The Centers for Disease Control and Prevention reports that 63,632 individuals died in 2016 as a result of drug overdose. Among these, 66 percent died from opioid overdose. The statistics are derived from in-depth research that was carried out by the research institute in 2016. The Centers for Disease Control and Prevention warns that cases of drug abuse are swiftly spreading geographically and increasing demographically. The …
I sometimes get messages from people who have lost physician colleagues and loved ones to suicide. It’s the specifics of these stories that wound me: a note left for an unexpected person; an insignificant fight at sign-out that in retrospect is full of meaning; the white coat that a woman wore when she jumped to her death. Each of these lives is complex, and each of these deaths …
Summer is upon us, and with it comes the end of the academic year, graduations and the arrival of the newest crop of interns. Soon these fresh-faced physicians will enter into one of the most remarkable educational experiences of their medical careers: residency. Many of these soon-to-be-interns are looking to attendings now for advice on how to excel during (or survive through) the arduous first year of training. Suggestions like …
Where I practice, the process of referring a patient suffering a mental illness is quite infuriating. The wait to get in to see a psychiatrist or psychologist can be months all the while patients are suffering. Worse yet, with certain insurances, there are just no mental health providers available for any of their covered patients. The failure of treating mental health disease in the U.S. is glaring.
In the U.S., approximately …
What is borderline personality disorder (BPD)? According to the National Institute of Mental Health, unstable moods; impulsive and reckless behavior, and unstable or volatile relationships may be indicative of BPD. People with BPD often have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides. They often make poor life choices and take unwise risks. Thus, adults with …
Well done! Strong work! You’ve done it!
Four years (often more) of perspiration have earned you two extra letters (often more) in your name. You should be proud. Nothing should get between you and a gigantic glass of bubbly today. The world feels different. You feel different. But are you?
The thing about ceremonies that feature costumes, protocols and rituals is that they confer upon participants a sense of change. Just look …
Cyberbullying is a major and growing public health problem associated with increased risk of greater psychiatric morbidity and mortality among children and adolescents. Its prevalence, varieties, associations with other forms of maltreatment, risk factors and deleterious effects in different populations are poorly understood.
Furthermore, effective, evidence-based approaches to screening and prevention in different populations are lacking. Developing such approaches is challenged by the rapidity and unpredictability with which electronic social media …
Martha (not her real name) was not an overly complex case in my field of geriatric psychology. But the case was complex enough to require multiple approaches and reliable follow up. And in rural Mississippi, follow up can be elusive. Soon it occurred to me that Martha’s case is emblematic of how caring for this vulnerable population often runs up against a huge problem — the Medicare merry-go-round.
A 78-eight-year-old with …
In 1994, Penguin Books published what would become a national bestseller titled, Listening to Prozac written by Dr. Peter Kramer, a Clinical Professor of Psychiatry at Brown University at the time. Throughout the book, he debates the ethics of “cosmetic pharmacology” a term associated with the transformation of personality traits through medication. Kramer describes several patients as becoming “better than well” on Prozac — more socially adept, less inhibited, and …
Since the advent of the internet and rise of social media, patients can connect and compare their experiences with prescribed drug withdrawal. A problem that was once considered rare is a worldwide epidemic that is finally getting noticed. A recent New York Times article discussed the problems many have discontinuing antidepressants, and more than 8,800 readers responded about their difficulty stopping …
The mental health community must increase its clinical acumen regarding complex psycho-pathology consisting of the avoidant personality, social impotence, and related rage. School violence has taken on epidemic proportions since two disturbed adolescents masterminded Columbine and became role models for the mentally ill young men who drive the new culture of school shootings.
While the profile of the school shooter has evolved over the last couple of decades, it’s worth considering …
Learned helplessness. It’s a psychological concept marked by a perceived loss of power, and it’s prevalent in medicine. We are taught early on how little we are in this colossal world. We are told what to do, when to do it, and what we will get for it. Our objections go unheard or—worse—ignored.
Let me quote a paragraph from The Paradox of Choice by Barry Schwartz:
They were conducting a series of experiments on basic …
To the intern on the trauma surgery service when I was a medical student: Thanks for occasionally wearing leather pants to work. Thanks for smiling and having a sense of humor despite having to round on thirty patients. Thanks for teaching us medical students while running a significant sleep deficit.
To the internal medicine resident who wanted to become a cardiologist: Thank you for indulging me and telling me how you …
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Today a physician told me she lost three colleagues to suicide in the last two months.
Loma Linda Hospital just lost three young doctors to suicide in 6 months.
Mount Sinai had 3 docs jump in less than 2 years — from the same building.
An anesthesiologist recently told me he lost 8 of his colleagues to suicide.
Each suicide should be fully investigated, …
Two recent posts highlight the problems facing many medical students today.
The first was by an anonymous rising fourth-year student who has come to the conclusion that going to medical school was “a terrible, terrible decision.” It ended with a comment that medical school “is not fun. It’s jarring, scary, disappointing and absolutely depressing.”
The second was by another anonymous student who described how miserable he (or she) has been …
If a physician has a substance use or mental health problem, it is in everyone’s interest — the physicians themselves, their patients and their families — for them to get treatment. And if they go for treatment, they deserve to be treated fairly, but given my six years of experience as an associate director in one state physician health program (PHP) and in working with physicians from all across the …
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As physicians, we are experts at prescribing medications. However, we often fail miserably when it comes to recognizing adverse reactions and tapering medications. It’s something that is simply lacking in our medical training. I have become a victim of this with benzodiazepines, as I detailed in a prior blog post. Benzodiazepines, in particular, are very difficult drugs to taper. I would like to share with you …
Eight-year-old Tommy has trouble paying attention in school, is always restless in class, unable to complete his tasks, hyperactive both in school and home and his teacher discusses the possibility of him having ADHD with his parents. They decide to take him to see a pediatric psychiatrist. After some analysis, he’s diagnosed with ADHD, prescribed with Ritalin and is on his way home with his medicine. Classic childhood ADHD story, …
Many things in life can only be truly appreciated once reflected upon — like the onset of dementia, depression, and cancer, just to name a few. This got me thinking about the onset of burnout and how the true presentation in life is quite different than reading about it.
The term “burnout” is often thrown around loosely but is an actual syndrome comprised of the progression of “exhaustion, cynicism and reduced …
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Recently, a form showed up on my desk to sign, approval for something or other. Not uncommon, given my role at the time as a chief psychiatrist, I signed dozens of such letters, memos, or forms, drafted by an administrative assistant. I signed so many; I never looked at the last line — at how my name had been typed out. Just once my eyes wandered to the end and …
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