Thread by @kateneuropsych

@awaisaftab @nassirghaemi Maybe because ITS NOT MDD OR BIPOLAR BUT BLAST INJURY. After all
1) general rule of thumb if lithium doesn't work ITS NOT BI POLAR
2) if you use a hammer to to find a needle YOULL NEVER FIND IT and that's basically the way the VA operates when it comes to detecting blast
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@awaisaftab @nassirghaemi INJURY and/or in dismissing any attempt to make such a determination.
3) More they refusal gets worse when you realize that YOU DONT TREAT BRAIN INJURY (blast or otherwise) IN THE SAME WAY YOU TREAT PSYCHIATRIC DISORDERS even if the symptoms ARE THE SAME.
So no you are
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@awaisaftab @nassirghaemi not going to see/find/determine blast injury with an MRI but if the MRI shows nothing then you've no med rational to use more delicate or refined approach to imaging WHICH SHOULD BE AUTOMATIC anyway as every SM who saw combat was exposed to blast and determining what's
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@awaisaftab @nassirghaemi driven by Psychiatric vs neuroinjury masquerading as Psychiatric should be the first order of the day in youre approach to psych SX & DX
Here's why that's not happening:
1) if it was known how widespread blast INJURY was (& let's be clear that happens to the entire body not
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@awaisaftab @nassirghaemi just the brain) the VA would have a much harder time denying the proper protocols as should be routine to rule out blast injury
2)they'd have to hire way more Neuropsychologists, revamp treatment, & compensation and pension would increase exponentially. T/VA DOESN'T NOW
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@awaisaftab @nassirghaemi HAVE THE $$ FOR THAT
3) WE DON'T NOW IN EITHER THE CIVILIAN OR VAMC domains have the wherewithall to address the coming epidemic of early AD behind our unwillingness to deal with blast injury.
All this time spent denying that's what's going on could have instead been
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@awaisaftab @nassirghaemi used for funding and research. However I fully expect that VAMC and the VA overall, will in 30 or so years acknowledge that this is the problem just as they did for "agent orange" and "gulf war syndrome".
As for Psychiatry and Psychology in my experience the majorityof folks
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@awaisaftab @nassirghaemi seem poised to PERSEVERATE in perpetuity on the Psychological and Psychiatric issues and dismiss the realities of blast injury and mTBI.
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@awaisaftab @nassirghaemi PS. AND ANN MCKEE IS STILL MY HERO!
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