It seems appropriate to write about an aspect of recovering from disaster. We have been through an extraordinary period of natural and human caused disasters these past few months. And while every experience is different, one thing that successful recovery requires, is the capacity to reengage with the world as it is, and with a sense of the possibility of …
An Epidemic of Fatigue
Several of my patients reported odd changes in their sleep and their energy level this past week, as though there was an epidemic of fatigue going around. They noted that their sleep was a bit more disrupted and that they didn’t feel as rested in the morning and, for the first time in months, they began taking afternoon naps. Going …
Increased Alcohol Use in the US
A detailed and impressive study finds dramatically increased alcohol use disorders in the US in the past decade. Between 2001-2002 and 2012-2013, regular high-risk drinking increased by almost 30%, and the number of people meeting criteria for alcohol use disorder grew by 49.4%. What else do we know about the health of Americans in the past few years? We know …
Exercise Solutions to Roadblocks
I was inspired to write this post on exercise solutions by a wonderful article in BP Hope that not only talks about reasons for making sure that you are exercising but also tries to overcome some of the barriers to making this change. You already know why Exercise is critical for brain health Exercise and physical activity is the most …
Travel Preparation for Bipolar
Travel and mood are very much related. Often a trip is associated with a significant change in mood. This can be…
Psychotic Experiences in Normal People
Worldwide Study Finds some People without Mental Illness Report “Psychotic” Experiences Psychiatrists tend to assume that certain experiences are a clear sign of mental illness. These experiences include psychotic experiences such as hallucinations (hearing voices, seeing visions) and delusions (beliefs that are contrary to “consensual reality” for example the belief that one is being plotted against, or that thoughts are being …
Jet Lag Explained
What is “jet lag” and why do most people feel worse when they travel around the globe in one direction, rather than the other? An article in the journal Chaos, summarized in the New York Times, suggests an answer. And offers some hope that you can reduce the severity and duration of the symptoms. For people with mood disorders, this …
Secrets are Dangerous
A young, attractive, and very successful man who recently got married came in to see me the other day and told me that he was in recovery from sex addiction. That caught my attention and, I have to admit, living as I do in a very mental health oriented world, made me wonder if this was an example of over …
TV Watching Leads to Impaired Cognition
How can we build up foundational, long-lasting healthy habits while young? We know it’s important—a perennial question, if not one we face day-to-day. By building those habits early on, we can set ourselves up for healthier living long-term, and place our children on a better track for a healthier, more positive adolescence and early adulthood. In fact, the habits we …
Insomnia Causes the Munchies
In an article that appeared in the journal SLEEP in February, 2016, and which was summarized in a New York Times post entitled “Poor Sleep Gives You the Munchies,” researchers report that one way that poor sleep and insomnia may lead to weight gain is that insomnia increases activity of the endocannabinoid system in the brain, the part of the …
Hidden Psychosis
In the last six months I’ve had a couple of experiences that I’m still trying to make a sense of. Two very bright and personable women who seemed to have everything going for them, who both have bipolar, revealed to me that they have been suffering from severe symptoms that they had not told me about, symptoms which suggest that they really …
Adult ADHD
Adult ADHD May Be Distinct From Childhood ADHD Attention-deficit/hyperactivity disorder (ADHD) in children may be distinct from and unrelated to ADHD in adults, according to a study in the American Journal of Psychiatry. It is long been understood that adult ADHD is the natural extension of childhood onset ADHD. In other words that adults with ADHD began as children with …
Psychopharmacology and Psychobiology
The wonderful thing about having two blogs (www.moodsurfing.com and www.gatewaypsychiatric.com) is that there are two sets of readers for the articles that I post. The problem is that sometimes I’m much more prolific in one area or another. For whatever reason, I have been writing more regularly on the Gateway Psychiatric website, which is where I post articles related to …
Antidepressants in Pregnancy and Autism
Antidepressants in Pregnancy: Is Excess Risk for Autism Spectrum Disorder Believable? Journal Watch Psychiatry editor, Allison Bryant, MD, MPH, reviewed a recent article on this topic Boukhris T et al. JAMA Pediatr 2015 Dec 14. In this study the risk for autism spectrum disorder appeared to be higher in those women who used antidepressants (especially SRIs) during late pregnancy; but the question is whether maternal …
Pregnancy and Mental Health
Pregnancy and mental health problems – how to reconcile the two – are often topics of discussion on this website and in my clinical practice. In the past we have often referred people to Vivien K. Burt, MD, PhD, Professor Emeritus of Clinical Psychiatry and the Director of the Women’s Life Center at UCLA and the Massachusetts General Hospital Center for …
Mood Charting for Complicated Problems
Lucy is a single woman who is a professor of anthropology at a local university. She is in her late 30s and she was referred to me for a consultation because of a complicated set of potentially interrelated problems with cognitive impairment, sleep disruption, anxiety, depression, a seizure disorder, and migraine headaches. She’s an interesting person and I really wanted to help her figure …
Omega 3 Prevents Psychosis
The Omega – 3 supplementation story seems to take many twists and turns. At one point, based on double blinded controlled study published by Andy Stoll, et al, from Harvard, in JAMA Psychiatry in 1999, it looked as though omega 3 fatty acids would turn out to be a very effective treatment for bipolar, with almost no side effects. Subsequent …
Distress Tolerance
A wonderful young woman we have been seeing for a few months asked for some recommendations for skills to help her deal with her experience of moments of overwhelming negative emotions that often seem to come out of nowhere. This post is a relatively quickly pulled together document derived from Marsha Linehan’s Dialectical Behavior Therapy. Think of it as a “draft” …
Our Relationship to Pain, Matters
Chronic pain can significantly affect our lives. It can result in not being able to engage in activities we loved to do. It impacts our relationships with loved ones. The limitations brought on by pain, can lead us to question our identity and certainly our quality of life. Years ago, I worked with a gentleman (we’ll call him Marcos) who was …
Travel and Mood
Travel and mood are very much related. Often a trip is associated with a significant change in mood. This can be due to many factors. Getting out of a rut, experiencing new locations and meeting new people can bring you out of the depression. However there is also the possibility that travel may disrupt circadian rhythms in a way that leads …




