Free Associations
Blog Address: http://blogs.medscape.com/nassirghaemi
September 7, 2015

Does trauma lead to PTSD?

It's a poorly appreciated fact that most people who experience legitimate severe trauma do not go on to develop post-traumatic stress disorder (PTSD).  In fact, studies suggest that about 80-90% of persons who experience trauma, such as the 9/11 attacks, don't later develop PTSD on a long-term basis.

The tenuous relationship between trauma and PTSD is anatomically...

Posted By: Nassir Ghaemi  

June 9, 2015

Dementia: Think vascular

Usually when we think of dementia, we tend to think of Alzheimer's disease (AD).  Drug companies have spent two decades trying to tweak the products of the apo E4 gene to treat AD, without success. But it doesn't tend to be appreciated that about one-half of all dementia is vascular dementia, the product of small vessel disease. 

The importance of vascular dementia partly has ...

Posted By: Nassir Ghaemi  

April 1, 2015

Suicide in April, an eyemask and low-dose lithium,

In my last post, I wrote about raising the shades to help with winter depression.  Now I want to emphasize the need to reverse course:  Pull the shades down, and/or wear an eye mask, to reduce light exposure.

People often think about winter depression, but they don't worry about spring/summer mania.  The two things are connected.  What goes up must come down.  T...

Posted By: Nassir Ghaemi  

January 12, 2015

Raise the shades: A simple solution in Seasonal Affective "Disorder"

In recent years, I've noticed that a simple approach that can help Seasonal Affective "Disorder" is to raise the window shades in the bedroom. 

The problem with SAD is that light decreases in the fall and winter, and people with mood illnesses are especially sensitive to light.  So they become depressed.  The light which is lost is at dawn and at dusk.  What matters ...

Posted By: Nassir Ghaemi  

August 8, 2013

The psychological fallacy in psychiatry

How many times has a patient told me, when I asked about depressive or manic symptoms: "Yes, but I was depressed because of x, y, and z"? Or "I get manic when I get really interested in things"? 

How many times have I seen psychiatrists downplay a mood illness diagnosis because they were associated with many psychosocial stressors?


Some critics of psychiatry, especia...

Posted By: Nassir Ghaemi  

August 5, 2013

The genetic fallacy in psychiatry

Recently I visited a venerable senior colleage in our profession, a psychiatrist at a very prestigious institution who has held the highest professional posts in our field in previous decades. Now in semi-retirement, he asked me, "Why do you think those old German psychiatrists, like Kraepelin, had it right?" "Why do you think they got it wrong?" I replied.


"Because after 100 yea...

Posted By: Nassir Ghaemi  

August 5, 2013

The biological fallacy in psychiatry

Frequently, when I express some skepticism about the diagnostic validity of constructs like adult ADHD or borderline personality, I receive variations on the following rejoinder: "But they cause changes X, Y, and Z in the brain, as shown in neuroimaging. How can you ignore that? Isn't that proof that they are "real", that they are biological diseases."

I suppose that would be the case ...

Posted By: Nassir Ghaemi  

May 2, 2013

Borderline or bipolar II?

It interests me that many psychotherapeutically-oriented clinicians seem to think that borderline personality disorder and type II bipolar disorder are very similar. Some of this presumption has to do with the word "disorder". Well a disorder is a disorder is a disorder. So they must be somehow ontologically equal. But are all DSM "disorders" equal? Schizophrenia has been defined for two ce...

Posted By: Nassir Ghaemi  

April 16, 2013

Profiles of the past: R. D. Laing

Psychiatry has a past. It didn't begin with the watershed year of 1980 and DSM-III.  I will try in some posts to discuss some of our past as it relates to our present.

Here I want to introduce readers to Ronald D. Laing, a Scottish psychiatrist prominent in the 1950s and 1960s.  His most famous work is

Posted By: Nassir Ghaemi  

March 27, 2013

Adolescent suicidality: It's not normal

When Martin Luther King was about twelve years old, he jumped out of the second story window in his family home after his grandmother died.  Was that a suicide attempt? Does it predict anything psychiatric? 

We want to say no, not just for Dr. King, who grew up to become a great leader, but also for many adolescents:  We tend to say, when adolescents seem especially moody...

Posted By: Nassir Ghaemi  

 
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About This Blog

A view of psychiatry from the inside. Nassir Ghaemi, MD, MPH, provides insights and current updates on events and studies in psychiatry.

Nassir Ghaemi, MD, has disclosed the following relevant financial relationships in the last 12 months:
None



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  • Nassir Ghaemi

    Nassir Ghaemi, MD, MPH, is Professor of Psychiatry at Tufts University School of Medicine and Director of the Mood Disorders Program at Tufts Medical Center. His most recent book is On Depression: Diagnosis, Drugs and Despair in the Modern World (2013).  Previously he published A First-Rate Madness: Uncovering the links between mental illness and leadership (Penguin Press, 2011).  He also has written The Rise and Fall of the Biopsychosocial Model: Reconciling Art and Science in Psychiatry (2009); A Clinician's Guide to Statistics and Epidemiology in Mental Health (2009); The Concepts of Psychiatry (2007); and Mood Disorders: A Practical Guide (2007). 

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