In 1987 I started my psychiatry residency. Since then, they have changed the Diagnostic and Statistic Manual three times and it still does not seem to be keeping up with how fast the world is changing around me.
I one saw lots of “lethargic” depressions. Slow and sleepy “ain’t got no energy” depressions. “I feel like a human blob” kind of depressions.
Now most of them turn out to be Type II (“adult onset”) sugar diabetes or the thyroid just stopped working for some creative reason. Read more on Then and Now…
Filed under depression, Diagnosis, Disease, Doctors, Education, life, medicine, Mental Illness, News, Psychiatrists, Psychology by on Jun 11th, 2020. Comment. 
My preceptor in Kansas taught me — while I was finishing my training and in my psychopharmacology fellowship — how to do “ECT”, which stands for “Electroconvulsive therapy.”
AKA: Electroshock therapy Read more on Yes They Can Still Force Electroshock Therapy…
Filed under Alternative Medicine, Diagnosis, Doctors, medicine, Mental Illness, News, Psychiatrists, Psychotherapy by on Feb 14th, 2020. Comment.
My medical career has so far encompassed training in multiple specialties (general and orthopedic surgery, neurological surgery, neurology, psychiatry, and psychopharmacology). I have practiced in France, Canada, the United States Army, and more States of the United States than I can name.
I have been sexually assaulted and harassed more times that I could count. “Bullying,” is common in medicine, often viewed as a necessary process of “toughening up” to deal with the all too frequent tragedies lived with by patients. Read more on Me Too…
Filed under abuse, life, Mental Illness, News, Psychiatrists, Psychology, Sexual Misconduct by on Nov 3rd, 2019. Comment.
Psychiatry is an imperfect science at best. It is by no means a “pseudoscrience,” although it is frequently blamed for being same.
I have known LOTS of honest, decent people who have (I think, sincerely) seen psychiatric research as a difficult attempt to elucidate truth about the human animal. Read more on The “Crazies” are not very violent…
Filed under Diagnosis, Doctors, Government, Mental Illness, News, Psychiatrists, Violence by on Oct 27th, 2019. Comment.
His mother had been seeing me and they had signed mutual releases. Mother wanted me to see him as soon as possible, because he was “nervous and unable to sit still at all.”
When he came, he denied a “nervousness” which his mother thought looked like “attention deficit disorder.”
I can’t treat what people don’t think they have.
He described problems with his girlfriend and his mother, since his mother had told him he could not go to a party in the home of his girlfriend’s family on the bad side of town, “where they would just as soon shoot you in the street as say ‘hello.'”
He sounded like he had pretty routine mother-and-girlfriend problems.
She contacted me on the weekend, worrying about him frequenting strip clubs, something I had not asked about and he had not told me about. Sometimes, she said he became so angry she physically feared him.
Their two narratives were simply inconsistent. I drew the line at her feeling scared of him physically.
I told her about “tough love,” and I told her if that happened again, to call the cops.
My husband reminded me of the ultimate authority in my profession — Hugh Laurie as “Dr. House” — who repeatedly said on television in public for all the world to hear, “Patients lie.”
Which one of them? Maybe both of them. I told her what I had told them; and would indeed, tell anybody who gave me the opportunity. I can try a session with the two of them together and help to resolve things, but I could not promise that it would resolve things. I would try. I always try as hard as I can to do the best that I can.
She said she knew this to be true.
I had told him and also told his mother on the phone, that the hardest thing a young man (or a young woman) ever had to do in his (her) life was establishing themselves as an individual distinct from parents. This usually meant a period of confusion before resolution. There may be (and there was) some confusion about vocational direction, too.
One can only press forward. The ability to communicate openly is precious, and irreplaceable.
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Filed under Alternative Medicine, depression, Diagnosis, Disease, Family, life, medicine, Mental Illness, Personality Disorders, Psychology, relationships by on Oct 11th, 2019. Comment.
I had not set out to be a radical for anything other than mental health, but as of today I am forced to become a radical for something called “handicapped inclusion.” I walk with a cane because I have what I have come to realize is a familial peripheral neuropathy. It is quite benign and won’t kill me. I know it is possible to avoid a wheelchair because my mother and grandmother did that I do fight tooth and nail to move around the best I can, and build strength and such with both exercise and nutrition.
When a doctor told me once I needed disability and a wheelchair, I yelled Holy Hell at him and explained that I practice medicine with my head and not with my feet. I am still practicing, but I have no plans for competitive athletics in the near future. I do dance every chance I get, as you may have seen a video on one of my social media sites. Today I am at the DMV where they put me in the “handicapped” line, thus rushing me to an area with “standing desks,” where my husband had to fill out my application for an ID card because the ONE thing that is sometimes hard for me to do is-standing.
I see the instructions for “handicapped inclusion” are written by the CDC (Centers for Disease Control, U.S. Government). I am worried because after my research on Chronic Fatigue Syndrome, I found the CDC write-up and it seemed to me that that with their new criteria, less people had the problem so it sounded like a less serious one. Was this propaganda? Who can tell? There is lots of stuff available about including students with disabilities in the classroom.
A classroom has got to be one of the most controlled human environments on earth. Contrary-wise (as Humpty Dumpty told Alice), the Department of Motor Vehicles office has got to be one of the poorest-controlled human environments on earth. I suggest neophytes (which some people I have known in the field call “TABS” or “Temporary Able-bodies,” since we all start as babies and end as needing some kind of care) start by directing some of the obviously confused people if you know how (not all handicaps are visible) or at least smiling at people in walkers or wheelchairs. Or with a cane, like me.
Filed under life, Mental Illness, News by on May 10th, 2019. Comment.
The show is “Hot Topics.” I do not know the personalities of the folks on the oversized screen of this breakfast room where we happen to be staying. They throw around the names of celebrities I never heard of and they tell their intimate family lives painting in broad strokes without any testimonial evidence. A “gossip” show, my mother would have called it.
My mother would have turned such shows off on the television. My grandmother of blessed memory, my “Bobie,” would have turned the channel back to the gossip show, and commented how my Mother, who seemed to think she was head of the household, ran the place in a way similar to Adolf Hitler. Read more on Estelle is Magically Stuck Watching Television…
Filed under culture, Family, Fashion, life, Memory, Mental Illness, News by on Feb 8th, 2019. Comment.
It was a particularly beloved patient who asked me if I had any advice about improving creativity. She believed, as many people do, that it is a side effect of treating (even a relatively minor form) of bipolar illness. A lot of research back in the days of lithium, one of the first really robust treatments for bipolar illness, strongly suggested it just wasn’t so. Read more on Will Bipolar Treatment Kill Creativity?…
Filed under Alternative Medicine, Brain, Diagnosis, Disease, Doctors, Family, medicine, Mental Illness, News by on Sep 21st, 2018. Comment.
You really can buy almost anything at WalMart.
I run quickly by the food section. Love the crumbled Feta cheese. I mean, at least it’s honest.
The imported Israeli Mexican specialties are more amusing. Read more on Walmart…
Filed under Mental Illness, News, Society by on Aug 31st, 2018. Comment.
Although it theoretically is marginally ethical, I frequently find myself performing a rudimentary psychoanalysis of people I have never met.
I usually find it helps to explain a life or an origin of suffering, or some kind of human empathy, and can bring peace or closure to the folks who come into my office — or the folks who are my friends.
It was a really good friend who told me on the phone today, “I thought of you this past week. My Uncle Ed died.” Read more on Uncle Ed — The War Hero…
Filed under Diagnosis, Disease, Doctors, Education, Mental Illness, military, News, war by on Aug 30th, 2018. Comment.