The unparalleled and pervasive nature of the evolving COVID-19 pandemic has touched all of us in some way. There is limited, albeit growing, research on the mental health effects of disasters.  A recent review article pointed out the potentially negative consequences of prolonged quarantine, while other research from Wuhan, China, highlighted the impact of COVID-19, particularly amongst healthcare personnel. Psychiatrists and mental health professionals will play a ...

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It is well known that physicians are more likely to screen positive for depression and have higher rates of suicide than their counterparts in the general population. But how is this fact exacerbated by the global pandemic of fear, anxiety, and mounting death tolls known as COVID-19? For starters, health care workers are at the front lines of the emerging disaster, having to ...

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I woke up today wearing the lead suit of grief. I was tired, irritable, and tearful.  I was angry at the lack of PPE and the risk that this poses to my colleagues.  I was sad, anticipating the loss of my colleagues who are still alive and well.  I was in denial, wondering if I could sneak my kids out of town for spring break.  But in reality, I was ...

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He was supposed to be the first patient of the day — not the last. He started as a "no-show" on an already overbooked afternoon office schedule. A gift of sorts, I thought, making clinic a little bit easier and a tiny bit quicker. But Jim showed up hours later in my waiting room. The front office staff asked if I was willing to squeeze him in, presenting me a ...

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The percentage of U.S. college students who are living with mental health issues, including depression, anxiety, eating disorders, substance, and alcohol misuse, and self-harm are significant. Approximately 39% of college students experience a significant mental health issue. The 2018-2019 Healthy Minds study found that:

  • 36% of the random sample of students from colleges and universities across the U.S. who answered the study’s web-based questionnaire had experienced mild, moderate or major ...

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I had my first full day of telemedicine today. Telemedicine is my happy place.  For the last two years, I have provided telepsychiatry for a rural facility in my home state. I had the privilege of talking to my patients in their homes today. I was beyond humbled that my patients embraced the change with me and invited me into their homes. As I saw them in their homes ...

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In light of the COVID-19 pandemic, people across the country are grappling with the question, "What and who is essential?" Instructions to reduce non-essential activity hit differently in crisis compared to our normal mindset that our day-planners are scheduled with only crucial tasks. When suddenly gyms, churches, and restaurants close their doors, one must reflect on what is truly indispensable. This hits home in my field ...

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In November each year, I usually attend an all-day conference in Louisville on the subject of depression. Some of it can become a little grim, but there is an especially tasty free box-lunch that I appreciate. Suicide is a big subject at depression conferences. One might expect this to be true. The focus is on suicide prevention, which is as it should be. The discussion is usually led by university professors, and ...

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Since the coronavirus outbreak, reports of anxiety have increased, especially among physicians. Physicians face numerous stressors, including fears of contracting the coronavirus, concerns about potentially infecting loved ones, PPE shortages, testing delays, and frequently making quick decisions with limited information. Common symptoms of anxiety are increased worrying about one’s self and/or loved ones, difficulty sleeping, difficulty eating, poor concentration, increased heart rate, hyperventilation, and struggling to control worrying. Here are five ways ...

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Past experiences should inform, but not determine, future action.  This has been much on my mind as we bolstered outpatient psychiatric services in response to the COVID-19 crisis.  The effort has felt deeply personal, as well as professionally imperative.  Waiting now for my own COVID-19 test results, keeping physical distance from my family, I suddenly lost focus and momentum.  For a fortnight, it seemed to take more energy ...

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In February, I had my first patient ask about my thoughts on the coronavirus. At that time, I was aware of the coronavirus and cautiously optimistic about the situation. My advice to the patient was to have a healthy level of concern about the virus, given the medical communities limited data on the virus. I instructed the patient on proper handwashing techniques since this is an issue, even for many ...

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One week ago, a mere glance at my phone between patients would have sufficiently caught me up on 30 minutes of disconnect from both social and mainstream media. Today, as I closed one virtual appointment and waited for my 9 o’clock follow-up to join me on-line, I was met with 16 texts, 148 WhatsApp messages, and four breaking news alerts from a variety of apps. Yes, I was thinking about ...

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Physician burnout. Physician suicide awareness. Buzzwords. Words that get tossed around. People in leadership seem to be concerned about. Institutions say they care. “Solutions” get created.  Solutions that look great on paper. Sometimes under the guise of the employee assistance program. The brochure says we care about your mental and emotional health. We get that life is hard. So we’re here to help. We’ll set you up ...

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Serving others My career path has been non-traditional, but my mission and values as a psychiatrist emerge from the traditions of medicine and religion. Although I studied visual arts in college, I was drawn to the challenge and meaning of a career serving others. Understanding patients During residency at Hopkins, I was trained in a psychiatry that recognizes that similar distressful mental symptoms can emerge from several different sources and that psychiatric disorders ...

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As I drove back home from the hospital yesterday, I noticed that traffic was lighter. Then tonight, as I walked my dog in the early evening, I cannot help but notice the lack of foot traffic, the relative emptiness of the street. There are others like me walking their dogs, but as I pass the popular coffee shop, I notice the quiet. It is not a calm quiet, but an ...

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Ed is not from Kentucky. I believe he told me he is from West Virginia and from a very low-income family. At about 15, he was hit by a car and paralyzed from the waist down. He's now about 30. But for a guy in a wheelchair, he is nothing short of remarkable for what he gets done. He goes everywhere, either by his own strength or by bus, even on ...

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I was busy running around the ER on a particularly busy shift when my phone buzzed, and a text message from Jane's ex-boyfriend David popped up on the screen. I was surprised since I had not talked to him in over three years; therefore, I ignored it until I had a moment to myself an hour later and finally opened the message. The first line of his message got straight to ...

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Is it time to rethink how we determine the capacity of our patients who are addicted to drugs?  I recently began debating this question after I took care of a young woman with endocarditis.  She had a long history of IV drug abuse that had led to the development of endocarditis.  She had been admitted one week earlier and was being prepared for surgery, but she left against medical advice ...

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Recently the Wall Street Journal reported on how many young people are now seeking "accommodations" at work for their anxiety, PTSD, depression, and other mental conditions. The article provoked a lively discussion split largely on age lines. While older people accuse Gen Z members of being "emotional hemophiliacs," Gen Z members often say they have real, palpable "mental illnesses" and need extra time to complete their ...

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It all began on Valentine's Day when I arrived at my office and listened to my messages from the afternoon before. There was only one from a nurse at the state mental hospital. She had just seen, she said, a Mr. Lonnie M. and was calling to alert me (there is a law to this effect) that Lonnie had expressed very hostile feelings toward me, quite specific in nature. He planned ...

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