depression

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Teency children, starting at about four months, laugh about 400 times a day. Adults seem to laugh only about five times a day. This has got to have at least something to do with why growing up often stinks. The authors of this article start by reporting about a case of a woman with a mood disorder that was difficult to control. But she was more easily controlled with medication once she started doing “laughter yoga.”

Now “laughter yoga” sounds like my idea of a crashing bore.  I think that this discipline — invented by an Indian Doctor in the 1990’s — is intended to make people laugh without using words.  From what little I can find it seems to depend more on the “contagious” nature of laughter than on any humorous content. I suppose laughter can exist, as a neurophysiological entity, apart from content. A bunch of neurophysiological imaging studies, which I have actually attempted to read, implicate practically every part of the brain I can think of. Tickling initiates laughter in a baby (and on several occasions, in my husband as well). Read more on The Good Stuff…

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I just did one of those continuing medical education courses — in psychiatry, my very own field no less. It says that people who get a bout of depression are twice as likely to get a bout of back pain. What I read is a meta-analysis.  That means some clever person who probably needed the publication on his (or her) resume did a statistical (and critical) analysis of research other people did. This a noble attempt to asymptotically approach “the Truth and the Light” on a subject. It is also a delightfully erudite way to do research and get a publication without using a lot of time and money that the author had to scrape up.

Look, the relationship between depression and low back pain is something I have seen from every imaginable angle. As a neurosurgeon, it did not take me terribly long to figure out that surgery was not a very good solution for back pain. Of course, we rigorously restricted ourselves to operating focalized sciatica.  Cases where we could reasonably infer that an intervertebral disc seemed to be compressing a distinct (lumbar) nerve root that formed part of the sciatic nerve (plexus) that descended from the spinal cord to the leg and foot. There was the physical examination.  If someone were lying flat on his (more rarely, her) back and their straight leg was raised toward the ceiling, pain would appear on a trajectory anatomically consistent with one of those nerves. This was the sign of Laseque.  And we took it to be as solid as money in the bank. Read more on Depression and Low Back Pain…

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I find a lot of things I like in the New York Times. This article resonated with me as few others. First, there is the purpose of the human profiled.  Changing medicine into data science?  God save us all.

Sometimes I feel the best thing I do for a patient is to be human.  Just to have the pretension (a pretension which I do not take lightly) of being one human being in a room with another human being, trying to make them feel better.  This does more, I think, to make most of my patients “better” than all of the pills I have spent years studying about. All those years studying normative use of medications on large populations of humans.  And they work enough to please the powers that be.

Read more on Human Beings Are Not Computers…

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I was about three years old when I enjoyed tending our backyard with her.  I had been a marvel to her, since she was a little girl, earning her keep as an agricultural worker in the Ukraine, it what was then known as Russia.

Read more on What You Eat Makes You Who You Are (Smart!)…

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“I don’t like other women.  They gossip.  I hate gossip.  I think they should all go pound sand.” No, it is not a patient who said this. It was my (Great-) aunt Etta, who wore her hair like “Bride of Frankenstein.” She had been militant about her disdain for “gossip,” and certainly wore a bitter expression on her face most of the time.  But she would not tell the little girl I was then any more of her story.

Read more on Gossip Can Drive Some People Crazy…

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I had a really depressed patient.  She had just had one leg amputated below the knee because of advanced diabetes. Of course, I prescribed some antidepressants, and made sure the medical stuff (medical causes of diabetes) had been eliminated. I asked her why she couldn’t dance. “I can’t walk and you want me to dance?”  she asked, as if holding back tears.

Read more on Never say “Never” — Especially to dancing!…

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I think I was in my teens when I heard the playwright Edward Albee interviewed.  It was one of those interviews that sears your soul and that you remember over 40 years later. He said something about people who get older, like when their children who are adults and start having families of their own.  They all ask themselves the same question, which is “Did I do it right?” — meaning “Life” definitely with a capital “L.”

Read more on Don’t Live A Life Of Regrets…

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Natural treatment of obsessionality. “Estelle, you’re such a little worrier.  Yes you are.” When I was little, I never understood why my Auntie Charlotte always addressed me this way.  I did know that my family had “adopted” her which seemed to give her the right to “adopt” me.  Her orthodox Jewish family had rejected her because she wanted to marry a guy who had been married before, even though he was very Jewish. I was not supposed to know or care about such things.  But I did know she was the first person in my life to tell me I worried too much about things that didn’t need worrying about.

Read more on Obsessions…

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No, I haven’t downloaded it to my android.
My professional life and my thoughts and writing are still too mired in direct human-to-human interaction.  I will admit to feeling a kinship, with some minimal sense of attraction, to “cute” characters, mostly because that seems to be my husband’s favorite adjective for me.

I suppose I should give a very official link to download it; it’s free, although it did allegedly make the developers 1.6 million dollars in the first day when they released it. Read more on Waiting For Love Or Death With Pokemon Go…

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He was just 18. He had been followed by child psychiatry with a diagnosis of depression. He had long refused to take any pills.  As far as this poor, agricultural county was concerned, I was just seeing him so I could bill MediCal and fatten up the county coffers. The previous psychiatrists had simply noted he was depressed, was not suicidal, and refused any participation in his own treatment.

He was a young man of few words, with a common Hispanic name.  He sat there and twirled one of his lush curls. It became pretty obvious he wasn’t going to give me a complete history.  He said he would never take pills, not ever. To his credit, he did say I could talk to his mother, if I wanted to, but he had to be in the room and hear what she said. Someone brought her to me, from the waiting room.  She spoke only Spanish; fine with me. I learned my Spanish mostly from my patients, who in that time and place could rarely communicate well in either Spanish or English. His mother was charming, really grateful that I wanted to talk to her. She kept complimenting my clothes and elegance. I told her it was all thrift shop.  I doubt she believed me. Read more on Diagnosis From The Guts…