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Showing posts from October, 2019

Spiritual Practices for the Dark Night - Giving Thanks. Again.

This post transitions from a month dedicated to PsychiatricTimes.com  to a month dedicated to gratitude. In short, I am grateful for Psychiatric Times. When I needed to figure out what the hell happened to my brain and how do I fix it, this online magazine for psychiatrists and other mental health professionals began my slow, steady self-education with its research reports, book reviews, philosophical discussions and occasional rants.

Mmm, sort of like Prozac Monologues: information, provocation, entertainment, and an occasional rant. That's how Google describes this blog. What do you think?

In the month of November, I will write posts about other resources and people for whom I am grateful. Today I repeat a post from ten years ago, part of a series on Spiritual Practices for the Dark Night. Those were dark nights, indeed, for me. These days, I think they are dark nights for everybody. But I digress...

From December 30, 2009, Spiritual Practices for the Dark Night -- Giving Thanks:

I …

The Brain Science of Caffeine

It's Pumpkin Spice Latte Season -- what better time to pour a cup of Caffeine: Neurological and Psychiatric Implications? It's the next up in my PsychiatricTimes.com Appreciation Month.

Sergi Ferré, MD, PhD offers this continuing education course for doctors and other health care providers. The goal of this activity is to provide an understanding of the mechanisms involved in the innervating effects of caffeine and the impact that caffeine may have on psychiatric disorders.

So settle in to learn about your favorite beverage.

Disclaimer: Though I have read the thing many times and looked up many big words, I cannot honestly say that I have satisfied all of the learning goals. Specifically, I cannot:
Explain the adenosine-dependent modulation of striatal dopamine and glutamate neurotransmissionnor
Describe the adenosine-dependent modulation of glutamate neurotransmission in the amygdala.Good thing I don't need the grade.

Nevertheless, I gleaned a few fun facts which I will share w…

Trading Symptom Relief for Side Effect Relief

Why do people stop taking their psych medication?


Psychiatrists spend a lot of time on this question. They used to call it noncompliance. Then they figured out that the word fed the power struggle between doctor and patient. Now they call it nonadherence. Me, I am not convinced that the word change reflects an attitude shift on doctors' parts, i.e., that they have changed their attitudes toward noncompliantpatients,haveabandoned the power struggle themselves, and instead want to partner with their patients. I suspect the word change is a cosmetic shift designed to change the patient's attitude.

Psychiatric Times regularly publishes articles on why patients don't take their meds and best practices for improving adherence. Suboptimal adherence is pervasive among individuals with chronic health conditions, including psychiatric disorders... However, many mental health practitioners ascribe nonadherence to the mental illness itself.

Xavier Amador thinks it is because we don't…

Physician-Assisted Suicide for Mental Illness - It's Complicated, or Not

Two years ago, Mark Komrad attended and presented at a symposium in Belgium on physician-assisted suicide for people with mental illness. Komrad is a clinical psychiatrist, ethicist, and faculty member at Johns Hopkins. He just finished a 6-year tenure on the APA Ethics Committee and helped craft the current APA position on Medical Euthanasia for non-terminally ill patients. [That position joins the AMA to say, in a word, Don't.]

Komrad reported back on his experiences to PsychiatricTimes.com. You can read or listen to the his entire report here. This post quotes the parts that particularly struck me from a suicide prevention perspective.

In 2002 Belgium legalized euthanasia by physician (typically by injection) at the request of patients, and removed any distinctions between terminal vs. nonterminal illness, and physical vs. psychological suffering. As long as the condition is deemed "untreatable" and "insufferable," a psychiatric patient can be potentially elig…

Got Bipolar 2? Chris Aiken Can Help

If you want to know best practices for treating bipolar, "bipolar not so much," recurrent depression, "more than depression," "something-about-this-depression-treatment-just-isn't-working," read  Chris Aiken.

When I needed a subtitle for my book, I tried really hard to sell my publisher on What if it's more than depression? - a subtle reference to Bipolar Not So Much by Aiken and Jim Phelps, who is another of my mental health go-to resources. I flatter myself that Prozac Monologues is the companion piece, written from the other side of the prescription pad. The publisher had something else in mind, but if you find one book useful, you will like the other.

When my new nurse practitioner talked me into a chart review by the cookie cutter psychiatrist employed by the practice, the recommendation came back, Abilify and Zoloft. I said, No thanks, and sent her an article by Aiken. I hope it helps my NP get over her Free-Range Bipolar on Aisle 2(i.e., no…