Psychiatry Articles

The Lie of Focusing on Those with Serious Mental Illness

Thursday, April 17th, 2014

The Lie of Focusing on Those with Serious Mental IllnessI’ve long scratched my head at one of the arbitrary political lines drawn in the sand in the world of mental health and mental illness advocacy — “serious mental illness.” (Some people refer to it as “severe mental illness,” but the correct term is “serious.”)

Focusing on this division is a lie. It is a lie told to Congress and to the public with earnest testimonials. But also with little evidence that it represents a valid — or meaningful — scientific distinction.

Ketamine Infusions Show Some Small, Limited Value in Open-Label Study

Monday, April 7th, 2014

Ketamine Infusions Show Some Small, Limited Value in Open-Label StudyThe sad state of affairs for treatment-resistant depression is that even if your treatment fails in 70 percent of the subjects you try it on, folks will still hail it as a success.

So it goes with a small study of 28 patients in the UK who had severe clinical depression that didn’t respond to any previous treatments. Only 8 of them responded to ketamine infusions. Of those 8, only 4 actually remitted — meaning they had no depression at the end of the study.

Those are not great statistics for any treatment to hail as a success. Why the disconnect?

5 Essential Remedies for Treating Depression: Coming Back from the Brink

Friday, March 7th, 2014

5 Essential Remedies for Treating Depression: Coming Back from the BrinkGraeme Cowan suffered through a five-year episode of depression that his psychiatrist described as the worst he has ever treated.

Part of his recovery involves helping people build their resilience and mental fitness as the Director of R U OK? In his book, Back From the Brink: True Stories and Practical Help for Overcoming Depression and Bipolar Disorder, he offers advice gleaned from interviews with 4,064 people who live with mood disorders.

He asked the respondents to rate the treatments they had tried and how much each had contributed to their recovery. Here’s what he found.

9 Habits of Highly Effective Psychiatrists

Monday, March 3rd, 2014

9 Habits of Highly Effective PsychiatristsHaving seen a half dozen psychiatrists in town, I can appreciate the differences in bedside manners, communication styles, and psychiatric strategies.

I also know what makes a person a good psychiatrist, a mediocre one, and one that should have been held back in medical school, without a license to dole out antipsychotics and other powerful drugs to vulnerable patients.

Here are a few things I look for in a doctor, qualities that set them apart from your average psychiatrist.

14 Recommended Books for Psychiatry Patients

Thursday, February 27th, 2014

14 Recommended Books for Psychiatry PatientsAn effective psychiatrist or psychologist will own a bookshelf stocked with recommended reading for his patients. 

He will have read a host of books on various topics, from sleep strategies to marital advice, so he knows what he is recommending. My psychiatrist has compiled the following list of recommended books for patients. It may be helpful to you too.

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.

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