MIND-BODY INTERACTIONS IN PATIENTS WITH A CANCER DIAGNOSIS.
The age-old split of mind and body may be gradually closing as general medicine is becoming aware of the impact of stress and emotions on health and disease.
read moreWHAT THE INITIAL PSYCHIATRIC EVALUATION LOOKS LIKE
Many patients, when they first set up an initial appointment, are mystified as to what will happen in the first session. That initial session looks very similar to the way a visit to a general physician might be structured.
read moreOn assisted suicide.
This topic has been debated, at times hotly, over 10 to 20 years or longer. There are ethical and philosophical questions tied up with this topic and people are either against or in favor of it, depending on which side of the fence they are sitting. It is beyond question that if one is in the situation that is appearing hopeless that one wants to get out, with assisted suicide as one of the frontline options.
read moreThe loss of the psychotherapy
Psychotherapy is now being practiced less and less since psychiatry has abandoned this treatment method in favor of medication management. We have seen this phenomenon before when a new form of treatment was discovered.
read moreSeattle Has Figured Out How to End the War on Drugs
SEATTLE — On gritty streets where heroin, fentanyl and meth stride like Death Eaters, where for decades both drugs and the war on drugs have wrecked lives, the city of Seattle is pioneering a bold approach to narcotics that should be a model for America. Anyone caught here with a small amount of drugs — even heroin — isn’t typically prosecuted. Instead, that person is steered toward social services to get help. This model is becoming the consensus preference among public health experts in the U.S. and abroad. Still, it shocks many Americans to see no criminal penalty for using drugs illegally, so it takes courage and vision to adopt this approach: a partial retreat in the war on drugs coupled with a stepped-up campaign against addiction. The war on drugs has been one of America’s most grievous mistakes, resulting in as many citizens with arrest records as with college diplomas. At last count, an American was arrested for drug possession every 25 seconds, yet the mass incarceration this leads to has not turned the tide on narcotics. The number of opioid users has surged, and more Americans now die each year from overdoses than perished in the Vietnam, Afghan and Iraq wars combined. And that doesn’t account for the way drug addiction has ripped apart families and stunted children’s futures. More than two million children in America live with a parent suffering from an illicit-drug dependency. So Seattle is undertaking what feels like the beginning of a historic course correction, with other cities discussing how to follow. This could be far more consequential than the legalization of pot: By some estimates, nearly half of Americans have a family member or close friend enmeshed in addiction, and if the experiment in Seattle succeeds, we’ll have a chance to rescue America from our own failed policies. In effect, Seattle is decriminalizing the use of hard drugs. It is relying less on the criminal justice toolbox to deal with hard drugs and more on the public health toolbox. Decriminalization is unfolding here in part because of Dan Satterberg, the prosecuting attorney for King County, which includes Seattle. It’s also arguably underway because of what happened to his little sister, Shelley Kay Satterberg. At the age of 14, Shelley ran away from home because her parents wouldn’t let her go to a concert on a school night. It was a rebellion that proved devastating. She was away for several months, was gang-raped by two men, was introduced to hard drugs and began to self-medicate with those drugs to deal with the trauma of rape. As Dan Satterberg rose through the ranks of prosecutors, Shelley Satterberg wrestled with addiction. She was never arrested or jailed (middle-class drug users often avoid police attention, which focuses on marginalized people who use or sell in public). Dan told me that he was angry at Shelley — angry that she had made terrible choices, angry that she had hurt their parents. But over time he also concluded that his own approach of prosecuting drug users accomplished little, except that it isolated them from the family and friends who offered the best support system to escape addiction. In 2015, Dan took Shelley to Navos, a nonprofit that provides mental health and addiction services, and she was able to...
read moreHealthy lifestyle may cut risk of dementia regardless of genes
A healthy lifestyle that includes regular exercise, a balanced diet, not smoking and watching alcohol intake could reduce the risk of dementia – even in those with a genetic predisposition to such conditions, researchers say.
Recent figures suggest there are 850,000 people living with dementia in the UK, and it is the leading cause of death for women in England. Many studies have indicated that lifestyle changes can reduce the risk of developing such conditions. A recent report suggested a third of cases could be prevented by tackling factors such as exercise, blood pressure, hearing and diet. In May, the World Health Organisation released guidelines on how to lead a brain-healthy lifestyle.
read moreWhy Did So Many Women Vote for Roy Moore?
On Monday, December 13, 2017, it became known that Doug Jones, a Democrat, had defeated Roy Moore, a Republican, in the traditionally Republican state of Alabama, for a seat in the US Senate. Mr. Moore seems to be, let’s charitably say, a colorful character.
read moreCancer and the Power of Placebo
An interview with author Dr. Paul Offit gives us some insight into the placebo effect, and its place in alternative medicine, complementary medicine and traditional, evidence-based medical treatment…
read moreWhy We Shop
I recently read an article about shopping (on Medscape.com) and the psychology of consumption that I think is very relevant to life in our modern world. The article was an interview with consumer psychologist Kit Yarrow, PhD., who talks about the neuropsychological influences of shopping. As the holiday season commences and shopping is a fact of life for many of us, I think the points she makes are important to keep in mind. Dr. Yarrow specializes in the study of consumers and the psychology behind shopping, and she has published her findings in a recent book entitled “Decoding the Consumer Mind”. (Available here on Barnes & Noble). One of the most important points Dr. Yarrow makes is this one: The motivation for almost everything we buy has something to do with connecting with other human beings. Even when it comes to practical purchases, the particular brand or product we choose relates to our connections with other human beings. She goes on to say that there has been a shift in our society towards loneliness, anxiety, societal anger and individualism… all emotions which are relieved in the shopping process. She says that as a society, we have more anxiety and less support from our community. This creates an environment of anxiety when we are shopping, and in that type of environment, we process information differently. People tend to start from a position of mistrust, and the vendor has to do more than ever before to win our loyalty and attention. Dr. Yarrow goes on to say that we tend to use shopping as a way to calm our anxiety and prepare for events. As we shop, we visualize our future with the product we are shopping for and this is almost like an athlete who is visualizing to enhance his or her performance. She says that shopping is also a way to express creativity. When we shop online, it’s a way to take a break from our everyday world as well. And then there is the hunt for bargains. Dr. Yarrow validates that there is a dopamine spike… a pleasurable experience… that comes from shopping and finding a bargain. That can account for the addictive quality that some people feel with shopping. When asked about the Black Friday shopping phenomenon, she says there are some people that see shopping almost as a competitive sport and go out looking for the fabulous bargain. But most people, she says, are either using shopping as a way to connect with family (it’s a tradition to go shopping together), or if they are alone, it’s a way to get out and connect with other people. Dr. Yarrow points out that in a Black Friday shopping situation, the stress and excitement put the shopper in a vulnerable position due to “the autonomic nervous system arousal that accompanies being in crowded, stressful places or experiencing a fear of missing out.” She always encourages people to wait 20 minutes before they buy something, allowing their brain to re-engage and their emotions to subside. Vendors are wise in the ways of attraction and how the brain works these days. They use odors, music and symbolic clues to attract the buyer and get them to make a purchase. They know that people are more likely to buy something if...
read moreDepression Types
Here is my personal view of the different personalities of depression, and possible treatments for each of them. The most prescribed antidepressants today belong to a group of medications called the SSRIs. To this group belongs Prozac, Effexor, Zoloft, Celexa, Lexapro, Paxil and others. Depression (excluding psychotic depression) seems to come in two flavors: low energy depression or its anxious cousin. The type of depression you are experiencing should dictate your choice of medication. In addition to recommending psychotherapy, which is a crucial treatment component for sufferers of depression, when you come to me as a patient, I may decide to prescribe one of the SSRIs. In my view, it is important to match the pharmacologic effect of a particular medication with the type of depression being experienced. The SSRIs each have their specific spectrum of effects. Prozac and Effexor tend to energize patients. Paxil, on the other hand, often has a calming effect. Zoloft, Celexa and Lexapro produce a more neutral effect. They may energize or calm, depending on a patient’s own biochemistry and sensitivity. Therefore, if you come to me with an anxious depression, I would probably prescribe one of the middle-of-the-road antidepressants or I might prescxribe Paxil to calm your anxiety. Taking a more calming antidepressant may also keep you from having to take a sedating medication such as Ativan, Xanax, Buspar or Valium, as the calming effect you are looking for is already built into those particular SSRIs. For the low energy depression, on the other hand, Prozac and Effexor might work better. Usually, I try to avoid giving an anxious patient an energizing SSRI because they may experience the energizing effect as an increase in anxiety. Obviously, this is something we will try to avoid. Despite the science involved, prescribing psychiatric medications is still an art where intuition and experience play an important role in making the right choice. Every physician will approach this task differently and each patient’s body and mind will respond differently. It is important to keep this in mind as you and your physician search for the correct medication that will relieve your unwanted symptoms of depression. In the end, your body and mind will make the best...
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