mental health, psychiatry, and friends 💊 🩺

Have you heard? No one wants to hear about your mental health anymore, if they ever did. It’s passé. It’s cringe. It’s a sign of a cultural decay which you, the individual, are responsible for upholding. We can all un-diagnose ourselves and breathe a sigh of relief that the powers that be have decided it’s over.

We psychiatrists tend to start our first sessions with some variant of the question: “What would you like to change?” People often list negative goals: to be less depressed, stop using drugs, feel less anxious, etc. It’s a start, but we often need more. There is a helpful reframing found in Acceptance and Commitment Therapy: no dead person’s goals.

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People who are miserable are ugly and unapproachable and have a “victim mindset” because they can’t accept that it is all their own fault, and therefore they are bad. People who are happy must be strong and living virtuous lives full of beauty and tradition. People who are not must therefore be weak and moral failures. This framework of logic makes... See more

Studies have shown promise in treating Alzheimer’s and Parkinson’s with GLP-1 drugs, perhaps by regulating insulin levels and reducing inflammation, and the drugs may yet prove useful in treating many other conditions made worse by chronic inflammation. Some studies have found large decreases in the risk of depression and anxiety; others found smal... See more

At the core of it seems to be a belief that you - the patient, the self-healer, the consumer - are not the problem, and everyone else is toxic, or a narcissist, or an abuser. You are just vibrating at a higher frequency than they are. Everyone is out to get you. Crucially, the customer is always right.

IFS illuminates the mind's landscape as a mosaic of distinct parts, each with its own voice, identity, and role to play. This concept resonates with our daily experiences; we often catch ourselves saying, "A part of me wants this, but another part of me wants that." Addiction can amplify this internal dialogue, making it feel like an alien force ha... See more

Some people, especially those who are autistic, dohave a flat emotional affect, do rely on scripts and do have a clear-cut sense of justice which leads them to cut off those who transgress it. When we talk about these traits as inhuman and robotic, what are we implying about the people who display them? The impulse to be unapologetic about emotiona... See more

Many scientific theories assume constructs that are not directly observable (muons, genetic drift) but whose existence is inferred. In mental health research, psychiatric diagnoses play such a role. We assume that constructs, such as schizophrenia or alcohol use disorder, exist but we can only observe the signs, symptoms, and course of illness that... See more

The same is true for any assumption that holds the mind or its pathologies to be inexplicable in some fundamental sense: it can only lead to extremely bad explanations. We have no choice but to treat mental illness as unknown but knowable .