Dr. Eric Nestler, M.D. believes that when it comes to treating depression, we should be doing better. Less than half of those with depression get better after receiving maximum treatment. Dr. Nestler describes depression as a broad syndrome hat involves many different diseases. Because the specific causes of depression cannot be identified, this disorder is difficult to treat. In order …
Effects of Vitamin D on Mental Illness
Current Psychiatry posted an article suggesting that vitamin D levels are related to different mental illnesses. Although more than 50% of psychiatric patients are reported to have vitamin D deficiencies, there is still not enough evidence to say that vitamin D supplementation will help with symptoms. One way vitamin D enters our systems is through exposure to sunlight. UV radiation …
Check Your Wallet
Recently, we were writing about the bias that practitioners have that the technique that they they have mastered is the most effective treatment for any condition. We were reminded of this issue very vividly this morning when we met up with one of our favorite people, an older man who has been seeing us for a couple of years. He …
DSM5
In the next few days the American Psychiatric Association is meeting in San Francisco and will announce the latest version of its diagnostic and statistical manual: DSM5. Tom Insel, the Chief of the National Institute for Mental Health, created quite a stir last week by seeming to announce that the new diagnostic manual was an emperor with no clothes. The …
Parallel Universes: The Duality of Hopelessness and Optimism
It’s hard to explain how it is possible to go from a state of complete hopelessness and a sense that the universe is profoundly hostile, to a state of optimism and and the experience of receiving support from the world and others within a single day. The fact of the matter is that it often seems as though there are …
Phew… That’s Done: Sustaining Attention
It is such a relief, after worrying about some health problem for a long time, to suddenly realize that that problem no longer needs acute and urgent attention. This is as true for an ankle or knee injury in sports as it is of anxiety or depression, or any other mood state that impairs our ability to function. There is …
Depression and Heart Disease: Inflammation
A large study published in April of 2013 in the journal Psychoneuroendocrinology followed 667 people with heart disease for 5 years and found that depression appears to lead to inflammation rather than inflammation leading to depression. Excessive inflammation is one of the main causes of heart disease, because it is associated with blockages in the blood vessels that deliver blood to …
Iron for PMS
A recent study suggested that women who consumed higher amounts of iron (from plant not animal sources) had a lower rate of premenstrual symptoms. Those who consumed more than 20 milligrams per day had about a 30% reduction in PMS symptoms compared with those who consumed less than the average amount (average intake of 9.4 milligrams per day). This study …
Escape from Depression
I met a young woman yesterday who got me thinking about the reasons why I feel so strongly about the work I do as a psychiatrist, helping people with chronic mood problems. She came in for help with what she described as a “mild but chronic depression.” She had already seen one psychiatrist, and he had not been terribly helpful; …
St. John’s Wort
St. John’s Wort is a plant which has been shown in many well controlled clinical trials to be more effective than placebo in treating mild to moderate depression (not transient sadness). In fact the evidence supporting its effectiveness is better than the evidence supporting the effectiveness of some FDA approved anti-depressants. It does not, in our experience, work as well …
The Gift of Hope
I have never been able to find the short article in the Journal of the American Medical Association that talked about a miraculous treatment for many ailments of the human mind and body… The article was about “hope.” When we have it there is hardly any problem we can’t tackle, and when we lack it every challenge seems insurmountable. This …
Trojan Horse Medications
From time to time we are asked to review the care that people with cycling moods have received, trying to figure out, from a complicated story of medication changes and mood cycles, what to do to get someone out of a period of deep pain and dysfunction. A few years ago I did such a review on a young man …
Fish Oil Update
Since so many people with bipolar and depression take fish oil we thought we would pass on some information in a summary form from Consumer Labs. The full information is available if you subscribe. Consumer Labs is the only source of reliable information about supplements (the only place that does any testing) and if you take supplements we strongly encourage …
A Protest
So many of us have to deal with things that are not fair – depression, unsupporting spouses, financial reversals, weight gain, etcetera, it can be tempting to launch a protest of some kind against the unfairness. These protest actions don’t have to be obvious at all, but they can have powerful effects, nonetheless. A few women recently told me, “I …
Drug Companies
This blog has mostly not dealt with questions related to medications for treating mood disorders. When we looked around to see what was out there on the Internet, it seemed to us that there was no dearth of information about medications. The problem was finding reliable information about non-medication approaches to living with moods. This morning I met with an …
Mistrust in Action
I was talking to one of my clients, a very bright and wonderful woman, mother of a delightful young girl, and usually one of my favorite people. This visit, however, I began to experience the cycle of mistrust. When she came in I was in a good mood, I smiled and said hello. She looked serious. The last time we …
What If It Works?
For a number of years after I first got started in psychiatry I wrestled with the dilemma of what to do when someone with severe, disabling depression came in for an evaluation, seemed to be an excellent candidate for treatment with an anti-depressant, but was completely preoccupied with potential adverse effects and focused almost entirely on all of the negative …
Stigma and Psychiatry
I ran across an article written by a columnist for the New York Times a couple of days ago about what the columnist felt was psychiatry’s “overreaching” (saying that some people who are bereaved may also have a major depression). The article made reference to Michel Foucault’s view that psychiatry is essentially all about making moral judgments on behalf of …
Tripolar Disorder
For a long time I have been trying to figure out how to convey to the people I work with the view of mental health professionals that a certain type of depression is really a kind of mania, called “mixed mania.” From an “objective” standpoint, this makes a lot of sense. A mixed state generates lots of energy and agitation. …
Mary Poppins: Overcoming the Winter Months
What I most want to have available to me in the long winter months, to help me with my patients with bipolar and depression, is access to someone a lot like Mary Poppins. You may remember that Mary, played by Julie Andrews, was the incredibly cheerful nanny who transformed the unhappy and dysfunctional lives of the family she joined. What …