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What I Wish They Taught About Bipolar Disorder, Tardive Dyskinesia, and Schizophrenia in Medical School

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As a movement disorder commonly induced by antipsychotic medications, tardive dyskinesia (TD) is important to study in medical school. Although often categorized as a “side effect” of conditions like bipolar disorder and schizophrenia, TD merits attention as a distinct medical condition in its own right. Beyond acquiring essential technical knowledge, medical students could benefit from a comprehensive understanding of TD, including the patient experience,to enhance their educational perspective.

First, like many neurological conditions, TD looks different for everyone. Students may learn that the main symptom is involuntary movements throughout the body. These movements can vary in severity and also can involve arm and leg movements, hand coordination, and most commonly, movements of the face and neck. Doctors may ask questions about the prevalence of specific movements, such as head bobbing, neck turning, and rapid jerking; however, TD can still be present without these more common presentations. 

TD can also be difficult to diagnose. Symptoms of TD are uncontrollable body movements, which can be confused with muscle contractions or other tics in the body. It is important to note that any form of movement could be linked to TD, and prolonged use of antipsychotic drugs should always be considered when diagnosing someone for similar physical symptoms. 

Since TD is caused by antipsychotics, it is commonly understood that the most effective form of treatment would be to alter the use of medication. For conditions such as bipolar disorder and schizophrenia, it can take time to find a medication that works best, and it can be a difficult decision to consider stopping a plan that makes you feel better. In some patients, stopping medication can be a risk, as it could lead to worsening symptoms of the initial condition. Therefore, knowledge regarding all treatment methods is important to ensure the best and most efficient treatment for the patient. 

TD should be addressed on a case-by-case basis during every step of treatment. Symptoms of TD can vary greatly, from being hardly noticeable to having a profound impact on one’s physical abilities and confidence. Finding treatment for TD can be an emotionally taxing process, and remaining calm is also a main factor in avoiding worsening symptoms. 

Treatment plans taught during medical school should also emphasize the importance of emotional support during this process. TD has been linked to increased frustration, anger, insecurity, and increased risk for anxiety and depression. Due to these factors, any medical professional treating individuals for TD should emphasize the importance of seeking support.  

TD is a nuanced condition that can have a variety of appearances and impacts, and it is different for everyone. TD should be assessed in a way that is personalized to the patient, and medical schools should emphasize the care that needs to be taken in doing so. This increased knowledge can lead to empathy, understanding, and better care for schizophrenia, bipolar disorder, and the TD that could potentially accompany these conditions.

Originally published: September 1, 2023
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