An excerpt from Understanding Medicines for Anxiety.
In addition to medicines with FDA indications for anxiety, such as benzodiazepines and some antidepressants, a number of drugs are frequently prescribed off-label. Among these are gabapentin and the related compound pregabalin, collectively known as gabapentinoids. Their popularity is remarkable: gabapentin has been …
An excerpt from Understanding Medicines for Anxiety.
Although the SSRIs (selective serotonin reuptake inhibitors) are among the most widely prescribed medicines for depression, they also have a useful role to play in treating anxiety disorders. In this article, we will look at their benefits and limitations when used in this …
Literature surrounding the effects of social isolation and loneliness for older adults is no longer lacking. Studies and articles outlining the dreadful consequences of these epidemics have even pierced large media outlets like Time magazine, where they emphasize how one in three older adults are lonely.
While any attention brought to the fact that the age group containing people age of 85 and up is …
Although Arnold Knutsen and I “met” virtually five years ago, we only first spoke on the phone recently when he called to share his story. He’s the eldest member of the online benzodiazepine support group we cohabitate. His posts in the group always reeked of desperation, and there was a palpable sense of urgency to his pursuit of a cure for his situation. It was clear …
Here is a standard emergency department situation, played out all across America today.
Patient X has schizophrenia. He takes medication, but only until he feels better. He is calm when he takes it, but sometimes aggressive and assaultive when out of treatment and off medications.
Patient X decides to leave town and drive somewhere else because he is angry at 1) family 2) significant other 3) health care system 4) situation.
He is …
Residing in all of us, whether or not we feel it, is an innate zest for life. As a family medicine resident, I live with enthusiasm daily, because I am happy seeing patients, no matter my rotation. From the acute care wards to the family medicine clinic, I enjoy and relish the opportunities to sit with patients. Unfortunately, this zest for life was once lost on me, and at times …
It took me a long time to put a name to what I was feeling. Only recently had I started to read about imposter syndrome. I’ve had this feeling multiple times throughout my life, and it always had the potential to pull me backward instead of allowing me to propel forward towards my goals.
I had this feeling when I made it into college, then again in medical school. Even when …
Physician compensation in most employed positions is based on how much a physician “produces.” I work as a psychiatrist, and this amounts to how many patients you see per hour. The more patients you see, the more “productive” you are, the more money you generate, the more valued you are by your organization and the more RVUs you churn out for a larger paycheck. But, in human terms, what exactly …
As physicians, we have embraced a calling where we help others. A commitment many of us fully relish. We are grateful for our patients and the families who put their trust in us as we diagnose and treat their sometimes incredibly complex illnesses. I have been genuinely inspired by the stories I have heard from patients and my colleagues on the work we do.
Yet, in spite of the incredible advancements …
When I told my colleagues that I was going to try to create the first psychiatry review course at the University of Toronto, I received the same two responses: “It’s about time somebody did that!” and “What is wrong with you?” — sometimes from the same person!
The first reaction taps into the excellence of our department. With approximately 1,000 faculty with diverse expertise and the largest residency program in Canada, …
Dear colleagues, I know you have seen these questions:
Do you currently have any physical or mental impairment that could limit your clinical practice?
Are you currently taking any medication?
Have you ever been hospitalized for any reason?
Have you ever been hospitalized for, or diagnosed with, a psychiatric disorder to include substance abuse?
Ugh! I hate, hate, HATE these questions! “It is none of their business,” or at least that is what I told …
Anyone can exhibit narcissism or narcissistic personality traits or types from time to time in different forms from mild to severe. When doctors are under stress, they can “act out,” or their behavior can worsen. Greater awareness of damaging behaviors is therefore important. The more we recognize the traits in ourselves and others, the less likely they become a problem. However, unfairly labeling or stereotyping doctors as narcissists is to …
A swimming pool. Most of a Tesla. Not nearly enough to have your kid swapped out during their sham SAT test. Nor would an ICU bill for a stay that resulted in survival — $48,744 is the cost of that. What costs an alarming amount more is the bill the US Government pays annually on erectile dysfunction medications for servicemen — a whopping $8.7 million according to a 2016 Rand …
ADVERTISEMENT
My interest in understanding burnout among medical trainees started during my second year of medical school. With Step 1 nearing, I noticed a dynamic shift in my classmates. The growing tension, petty arguments, and constant worry surrounding our futures took over. This led to a research project assessing burnout risk factors that stood out like a red flag on my application for residency. I found most of my interviewers were …
How is it possible that endemic bullying persists in medicine despite myriad initiatives to improve awareness, mutual respect and medical culture?
In some cases, we can blame health systems issues, such as medical workforce shortages, lack of funding and unsafe hours. But in other cases, we must take collective responsibility for failing to hold individual doctors to account for their damaging behaviors.
Most doctors readily change after being counseled about poor social …
1. Stop comparing yourself to others. You got into medical school, that is an extraordinary achievement. Whatever you have done so far has worked, you already have proven your intelligence and study habits. You need to trust that you are capable of succeeding in medical school. Every student has different study habits, and different things work for everyone. Just because your classmate is pulling an all-nighter before an exam doesn’t …
Health care is increasingly complex. Objective peer review, constructive feedback, and robust debate are essential to continually improve the quality of patient care.
But doctors don’t always disagree well. One of the contributing factors to bullying in medicine is the complex interplay of different personality types in very stressful situations. Some doctors have personality traits that predispose them to have interpersonal conflict and being unable to see the view from the …
K: “I was assaulted by an intoxicated female. She punched me and ruptured two discs in my back. I lost my whole self. I could no longer take the CPR course required. I lost my income that was supporting me and my three children.
I needed the narcotics — not only to dull the physical pain but to numb the emotions. I found myself taking more than prescribed. I asked the …
There are roughly 15 percent of the nation’s children who suffer from a developmental-behavioral condition or about 1 in 6 children. Unfortunately, many of those children often do not get the help they need.
Children with developmental and behavioral challenges can easily be missed, especially when the behaviors are more subtle or impacts on function are not evident daily, such as with a …
Some children present to me with complex problems or multiple problems that fail to resolve after the typical interventions.
I recall a child with severe abdominal pain. He had tried numerous medicines and had had scopes and studies galore. It had reached the point where he was being scheduled for exploratory surgery to try and see the cause of his pain. I lost track of his case when I rotated elsewhere …
Get free updates delivered free to your inbox.
