Real Psychiatry
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The reality of psychiatry rather than the perception. I am a practicing psychiatrist with 30 years experience. In the Real Psychiatry blog, I correct the distortions about psychiatry that occur in the media.
Real Psychiatry
2d ago
“Well I woke up this morning and I had myself a beer.” Roadhouse Blues (1970) Jim Morrison Lyrics The Doors Composition
Many years ago, I was asking a patient about his morning routine and he replied with the Roadhouse Blues lyric and started laughing. At the time he was taking medications that I prescribed but also seeing a naturopath who was giving him a complex solution of minerals that was supposed to treat his mental illness. His family was more concerned about him than he was concerned about himself. Severe mental illness leaves a person focused on irrelevant pieces of informati ..read more
Real Psychiatry
5d ago
It is always good to take an in depth look at articles in the popular press about psychiatry – because of the clear antipsychiatry bias. An article from the Economist was posted recently that seemed to get a positive reception in some areas. In my estimation that reception was not warranted. Interestingly the same principles of analyzing rhetoric can be applied to this article as the last post on this blog about “doing your own research.” I will use the same concept by concept approach to examine this article that I used for that video. At the time the article was p ..read more
Real Psychiatry
1w ago
Medical training is an exercise in repeatedly meeting people who know a lot more about the field than you do and hoping to learn something in the process. It happens regularly – often several times a day. It is a common occurrence to meet people with encyclopedic knowledge – not just of textbooks and papers but disease patterns and presentations as well as the best treatment approaches. The knowledge can be obtained through straight didactics, informal seminars, bedside interactions, and direct observation. It can be affiliative or adversarial. In other ..read more
Real Psychiatry
2w ago
I thought I would review a book sent to me by a friend who I emailed about the concept of suffering. At issue was whether suffering was useful or not. That issue was used as a social media cudgel against psychiatrists – specifically that psychiatrists are trained to alleviate suffering but if they did not people would benefit from it instead. That is obviously an overly simplistic argument by a person who does not know very much about psychiatric practice. I don’t want to get too far afield from the actual book.
The author is Sylvain Tesson who is generally described as a world ..read more
Real Psychiatry
3w ago
In addition to the clinical work – psychiatrists need to have their finger on the pulse of popular culture. Not just the content – but the process of it all. How else can you talk with a young patient who is describing their experience of a rock and roll lyric and what it means for their life? Or patients who are caught up in the latest cultural movements – whether they are useful or not. Sports of course are a big part of the culture and in the last few months there has been no bigger sports phenomenon than Caitlin Clark of the Iowa Hawkeyes basketball team.&nb ..read more
Real Psychiatry
1M ago
Receiving a novel to review this morning reminded me that I should probably comment on that process. I am very grateful to any authors, editors, or publishers who send papers, books, and book chapters my way. I have a rigorous reading schedule – especially post-retirement. Scientific papers are my top priority and I generally read 4 or 5 a day. That number can go way up if I am working on a specific blog post that requires it.
I rarely read fiction but it all depends on what I am focused on. For example, the question of suffering came up and I am ..read more
Real Psychiatry
1M ago
I finished my second MRI scan this year earlier this afternoon. So far lifetime – I have had 5 and will have 6 by the end of next month. I am sure that many people reading this have had the experience and I would not rate it as pleasant at all. Just the obsessive checklist that must be completed prior to the scan is enough to raise the anxiety level. Is my body free of implanted or tattooed or accidentally placed metals? When they were scanning my pancreas – my first thought was: “What about that laparoscopic cholecystectomy I had done in 2015?” I had read the o ..read more
Real Psychiatry
1M ago
Depression is a significant cause of disability in the world. That is complicated by the fact that there are not enough resources to treat people with depression, access is rationed in many areas including the United States, there is a high rate of attrition during treatment, and depression is often associated with significant medical and neurological disability further restricting access to adequate care.
Over the past 30 years, strategies for treating depression have increased considerably since antidepressants medications are not uniformly effective and they have side effects ..read more
Real Psychiatry
1M ago
Last night around midnight – I noticed that I had crossed the 2 million reads mark on this blog. The Google Blogger interface that I use is not very granular so it is difficult to tell how many of those hits are actual reads as opposed to something else. By something else I mean hackers, bots, and people trying to use my blog for free advertising. The products are typically illegal or barely legal drugs or psychiatric services outside of the US. The increase in VPNs is also probably a factor. Over the years the number of hits per page has flattened out while the ..read more
Real Psychiatry
1M ago
I was notified this morning that a letter I sent in to the New England Journal of Medicine would not be published because they had limited space. Anyone sending a letter is notified that if the letter does not respond to one of their articles you are limited to 400 words. If your letter does respond to an article the word limit is 200 words. I was responding to an essay by Lisa Rosenbaum, MD (1) and whether medicine is a calling or just a vocation and the implications that each of those categories have. My first attempt at the 400-word mark (374 a ..read more