Farid Sabet-Sharghi is a psychiatrist.
Addiction is no longer a clinical category. It has become the cultural baseline.
We used to think of addiction as something that happened to a few vulnerable people who “couldn’t handle” life’s pressures. Now it’s woven into everyday existence. Most of us reach for our phones before we reach for a breath. We chase stimulation without noticing we’re chasing. We live in a world that subtly trains us to crave.
Somewhere along …
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 …
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 …
A new patient recently told me, “I’ve already seen two doctors about this.” She meant a life coach with an online certificate and a therapist with a doctorate in education. Neither was a physician. Neither had examined her, ordered labs, or considered medical causes for her rapid cognitive decline.
When I evaluated her, it was immediately clear she needed urgent neurological workup. She wasn’t suffering from “stress.” She had an early …
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 …
The human psyche is built for connection. Our evolutionary history, our families, and our communities shape us to seek cooperation, mutual respect, and shared purpose. We are, by design, social beings whose sense of safety depends on trust and belonging.
When that natural orientation toward unity is fractured; when instead we encounter hostility, harsh language, or dehumanization, it cuts against the grain of who we are. What might once have been …
Psychiatrists know what it feels like to practice in a field questioned at every turn. From the earliest days of our specialty, we have faced doubts not only from the public but also from our own colleagues in medicine. The very existence of conditions such as schizophrenia, melancholic depression, bipolar disorder, or attention-deficit disorder has been challenged repeatedly. We have heard the claims: It’s just weakness. It’s a vitamin deficiency. …
Psychiatry, perhaps more than any other medical specialty, is a field defined by ambiguity. Unlike other branches of medicine, where diagnostic tests and standardized protocols guide treatment, psychiatry often operates in a landscape where clear-cut answers are rare. The psychiatrist’s primary tools are not scalpels or stethoscopes, but words, presence, and (most crucially) the self.
Psychological transference and countertransference: double-edged swords
Psychological transference and countertransference are central to the practice of psychiatry, …
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