Category: Psychiatry

Stressed is desserts spelled backward

Tiramisu, chocolate mousse, red velvet cake, freshly baked cookies, and warm brownies topped with ice cream. These are some of my favorite desserts and the things I start thinking about when I am under intense stress. I often gaze at the bakery section…

Improve mental health by improving how we finance health care

It takes an average of 10 years between symptom onset for mental health conditions to be accurately diagnosed and therefore treated. In addition to general misunderstandings about mental health, the nationwide shortage of mental health providers is one…

Could this patient have been saved?

Wiley Boynton is dead. I first heard the news when Katie, a colleague, called me on my cell phone. Wiley had been taken to the hospital with a knife wound. I asked her right away: “Self-inflicted?” “I think so,” she said. A self…

The most powerful way to provide substance abuse treatment is in a group setting

We knew that the most powerful way to provide substance abuse treatment is in a group setting. Group members can offer support to each other and call out each other’s self-deceptions and public excuses, oftentimes more effectively than the clinicians. …

Making America great again with harm reduction

I recently discovered a fact about the United States of America that should be a source of embarrassment for all Americans. What I found out is this: There is not a single safe injection site anywhere in the entire country. Safe injection sites save th…

Preceding traumas lead to current ones

Anita is 37 with blonde, wild, disheveled hair. She is overweight, has bad teeth, wears too much make-up, and is severely depressed — sometimes psychotic. She tells me she often hears voices. And she constantly complains that the medicine she gets from…

Finding meaning in the intersection between marriage and medicine

When I first saw Jea-Hyoun, in a medical meet-cute straight out of a romantic comedy, she was being evaluated for thyroid cancer. I was an allergy/immunology fellow harried by a pile of paperwork. She was a patient, in the same building where she saw p…

Can a unique boarding home save my patient?

James is a tall, lanky Caucasian man, well into his 40s. He has brown curly hair and is not a bad looking fellow except for the vacant look in his large brown eyes. He is a pacer, which is a manifestation of his illness, and a consumer of excessive amo…

What Karl Marx can teach doctors about burnout

Professional burnout is widely identified using the Maslach Burnout Inventory, which defines it along psychological lines: emotional exhaustion, a feeling of depersonalization and cynicism, and a low sense of personal accomplishment. Accordingly, the p…

How physicians can deal with stress

Stress is one of the epidemics of modern-day living—especially work-related stress. At a basic fundamental level, it’s just simply a chemical reaction. Your adrenaline and cortisol levels shoot up in response to a stressful stimulus, the primitive “fig…