Soundless you ceased to be, Oh my daughter. Unliving A shell of a life A sigh with no start. Is it better To live, twenty years and more, To long and yearn, To lose the distance That never comes? Or does the pulling darkness, The lack of time, Beguile you more? I never saw your…
Being good and staying alive
When I was young and hopeful and sixteen, striving for dreams and ideas, I learnt German at school. I must have learnt quite a lot, because I read Bertolt Brecht and listened to Lieder, and was probably quite a pain in the arse. I’ve forgotten most of it since, but there is a phrase that…
Risk and fear
I sometimes wonder why we talk differently about risk in psychiatry than we do in other medical specialties. The risk of harm or death is high in many illnesses, yet in psychiatry we manage risk in a way that seems much more personally attributable. There are balances of risk in diagnosing and managing heart disease,…
Depression – a lack of energy
What is energy, as we experience it? It is a word with a positive force behind it, that glows and lives, and is the opposite of all that one usually experiences when depressed. Personally I find it quite difficult to recognise the feeling of low mood when I’m depressed, but reduced energy is actually more…
Wellbeing
I’ve really been doing pretty well over lockdown, at least I thought I was. I’m not so sure now, and I’m finding myself wondering what I mean by ‘doing well’. It is with some dismay that I realise that for me this means not relapsing into severe depression, or requiring even more noxious psychotropic drugs,…
Alcohol – pleasure or poison
I think a lot about alcohol. This is inevitable, given that I work on an in-patient unit in a psychiatric hospital, treating people who have become alcohol dependent, but my views are less clear than you might think. When I talk about mental illness, I do so from the perspective of both psychiatrist and patient,…
The effects of ECT
I have always written fairly confidently that ECT has not caused me any brain damage. I have had around 70 treatments in total, over nearly 30 years, and during that time I have – mostly – lived a full life, sitting professional exams and postgraduate degrees, and working as a psychiatrist. I have nothing to…
Is mental illness the same as physical illness?
Lots of people ask this question, or variants on it. Perhaps not that it’s real, but is it what it says it is? There are many possible answers, and these may depend on what is meant by mental illness; but, to my mind, if something has gone wrong with your brain, then you are probably…
Continue reading ➞ Is mental illness the same as physical illness?
Thoughts about confidentiality
When I looked up the meaning of the word confidential just now, it stated that it was information that was intended to be kept secret. Intimate, personal, privileged – these were the kind of words I found. To me that implies something you would keep to yourself and about your person, sharing it only if…
Remission or recovery
As a psychiatric patient you don’t always hope for a cure. The best you can expect is to go into remission from your illness, perhaps with medication, perhaps with psychological help, or even just with the passage of time. Illness is more often controlled than vanquished, lurking in the wings, ready to return when you…
Stories of illness
I’ve wondered recently why we, as doctors and other health professionals, choose to tell our own stories of illness. You would think that we would want to swerve away from all such things, faced as we are with illness and suffering, often on a daily basis. But not only do these stories continue to be…
Can a psychiatrist be a real doctor?
This is a question that is asked seriously by some, and tongue in cheek by others (usually other doctors). Yet we too go through the slog of medical school, followed by two years as foundation doctors in a variety of specialties, including those in acute hospital settings. At this point, some embark on the long…
Merry Christmas!
2020 hasn’t been the best of years. Think where you were this time last year, and what you expected from this one – I doubt that it was learning to share your screen on zoom. I can’t think of any other skills I’ve attained, and I’m not even very good at that. Break-out rooms sound…
Lockdown Toxicity
This year has been one of lockdown and restrictions, that have been grim for many. All the normal human things we do, like touch each other, smile and gather in groups, have been snatched away or rationed in a way that we could never have imagined. There is growing concern about the effect on people’s…
Changing minds
Why do we change our minds, and what does this actually mean? Every day we do things, and then decide not to – ‘I’ve changed my mind, I’m not going to come with you to the shops.’ It implies free will as well as a mind to change, neither of which are concepts that are…