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What the teachers in my practice have taught me

Through the years I have had a few teachers in my psychiatric practice. They have been a varied group of people, vulnerable to the same mental health issues as the rest of us. I have noticed in more vocational professions, careers to which people feel they have been “called”, that there is a higher rate of burnout. It holds true for the teachers whom I have treated. It seems like a process people with a deep calling have to go through. They give too much, then crash and burn, Part of their healing is learning how to return to teaching…

Resilience – life’s bounce back

Resilience is one of the sexiest topics in psychological research at the moment. That property which enables one to bounce back after hardship or trauma. Researchers have tried to examine why some are broken by trauma and why some do better than survive, they flourish. The prior models of “grit and determination” helped previous generations endure difficult times; think of the stiff upper lip British in WW2.  It also has the dark side of people toughing out toxic situations, like an abusive marriage or work situation. Nowadays, a more transcendental model is being put forth. Resilience now not only means enduring…

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…

Suicide – the truth about Romeo and Juliet

Suicide Prevention Day was 10 September. Since then there have been an average of 23 reported suicides in South Africa per day. Tragically, teens are increasingly at risk, as Cape Town recently bore witness. I am happy to see that recent suicide media coverage is mostly compassionate and sensitive. The message behind Suicide Prevention Day was “a minute to save a life” – that you can save someone’s life by checking in on them. Unfortunately, suicide is also a magnet for sensationalism. Facebook and social media flare up when a suicide occurs within a community. Excessive coverage of celebrity suicides…

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…

The weight issue- if diets don’t work, what does?

Diets don’t work. (www.drmarcellestastny.co.za/diets do not work) An obese woman has a one in 677 chance of achieving a normal weight in a year. An obese man has a one in 1 290 chance of being a normal weight in a year. A major risk factor for being 5kg heavier in a year from now is to be on a diet now. All recommendations seem to be that whatever you do it must be “simple, flexible and sustainable.” Kilojoule restriction for weight loss does not work. Permanent modifications to diet and lifestyle do work. If you have been gaining 2kg every…

Let’s talk about self care- introduction

We are biological beings. At a basic level everybody knows that for a plant to flourish it needs water, nutrient rich soil, air and sunshine. Human beings aren’t that different. To thrive and avoid disease we need at minimum a healthy diet, exercise, fresh air and like our chlorophyll infused friends- sunshine. It seems obvious, doesn’t it? When we are hungry, we should eat. When we are tired, we should rest. Yet, for many in my practice, meeting these basic biological needs seems like an indulgence. An unobtainable luxury. Success is often driven by grit, determination and a high threshold…

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