The Ghaemi Psychiatry Podcast

Some questions for conversation in the chat and discussion:

Dr. Oepen identified his favorite thinker in the field as Dr. Oliver Sacks, a neurologist. What do you think about his choice?

The worst idea in psychiatry was the ideas of blaming the mother for mental conditions. Many clinicians, especially trained in the Freudian tradition, still tend to blame parents for the problems of their clients. Why? Is this acceptable?

Dr. Oepen’s family suffered from the Nazi regime, and resisted it. Yet he was blamed by some people throughout his life for being German. Discrimination occurs in people where we might not realize it is occuring, such as in his case, a person outsiders might simply see as a priviliged white male. How does this observation affect many of our assumptions today about discrimination?

An important psychiatric teacher in his life was Dr. Rudolf Degkwitz? Who was he? Read more here: https://en.wikipedia.org/wiki/Rudolf_Degkwitz

And he mentioned Dr. Kurt Goldstein, as an important influence. Who was he? Read more here: https://en.wikipedia.org/wiki/Kurt_Goldstein

About a year ago, I got to know General Gregg Martin. A decorated combat leader from the Iraq war, he had been forced to resign as president of the National Defense University about a decade ago, because of a severe manic episode. Up to then, he had a decades-long career as a successful military leader. His manic episode was followed by severe psychotic depression, psychiatric hospitalization, mistreatment with multiple antidepressants, and eventual full recovery on lithium. About a decade later, he’s telling his story in his new memoir, and on this podcast.

Listen to his incredible experience.

Buy Bipolar General here

An excellent gift just in time for the holidays!

Ketamine and psychedelics are getting a lot of hype, but they won't live up to it. This episode explains why, the main reason being that these treatments are just symptomatic, like tylenol or aspirin, and not disease-modifying. They thus don't have long-term benefits. They are like super-tylenol, which is not transformative for psychiatry.

In this podcast, I reply to some reactions on Twitter and by email to my prior podcast on the invalidity of adult ADD.

Adult ADD is diagnosed frequently, but this podcast describes how it really represents other conditions, like mood or anxiety states or mood temperaments, or how it reflects normal inattention.  

For further reading, see:  https://psychiatryletter.com/adult-add/

Some of the cited articles are linked in that reading. All the sources also are referenced in SN Ghaemi, Clinical Psychopharmacology, Oxford University Press, 2019 in a detailed appendix chapter on ADD in children and adults. 

For further general reading and links to webinars and other educational materials, go to www.psychiatryletter.com

The serotonin hypothesis of depression is false and it really doesn't matter much.  The "chemical imbalance" approach to understanding and explaining medications if far too simplistic, to the point of simply being false. 

DSM is the diagnostic system of psychiatry, currently in its 5th revision. This podcast discusses why it is mostly false scientifically, and why it is important to change it. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799243/

https://journals.sagepub.com/doi/10.1177/0004867413519504

https://www.psychiatrictimes.com/view/requiem-dsm

https://www.psychologytoday.com/us/blog/mood-swings/201301/dsm-5-if-you-dont-the-effects-look-the-causes

Chronic traumatic encephalopathy (CTE) is an illness that occurs with concussions and subconcussive impacts, leading to depression, manic symptoms, anger, aggression, suicidality, headaches, cognitive impairment, and eventually dementia.  I have proposed that lithium can treat or prevent CTE. In this episode, I explain why and interview Jim Scarborough, who describes his family's struggle with CTE in their son and his decision to begin lithium treatment. 

https://pubmed.ncbi.nlm.nih.gov/30748078/

I discuss my recent article defining psychiatric drugs in two categories: those that improve symptoms and those that affect the underlying disease process. Most psychiatric drugs are symptomatic, and not disease-modifying, and thus should be used less and short-term, in my view. Disease modifying drugs should be used more and long-term. They include lithium and other mood stabilizers.  

The article has generated some discussion on the internet, including some claims with which I don't agree. 

The podcast describes and clarifies the concept. 

The article can be found here:

https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.13459

I discuss my perspective that the diagnosis of ADD, in children and adults, is not scientifically valid, and give reasons why. I also explain that amphetamines, including methylphenidate (Ritalin, Adderall, which is an amphetamine), are biologically harmful to the brain and have other harms. Sources for this podcast are below:

SN Ghaemi, Clinical Psychopharmacology, Oxford University Press, 2019 - see appendix on ADD

https://www.psychiatryletter.net/education/adderall-amphetamines

https://www.psychiatryletter.net/education/adult-adhd-misconceptions

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2522749

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/1378851

https://www.jneuropsychiatry.org/peer-review/adult-adhd-and-amphetamines-a-new-paradigm-neuropsychiatry.pdf

https://pubmed.ncbi.nlm.nih.gov/18052572/

https://www.mdedge.com/psychiatry/article/24418/pediatrics/stimulant-use-adhd-bipolar-discouraged-expert-mood-disorders

https://journals.lww.com/hrpjournal/fulltext/2020/03000/approach_to_evaluating_and_managing_adult.3.aspx