mental health, psychiatry, and friends 💊 🩺

There is only so much powerlessness, so much indignity in the mounting pressure that people can tolerate, and God, family values, or appeals to a mythical utopian past quite frankly are not going to change a single concrete thing for them. Resorting to the dopamine rush of endless scrolling, or to the sticking-plaster medical intervention of SSRIs,... See more

With that investigative spirit, Halsted had embarked on experiments with cocaine—then touted as a wonder drug—with a group of colleagues in 1884. Submitting themselves as test subjects, they explored the drug's pain-numbing abilities by injecting it into their peripheral nerves. In doing so, they would advance the concept of local anesthetic, a... See more

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.... See more

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

Szaszians hold on to a fantasy where an objective definition of “disorder” not only exists, but it also successfully covers recognized disorders in general medicine while conveniently excluding mental illnesses as faux-disorders. Szaszians also commit themselves to some version of the idea that medical authority only applies to genuine disorders,... See more

Philosophy of science has had a long-running debate about the status of such postulated entities. Two major positions have evolved: scientific realism and instrumentalism. Advocates of the former argue that these constructs truly exist. Instrumentalists are more modest and argue that such constructs should be treated as tools and evaluated on their... See more

The search for root causes often means a life event that has triggered the mental disorder. When I hear people talk about root causes, it usually means they are not happy with a biological explanation and want something more psychological, more meaningful, more profound.

In clinical practice, this is tricky though - we can rarely, if ever, put our... 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

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... See more