Depression, Anxiety and Amnesia

Organ failure can be hard to diagnose because the symptoms and signs may be nonspecific, like the symptoms and signs of slowly dying. Patients who are very sick will all exhibit signs of depression, anxiety and amnesia because they will be experiencing problems maintaining their acid base status in the blood. Organ failure of any kind, heart failure, kidney failure, respiratory failure , etc…can happen at any age and will interfere with appetite, body temperature and thirst. Again, the patient may not be aware of this, so it is important for the doctor to recognize the slow trajectory of mental and physical decline in order to improve patient quality of life whenever possible.

I have accompanied a number of patients to see their doctors. These patients all had organ failure [I eventually learnt] ; all their doctors missed the diagnosis and thus were unable to give them the proper care.

it was frustrating to find out that there were specialized clinics and support services for the various organ failures they had that they were never referred to….for decades during their clearly declining health.

Doctors are failing; if the patient is not having a respiratory arrest or cardiac arrest or something which is “in their face- obvious” they are unable to figure out the problem.

Something as simple as checking the patient for changes to their respiratory rate, body temperature, heart rate and blood pressure would help the doctor to recognize when the patients getting sicker. . Different patterns of abnormal vital signs will suggest different types of organ failures. Asking the patient for their phone number will identify which patients have potentially reversible mental confusion. If the patient is confused, they will probably also be depressed and anxious. The patient will not know that they cannot tell the doctor how they are doing. The doctor will have to rely more heavily on what the family reports, plus the physical examination will become more important. The patient can then get better care to improve their quality of life; breathing support if needed, pain relief, etc….

If this is true for doctors patients with heart problems, breathing problems, etc….it is hopeless for patients with a psychiatric history who become depressed, anxious, and amnesic because of unlooked for organ failure. Psychiatrists know even less about organ failure [a slow ongoing process] than cardiologists

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