In the hallowed halls of medical school, we are often screened for traits that make the “ideal doctor”: high empathy, meticulous perfectionism, and a profound sense of duty. We are the fixers, the ones who find deep meaning in the intersubjective space between healer and patient. Yet, there is a shadow side to this personality architecture that no one talks about, an underlying proclivity toward rejection sensitivity.

The very traits that …

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I remember a patient who sat silently, staring at the hospital ceiling. She had survived a sudden illness that left her body weak and her spirit shaken. No tests, medications, or procedures could touch the despair in her eyes. In that moment, I realized something fundamental: The physician’s presence itself can be the most potent form of care.

Medicine, at its best, is more than diagnosis or intervention. It is an …

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Artificial intelligence in mental health has become an easy target. Headlines warn of hallucinating chatbots, reckless advice, and sensational claims that AI therapy is pushing vulnerable patients toward self-harm or suicide. The implication is clear: AI is dangerous, irresponsible, and incompatible with serious clinical care.

That conclusion is too simple and, in many cases, wrong.

The uncomfortable truth is that many patients are already receiving something far riskier than supervised AI therapy. …

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As a psychiatrist, I increasingly meet patients who come in convinced they have attention-deficit/hyperactivity disorder (ADHD). They arrive prepared: an online screening test, a list of symptoms (poor concentration, low motivation, distractibility) and often a quiet sense of relief at finally having an explanation. Then I do what physicians are trained to do. I take a careful history. I review medications. I ask about sleep, mood, anxiety, substance use, and …

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Somewhere over the last two decades, medicine began to drift into strange territory. Authority (once grounded in evidence, humility, and disciplined expertise) became diluted. Being loud, charismatic, or highly visible somehow became a substitute for scientific credibility.

We’ve long had celebrity doctors, but a new hybrid has emerged: Physicians who are not celebrities in the traditional sense, yet who speak with sweeping certainty far outside their field of training. A neurosurgeon …

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For the past several decades, Western spiritual culture has been profoundly shaped by the rebranding of Buddhist contemplative practices (mindfulness, presence, and the exaltation of “the now”). As a psychiatrist, I have witnessed the arrival of this movement inside the consultation room. Patients arrive quoting teachers, apps, and books urging them to stay present, to watch their breath, to release attachment to the future or past. Many have tried, often …

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As a physician-psychiatrist, I have watched the rise of GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound) with genuine admiration. They are transforming metabolic health, reducing cardiovascular risk, and offering hope to patients who have struggled for decades. For many, these medications are lifesaving.

But alongside the excitement, I’m witnessing something rarely discussed: a change in personality and affect, especially at higher doses.

This pattern reminds me of the early days of SSRIs. When …

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As a psychiatrist, I’m often asked by family or friends to “help,” to intervene in the mental struggles of a loved one, a friend, or even a distant acquaintance. It usually begins with kindness and concern: “Could you just talk to them?” or “Maybe you can prescribe something, you’d know what’s best.” What follows is always a difficult conversation, because I have to explain something that sounds incomprehensible to most …

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