Mental health

The spirit of community

Simon and Garfunkel sang “I am a rock, I am an island” in the 60’s. Concepts like autonomy, self-reliance, winning and individuation have all been useful in carrying mankind forward. “Tall poppies” are no longer cut down, but celebrated. You no longer have to feel bad for being ambitious beyond your circumstance, or for putting yourself first. The pendulum might have swung out a bit far; there has been a cost to this kind of mindset. Loneliness and isolation are on the rise. In a US survey, the number of adults with zero confidants has tripled since the 80’s. Adults, especially…

Anxiety myths busted

Anxiety is a cluster of psychological and physical symptoms. The psychological symptoms include feelings of dread, fear and being overwhelmed. Patients having a panic attack tell me it feels like they are going to die or go insane. Physical symptoms manifest all over the body: racing pulse, sweating, blushing, irritable bowel, irritable bladder, shaking and muscle tension. Anxiety is normal. It makes us look both ways when crossing the street. It becomes abnormal when the sufferer starts worrying and dreading everyday situations.It can start making it difficult to work, attend school or socialise. When it starts making someone’s world small, stops…

What’s the deal with dreaming?

My patients often ask me about dreaming. Why do we dream? Is dreaming important? What does my dream mean? Many cultures would not dream of questioning the relevance of dreaming. Aboriginal tribes have “Dreamtime” which they feel connects them to all time; past, present and future. Some of the Native American tribes highly regard dreams as a source of information and guidance. Scientists have long wrestled with the question of why we dream. Sigmund Freud, who wrote “The interpretation of dreams”, said that dreams were the “highway to the unconsciousness”. He felt that by examining our dreams, we would understand our…

Dementia. Darn, it’s on the tip of my tongue

I am taking a break over the holidays. For the next four weeks, I will be republishing a few of my favourite blogs. I’ve noticed an alarming thing lately, although I should not be surprised. My patients are growing older. Teenagers I was helping with their self-destructive behaviours two decades ago are now anxious mothers. Anxious mothers whom I met 20 years ago are now looking at retirement. It shouldn’t be surprising; I am getting older too. So is the rest of the world. Life expectancy has been steadily increasing worldwide over the last two decades. This is largely…

Let’s talk about food

I am taking a break over the holidays. For the next four weeks I will be republishing a few of my favourite blogs. In continuing with thoughts about selfcare, I would like to talk about food. I hosted a dinner party the other night and there was a vegetarian, someone who was Banting-it and a gluten intolerant guest. We generally agreed that Trump was a disaster, wailed about corruption in SA politics and lamented the drought. But when we got to food, the opinions clashed and arguments got heated. I bet that Mrs Cavewoman host did not have these problems.…

Exam time: the outer rim of hell

It’s the time of the year when I, as a psychiatrist, find myself writing letters motivating for extensions, deferments and more time. Nobody likes exams; it’s hard work and the feeling of being evaluated can be unpleasant. But for some people exam time becomes a psychic hell. A patient came to me having continuous panic attacks. She was incapable of sleeping or studying. She had been procrastinating with exam preparations; once she started, she was overwhelmed by the sheer volume. She started working non-stop, breaking only to refill her coffee or buy some cigarettes. Initially, she made good headway. The problem began when she was…

Why can’t I shake this recurrent depression?

By the time patients come to me for the treatment of their depression, they have often been sick for some time. When we go into the history of the illness, it becomes clear that most have been depressed before.  If you have had two episodes, more than likely, you will have a third one. If you have had three episodes, there’s a 90 percent chance you will have a 4th. It seems that a single episode of depression is more the exception than the rule. The greatest predictor of a relapse of depression is stopping antidepressant treatment. More and more evidence…

What science says about bullying

The thought of your child being bullied is enough to make a parent’s blood boil. With good reason. The consequences of bullying can be devastating and long-lasting on the psyche. Sometimes the outcome can even be violent – bullying has often been quoted as a contributing cause in suicide and school shootings. With such overwhelming feelings, how can we as adults take informed actions? Fortunately, the scientific community has been researching this very question. When studying a behaviour, the first thing we have to do is define it. What is bullying? Psychological research says that it is a behaviour that…

Happy Pills and other myths

Suffering from depression is hard. It’s possibly one of the toughest illnesses out there because it corrodes your very core, your self-esteem, your connection with others. Help is available. I tell my patients that together we will always win against depression, even if the path is rocky. I make use of many modalities to treat depression: therapy, diet, exercise, creative and spiritual outlets, and medication. Medication is a godsend in the management of depression. Yet it is the modality that carries with it the most resistance and false preconceptions. Some of the questions my patients most frequently ask are: Is it…

Psychopaths- the wolves among us

The joy of my job is that I get to talk to a lot of people. I talk with them when they are at low points in their lives; when they are vulnerable and hurt. There is a lot of honesty, much barebones of stories, not much bull. As a result of my experience, I have concluded that 90% of humanity is mostly good. Granted, mostly good people can commit the most heinous of crimes, but the struggle is universal. We try our best for our children; we mourn the loss of loved ones. We feel pride, envy, love, fear and…

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