Discover and read the best of Twitter Threads about #psychiatry

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Day 1 of #RANZCP2022 is starting soon! Am looking forward to tweeting up a storm over the next few days. The program is jam-packed full of great presentations, updates and conversations about #psychiatry & mental health.
I would like to acknowledge that I will be tweeting on the traditional lands for the Kaurna people and respect their spiritual relationship with their country. I also pay my respects to Elders past and present.
#KaurnaCountry #RANZCP2022 Image
A little bit about me - I started working with @CroakeyNews at the beginning of the pandemic writing the #COVID19Wrap, a summary of COVID research, news and updates. I am also a research assistant @UniversitySA. You can find me on Twitter @AlisonSBarrett.…
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I'll be adding short important points which would hopefully help in remembering certain concepts during #PLAB preparation, to this thread🧵every now and then as I take them out from my scattered notes. Feel free to comment your tips and tricks which would help others, as well 👇
Please don't take any of these as medical advice 😂🙏. Real life stuff is much more nuanced. These are just clinchers for the sake of the exam.
1. Drug contraindications...
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
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@_pem_pem Why this is nonsensical: "Jeffrey Lieberman, a professor of #psychiatry at Columbia University...“The problems that they’ve been criticized for have more to do [with] the way they’re used by doctors & the heterogeneity of the condition that they’re indicated for.” /1
@_pem_pem What Lieberman is saying is that if #antidepressants were prescribed to a population for which they are known to work well, they would have a much better track record. This is true, because it is a tautology. /2
@_pem_pem The reasoning is circular, if #antidepressants were prescribed for those people for whom the drugs worked, they would work. /3
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On #DarwinDay it is wonderful to anticipate the fast progress coming to psychiatry as it discovers its missing foundation in evolutionary biology.
@isemph @HumBehEvoSoc @AllenFrancesMD @mentaldaily_com @Got_Anxiety @sse_evolution @eshb @RiadhAbed1 @PFinuras @APAPsychiatric
The day between #DarwinDay and #ValentinesDay gives an opportunity to respond to questions about
what #evolution offers to #psychiatry and
why I think it will bring fast progress.
Painful emotions, especially anxiety & depression, are by far the most common reasons people seek help. An evolutionary perspective recognizes emotions as special states shaped by natural selection along with control systems that express them in situations where they are useful.
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Monoamine hypothesis aka "chemical imbalance" & other synonyms, arose circa 1965, but was known to only #psychiatrists, who were unhappily prescribing TCAs and MAOIs to a niche market. Patients hated the many adverse effects of the drugs. /1
Until mid-1990s, monoamine hypothesis (aka "chemical imbalance", "serotonin deficiency" etc.) was not circulating as a "folk model", not in medicine or in the general public. 1990 is ~center of this chart, when #psychiatrists, many paid by pharma, started churning out papers. /2
As a meme or "folk model", monoamine hypothesis (aka "chemical imbalance", "serotonin deficiency", "neurohormone imbalance", etc.) was diligently planted by dozens of #psychiatrists -- not a few -- many paid by pharma. Not something that arose organically out of nowhere. /3
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This is what targeted racial harassment looks like: nitpicking things like “smiled” or “wore clothes like a celebrity, as a celebrity” or “bought cookware.” It is part of the “gold digger” narrative.
This is common in #healthcare#professionalism” where there is hazing & bullying by racist &/or classist made up non-rules lacking standards…yet people are called “breaking the rules.”

It’s exactly how bullies operate: double standards, mislabel/smear, exclude, marginalize.
In the U.K., “BAME” includes the formerly colonized, thus making race constructs or power different from U.S. as latter had race-based chattel slavery.

Thing is, those formerly colonized have many who have internalized self hate & racism.…
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@sanilrege @markhoro @SenadHasanagic1 Not at all, Sanil. Among my site members, many people come off #antidepressants & other drugs with slight or no withdrawal symptoms except an emotional anesthesia, which they may describe as depression, anhedonia, various kinds of malaise, even "relapse" but.... /1
@sanilrege @markhoro @SenadHasanagic1's a "relapse" unlike anything they've experienced before. While they may use #psychiatry's vocabulary, because that's all they've got, this emotional anesthesia is actually a result of long-term psychotropic exposure, not "relapse"..../2
@sanilrege @markhoro @SenadHasanagic1 Post-drug emotional anesthesia is well known among those who have gone off psychotropics classified as addictive & considered a feature of those protracted withdrawal syndromes. There is no reason to think chronic #psychiatric psychotropics are exempt..../3
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Happy Saturday, beloved family! I hope your weekend has been off to an excellent start! 🌅☀️❤️
Our focus text for today, comes to us from Romans chapter 8, which focuses on life in the Spirit.

In verse 1, we have THE blessed assurance from God, that there is indeed NO CONDEMNATION FOR THOSE WHO ARE IN CHRIST JESUS.
To be “in Christ Jesus” means that He dwells within us, & us within Him. We are ONE.
So, by sending His own son, Jesus Christ, to die for our sins, God made sure that there is NO CONDEMNATION for us.
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Blessed Friyay morning to you all, beloved children of God! 🌅☀️❤️
Our focus today will be within 1st John , chapter 3. This chapter deals EXCLUSIVELY with our identities as children of God. We are encouraged to strive to be a people of ethical integrity & to live a life that is reflective of our spiritual identity.
In verse 20, we are reminded of the truth that God is actually GREATER THAN OUR HEART. People of God, this is a quite profound assertion! 🤯🤯🤯
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I SO respect & appreciate @ZJAyres sharing this today. There is ABSOLUTELY POSITIVELY nothing wrong with taking medication to improve your #mentalhealth . I used to be vehemently opposed to taking psychotropic medication…
because of stigma & my Christian upbringing. NOW, based on my own lived experiences & through seeking out EXTENSIVE knowledge in the #mentalhealth space, I have a VERY different view of #mentalhealth & medications than most followers of Christ do.
Here’s the thing. Often times, people NEED medication to bring back the levels of their brain chemicals to where it needs to be. And that’s totally OK. Everyone’s condition is a little bit different.
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1/🧵Human Error in Decision Making and Judgment:
For those who loved @NobelPrize Laureate’s book Thinking Fast & Slow, there is a new Kahneman book called Noise reviewed @TheLancet. It’s worthy of a bit of commentary…

#MedTwitter #ScienceTwitter
2/In statistics, #NOISE refers to random scatter, ie, variations in our judgment that are NOT caused by individual judgment. #BIAS on the other hand is systematic deviation in judgment.
@nataliexdean @EpiEllie @f2harrell – teach us more & did you read Kahneman’s book yet?
3/ Kahneman himself (see quote in @TheLancet review👆) acknowledges that this book is somewhat data-o-penic. We need much more knowledge about “noise”…it’s a limitation in science at this point. In Medicine, he claims #Psychiatry is an extreme noise factory…@APAPsychiatric
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(1/12) New article! I'm very pleased to share our most recent report: A neural circuit for spirituality and religiosity derived from patients with brain lesions. Here is my Twitter summary of our findings...…
(2/12) Over 80% of the global population consider themselves religious or spiritual, but neural substrates remain unresolved. In two independent datasets (N1=88; N2=105), brain lesions associated with spirituality map to a brain circuit centered on the periaqueductal grey.
(3/12) Spirituality (or, more precisely “spiritual acceptance”) is measured by the Temperament and Character Inventory using a series of True or False self-report items. Lesion locations associated with changes in spirituality occur in many different brain locations. Image
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1/ 🧵🎥 Chronic Pain

#Pain comes in all shapes & sizes. Let’s explore how we process pain. Watch & Listen to what Anderson Cooper tells Stephen Colbert about #grief and #suffering: “You can’t have happiness without having loss and suffering.”
2/ My lucid & kind patient (pic w written perm) uses scalding water as a coping mechanism for abdominal pain from pancreatitis. He wants to share his rationale.

#MedTwitter #ChronicPain #nurse
3/ Before I share what he told me, I first want to make my mindset as his #physician clear: My first job is to believe in him. Then to understand him. Then to devise a plan to help him.
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When caring for patients with psychopathological problems, sometimes the clinician must consider whether the patient has an underlying neurological condition. When should we order diagnostic studies (brain imaging and others) in #Psychiatry? Here are some general recommendations:
1) Abnormal neurological examination. A neurological clinical exam showing abnormal sensitive, motor or autonomic signs.

As an example: a woman had a new onset of psychotic #depression. The presence of visual impairment was the clue to indicate a MRI, which showed a brain tumor
2) Focal neuropsychologic syndromes. Presence of cognitive deficits with a well-known neurological basis (aphasia, apraxia, agnosia, amnesia, dysexecutive syndrome, Balint syndrome, Gertsmann syndrome, etc)

Below: a man had behavioral disturbances, aphasia, and a brain abscess
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Please don’t call me a medication provider- A 🧵 and discussion

Psychiatrists and other physicians are being referred by many as “medication providers.” I do prescribe medications but that is only a VERY small part of what I do ... /1
#medtwitter #psychtwitter
and labeling me as a “medication provider” or “medication doctor” reduces me to that, confuses patients, and propagates misconceptions about #mentahealth and #psychiatry. In general, people are already confused about the different professions within the #mentalhealth system /2
Mental healthcare is a complex and sometimes confusing system. However, because of its complexity, we need to work hard on education rather than reducing the roles to one tool the person uses (e.g. medication provider).
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Daily Bookmarks to GAVNet 04/23/2021…
I Have Read Thousands of Résumés, and I Have Some Advice…

#résumés #writing
Everything You Know About Passwords Is Wrong…

#passwords #security
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#MedTwitter showed me the dark side of this, of all times, during a #pandemic. Turns out some who are employed in supposed #SciComm actually stalk patients on behalf of doctors & administrators. Sadly, #bullying patients has gone from "just" in hospitals to dark web.
There is a type of doctor, not all, who believes self a "victim" of patients.. "I am a victim" is used to do mental gymnastics to "justify" #bullying patients who seek answers, report error or harm, initiate lawsuits.

Yes, there is too much litigation. But this is America.
#Tweetiatrician training is for #advocacy on #vaccines #VaccinesWork #VaccinesSaveLives

This has been our lane for well over a decade. As long as I've been a pediatrician we've been using every form of #communication and #SciComm, the sillier the better…
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(1/9) A brief thread by @julianmutz on brain stimulation treatments for individuals with #depression

Please RT! #Psychiatry #Brainstimulation

Some recent findings summarised below 👇 Image
(2/9) Pharmacological & psychological treatments for depression, while effective in many patients, have limited efficacy in some patients and/or are sometimes not well tolerated.

Brain stimulation could be considered as additional or alternative treatment in these patients.
(3/9) In a 2018 meta-analysis we analysed data from 54 clinical trials that included a total of almost 3000 patients.… Image
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Was #TheDarkKnight's Two-Face the product of brain injury? Harvey Dent was hospitalized after surviving the explosion and disfiguring burns that transformed him into the psychopathic villain, Two-Face. The background offers insight into the villain's psychological origins. (1/6)
A monitor shows a computed tomography (CT) scan of Dent's head, which reveals contusions (blood) in both frontal lobes of the brain. Such contusions are common after traumatic brain injury, resulting from the brain striking the front of the skull during sudden deceleration. (2/6)
The frontal lobes support higher-order cognition, such as planning, emotional regulation, and impulse control. The ventromedial prefrontal cortex (vmPFC), the frontal region most vulnerable to contusions, is important for moral judgement and emotional decision-making. (3/6)
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Back to roots.

Psychiatry is presently not as ostracized as it once used to be, confined to asylums.

Now a days you may even find psychiatrists invited to public functions.

A welcome change but likely to be short lived.

Read on -
#stigma has always been a huge problem for psychiatry.

We got mental health away from Shamans but managed to get stigma in the process.

Persons with mental illness were always feared and hated. Hence confined to asylum, away from sanitized life of people.
Anything perceived as threatening (mentally ill, free thinking women, disenfranchised minorities, political opponents, sexual minorities) was labelled as "madness/character flaw/unsoundness" etc and sent to asylum to spend rest of their life.
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Spotlight: MIA’s @emalinus4 interviews feminist psychologist and filmmaker @JanHaaken about the role of #trauma and #mentalhealth discourse in social movements.

#podcast #psychiatry #psychtwitter #psychchatter…
“The progressive mental health movement must demand something of the larger public and not just settle for spiriting people away to places or directing them to services. As a broader society, we must have greater respect and not call the police when someone is acting odd.”
“My own feeling is that the mental health field has not been a very interesting place for radical ideas, maybe beyond how it surfaced in the occupy movement. There was some interesting activity as #Occupy camps became places for taking care of people who lived on the streets...”
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@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk Sam, please note 3 Blind Psychs whining that there are real, serious flaws that need attention in #psychiatry but they are prevented from addressing them because dings from "anti-psychiatry" patients (on Twitter, no less) hurt their feelings. What does this say about the doctors?
@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk The epithet "anti-psychiatry" directed at patients is nothing but ad hominem from clinicians who have no intention of bringing patients into the discussions of improving clinical care. (This is #psychiatry we're talking about, the science of human emotion.)
@sash_andy @samwoolfe @lisa63artist @jonathanstea @bmj_latest @hrw @C4Dispatches @gmcuk The argument that people are dissuaded from necessary #psychiatric treatment by purported "anti-psychiatry" is intellectually dishonest on so many levels.

1) #Psychiatric prescribers report being swamped by demand for their services; they plead for additional prescribers. /1
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@awaisaftab Hello, Awais. I will attempt to answer your excellent questions. @HengartnerMP may wish to add his perspective as well. /1
@awaisaftab @HengartnerMP Re your #2: This was a retrospective study. Duration & symptom criteria from Chouinard & Chouinard, 2015 were used in selecting subject population. Other of C&C's criteria (C) were addressed in analysis & discussion. The paper only weakly corroborates C&C's criteria (C). /2
@awaisaftab @HengartnerMP "Greater severity of illness": We relied upon subjects reporting symptoms were qualitatively different than prior to treatment. It is impossible to quantify "greater severity", the symptoms being so various & most unlike original condition. They certainly were distressing. /3
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#Mentalhealth x #minorityhealth are very close to my heart! I serve on the board of @SAMHINorg , a NJ based NPO focused on #SouthAsian mental health

We are looking for dedicated #volunteers (1/n)
with an interest and skills in the following:
- #socialmedia management
-social media content creation
- fundraising

Here’s our Instagram:…

Here’s our website:

DM me if interested for the application process!
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