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Tyler Black, MD Profile picture
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27 Apr, 5 tweets, 1 min read
I mean, yes of course I hope these things can be helpful. On the other hand, to have someone so prominent in psychiatry to give such a generic list as if those things haven't been tried when meds and psychotherapy fail is... Disturbingly condescending and a bit ableist
When someone has depression that has resisted pharmacotherapy AND psychotherapy, a hard look should be given to:
* Reexamine diagnosis
* Examine therapy modalities and search for new strategies (med groups or therapy modalities)
* Consider combination treatments/ect
* Advocate for social + financial support for disabling symptoms
This idea that people with severe depression need to get out more or watch more movies is extremely stigmatizing and completely minimizes what is happening.
The more I look at that list the angrier I get. "Oh your depression hasnt improved with psychotherapy and medication? How about a puppy?!"

Gah.

I'm done

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More from @tylerblack32

Tyler Black, MD Profile picture
16 Apr
1/ Thread: "Pseudo-profound headlines"

One of the worst examples of the media moral panic about suicides during the pandemic occurred when western media got a hold of Japanese suicide rates.
2/ @CNN @CBSNews wrote scary articles with scary headlines ... even my good friend and excellent writer @drjessigold wrote about as nuanced a piece about it one could do in Forbes (without getting a quote from me?!?!?!??!!), and look at the headline. Headline on CNN : "In Japan, more people died from suicCBS Headline: Suicide claimed more Japanese lives in OctobeForbes headline: "Deaths By Suicide In Japan Surpassed
3/ I call this a "pseudoprofound headline." Automatically interesting, but fails with any scrutiny or thought. Dr. Gold's article goes into some of it with respect to the lack of data compared to real-time Japanese data, (now we know the US did NOT show this same effect), but...
Read 21 tweets
Tyler Black, MD Profile picture
15 Apr
Total over-hyping of the evidence, which did not show superiority. Griffiths showing allegiance bias towards his own research passion, and not the nuance the science actually showed.

"In this small study, psychotherapy + either psilocybin or escitalopram had similar outcomes."
The researcher of the study (first author) here has retweeted this inaccurate summary of the science. As a phase 2 trial, it is not designed to test superiority to standard treatments.
This is why @sanilrege's comment couldn't be more prescient. We need larger studies done by independent (not biased) researchers. Allegiance and researcher bias is an issue here.

Read 5 tweets
Tyler Black, MD Profile picture
13 Apr
Oh look, I recognize this data! Great publication showing what (if you followed me) you already know: suicide rates generally declined or stayed the same across the world in 2020. Mostly these countries are middle to high income.
Personally, it's a citable vindication of the work I did to independently collect the data myself:

docs.google.com/spreadsheets/d…

docs.google.com/spreadsheets/d…

docs.google.com/spreadsheets/d…

(I didn't have a team of 40+ researchers! Just me and spreadsheets!)
Because I'm still collecting the data, there is a stronger signal for increase in Asia (Phillipines, japan, some parts of China) than in the rest of the world.

Malawi had an unofficial report (a health official to a radio station) of a strong increase in suicides.
Read 5 tweets
Tyler Black, MD Profile picture
13 Apr
1/ **thread: Mental Health and COVID**

Few things annoy me more than "experts" making claims and headline-horny academics publishing surveys about mental health and Covid-19 doing so with complete lack of nuance and scientific humility.
2/ Most of our studies show associations with "a cross section now" and some change to mental health (many worse, some better, some no change)
3/ Yet if a study shows a negative result, it's always "effects of lockdown restrictions" or "effects of school changes."

What about the effing effect of a WORLDWIDE PANDEMIC that's now claimed 3 million people (millions more seriously ill), entering its 16th month?
Read 7 tweets
Tyler Black, MD Profile picture
7 Apr
To any survivors of those who died by suicide:

The incorrect and stigmatizing messages of "warning signs" & mental illness made you feel guilt you shouldn't bear.

You did nothing wrong.
You didn't miss anything.
The death you grieve was complex and unpredictable.

/1
Our brains do terrible things to us when we know someone dies of suicide: straight line cause connections (always wrong), fantasies of rescue (rarely possible), and imagined hindsight-driven redoing (never testable).

You did your best with your knowledge, skills, and position.
The best advice I can give about "warning signs": they are over-broad and useless to you.

Instead:
1) check in on people you care about
2) express your concerns when you see it
3) let people you know your willingness to help them
4) be genuinely kind and compassionate to people
Read 4 tweets
Tyler Black, MD Profile picture
19 Mar
In America, every day, about 7800 people die, during that day's events.

Some of these events (driving without a seatbelt, kissing a possum) will be related to their death, some (watching Judge Judy, choosing marmalade over strawberry jam) will be unrelated.

/1
In the past 95 days in America, 77 million people have received one COVID-19 vaccine and 44 million have received a second dose.

That makes 121 million worth of days in which a covid vaccine was given (1.2 million doses per day).

/2
1335 deaths have been recorded in VAERS.
14 deaths per day. 1 death per 90,000 "days events" worth of vaccines.

In these 95 days, we would expect about 743k deaths. 1335 are in the system "possibly" associated with vaccine.

/3
Read 5 tweets

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