Psychiatry - East and West
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November 21, 2011

Observations from India

These past few months, I've been working in India. The biggest challenge in India continues to be the stigma against mental illness. Many people are unwilling to take medications and interestingly develop profound side effects (the "nocebo" effect) and many patients try the medication only for a day or two before stopping it.

Consequently, I have had to try to treat depression and anxiety, and even the occasional case of OCD only with psychotherapy. What I find really surprising and gratifying is that psychotherapy alone is efficacious for many patients suffering from even moderate depression and anxiety.

Here are my observations about psychotherapy in India

1. A goal oriented, problem focused approach is effective, especially in those who have a hi...

Posted By: Shyam Bhat  

June 12, 2011

Treatment by Hearsay

Would you ever recommend a medication to a person you've never seen?

Posted By: Shyam Bhat  

June 12, 2011

War on Drugs

Suboxone (buprenorphone and naloxone) cannot be used as an intravenous drug of abuse right?

Posted By: Shyam Bhat  

April 5, 2011

The Chicken and the Egg: Axis I and Axis IV

What is the contribution of the environment -the larger “normative” environment, not the immediate familial environment  - on the causation of emotional distress?

We can get hints of the answer by studying the situation in India, a country that is changing rapidly from socialist to capitalist from collectivist to individualistic.

For the last 2 years, I have bee...

Posted By: Shyam Bhat  

February 21, 2011

February 1, 2011

Not Listening to Prozac

“I want to get off this medicine as soon as possible,” said the patient. She was in her twenties, and struggling with anxiety, and the medicine she was referring to was clonazepam.

Her desire to stop the medication is not unusual in Bangalore, but would have been a refreshing supris...

Posted By: Shyam Bhat  

October 16, 2010

The Mask of Extroversion

If there’s one feature of American society that is the most striking to an observer like me, it is that extroversion has become the norm.

Posted By: Shyam Bhat  

July 19, 2010

The Narrative

The patient, a middle aged man, smart, successful, self-deprecating, had symptoms of depression.

He had been diagnosed with depression many years ago, and was prescribed Citalopram. He took 40 mg, he said, for a few years and felt well as long as he was on the medication.

"I didn't feel sad or anxious and I slept well and most importantly I could focus on work. But then -...

Posted By: Shyam Bhat  

May 8, 2010

Medical School Chronicles: Depression in Tipu's Fort

It was the summer of 1995, Bangalore, and I was in my final year of medical school when one of my classmates, Imran (not his real name) began missing class. Now this was not considered a huge problem because many students  bunked  their classes and headed out to movies and lunches rather than listen to a monotonous lecture in a cavernous classroom.

But apparently, he had been ...

Posted By: Shyam Bhat  

April 8, 2010

Apathy and Acceptance

As with so many complex emotional states, “apathy” is easy to recognize but difficult to define.We know apathy when we see it – the impassivity, the indifference to the environment, the sluggishness, and the sense that the person is numb and disconnected with the environment.

And yet, a few centuri...

Posted By: Shyam Bhat  

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About This Blog

A blog that offers a cross cultural perspective of psychiatry, and psychiatrists.

  • Shyam Bhat

    Shyam K Bhat MD is an internist, and psychiatrist. He has lived and worked in England, the United States and India.

    His clinical and research interests focus on cross cultural psychiatry, and integrative psychiatry and medicine.

The content of this blog does not necessarily reflect the viewpoints of Medscape.
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