21F Clinical Conversations Recap #3

October 10th, 2021 by Nina Ham

For the third Clinical Conversations event of 21F, NSS welcomed Dr. Gillian Sowden, a psychiatrist affiliated with DHMC and an assistant professor of medicine at Geisel. She attended Williams College for undergraduate studies. Following, she attended Harvard Medical School and completed her residency at Cambridge Health Alliance. Her experience guided an enriching conversation and presentation about mental health and psychiatric conditions.

Dr. Sowden began her presentation by presenting an overview about psychiatry and patient burdens. She then presented a clinical vignette following a 45 year old female referred by her primary care physician for “anxiety attacks.” The patient was diagnosed with bipolar disorder and was prescribed Lurasidone and Sertraline. Dr. Sowden then guided a discussion on panic attacks, panic disorders, anti-psychotics, and antidepressants. She also mentioned that the patient had been experiencing worsening episodes that caused laryngospasms and painful “lock jaw.” Dr. Sowden described how she was able to recognize that these episodes were actually caused by the medication the patient was prescribed to treat her bipolar disorder.

Dr. Sowden presented a second vignette about a 28 year old female who presented to the emergency department after running around the Dartmouth Green wearing only a trash bag. The patient believed that the trash bag gave her special powers and allowed her to connect directly with God. She also had not slept in two nights. After a discussion with the undergraduate students, Dr. Sowden agreed that this patient was experiencing a manic episode.

The final vignette was about a 19 year old college student who had trouble trusting others and felt like she didn’t know who she really was. She felt like she existed outside of her own body and felt invisible at parties. The undergraduates thought it could be depression or social anxiety disorder. Dr. Sowden took this opportunity to discuss misperceptions and stigma surrounding borderline personality disorder.

After the presentation, our undergrads sparked a brief Q&A on the difference between borderline personality disorder and bipolar disorder. Additionally, Dr. Sowden talked about the rate of psychiatric misdiagnosis as well as the lack of definitive symptoms for many psychiatric conditions. NSS is extremely grateful for Dr. Gillian Sowden’s thoughtful and engaging presentation filled with interesting case vignettes and supporting videos!