“Antidepressants have limitations. Not all patients respond to them or can tolerate the side effects. Alternatives, such as Bikram yoga, “may be more feasible and more acceptable for a lot of patients,” said David Mischoulon, M.D., Ph.D, A Psychiatrist at Massachusetts General Hospital.
Having a demanding job over which one has little control may raise the risk of developing common mental disorders in midlife, new research suggests.
The term “narcissism” has seized the popular culture in the last couple of years in a way that few might have imagined 10 years ago. Yet psychiatrists and mental health professionals continue to find the diagnosis of narcissistic personality disorder (NPD) a vexing challenge that produces a good deal of discontent.Does pathological narcissism denote too much self-love? Profound insecurity? Low self-esteem? Too much self-esteem? Selfishness? Aloofness? A conviction that one is smarter, better looking, more fashionable, or better connected than others? Incapable of tuning in to what others are feeling or thinking?
Used as an adjective, “narcissistic” may refer to someone who is thoroughly unpleasant and obnoxious, someone who bristles easily and is sensitive to slights, or someone whose success and confidence are envied.
Varenicline, bupropion, and the nicotine patch pose no more risks of heart attacks, strokes, or other major cardiovascular complications than placebo, even among smokers with psychiatric illness.
Every physician who cares for patients today has the same complaints: too many patients scheduled, not enough time spent with patients, too much time spent documenting care in cumbersome systems and defending our decisions to nonclinicians in the insurance industry, too much administrative oversight—the list is long.
The reasons we were inspired to become doctors—to care for patients, to use our scientific knowledge, to influence individuals and society to be healthier and to have some autonomy in our professional lives—have been crushed beneath the heels of economic imperatives. We did not set these conditions, but we are captive victims of them.
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