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Reading of the Week: Dr. Doidge and Neuroplasticity

February 12, 2015 /

First he noticed it was becoming hard to sing, a nightmare because that was how he made his living and singing was who he was. Then he could barely sing at all but could still speak his lines. And then over a couple of years he began to lose his speaking voice, until it became wispy thin and trailed off, so that he could generate only short, barely audible bursts of whispered air.

“It was agonizing to watch him lose his beautiful singing voice, heartbreaking. I fell in love with that voice,” said Patsy Husmann, his wife of 50 years.

Years ago, I was invited to a dinner party. I found myself seated at a table with a noted poet, a New York Times bestselling author, a Toronto psychoanalyst, the former editor of a smart literary review, and an award-winning essayist. All these people were named Dr. Norman Doidge. Continue reading

Reading of the Week: My lovely wife in the psych ward

February 5, 2015 /

There’s no handbook on how to survive your young wife’s psychiatric crisis. The person you love is no longer there, replaced by a stranger who’s shocking and exotic. Every day I tasted the bittersweet saliva that signals you’re about to puke. To keep myself sane I hurled myself at being an excellent psychotic-person’s spouse. I kept notes on what made things better and what made things worse. I made Giulia take her medicine as prescribed. Sometime this meant watching her swallow, then checking her mouth to confirm that she hadn’t hidden the pills under her tongue. This dynamic led us to become less than equals, which was unsettling.

I’ve been a physician now for nearly a decade and a half. Much of everything has become routine. It wasn’t always like this. I remember the first night on call as a medical student doing my Internal Medicine rotation – the angst and confusion, as I received page after page. As a resident, I remember my first few “observed” psychiatric interviews, with the entire team present, so many people watching me. I remember the first few months of being an attending, trying to pace myself and navigate everything from dictations to the parking lot. But those days are behind me. Practicing day after day, week after week, year after year, routine sets in.

For patients and their families, though, health care is so often not routine – and that’s especially true with mental illness. It’s a world of first appointments, unexpected side effects and complications, recovery and relapse. Continue reading

Reading of the Week: Mental Health Commission’s New Report

January 29, 2015 /

You can’t change what you can’t measure.

So suggests Dr. David Goldbloom, Chair of the Mental Health Commission of Canada, on the release of the Commission’s new report.

Reports from government and government agencies aren’t exactly uncommon in health care. Too often, they are heavy in rhetoric and light in impact. Last Thursday, the Commission released: Informing the Future: Mental Health Indicators for Canada. This report is different; it’s worth careful consideration. The Commission’s work offers the first national-level set of indicators to identify and report on Canadians’ mental health. This report considers 13 indicators; in April, a fuller report will contain 63 indicators.

Continue reading

Reading of the Week: Benzodiazepines, Part I of II

January 15, 2015 /

Kids are different today, I hear ev’ry mother say

Mother needs something today to calm her down
And though she’s not really ill, there’s a little yellow pill
She goes running for the shelter of a mother’s little helper
And it helps her on her way, gets her through her busy day

– Mother’s Little Helper, The Rolling Stones

On the Reading of the Week

This Reading will be part of a two-paper, two-part series. The selection was made with the editorial board of the International Psychiatry Twitter Journal Club, allowing us to consider these papers now, and to continue the conversation on Twitter and include experts from Canada and around the world. Continue reading

Reading of the Week: Dr. Garfinkel’s Book and 1980 – The Year that Psychiatry Changed

December 18, 2014 /

Vivian Rakoff, the chair of the University of Toronto’s Department of Psychiatry during the 1980s and one of the legends of Canadian psychiatry, used to say that psychiatry was both a science and an art, and the essence was to balance the two. More than four decades later, his words ring as true as ever.

So begins Dr. Paul Garfinkel in the chapter “Science and Care” of his newly released autobiography, A Life in Psychiatry: Looking out, Looking in.

Continue reading

Reading of the Week: Depression and the Developing World

December 11, 2014 /

It has the feel of a bad movie.

When the BBC goes to interview psychiatrist Dr. Egip Bolsane in his native Chad, they find a man in a small office with a small wooden desk. Dr. Bolsane speaks enthusiastically about his work, wiping sweat from his forehead (he can’t afford an air conditioner) as he talks about the challenges of practice in a country where mental illness is often confused with possession.

Continue reading

Reading of the Week: Exercise and Depression

December 4, 2014 /

When was the last time you recommended exercise to one of your depressed patients?

Too often, we tend to be too selective with our patients, choosing to talk up the drugs, and choosing not to talk about the other things that can help.

It’s a problem not confined to clinicians: 2014 seems to be the Year of the Obscure Depression Treatment. The American Journal of Psychiatry has published papers on ketamine and NSAIDs. The New York Times ran an op ed suggesting that mushrooms may be the future of treatment (citing the British Journal of Psychiatry, no less).

And with such attention-grabbing remedies, exercise seems so much less dazzling.

Continue reading

Reading of the Week: Psychiatry, Technology, and Apps

November 27, 2014 /

Case study: Bryan is a 57 year old male who is employed as a graphic designer. He has Bipolar Affective Disorder and has frequent episodes. “Being bipolar is like jumping out of an airplane knowing you don’t have a parachute on. You know you’re going to be hurt, but the high is so euphoric that it’s worth the risk. You can deal with the consequences later.”

Question: Can technology help this patient stay healthy and out of hospital?

http://www.wired.com/2014/11/mental-health-apps/

(Because of firewall issues, this link may not work. The article follows.)

This week’s Reading isn’t from a peer-reviewed journal, it’s from Wired. Continue reading