Psychiatry Articles

Why Getting Good Mental Health Treatment is Complicated

Tuesday, February 25th, 2014

Why Getting Good Mental Health Treatment is ComplicatedAs long-time readers of World of Psychology know, there’s no easy fix to the convoluted, second-class mental health care system in the United States. People with mental disorders — like depression, anxiety, ADHD or bipolar disorder — are shunted away from the mainstream healthcare system into a patchwork quilt of “care” that varies greatly depending upon where you live, what kind of insurance you have (if you have any), and whether you want to pay cash for treatment instead of using your insurance.

It shouldn’t be this way. It shouldn’t be so hard to find a good treatment provider. It shouldn’t be so complicated to get integrated care from a single practice.

Why is it so hard to get good mental health treatment in the U.S.?

Understanding Humor Can Lead to New Psychiatric Treatments

Friday, February 7th, 2014

Understanding Humor Can Lead to New Psychiatric TreatmentsResearch led by Swiss neuroscientist Pascal Vrticka and his U.S. colleagues at Stanford University has found that, among other things, humor plays a key role in psychological health. According to the study, recently published in the journal Nature Reviews Neuroscience, adults with psychological disorders such as autism or depression often have a modified humor processing activity and respond less evidently to humor than people who do not have these disorders. Vrticka believes that a better understanding how the brain processes humor could lead to the development of new treatments.

This is not the first study to explore the healing force of humor. In 2006 researchers led by Lee Berk and Stanley A. Tan at Loma Linda University in Loma Linda, California, found that two hormones — beta-endorphins (which alleviate depression) and human growth hormone (HGH, which helps with immunity) — increased by 27 and 87 percent respectively when volunteers anticipated watching a humorous video. Simply anticipating laughter boosted health-protecting hormones and chemicals.

Lawmakers: Don’t Pass New Involuntary Commitment Bills Without Funding

Wednesday, February 5th, 2014

Lawmakers: Don't Pass New Involuntary Commitment Bills Without FundingNothing angers me more than when the media — and the public — come down on those with a mental illness when we hear of another violent mass shooting. The vast majority of shootings and deaths in America are due to the ease-of-access to a handgun, and simply knowing the person you’re going to kill (as most murders are conducted by people known to the victim). Mental illness does not enter into the picture in most homicides.

Well, wait a minute… There is one thing that angers me more than attributing a higher rate of violence to someone with mental illness. And that’s feel-good but idiotic lawmakers across the country passing a new round of involuntary commitment bills in their state — but leaving out any additional money to help fund these efforts.

Apparently common sense doesn’t enter into a lawmaker’s head when they author or lobby for the passage of such bills.

What’s the Point if Psychiatrists Don’t Accept Insurance, Medicare?

Sunday, January 12th, 2014

What's the Point if Psychiatrists Don't Accept Insurance, Medicare?For all of the hailing of mental health parity rules and the affordable care act over the past year, few advocates in these discussions actually talk about the reality on the ground.

And that reality is that most psychiatrists — about 57 percent — don’t accept Medicaid, the government’s insurance for the poor. Which probably doesn’t matter to you if you’re not poor.

But what might matter to you more is how few psychiatrists accept private insurance or Medicare. According to a recent study, that number is at a surprising 55 percent — and dropping.

What’s the point of these laws if so few psychiatrists even accept this form of payment?

The Differences Between Normal Worry & General Anxiety Disorder

Thursday, January 2nd, 2014

The Differences Between Normal Worry & General Anxiety DisorderYou’re worried about X, Y, and Z. You obsess about them for hours every day, maybe for weeks.

How do you know whether this is typical worrying, a normal way of processing something that’s important to you, or if you have generalized anxiety disorder (GAD)?

Karen Swartz, M.D., the Director of Clinical Programs at the Johns Hopkins Mood Disorders Center, says the main difference between worry and GAD is that the symptoms are more frequent with GAD. In a Depression and Anxiety Health Alert, she mentions one study that found that people without GAD tended to worry an average of 55 minutes a day, while those with GAD worried for 310 minutes each day. That’s one hour compared to five.

When Should You Go to the Hospital for Severe Depression?

Friday, November 22nd, 2013

When Should You Go to the Hospital for Severe Depression?Knowing when to commit yourself or a loved one to the hospital to be treated for severe depression can be a very gray area. I wish there were a set of directions much like those when you are in labor: if contractions come within five minutes of each other and last a minute, pack your bags.

Some physicians will make the decision for you, but usually it is up to you. Here are a few guidelines.

3 Reasons Why Not All Mental Health Professionals are Created Equal

Thursday, November 14th, 2013

3 Reasons Why Not All Mental Health Professionals are Created EqualThe biggest regret of those who have lived through a depressive or bipolar disorder episode is that they didn’t obtain a rigorous diagnosis and treatment plan early enough.

Lora Inman is one such person, interviewed in my book Back From The Brink. A long-time depression sufferer and passionate mental health advocate, she went for decades without a proper diagnosis or treatment, which prolonged her suffering and made postpartum depression even harder to manage.

Lora’s story perfectly illustrates three very good reasons why you need a trusted mental health professional.

The Carlat Reports: Independent Publications You Should be Reading

Friday, October 4th, 2013

The Carlat Reports: Independent Publications You Should be ReadingBack in 2008, I met ground-breaking psychiatrist Danny Carlat. You might remember Dr. Carlat because the year before he started a blog and published an important op-ed in the New York Times about the influence that pharmaceutical companies have in marketing their drugs to physicians. (To learn more, read about it when I interviewed him here.)

What you may not have realized is that Dr. Carlat got his start with his own monthly psychiatric newsletter called, fittingly enough, The Carlat Psychiatry Report in 2003. Since its humble beginnings as a single newsletter, the Carlat Publishing empire has grown, now supporting two additional newsletters — The Carlat Behavioral Health Report, and The Carlat Child Psychiatry Report.

They’ve also just recently launched a fourth, new newsletter, The Carlat Report Addiction Treatment.

We’re pleased to be partners with Carlat Publishing in helping publish their older, past years’ archives of these newsletters over at Psych Central Professional. But we’re doubly pleased to offer our readers a special discount subscription to these independent, must-read newsletters.

60 Minutes: Connecting Mental Illness to Violence with Little Data, Facts

Monday, September 30th, 2013

connecting-mental-illness-violence-dataLast night, a poorly researched piece by Steve Kroft appeared on the television news program, 60 Minutes. I say “poorly researched” because it took me all of five minutes to find problems in what some of those interviewed on the program said. While truthy, it wasn’t exactly the whole truth.

The core problem this program displayed is making a post hoc logical fallacy of connecting two seemingly-related things and suggesting a causal relationship exists. Because some of the people who commit mass killings have mental health issues, this is a sign of “a failed mental health system that’s prohibited from intervening until a judge determines that someone presents an “imminent danger to themself or others.”" The two may have little to do with each other (and in fact, according to real research, don’t).

No, the sign your mental health system has failed is when you’re locking up tens of thousands of people with serious mental illness in prison for petty crimes, rather than simply treating them in less restrictive settings.

Revisiting Glasser’s Controversial Choice Theory

Monday, September 16th, 2013

Revisiting Glasser's Controversial Choice TheoryWhen I was in graduate school, I took a course on Dr. William Glasser’s controversial choice theory. I had never heard of the man before I signed up for the class and had no idea that he was a psychiatrist with some controversial ideas.

Until recently, when I read that Dr. Glasser had passed away, I had completely forgotten about choice theory and my experience in the class. After I read Dr. Glasser’s obituary, I started to think about what had been covered in my course and how I had initially reacted to it.

The first thing I learned about Dr. Glasser was that he did not believe in mental illness. He believed that everything was a choice — that we choose everything we do (even to be unhappy or mentally ill).

Small Acts of Kindness Can Have Big Effects

Saturday, September 14th, 2013

Small Acts of Kindness Can Have Big EffectsI live in Rochester, Minnesota, which basically is famous only for being home to the Mayo Clinic. My biggest health problem is mental, not physical (I’m bipolar).

Several years ago, my internist snagged me a consultation with the psychiatrist who is nationally known for his work with bipolar disorder. After a three-hour discussion that felt like it ranged from birth to present day, he asked if I had questions. I said yes, just one: “Is this ever going to get any better?”

He then felt compelled — after all that time — to tell me the research showed it got worse as people aged, not better, and he was very sorry, but he couldn’t help me.

I was a little irked, as you might imagine.

A Mental Illness Epidemic? Or Hype Masquerading as Journalism?

Thursday, August 29th, 2013

A Mental Illness Epidemic? Or Hype Masquerading as Journalism?Are we in the midst of an epidemic of mental illness?

My dictionary would suggest the word “epidemic” is appropriate when discussing some that is “excessively prevalent” or “characterized by very widespread growth.” Is mental illness really growing as much as some critics claim?

It’s with some interest to examine the claims of those who say we’re in some sort of “epidemic” of mental illness. But owing to their sloppy premise, loose research efforts, and illogically connecting dots that have little to do with one another, I find it a hard claim to swallow.

In fact, research shows that prevalence rates for mental illness have actually declined somewhat from 1994, making it hard to understand where some are coming from about this “epidemic” nonsense.

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