Between Disorder and Demand
Adult ADHD, Cognitive Overload, and Practicing Psychiatry in the In-Between Photo by Gianfranco Grenar on Unsplash Between Disorder and Demand A few weeks ago, I was speaking with a PMHNP colleague who sounded unusually defeated. She wasn’t talking about patient acuity, staffing shortages, or reimbursement cuts. Instead, she said, almost apologetically, “I think I’m going to leave this practice. Every adult in this county thinks they have ADHD.” She wasn’t being dismissive.
Why I'd Still Choose Medicine-But Differently
The things about medicine that you don't learn in medical school... Photo by Gianfranco Grenar on Unsplash Why I'd Still Choose Medicine-But Differently Me as a newly wed new doctor with high hopes and ambition to conquer the world There are many things medical school teaches exceptionally well. It’s a four-year wide-open fire hydrant flood of information. There are also many topics it barely touches — even though they shape your life just as much or more as your clinical sk
Our Patients are Less Depressed-But More Empty
How depression changes with time, sex, and substances Photo by Gianfranco Grenar on Unsplash Our Patients are Less Depressed-But More Empty In recent years, an increasingly common clinical pattern has emerged across both outpatient and inpatient settings: many patients no longer present with the classic “deeply sad” and tearful depressive picture that once dominated diagnostic frameworks. Instead, many describe a pervasive sense of emptiness, an anhedonic inability to enjoy
What We Don't See, Even When We Are Trained to Look, Physician Grief
In memory of Nolan Williams, MD— research pioneer, colleague, friend Photo by Agence Olloweb on Unsplash Physician Grief My friend and colleague Dr. Nolan Williams died by suicide last year. Upon hearing the news, my first reaction was not shock in the way people usually mean it. It was pure disbelief. Complete cognitive dissonance. The facts did not match the reality. As both a psychiatrist and neurologist, Nolan was not only respected—he was transformational to modern inte
Understanding Co-Occurring Disorders: Why Integrated Treatment Is Essential for Recovery
It's a core feature of the human experience...not a flaw. Photo by Sydney Latham on Unsplash What Are Co-Occurring Disorders? Co-occurring disorders—also known as dual diagnoses—refer to the presence of both a substance use disorder (SUD) and a mental health condition in the same individual. This combination is far more common than most folks realize. In fact, more than half of those who experience a substance use disorder will also experience a mental illness during their l