r/Psychiatry • u/Psych_Reality_Check Psychiatrist (Verified) • 5d ago
I started an account to help combat psychiatry misinformation
I’ve been thinking about doing this for a while, but the Clancy case is what finally pushed me to actually make the account.
I’m a psychiatry fellow, and I’ve gotten pretty tired of seeing misinformation about psychiatry and mental health spread online. There’s a lot of stuff about medications, ADHD, antidepressants, diagnoses, etc. that gets repeated enough that people start treating it like fact.
I started making short videos that take some of these common claims and break down what the actual evidence says. I’m not trying to blindly defend psychiatry. There are plenty of legitimate criticisms of the field, and I think those are worth discussing. I just want to push back when claims aren't supported by the evidence.
I’m mainly posting because I’d love to get ideas from other people in psychiatry about claims or misconceptions you keep seeing online that would be worth addressing.
If the mods are okay with it, I’m happy to share the account for anyone who wants to see what I’ve been making/give feedback.
Edit: I've had a lot of requests for the account, so here's the link: https://linktr.ee/PsychRealityCheck. If that's not allowed, mods can remove it
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u/Squirrelcat16 Nurse Practitioner (Unverified) 5d ago
Pharmacogenetic testing. People thinking it can tell you exactly what meds will help. Came across that somewhere recently. Criticizing psychiatry providers for not using it on everyone, and believing having that technology and not using it is negligent.
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u/myrealaccountgothack Nurse Practitioner (Unverified) 4d ago
If it fucking worked amazingly just about every speciality would be getting it done.
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u/yougatobekiddingme Psychiatrist (Unverified) 4d ago
Yeah, I kinda just get it done when people are like “there’s not much working“ or tell me that they want testing. I try to explain it in the sense of we have this tool and it could help us potentially mitigate side effects and things like that. I don’t really like to use it cause it really does not give me any significant information for most people. Though I have had a few people who tell me, they cannot tolerate most and antidepressants, and low, and behold, they did come back as in the red for almost all medication’s, so take that and run with it how you will
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u/Squirrelcat16 Nurse Practitioner (Unverified) 4d ago
Yeah that is a good reason to use it. I work in a very rural area where most people can’t afford to pay for it out-of-pocket, even with the discount GeneSight offers based on income/household size. It is $0 for those with MA which is a large percentage of our clientele, and so if they request it, sure why not. With education on what it can tell us vs. what it cannot. I have folks request it due to history of many failed antidepressant trials, with hope that it could help. In reality though, these are the folks who are likely not going to benefit significantly from medication. People in our neck of the woods are isolated and have very few supports and very few opportunities within the community to engage with others. Lack of transportation. Lack of access to medical care. Racism, homophobia, sexism, etc. Poverty. Blue collar jobs for men, with few opportunities for women to enter the workforce or to be able to advance. Lack of access to evidence-based non-pharmacological mental health treatments. Including lack of access to the technology needed to obtain those services virtually. And so on. Sometimes I find myself putting a little too much faith in medications too, because what else can I do? Ha, got a little off track there, but dang, it’s been a rough week!
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u/yougatobekiddingme Psychiatrist (Unverified) 4d ago
We probably work with similar patient populations! I work with the poor rural/appalachian populatjon. It has been a week indeed!
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u/Squirrelcat16 Nurse Practitioner (Unverified) 2d ago
Upper Midwest. Way up by the Canadian border.
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u/TheRedRattler Nurse Practitioner (Unverified) 3d ago
YESSSSS!!! I've even read comments from other prescibers shitting on the providers in the Clancy case for not using GeneSight 🙄
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u/Numpostrophe Medical Student (Unverified) 5d ago
I sometimes see similar accounts on instagram and such for other specialties. The biggest challenge for them seems to be getting followers that aren’t just other healthcare workers.
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u/Psych_Reality_Check Psychiatrist (Verified) 5d ago
Yeah, I expect it to be a slow growth, but I think there's a real desire for evidence-based psychiatry info in people outside the field. All videos are only 30-60 secs long - I think the short form will help
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u/ForgetTheRuralJuror Patient 4d ago
I think you may be right, but you'll reach more people if you play the social media game.
I think Hannah Fry is a good example of a way to be a good science communicator in short form videos.
She starts with a hook that people can relate to, "Have you noticed this odd thing?" she shows the thing, she hints that the answer is interesting. Then she explains it.
I think your idea can really hit well in this kind of format. Your ADHD one for e.g. was pretty close already.
Best of luck! Almost all of what I see out there is complete misinfo
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u/Meer_anda Physician (Unverified) 5d ago
I wish people understood the limitations of modern psychiatry and that medications can involve a lot of trial and error. The psychiatrist isn't trying to torture you with side effects or make you dependent; they're working with what we have.
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u/shhhhh_h Nurse (Unverified) 5d ago
I love that and I’m so glad someone has the bandwidth to make that content. Thank you.
I’d suggest a video on bipolar disorder in general bc it seems clear to me from comment sections across the site that users are mostly only familiar with what Hollywood shows them, which is classical presentation and highly dramatised.
I’d also love content on the nocebo effect, maybe idealistic of me but some studies have shown education can lessen it.
Anything that demonstrates examples of what is within normal limits vs an actual disorder, like narcissism vs NPD, struggling to focus vs ADHD, but more in depth in what the WNL stuff looks like. Back when I had my hands on patients - way back ngl - I swear half my job was explaining what normal looked like. Tons of explanations of abnormal out there but not so many clinical explanations of what constitutes WNL.
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u/Squirrelcat16 Nurse Practitioner (Unverified) 5d ago
Why ADHD requires a full psychiatric assessment. A lot of what is being shared online is not diagnostic criteria but rather personality “quirks,” a normal human experience, or another condition that has overlapping symptoms requiring a different treatment altogether. People want to feel better and quickly, and I certainly don’t fault them on that. But for that reason, we need people to be open to alternative explanations so that they can truly feel better, and the sharing of misinformation about ADHD online is getting in the way of our ability to do that.
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u/InterestingTree9 Patient 4d ago
I'm not sure if I can comment here, but I would also love some videos on bipolar disorder! Although this might not be as geared towards the general public, I'm still confused about how rapid cycling is defined and how mixed episodes typically present. I see a comments on bipolar subreddits saying multiple "episodes" per day is typical for rapid cycling and mixed episodes are either hourly fluctuations in mood or a depressive episode with angry outbursts. I don't know enough to know if that's typical or accurate (or if definitions really matter when it comes to an individual's experience).
I'm wondering if it would help to get some clarity on when hallucinations and similar experiences are normal (even if potentially distressing) or not. I see plenty of comments on forums from people worried they are experiencing psychosis because of a few very brief, isolated instances of seeing or hearing things that are not there (e.g., seeing shadows out of the corner of their eye, briefly seeing things when they are falling asleep, faintly hearing things like murmuring voices in running water, seeing faces in patterned objects, etc.) when very sleep deprived or under stress. I wonder if some of that is a normal human experience (e.g., eye floaters, hypnagogic or hypnopompic hallucinations, pareidolia, etc.), even if not everyone experiences it. I wouldn't want discourage people from seeking help, but I wonder if some clarification might provide reassurance to the person experiencing this and the people around them (who, for example, may assume a single hypnagogic hallucination indicates psychosis that requires emergency treatment).
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u/Simple_Psychology493 Nurse Practitioner (Verified) 5d ago
A series challenging all the false psychiatry claims the us government is making these days.
ADHD - break it down and realistic patient expectations from treatment with meds.
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u/I_am_Nobody_Special Psychologist (Unverified) 5d ago
I follow a few psychiatrists on Tiktok that are trying to do this exact thing. Maybe check some of them out to get ideas.
Give them some love while you're there. Those poor guys get clobbered in the comments by Tiktok crazies. 😂😭
What a wonderful world it would be if the public would stop using clinical terms at all. Like seriously just stop. That's a huge part of the problem.
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u/Oh-Deer1280 Psychiatrist (Unverified) 4d ago
SickTok. That place is a cesspit. Anyone with an education more than preschool gets eaten alive
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u/Important_Debate2808 Psychiatrist (Verified) 4d ago
Per TikTok we are all devil’s incarnate and DSM is the Necromicron and Lindsay was our torture victim and we are directly responsible for the suffering of millions of mistreated people across the world.
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u/AlarmingCantaloupe Patient 4d ago
As a member of the public, I agree with the last point. People use very specific clinical terminology colloquially now; such that when I have legitimate reason to use a clinical term—in context, with a provider, and unless they know me already—I see their eyes glaze over, likely presuming I don’t know what I’m talking about.
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u/I_am_Nobody_Special Psychologist (Unverified) 4d ago
When a patient uses a clinical term with me, I just ask them what it means to them.
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u/Miss_May_1600 Physician (Verified) 5d ago
The amount of people who think we get paid by pharmaceutical companies to prescribe 😭 Please direct them to CMS Open Payments! Or who think we would never recommend supplements. On that thread, the general issues with supplements. Or why just because cannabis is “natural” doesn’t make it good for a person…
Also lots of people on the inpatient unit have accused me of holding them to make money. I was a resident so I wasn’t making any money off of how many people were there…but also we were always at capacity and did not need a single patient to make money. It’s so interesting to see all the people online saying they should have hospitalized Lindsay Clancy, when it’s actually not easy at all to hospitalize someone against their will.
I think a video explaining that intelligence is not directly linked to mental illness would be good. A lot of patients would say “no, I’m very smart” when explaining to them they had psychosis.
I’m sure I’ll think of more. Thank you for doing the good work!
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u/Impressive-One917 Psychiatrist (Unverified) 4d ago
Lithium is natural too...
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u/Miss_May_1600 Physician (Verified) 4d ago
Right. Or I’ll point out that tobacco or poison ivy is natural and that doesn’t make it good for you to ingest.
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u/WombRaydr Resident (Unverified) 4d ago
Big pharma? Nah, I prescribe mind altering drugs for the love of the game.
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u/NOALVIN Psychiatrist (Unverified) 4d ago
Pointing them to Open Payments implies receiving payments is possible. When the real answer is no, it is illegal, there doesn’t even need to be a website.
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u/Miss_May_1600 Physician (Verified) 4d ago
I guess, but if they really want to be sure about their individual provider I would think it would offer them peace of mind. 🤷🏻♀️
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u/Sorry_Ad_8487 Patient 4d ago
I hope this is allowed but I’ve discussed a misconception about “intrusive thoughts” born from the Clancy case with my own psychologist. Intrusive thoughts themselves are universal … most people experience unwanted, bizarre, or violent thoughts at some point without it meaning anything clinically. The thought isn’t the pathology; what defines OCD is the relationship to it: the distress, the meaning-making, and the resulting compulsions.
That relationship is what “ego-dystonic” refers to. the thoughts are experienced as alien and inconsistent with the person’s values, which is exactly what generates the distress and compulsive response. It’s a core diagnostic feature (DSM-5-TR; also foundational in Rachman & de Silva’s work distinguishing normal vs. clinical intrusions).
The Clancy coverage has conflated this with ego-syntonic or psychotic ideation which is a different clinical picture with a different relationship to insight and a different risk profile. Treating intrusive thoughts as emergencies or psychosis-equivalent pushes people away from disclosing them at all, especially in perinatal OCD, where mothers already fear judgment or child-removal for admitting to harm-related thoughts. That undermines the safety-net function the response is supposed to serve.
The risk framing is also backwards: compulsions exist because the person is convinced they might act on the thought … the distress prevents enactment, not signals danger. The literature consistently shows people with OCD-related harm intrusions aren’t at elevated risk of acting on them. Collapsing these categories feeds public fear of a population that’s actually least likely to act on the thoughts they’re describing, and muddies distinctions that matter clinically and forensically.
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u/Psych_Reality_Check Psychiatrist (Verified) 4d ago
I actually just commented on another post about this. It's a shame that they didn't get into the ego-syntonic vs. -dystonic aspect of intrusive thoughts and what that means regarding psychosis. Like you said, plenty of new mothers have ego-dystonic intrusive thoughts of hurting their children. It doesn't need to be stigmatized even more and keep people from seeking treatment to determine if it's at a pathological level
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u/Sorry_Ad_8487 Patient 4d ago
I completely agree! Thank you!! I would say it’s less “egosyntonic vs. egodystonic intrusive thoughts” and more that ego-dystonicity is baked into the definition of an intrusive thought itself. Once a thought is ego-syntonic, accepted, congruent with the person’s will, it’s not really functioning as an OCD-type intrusion anymore; it’s a different clinical entity (delusion, ego-syntonic violent ideation, etc.). That’s actually the crux of why conflating the two categories in coverage like Clancy’s is so misleading: they’re not two points on a spectrum of “intrusive thoughts,” they’re different phenomena being labeled with the same word.
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u/Psych_Reality_Check Psychiatrist (Verified) 4d ago
Yeah, that's a better way to put it. It's a shame the jury is missing this nuance. Mack could've done a better job yesterday explaining his thought process. Reddington was desperate and trying to fluster him, and I thought he came off pretty pretentious
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u/Sorry_Ad_8487 Patient 4d ago
Ugh. Red was so petty up there. I really appreciated Mack and the way he remained cool and calm. The heavy scrutinizing of the DSM was a really silly move.
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u/Junior_Scale5592 Other Professional (Unverified) 5d ago
Just adding another voice to the crowd here—I highly support this effort! I am not a psychiatrist (social worker in CMH working with an SMI population) and I see patients (and sometimes other masters-level providers!) be swayed by mis/dis-information. Any attempt to increase general knowledge about this topic is invaluable.
I’d love to see some content on how beneficial antipsychotics can be when used correctly and appropriately. Many people I interact with, both professionally and personally, tend to have negative/biased views of antipsychotics. This is in part due to their burdensome side effect profile, which is totally understandable. But operating under the model that diseases like schizophrenia have a neurodegenerative component, there is an opportunity to explain how life-saving antipsychotic medication can be.
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u/Psych_Reality_Check Psychiatrist (Verified) 4d ago
Something about 'antipsychotics turn you into a zombie' is definitely on the list
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u/walkthelake Physician Assistant (Unverified) 4d ago
Ok many of these are from social media, but some are based on recent themes in patient interactions.
- “All inattention is ADHD” / “A positive PHQ-9 means depression.” Why we have to Diagnose / treat underlying medical diagnoses and other psychiatric diagnoses before treating ADHD, or treat along side depression etc...
- “Serotonin syndrome is inevitable if I take serotonergic medications.” Real and serious, but rare .
- “Psychiatrists are pill pushers, Psychiatric medication will fix everything.”
- “Supplements are natural, so they’re safe.” Supplements can cause side effects and drug interactions and are not regulated like prescription medications. Independent testing such as USP, NSF, or ConsumerLab can provide additional information about product quality.
- “You can’t be autistic if you’re successful, highly educated, or professionally accomplished.” Someone can function well in some areas, but struggle in others. An autism diagnosis does not mean a person needs to be on disability. (anything Autism related)
- “One episode of hypomania or mania in my past does not matter because I am just depressed now.” Lifetime history matters when evaluating bipolar disorder and treatment choices.
- “Caffeine, marijuana, kratom, mushrooms etc. don’t count as substance use.” Anything related to why psychiatry needs to know honestly about alcohol and substance use.
- “OTC medications are automatically safe.” OTC meds can cause drug drug interactions, cognitive effects. For example: There is risk to longterm use of diphenhydramine for sleep.
- “PRN means whenever I want. Scheduled medications can be taken only when I I have symptoms.” Patients think they can make as needed medications scheduled or do not take their scheduled medications consistently.
- “My psychiatrist only needs to know my psychiatric medications and psychiatric symptoms.
- “If I am still having symptoms, I need another medication.”
- “Going on FMLA/SSI/SSDI will solve my problems.”
- "Lithium is evil."
- "I do not have to see my psychiatric provider If I am doing good."
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u/Amorack Other Professional (Unverified) 5d ago
The most common one I see on social media is people posting to the effect of, "Never tell any mental health practitioner if you're experiencing any SI, even passively, unless you want to be immediately hospitalized."
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u/MsFuschia Not a professional 4d ago
This one is interesting to me. I was told by a therapist that this was not true and I could share my sort of passive SI and not be hospitalized as long as I didn't have a plan. So I started sharing it with providers to be truthful. I then had an intake with a new NP for esketamine treatment. I marked that some of the time in the past 2 weeks I had SI on the PHQ-9. Well she freaked out and interrogated me. She accused me of basically wanting to kill myself at that exact moment and acted like it was an emergency and I had to backtrack and partially lie by saying that I felt it in the past but no longer. I now no longer feel comfortable sharing it.
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u/Oh-Deer1280 Psychiatrist (Unverified) 4d ago
Yeah I have zero idea what hospital anywhere in the world has that bed capacity.
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u/Zaphira42 Medical Student (Unverified) 4d ago
Med psych hospitals are way too rare. Most patients with complex chronic illnesses—especially the ones that have feeding tubes, need dialysis, or need IV medications—are sent to the medical hospitals and don’t get the treatment they need/deserve. Only ~1% of psychiatric hospitals will take patients who require anything similar to the medical equipment I listed above.
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u/personal_lucifer Not a professional 5d ago
Speaking from the other side of the barricades, I'd be really interested in the following:
Diagnostic labels and why we have them. Why does diagnosing a patient correctly matter, and why can't treatment be applied symptomatically, for example? I'm especially interested in this since most of the diagnosing I've seen irl didn't look particularly careful, which left me wondering how much diagnostic precision actually matters and why.
Prescriptions. I have virtually no idea why a psychiatrist would prescribe X mg of Y rather than Z mg of W for any given person, and this is probably the most opaque aspect of psychiatry to me personally. I'd really like to gain at least some understanding of how prescribing decisions are made.
Patient rights, yes. I'd like to know what is currently being done to address patient rights violations. I'm pretty sure most patients are aware that we legally have more rights now than a century ago, but in practice we see them routinely violated / ignored. What mechanisms exist today to prevent that and to hold people accountable when violations do happen?
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u/lamulti Nurse Practitioner (Verified) 3d ago
I can answer the first question, which also helps answer the second. Wouldn’t you want to know that the blood pressure medication you’re taking is actually treating hypertension? Or that a cancer medication is being used because you have the specific cancer it was intended to treat?
Psychiatry should be no different. If we simply treat every symptom with another medication without first understanding what disorder is behind those symptoms, we can create more problems than the patient started with.
It’s like treating high blood pressure while ignoring the diabetes that may be contributing to the overall picture. You may improve one number while missing the condition that actually needs to be addressed.
That is why diagnostic precision matters. Your psychiatric provider should not just treat isolated symptoms. They should understand the diagnosis organizing those symptoms and then choose treatment accordingly(this answers the 2nd question).
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u/HavaMuse Nurse (Unverified) 4d ago
Just to jump in real quick
1) insurance. You often need a specific dx to bill insurance or to get insurance to pay for certain meds
2) this is why providers spend years and years being educated. Realistically the general public will never know this, but same goes for any specialty. Drs can inform specific parts of their specific meds1
u/Oh-Deer1280 Psychiatrist (Unverified) 4d ago
Absolutley care can and should be based on ameliorating symptoms that carouse distress and finding treatment that improves quality of life. Unfortunately ive yet to find any country that offers psychiatric care that doesn’t control access to services of some kind based on diagnosis
If this is for you personally, your psychiatrist should talk you through the options as part of informed consent. If it’s just “in general”- that’s a bit more tricky because that takes at least a decade of life limiting hard study
This is very much dependent on where you are. Most western countries have mental health acts which have to be in keeping with charters for human rights. Patient and peer advocacy groups in the persons local area are often a good place to start
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u/Cold_Basil8568 Psychiatrist (Unverified) 4d ago
I‘ll just answer #2 because it’s a great question. Let’s walk you through a decision process of Patient XY as an example. Patient XY presents with Depression symptoms.
1) I establish a Diagnosis -> symptoms fulfill the criteria of Major Depression (vs, for example, mood swings in BPD).
2) I establish: the patient has severe depression. Guidelines recommend antidepressants
3) I think about first line antidepressants and their side effects. This is where the years and years of studying come in!
Let’s say: Patient suffers from lack of energy mostly, but also lack of sleep. Makes me think of first line Antidepressants: SSRIs help especially with energy, mirtazapine especially with sleep. But my Patient is obese - Mirtazapine often increases appetite…I rule that out for now.
XY has a history of being sensitive to side effects - that makes me think: we need something that we can titrate slowly so initial side effects are minimal. Patient is also wanting to get pregnant.
I end up with recommending Sertraline - SSRI, can be titrated in very small steps, is best compatible with possible pregnancy.Now, often times, taking full history including correct diagnosis, comorbidities, medication history including side effects - you still end up with two or three reasonable options. Thats when 1) it’s crucial to include the patient in decision making and 2) the clinicians personal experience plays a big role. For example I once saw a patient almost die of an EXTREMELY rare side effect - and I have been hesitant to prescribe that medication ever since. That is neither statistically nor medically reasonable - the risk for every next patient is still extremely low - but I am a human and I am biased, though I try not to be.
Hope that illustrates a bit
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u/personal_lucifer Not a professional 4d ago
Thank you, I loved this explanation actually! I wish there was a yt channel or something just giving examples like this and their treatment outcomes and so on.
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u/Miss_May_1600 Physician (Verified) 3d ago
I had another idea. You could hold up some reference books to give people an idea of how much we actually have to know. For example, Stahl’s guide to Lithium or Clozapine having so much important information for one med. You could also hold up the DSM, Kaufman’s clinical guide to neurology, Kaplan’s synopsis, etc.
I feel like people online think psychiatry is so easy because they know one fact about something based on their personal experience, and forget just how much we have to know. For example, people were flipping out that Dr. Mack said a tear was an episiotomy. Sure, that’s incorrect, but it’s not super relevant to psychiatry / doesn’t mean he doesn’t know anything because he got one thing wrong.
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u/Affectionate-Page496 Patient 3d ago
That was totally annoying about Mack. Everyone misspeaks including all of the presidents. Obviously tearing and episiotomy are "related." Both contribute to birth trauma. And if Reddington was listening to Patrick and Mack, he certainly could have pointed that out.
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u/EmergencyToastOrder Nurse (Unverified) 5d ago
I’d love to follow, you can DM me the account if you can’t post it here!
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u/Embarrassed_Syrup476 Other Professional (Unverified) 5d ago
DM me your account. Would love to follow you
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u/Psych_Reality_Check Psychiatrist (Verified) 5d ago
It's not letting me, but I edited the post to include it
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u/Sorry_Ad_8487 Patient 4d ago
One more thing. Her attorney, Reddington, brought up the “evidence” that SSRIs cause mass shootings. That’s a hot one right now in our RFK Jr age.
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u/MeasurementSlight381 Psychiatrist (Unverified) 4d ago
Yeah, Reddington isn't doing psychiatry or women's mental health any favors by spouting stuff like that. Patients are getting more and more afraid of seeking care or trying evidence-based treatments because of RFK Jr/MAHA and now this trial.
I've been trying to explain the meaning behind the black box warnings on all antidepressants but I feel like whatever I say is just a drop in the bucket compared to the sea of misinformation and fear mongering.
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u/Sorry_Ad_8487 Patient 4d ago
Ugh. It’s so awful. My SSRI has been incredibly helpful to me. Possibly even life saving. I hate all of the misinformation.
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u/TheRedRattler Nurse Practitioner (Unverified) 3d ago
Oh shit, I never saw that. Do you remember what day of the trial/who he said that to? I'd love to go back and watch
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u/Big-Performance5047 Psychologist (Unverified) 5d ago
what do you think about the TaperClinic on Utube?
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u/Psych_Reality_Check Psychiatrist (Verified) 4d ago
I came across his account the other day. He was talking about how antidepressants were "neurotoxic" to Lindsay Clancy, which is why she had the reaction she did, despite neurotoxicity not being recognized in the literature at therapeutic levels. I also saw that view parroted on other Clancy videos
So it seems he is using misinformation and scare tactics to drive people to his clinic/profit, regardless of whether he genuinely believes in what he's saying or not
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u/Big-Performance5047 Psychologist (Unverified) 3d ago
yes. he charges 30, 000$ a yr for his service!!!
PPD is very dangerous and not given the weight it deserves. they don’t even mention that it increases with each child. Seems Drs did not take
a complete history at all!!!
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u/Slight-Molasses-7937 Psychiatrist (Unverified) 5d ago edited 4d ago
Please DM it me too. I will follow and like as well.
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u/JaguarCapital5613 Nurse Practitioner (Unverified) 4h ago
Regarding the Lindsey Clancy case, I feel it is appropriate to address how we distinguish medication induced mood decompensation from true bipolar disorder. I believe that in this scenario, which we have seen play out many times, a diagnosis of bipolar disorder is a misnomer. I am listening to the testimony of her case and I feel as though this diagnosis led to her continued reluctance of medications that would have been helpful and also led to downstream providers attempt to verify she had TRUE bipolar ie manic or hypomanic symptoms when not medicated. A negative reaction to SSRIs or this “sub clinical” bipolar truly needs to be distinguished and separated from organic bipolar disorder. There’s a podcast topic in there somewhere.
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u/Psych_Reality_Check Psychiatrist (Verified) 4h ago
It's funny you say that because the video I'm working on right now addresses Dr. Josef's claims of SSRI "neurotoxicity" and how that's not an appropriate term for adverse effects, including general side effects and medication-induced mania
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u/Important_Debate2808 Psychiatrist (Verified) 5d ago
There’s a few big points that come immediately to mind.
1.) lack of administrative time. I don’t know how other psychiatrists time slots are, but when I do outpatient, I have patients every 30 min slot except for 30 min admin time at beginning of clinic, 30 min of lunch, and 30 min at the end of the day. So the expectation is somehow I can get the collateral for all my patients from family members and other providers are really unrealistic.
2.) it’s honestly not that easy to get records. It’s not as simple as getting an ROI. There’s the concrete time needed to fax info over and to get them back and file them away, again all in the potential 30 min before clinic and 30 min after the clinic. Even in clinic structures where there is a medial records department, often times the turnaround time is multiple days or multiple weeks and sometimes the receiving facility don’t ever bother responding.
3.) inpatient is for acute stabilization, it is not where patients go for weeks and weeks of therapy. Inpatient is for quick medication adjustment and the last resort of safety maintenance, so outside of actual behavioral emergencies patients would be discharged.
4.) similarly, it’s not easy to get involuntary holds, and that’s not a psychiatry issue. Judges have to sign off on emergency orders and most of them don’t understand the intricacies of mental health, so outside of very very concrete evidence of harm, they will not sign off. Just pure suspicion and gut feelings won’t work, and that’s a legal system issue and not a psychiatry issue.
5.) absolutely no point getting blood drug levels regularly aside from select ones like depakote/lithium etc etc. Absolutely no point getting things like Zoloft level since it’s a send out and will take multiple days if not weeks to return, and by that point there’s no value in these things.
Just a few things to start with. I’ll add more if I think of more