Clinical Reality

I don’t know who needs to hear this, but the only person you should listen to about SSRIs or any other psychiatric medication is a psychiatrist. Seeing far too much misinformation being shared on X by psychologists, therapists, and other randoms with no knowledge of psychopharmacology.

Internet: burnout. Clinic: 5 hours of sleep + constant stimulation.

Internet: SSRIs are poison. Clinic: millions of people quietly functioning better because of them.

Internet: ADHD means you can't focus. Clinic: ADHD often means you focus too much on the wrong thing.

Internet: everyone has trauma. Clinic: some people are chronically exhausted and overwhelmed.

Phones didn’t create ADHD, but they absolutely compete with attention in ways the brain never evolved for.

@ompsychiatrist @APApsychiatric Poor sleep, a lack of self care, poor nutrition/appetite, comorbid substance abuse within depressive episodes all contribute to the shorter lifespan.

As a psychiatrist, I’ve learned this over years of practice: Depression is not just about feeling low, it can affect how long a person lives. Good evidence backs this. A large meta-analysis (Cuijpers, 2014) @APApsychiatric (image) showed a roughly 50–60% higher risk of death in people with depression. Earlier work (Mykletun, 2007) found the same even after accounting for physical illness. In cardiology too, patients who are depressed after a heart attack tend to do worse (Lichtman, 2014). There are many reasons. Suicide risk is one, but not the only one. Depression is linked with more heart disease, poorer control of diabetes & blood pressure, missed medicines, poor sleep and less follow-up. In everyday practice, you see it as people delaying care, dropping out of treatment, and slowly declining, both physically and mentally. The uncomfortable truth is that untreated depression is not harmless. It quietly worsens outcomes. The reassuring part is that it can be treated. With the right support, therapy, medicines when needed and regular follow-up, people get better, function better and rebuild their lives. Mental health care is not optional. It is basic healthcare. #Depression #MentalHealth #Psychiatry #MentalHealthMatters #PublicHealth #MindBodyConnection #TreatDepression #Healthcare #PreventSuicide #MentalHealthAwareness

The brain adapts to what you repeatedly do — if your day is mostly scrolling, distraction starts to feel normal

Many people don't have a dopamine problem. They have a sleep and stimulation problem.

Not every uncomfortable personality trait is a disorder.

Some people want therapy to understand themselves. Others want therapy to never have to change themselves.

Internet mental health discourse loves diagnoses. Clinic loves behavior patterns.

One of the quietest causes of anxiety I see: a nervous system that never gets real rest.

Many people think they have ADHD when what they actually have is no boredom tolerance anymore.

The brain hates chronic uncertainty more than almost anything else.

Clinical reality: a shocking amount of “treatment-resistant depression” improves when sleep finally stabilizes.

One of the most baffling ongoing practices of the 21st century

One quiet truth from clinic: avoidance relieves anxiety in the short term and trains it in the long term.

Phones didn’t create ADHD, but they’ve definitely made sustained attention harder for almost everyone.

Many brains today aren’t “broken”—they’re just chronically overstimulated and profoundly under-rested.