depression

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The easy part is the FDA congratulating itself for an initial effort in 2004 to diminish the use of antidepressants in children and adolescents by adding the black-box warning that such medication may increase suicidal ideation.

Equally easy is blaming physicians who treat children and adolescents for becoming “inured” to warnings. Read more on More Kids On Antidepressants…

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I was not over 12 when my parents invited me to perform on the banjo which I played rather minimally for a family of synagogue friends.

I went straight to my best song, at that time “Where Have all the Flowers Gone,” by Peter, Paul and Mary. Read more on How Long Does This Continue?…

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There are many times I escort a patient back to my front desk Shouting things like “Never give up! Never surrender!”

I tell them how I was taught to say that when I was on active duty with the US Army Medical Corps.

“Think of whatever inspires you!” If a psychiatrist wonders if a patient is “untreatable,” then all we are really saying is that THAT patient is, at THAT moment, untreatable by THAT psychiatrist. Read more on The Untreatable Patient?…

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“I got low self-esteem.”

It is a surprisingly common initial complaint for new patients, especially younger ones.

If they make it to my office, folks often think a medication is going to fix this.  What the folks who complain about this are more likely to get, from me at least, is a response more like “Sorry, honey, if I had a pill for low self-esteem, I would have sold it out years ago.” Read more on …

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Sexual harassment has been making the news lately.  Dozens of powerful men in Hollywood (especially) and business and government are being accused of misconduct by vulnerable young women (and men in some cases).

Post Traumatic Stress Disorder can result from any trauma. Car accidents, animal attacks, a bad fall — not just sexual assault or war.

A high-school student doing a report for school recently wrote to me asking about PTSD.  I thought my answers might be of interest to others, so I’m sharing them with you. Read more on Student Questions About PTSD…

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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…