Leonard Fein | Cognivox
@cognivox.bsky.social
I write on psychiatry and depression to help orient patients and the public. I approach this work as a medical writer first and as a patient with depression second. Too many books; too few shelves.
The Manhattan DA indicted a psychotherapist for allegedly sexually assaulting two patients. Can NY immediately bar them from unsupervised patient contact? No. An emergency license suspension requires at least five days before a hearing. Weekends and holidays don’t count. That’s wrong.
"Psychiatry is a pathology of freedom: it is medicine applied to the diminishments of freedom." — Henri Ey, 1948 Ey is using the word "pathology" here to mean the study of pathological conditions, rather than as a synonym for "disease" itself. (My translation from the original French.)
I take psychiatric medications. They help me. This is why I get angry when I see psychiatrists portrayed as frauds. If psychiatrists are frauds, then I am a dupe. I am not a dupe. Neither are the millions like me. #Psychiatry
When you hear the name of a psychiatric drug, what comes to mind? For me: Vraylar is a Norse god. Caplyta is a sports drink. And bupropion is an animatronic purple gummy bear cheerfully urging me to seize the day. What are your associations?
Not all the letters after a mental health practitioner's name tell you the same kind of thing. Some point to licensure. Others describe education, certification, membership, or recognition. Sort first. Decode second.
The other day I searched the Library of Congress catalog for print books with “psychiatry” in the title. Of 3,437 results, the very first was David Cooper’s “Psychiatry and Anti-Psychiatry” (1967). The catalog has a sense of humor.
From my psychiatry shelves. Volume 2 was more cooperative for the camera. G. N. Christodoulou and colleagues, Ψυχιατρική [Psychiatry], vol. 2. Athens: ΒΗΤΑ Medical Arts, 2006. #Psychiatry
After a U.S. congressman earlier this week announced his recent hospitalization for depression, the NYT published an explainer on why someone with depression might need inpatient care, and what treatments they might be offered during their stay. Gift link below.
For Many Americans, Depression Is Familiar. Here’s What We Know.
nytimes.com
We call them antidepressants. An older word was thymoleptics. “Antidepressant” names the medication by what it opposes: depression. “Thymoleptic” names it by what it acts on: temper, emotion, mood. One term names the enemy. The other names the terrain. #Psychiatry
Depression is hard to describe. The novelist William Styron called it "so mysteriously painful and elusive ... as to verge close to being beyond description." #Psychiatry #Depression
Most depression treatment guidelines mention the patient’s family. But few make it central, and fewer still recognize that family members can depend on the patient, not just the other way around. Spain’s 2014 national guideline is a welcome exception. #Psychiatry #Depression
In debates over psychiatric “deprescribing,” the term has become an amalgam. It can refer to dose reduction, stopping one drug, consolidating a crowded regimen, managing withdrawal, or rethinking long-term treatment. Same neighborhood, different questions. Blurring them muddles the discussion.
Psychiatry and Religion in Two Textbooks: ‘[…] ministers often feel qualified to offer information and advice about how to handle “psychiatric problems” even though they may be unaware of distinctions as fundamental as the difference between psychiatry and psychology.’ (2021) #Psychiatry
What’s the most accurate metaphor for the DSM? a) Tool b) Bible c) Manual d) Dictionary e) Reader’s Digest f) None of the above #Psychiatry
“Treatment-resistant depression” collapses distinctions that matter. Its close cousin, “difficult-to-treat depression,” fares no better. Treatment is not a monolith. Resistance is not necessarily absolute. Nor is it a property of the disease alone. #Psychiatry #Depression
Humble Beginnings “Lithium salts have found a wide application in some countries (particularly England and Scandinavia) for the treatment of psychotic excitement, especially in manic patients.” – Comprehensive Textbook of Psychiatry, 1967 #Psychiatry #Lithium #BookSky
When the first Academy Awards were held in 1929, effective depression treatments did not exist. Today dozens do, and millions have benefited. Yet the image of psychiatry in cinema still mirrors that shown in Cuckoo’s Nest. The therapies have changed. The story has not. #Psychiatry #Oscars
Lothar Kalinowsky (1899–1992) was a doyen of 20th-century psychiatry, a pioneer of somatic treatments, and co-author of a major clinical textbook. He was not shy about biological therapies. #Psychiatry · #PsychShelf
→ Marginalia: Five psychiatry textbooks, five different conceptions of where the field begins. Each revealed by a single choice: what to put first. What do you think should come first – and why? a) The patient b) The encounter c) The examination d) The diagnosis e) The brain #Psychiatry
[1/4] Cocktail Hour 🍸 The rule: cocktails and antidepressants don’t mix. The exception: when the cocktail is pharmacologic.
[1/3] Book Route The other week, I bought a Polish psychiatry book from a seller who wouldn’t ship to the US. My only option was to set up a forwarding address in Germany. The seller ships to Germany; a forwarder reships to me. It felt vaguely clandestine. (Now it feels mundane.)
[1/10] Of Bibles, Constitutions, and DSM The DSM is often called “psychiatry’s bible.” The metaphor is vivid, and it captures how the manual shapes lives, governs institutions, and informs culture. But it is incomplete. DSM is less a bible than a constitution.
⚠ Not a medical professional. General information only, not medical advice. Always consult a qualified medical provider. If you need support now: (USA) Call/text 988 - TTY: 711 then 988 | (Global) findahelpline.com
A line catches. The page won’t let go. Psychiatry, in its own words. (Mostly.) #Psychiatry #PsychShelf #booksky
[1/5] Beyond the Opening Chapter In the previous threads, I looked only at opening chapter titles – what a textbook announces before it says anything else. Here, I relax that rule. These titles sit further inside their books. Let's dig deeper.
Reading my way through psychiatry textbooks from around the world, comparing how they begin. A US textbook begins with the brain. An Indian one with the clinical examination. A British one with the patient's perspective. What comes first is rarely accidental. #booksky
