The New York Times and NPR recently published articles related to the Goldwater Rule. In short, a magazine sent a survey to over 12,000 psychiatrists in the U.S. with the single question of whether they thought presidential nominee Mr. Barry Goldwater was fit to serve as president. Few psychiatrists responded. Of those that did, more than half -- still over 1,000 -- said that he was ...

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By the end of my first year of residency, I knew I was in trouble. I was overwhelmed by the 15-hour days, the unbearable sadness of the tragedies I witnessed, my feelings of impotence and my fears of making a mistake. My life was my work, and everything else seemed to be falling apart: my physical health, my relationships, my ability to sleep after months of night shifts. Yet, I came to work ...

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StephanieFired Dear Pamela, You’ll never guess what happened to me today. Hours after the National Day of Solidarity to Prevent Physician Suicide volunteer web page went live, I received an email stating that I am officially terminated from my psychiatry residency program. On this web page, I spoke about the fact that I had become interested in this event during my struggle to ...

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recent research paper from the University of Virginia may pound the final nail into the coffin of the long-standing medical dogma which rigidly labels diseases as "organic" or "psychiatric."  UVA researchers have discovered a complex network of lymphatic vessels which service the brain, prompting a serious update of the concept of a highly selective “blood-brain barrier.” When asked about methods to study the immune response of the brain and ...

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It is no secret that mental health conditions are prevalent, and recent years have seen an increase in the dialogue on their causes and consequences. However, we do ourselves a disservice when discussing mental health outside the context of the broader system in which care is provided, and the insurance constraints that drive shortcomings in health care delivery. SAMHSA estimated that 58 percent of adults have a medical condition ...

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I sat across from her and in my most official yet trusting psychiatrist’s tone gave the spiel I delivered many times. “Amanda, I’d like to start you on a medication that might help your depression. Like every medication it can cause side effects, however, many people have no side effects or only have minor ones. This drug can cause weight gain, increased risk of diabetes, and increased risk of heart disease.” A ...

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Ms. C was one of my first patients with schizophrenia. I saw her on the inpatient unit of a psychiatric hospital where I was training as a psychiatry resident. Ms. C suffered terribly from what we call the negative symptoms of schizophrenia; she sat mute for much of the day in her bed, staring out of the window. She would occasionally respond to a question with a one-word response, but ...

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Polypharmacy was once the exception in psychiatry; now it seems to have become the rule. Patients frequently are taking 3, 4, even 5 psych meds at one time. And often it’s primary care doctors, not psychiatrists, who are doing the prescribing -- usually without adequate training in psychiatry. Some polypharmacy is rational -- e.g., a patient with bipolar disorder who receives the combination of antidepressant and mood stabilizer. But most polypharmacy is ...

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Psychiatry was my first clinical rotation, and I did not know what to expect when I began. When I initially got assigned to the dialectal behavioral therapy (DBT) team, I had no clue what that would entail beyond working with some borderline patients and that the preconception of borderline patients is that they can be “the most difficult” patients to help due to their intense emotional instability, chronic feelings of ...

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I’m looking at a pile of little boy clothes outside my back door this morning. It often looks like this if we forget to clean up. My kids shed their clothes almost as soon as they are home in search of water play of some sort: hose on the slide, sprinklers, water gun fights. They are supposed to put their clothes in the hamper. That obviously doesn’t always happen. This ...

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