5+ hour, 23+ min ago   (834+ words) Patient details have been changed and combined where necessary to protect privacy. Then she stopped sleeping. The diagnosis cannot rest only on how a patient appears at the height of a crisis. Clinicians must also examine what happened before the…...

1+ mon, 3+ week ago   (297+ words) Physicians tend to view conditions affecting mental health as entirely different from those affecting the digestive system. Depression is managed in one clinic, irritability and constipation in another, and chronic fatigue somewhere in between. However, mounting evidence indicates that these…...

1+ mon, 4+ week ago   (472+ words) By most measures, the treatment was working. The symptoms had improved. Sleep was more consistent. The edge of panic had softened into something more manageable. The medications were tolerated, the therapy was progressing, and the follow-ups were steady. Antidepressants, for…...

2+ mon, 5+ day ago   (479+ words) One of the hardest parts of practicing psychiatry is that we still cannot reliably predict which medication will work for which patient. If this sounds primitive compared with the rest of medicine, honestly, it is. In oncology, treatment is increasingly…...

2+ mon, 1+ week ago   (238+ words) Psychiatric polypharmacy quietly folds side effects into the diagnostic picture. See why medication burden demands periodic reassessment, not more drugs....

3+ mon, 2+ week ago   (268+ words) A patient in his 20s recently came to see me in a state of severe distress. He described feeling consumed by his thoughts, constantly anxious, unable to function, and deeply exhausted. His sleep had collapsed. His sense of identity felt lost....

4+ mon, 1+ week ago   (130+ words) Depression is where the strongest evidence lives. Anxiety has fewer winners than the internet claims. Sleep is where people overspend and underthink. Schizophrenia is where false hope does real damage. What should patients and clinicians do now We need a…...

5+ mon, 1+ week ago   (592+ words) Almost every day, a physician says to me some version of the same sentence. It may sound like frustration about metrics. Or exhaustion. Or administrative opacity. But beneath it is something more elemental: “I am grieving what I hoped medicine…...