How one word may have harmed my patient

"With this single word, mom had now completely altered her willingness to see the deep suffering of her child. This single word watered all of this child’s five years of depression, crippling anxiety, history full of ACEs, and very significant struggle down to a simple, selfish, flippant choice.

Furthermore, mom said that the nursing staff asked her about the medications. Mom informed me that: 'The nurse said maybe it’s the Wellbutrin making her this way. Maybe she is suicidal because of this?' If the team had spent five minutes doing a real assessment of suicidal thinking, they would have learned her suicidal thoughts started years prior to her being on medications and have actually decreased in frequency since starting these meds in the hospital.

I could see in mom’s eyes. She now did not trust me when I spoke about the importance and urgency of treatment. Her child was now an inconvenience, my medication recommendations could be damaging, and our work together was now a waste of their time. Mom declined my recommendation to titrate up meds because of her concern about them now brought on by the nurse."

Shivana Naidoo is a child psychiatrist.

She shares her story and discusses her KevinMD article, "How one word may have harmed my patient." (https://www.kevinmd.com/blog/2021/06/how-one-word-may-have-harmed-my-patient.html)