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Mental illness has always been highly stigmatized. Mental Health Month and other awareness programs attempt to bring mental illness out of the shadows, yet many of those who should be leading the fight to de-stigmatize mental illness, my fellow physicians, continue to foster stigma through their actions and words. Many patients have been irreparably harmed by physicians from every area of medicine who don't read, don't listen, and don't care about mental illness.
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By Joe Farago, Executive Director Healthcare Innovation at Innovative Medicines Canada It's tough to talk about mental illness in the workplace. People worry about what their colleagues might think or...
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Families who care for people with schizophrenia once had an organization that gave them a national voice. They no longer do. This lack of national representation impacts not just our own situations; it also hurts the people we support, because they are often unable to advocate on their own behalf.
For last year's Bell Let's Talk Day I listed some reasons why we should be more open about our mental health struggles. But what happens when we do open up and seek treatment?
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The mental health of immigrants has been an abiding concern for policy-makers, health practitioners, as well as a small community of psychiatric researchers including myself. Indeed, activists pushed...
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Many believe pharmaceutical companies are repugnant. There were several serious issues that built the foundation of the anti-pharma movement. While not all companies are guilty or equally responsible, many behaved unethically. They didn't always fully disclose research and safety data if it didn't support their product. They attempted to prevent researchers from voicing serious concerns. They created inappropriate relationships with physicians, leaving the impression that doctors were being bought, and sometimes that was true. This had to change.
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The diagnosis of PTSD requires that a person has "...experienced, witnessed or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of self or others." The traumatic event must provoke intense fear, helplessness, or horror.
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Panic disorder is associated with anxiety that continues after the panic attack has resolved. Patients with panic disorder worry about having another attack or that they might lose control. Sometimes they fear they're suffering from a serious medical condition that hasn't been diagnosed. As a result, they change their behavior to avoid situations that might provoke another attack.
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People deserve to know and to understand what the Mental Health Act is about. They deserve to know the processes that are in place to commit someone against their will and to treat them. And they need to know the safeguards that are in place to prevent excesses and protect the rights of the individual.
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Some physicians are writing thousands of cannabis prescriptions every year for a wide variety of maladies. Many of their "patients" are not adequately assessed, nor are they informed about or encouraged to try conventional treatment options, which often have far more evidence for their safety and efficacy. Their "patient" wants cannabis and they get cannabis.
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Why do some teens find those years more challenging than others? Why do some teens make ridiculous, dangerous or inexplicable choices? One significant factor is rooted in brain development, a critical aspect of normal maturation. Unfortunately, sometimes brain development goes awry during adolescence resulting in mental illness.
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It pains me to hear the nonsense my patients are subjected to by sometimes well-meaning, yet utterly uninformed, self-taught mental health experts. Their lack of scientific training is merely a preamble ("I'm no doctor but..."). They speak with enthusiasm and authority as they peddle supplements, homeopathic tinctures, detox enemas and antioxidant smoothies, with the goal of liberating my patients from their evidence-based treatments and dollars from their wallets.
The trouble is, there is no recipe book for prescribing psychiatric medications. Every individual is unique, so with the guidance of their doctor, patients must find the treatment that's right for them. If a drug makes them feel worse, it's not the right drug, but that doesn't mean there are no other options. The right treatment must be found and sometimes that takes time, effort and creativity. Feeling like a zombie is never an acceptable outcome.
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Riley, a fictitious patient, was first depressed in high school. "I remember not caring about anything. I didn't see my friends. I just wanted to sleep. I seriously considered suicide. I had always be...
Depression is a libido killer. Our brain is our most important sexual organ and a depressed brain may cause a complete loss of sexual interest and make it difficult, sometimes impossible, to get or sustain an erection or have an orgasm. As depression resolves, usually sexual dysfunction resolves as well.
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Depression is horrible and sometimes it's deadly. Data from the World Health Organization demonstrates this serious public health issue. Yet depression is misunderstood by those who have never experienced it because they can't understand why depressed people don't just will themselves better.
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There is no single cause for schizophrenia. THC alone is not responsible, but there is an abundance of evidence that THC can provoke an earlier onset of schizophrenia by up to six years. There is also solid evidence to suggest a causal link between THC and schizophrenia.
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So why wouldn't mental health professionals want to talk to these families? Too often it is due to a misguided sense of the rules regarding confidentiality. Sometimes mental health care teams are over-extended and don't want to deal with the expectations of family members. Excluding family from important decision-making discussions leaves them frustrated and demoralized and is often not in the patient's best interest.
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One of the biggest complaints that families of the mentally ill have is the failure of the health system to provide them with information. Families provide ongoing care, support and housing,and yet the privacy legislation in most jurisdictions in both Canada and the U.S. prohibit staff from talking to them.
Our health system often divides mental health from physical health into distinct silos of care and treatment, yet no such mind-body duality exists in actual patients. Many individuals with chronic health conditions simultaneously experience mental health issues -- and the reverse -- and such "concurrent" health challenges are far from uncommon.
Two recent books by high profile psychiatrists provide readers with background knowledge that is essential in shaping our own responses to one of the biggest social problems of our times: severe mental illnesses. Now that psychiatrists are increasingly willing to enter into the messy public arena, it's up to the public to see what we can do with the information they are providing.
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Since 2001, Palestinian militants have launched thousands of mortar and missile attacks directed against the southern part of Israel, particularly the Gaza area. Most of the attacks have been directed...
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Mental illness is one of the biggest predictors of inequitable access to care in this country. We know that having a mental illness means that you are far less likely to get the healthcare you need than someone without a mental illness and that mental illness is a bigger predictor of poor access to care than low income.
Increasing insurance benefits increases access to private care, which has become a necessity in Canada. Those wanting psychological treatments must either choose between public care (ex: psychologist in a hospital) or private care (ex: psychologist in private practice). Unfortunately, there tend to be unreasonable wait lists for access to public care (typically one year or longer).
The best thing I ever did was to leave the academic texts behind and turn to memoirs written by people who live with mental illness. I don't know what brought me to this place -- maybe some vain hope that somewhere, someone else was experiencing what I was going through. And thankfully that's exactly what I found.
The death of comedian Robin Williams last month sparked a worldwide discussion about suicide, its underlying causes and how it might be prevented. And, with World Suicide Prevention Day taking place Sept. 10, the subject is certain to generate more debate as people seek to understand this important health issue. Having spent 10 years researching the subject while working as a professor of psychiatry, I believe there are things we can do as a community to tackle this problem. With that in mind, I thought it might be helpful to reflect on what researchers have learned over the years about strategies for preventing suicide.
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Lone-acting offenders were far more likely to have a history of mental illness than offenders who had been part of a group. Lone-actors with mental illness were also more likely to have a spouse or partner who was part of a larger movement (making them more vulnerable to outside influences) and to have parents who were divorced. Though offenders acting alone are often characterized as being "loners" without any real sources of emotional support, that doesn't appear to be the case.
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Previous reports stated that Maxim had a positive relationship with Massimo Maravalle and his wife Patrizia but questions are now being raised about what signs may have been missed. Other witnesses have reported that the suspect had been seen shaking Maxim a few days before his death although it is still unknown whether psychiatric problems contributed to his actions.
In Ontario, the fee schedule does not have limits on duration or frequency of visits. Changing that may be one way of opening up room for psychiatrists to see more patients. Another idea, adopted in Australia, the U.K and the U.S., includes shifting the psychiatrist's role to that of a consultant on a multidisciplinary team. In such a model, psychiatrists provide the initial diagnosis, oversee any pharmaceutical treatment, and work with a team of social workers and psychologists to provide psychotherapy, support and to monitor progress.
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They also found that patients who started smoking cannabis at age 15 or younger preferred to smoke high-potency "skunk" cannabis rather than lower potency "hash" type cannabis. The earliest onset of psychotic episodes occurred in males who have been smoking high-potency cannabis on a daily basis -- on average, their first psychotic episode occurred six years earlier than for non-users.
Let's make use of our churches in providing care for the mentally ill. Churches have been a refuge for hundreds of years. For many of us, places of worship are perfect for assisting in the care of the mentally ill because sometimes all one needs is someone to listen, a shoulder to lean on, a cup of tea, or a quiet place. Spiritual care is available to all, rich or poor, religious or not. And the infrastructure is already in place.
I have had many conversations with clients over the years where they tell me they've been feeling nauseous, panicky and depressed. The symptoms my clients describe are directly due to a reduction in, or complete termination of, their antidepressant medication. I hope the following advice is useful to patients.