomnia lasting over six days and no meds curing it. I got a Bipolar diagnosis before I even knew what it was. All I knew was some of it is like the movies and some wasn't that bad. I was at a good facility where the staff was sweet and half didn't want to leave that early. Couldn't tell who was crazy and who was on the wrong meds. All I know is unless you were violent, sick, or confined to your room for some reason - you had to interact with people you used to have preconceived notions about. Many were kind people who were struggling. After developing a psychiatric disability, I felt bad for judging people and casting them aside as crazy. Most of the psychiatric patients had been through some sort of trauma or abuse to end up where they did.
It's east to judge from the outside when you don't know why they act the way they do.
Can't wait for part 2.
The biggest withdrawal symptoms is the depression. There doesn't need to be an underlying reason for the depression.
I really want to see your take on the rest of the episodes where house is locked up.
I actually take Haloperidol for Tourettes syndrome. I'm just glad that I don't have the very vocal type of Tourettes; just spasms. It's bearable unless I haven't slept a lot for a while :)
The worst thing about the inaccuracy of urine drug screens is that the people being subjected to them are, by nature, extremely likely to have their own claims dismissed as lies. I have been on methadone maintenance for twelve years. FOUR TIMES over the years I’ve had urines come back with false positives. Two times it was for drugs I have no interest in and had hardly ever touched my whole life! But every time, the assumption has been that I was lying, with everyone assuring me it was the only explanation, because the test can’t be wrong. But I *know* the test is wrong, because I *know* I hadn’t done the drug. And even if the chemistry of the test is infallible, the humans administering them, labelling them, reading the little strips, entering the data into the computer, etc etc etc certainly aren’t. There’s a thousand ways it can go wrong, but everyone instantly defaults to “the patient is lying”. Which can ruin people’s lives!
Speaking for Australian psych wards, there's no way House would have been given that haloperidol - as a voluntary patient, he couldn't be forced to take any medications against his will (unless they slapped an involuntary order on him after the fact). Instead, he'd just be kicked out and the other patient encouraged to press charges 🤷
True but in Australian psych wards they can and often do switch a patient from one medication to another whether it really is best for the patient or not and usually because of the way they've been taught to regard certain medications as more or less harmful than others. A loved one had been evaluated by psychiatrists and prescribed Alprazolam for panic disorder that was part of C-PTSD yet in a psych ward that was changed to diazepam. That switch caused a big increase in both panic attacks and anxiety and a few days later upon release their usual medical practitioner returned them to Alprazolam.
@@Adara007 like you're not wrong, a very intentional part of all hospitals is that medications are changed by the doctors without much/any negotiation with the person who will actually be taking them (and any person who just asks for a basic explanation before taking a new drug gets labelled by the whole team of nurses and doctors as difficult).
That's a very different situation to forcing someone to take medication against their will, as was depicted. Involuntary treatment is either intensely regulated by state/territory-specific mental health acts, or by duty of care for life-threatening medical illnesses. Old mate arcing up in the late stages of his admission for substance withdrawal is transparently behavioural, and would not be covered by either.
YOU ARE THE BEST. I LOVE YOUR VIDEOS MATE 💗
That is one thing I didn't understand about this show when it came to House's rehab. The show spoke about methadone like it was evil (in a later episode) and it never mentioned Subutex even though its been available since 2002.
aye just realized the paranoid guy is the character from supernatural 😳
I hate when people use "dependency" rather than "addiction" just to be more polite. They are two different things. One is more physiological the other is phycological.
People with an addiction may not have a dependency and people with a dependency may not have an addiction though often both are present. Withdrawal symptoms are from the addiction side.
Just discovered your channel and I love it.
Having rewatched House several times and from what I can remember about the editing techniques used on occasion through the series, I think the opening scene was actually a jump back and forth between House drying out, and then the immediate time after that when he was on a strict regime with no opioids and still railing against been there. I don think he was actually going back and forth between been locked up and drying out, been let out then been locked up again - at least I'm not sure that's what the writers were doing based on the style of storytelling we usually saw.
I'm on withdrawals from codeine and I can't stop shivering and sneezing. And it feels like someone has smashed me in the pelvis, arms and legs with a sledgehammer...
It might be a little out of left field, but could you react to "Pickles vs. Rehab | Metalocalypse". A musical clip from an episode of Metalocalypse where a band member goes to rehab for alcohol dependence.
i saw the little metal part of your headphones coming out from one side and not the other and im like going crazy xD
pls react to one day at a time, especially the one called "hello penelope" in season two, it talks a lot about depression and the way her therapyst tried to help her.
I’ve never actually thought about it that way. Yes it’s bad if you relapse, for psychological reasons and because you’ve just undone all of your progress. But I never even considered that you’ll have a lower tolerance if you start again! That’s interesting asf❤
I spent five years attending group therapy in a casual setting. I'm Bipolar (don't ask which type, since my symptoms vary so much, I don't really fit in any of the established categories). Our regular group had several Bipolar, a couple of Autistic, one PTSD, several with Major Depressive Disorder, two paranoid schizophrenics, and one with a pretty severe personality disorder.
It was fun and therapeutic.
Part Two is also very good, especially the first scene between House and Dr. Nolan.
Ive had a few psych stays (in the US) and it has always been shared rooms. I felt so bad for the people who had difficult roommates. Thankfully all of my roommates were pretty nice and well behaved.