George Dawson
@dawso007
Followers
8K
Following
68K
Media
2K
Statuses
49K
Psychiatrist, addiction psychiatrist, neuropsychiatrist, physician, aging athlete, blogger/free lance writer with no mass appeal, lecturer, not an influencer.
Joined July 2013
Depression hypotheses continue to build - so far 40 hypotheses and 86 references. Much overlap of course as well as a walk down memory lane. Wanting to do this for some time and may expand to other disorders.
15
96
407
@cesifoti It is politics everywhere César! I had a similar experience as a clinician assuming that hard work and high quality work counted. I came to realize this is a blue collar assumption and the white collars don't think that way. The only thing that counts is in their minds. .
1
10
310
Just delivered. From what I have heard I anticipate that this will confirm what I did for the past 35 years and connect with all of my previous sources on supportive psychotherapy. Either way I will write about it on the blog.
12
29
318
@DrNeilStone This is all part of the current political movement to rewrite the actual history of the COVID pandemic. It is a purely political effort divorced from medical reality.
5
11
271
Public radio picks up on a story I have been writing about for years. But who listens to psychiatrists?. How The Loss Of U.S. Psychiatric Hospitals Led To A Mental Health Crisis
16
85
191
Twitter Hill to die on (everybody has one):. Everybody has one - mine is that psychiatric training needs more much medical and neurological exposure. Clinical psychiatrists are not hired to discuss philosophy or dimensional versus categorical diagnoses (for the 100th time).
25
32
176
As of an hour ago - I survived a case of COVID-19 and here are the details. I did not tally the variables but there are many and the genetics of this is are a black box. How it happened is still a mystery. But I am one grateful old man.
29
26
163
@TWLadyGrey @SydneyAnneToo The left has already influenced Biden's economic policy and there is a path for greater influence and advancing candidates in the future. But that will only happen if Biden wins. A loss leaves the party polarized reducing rather than enhancing communication.
2
12
150
59 depression hypotheses and counting. my appreciation of the field is expanding. Even an optimist like me can be affected by the political rhetoric that there has not been much useful research. no more!
14
32
147
30+ years of psychopharm texts and not a single mention of "chemical imbalance". If you are reading a book that includes that term - burn it. It was written by an antipsychiatrist.
40
40
143
There are few things in life as stressful as a manic friend or family member who is unable to accept treatment and having to stand by while they destroy their career, relationships, and social stability.
29
20
134
Newly detailed nerve links between brain and other organs shape thoughts, memories, and feelings
5
44
137
@RyanMarino Good case in the NEJM of fluorosis from excessive tea drinking illustrates this point. It only took 100-150 bags of tea per day for years (estimated F of > 20 mg/day):
20
4
137
Still working on my list of depression biological hypotheses. Read about 60 papers/book chapters over the weekend. Still looking for feedback/references where the dates are open - specifically the originator/best elaboration/best review. Post here or DM me.
21
36
137
Prazosin:. Amazing how well this medication works for PTSD related nightmares/hyperarousal. Murray Raskind and his collaborators deserve some kind of an award for this research - if they have not already received one.
12
14
121
@Toaster_Pastry Mute is definitely important. My rule for online behavior of physicians was always the way you needed to behave in a staff meeting in order to not be thrown out or fired. That may no longer apply.
2
1
99
Don’t know why I waited so long to get this book. Detailed review by Taylor and Fink of a confusing topic.
5
13
119
Easiest job in medicine- criticizing clinical trials. Hardest job - actually running one.
3
15
100
Why many inpatient psychiatric units are highly problematic and not very therapeutic.
13
39
102
The neurobiology of apathy in depression and neurocognitive impairment in older adults: a review of epidemiological, clinical, neuropsychological and biological research. Steffens, D.C., Fahed, M., Manning, K.J. et al. Transl Psychiatry 12, 525 (2022).
2
25
100
@Neuro_Skeptic I always thought that a wandering uterus was the problem. Good to know it has been updated.
4
3
91
Brief foray back into teaching today - 2 hr seminar on Existential Psychotherapy. Discussed Havens/Ghaemi paper and referenced this excellent text. Powerpoint next (I may take it on the road).
3
10
106
@angie_rasmussen My wife and I both got treatment for a bat flying around in our house. No bites but the ID consultant said exposure to aerosolized saliva was enough. Bat exposure without bites are very common.
2
8
103
@HolesomeMichael It is absurd - the 4th narrowest election margin is a mandate only in the fictional world.
19
2
95
The initial task of psychiatry is basic and and yet complex. You have to be able to talk to anyone who walks (or is brought) through the door. And by talk - I mean carry on a normal conversation with them in a way that other people don't.
2
15
88
Working on a primer of antipsychiatry rhetoric. Let me know if I missed anything - especially all of you philosophers out there.
16
14
91
Schizophrenia, Bipolar and Major Depressive Disorders: Overview of Clinical Features, Neurotransmitter Alterations, Pharmacological Interventions, and Impact of Oxidative Stress in the Disease Process
4
18
91
Lots of controversy about serotonin today. To put it in context - one of many hypotheses not an explanation or a theory.
8
21
87
Piece that Ron Pies and I did with some additional related essays - reworked to some degree by editorial staff for graphics effect. If you get a hard copy you will see what I mean. Serotonin or Not, Antidepressants Work via @psychtimes.
9
29
81
@jonathanstea Don't believe this BS - all you have to do is read the studies. Antipsychotics are on par with most other medication prescribed by physicians and absolutely necessary in acute care settings. They are life saving.
5
4
91
@michaelvkim Thanks for posting this. S. Korea has the best plan without a doubt. It should be adopted as the standard. Obviously too late at this point in the US. The freedom rhetoric will likely be reduced by a much more lethal virus and the odds of that in the future are high.
2
6
73
Has historical precedence. Tackle the epidemic, not the opioids
10
22
77
When I was a kid there were other kids in neighborhood paralyzed by polio. Whooping cough, measles, and smallpox were still a problem. I got mumps and was very ill. Very grateful for leaders at the time who believed in science and vaccines rather than natural herd immunity.
5
10
73
Academic departments of psychiatry need neuropsychiatrists: Plan to blog more about this but all psychiatrists need training in this are not just a few with interest. The reason is that psychiatric presentations of severe illness are common and these diagnoses can't be missed.
4
11
72
@CT_Bergstrom Thanks - also good example with smallpox eradication. Many countries did not reach herd immunity, but isolated outbreaks with surveillance containment. Premature reopening seems like an opposing concept.
0
2
62
Latest version of the identity chart for psychiatrists with additions - the main features. Always a balance with the detailed descriptions but I can add a bibliography of those as well. Feel free to DM me and use if you like.
5
24
75
Here is my response to the NEJM opinion piece suggesting that psychiatry/psychiatrists have an identity problem. No we don't and a lot of that evidence is right there in the NEJM.
10
27
72
New timeline for my "Everything You Wanted To Know About Psychiatry. " presentation this Friday. Had to eliminate a lot of detail that I will try to add back later (programs, hospitals, etc). If you have timelines yourself I am interested.
6
10
72
Real Psychiatry: Are there potential problems in the latest study on antipsychotic medication reduction and discontinuation?. My perspective as a clinical trialist.
10
21
65
@FinancialTimes You don't need to be in a Millennial anti-work discussion. Plenty of productive Gen Xers and even Boomers are walking away based on decades of employer leverage facilitated by Congress and gross mishandling of the pandemic.
2
2
64
Gun violence strikes the family:. Informed about an hour ago that one of my family members was shot and killed about 15 hours ago. Will refrain from posting any details here. 58% of Americans are affected by gun violence and my family is now in that group.
46
11
70
Open Access - excellent review:. Cutler, A.J., Mattingly, G.W. & Maletic, V. Understanding the mechanism of action and clinical effects of neuroactive steroids and GABAergic compounds in major depressive disorder. Transl Psychiatry 13, 228 (2023).
3
17
70
Read the background information- ready to read this. It comes highly recommended…
2
6
66
A glimpse at why psychiatry is more than a checklist or a DSM. Real Psychiatry: Depression Prevalence and Other Checklist Limits
4
24
69
The best way to connect during a psychiatric interview is being able to discuss a formulation at the end that makes sense to the patient. It should be a goal of any program that trains psychiatrists. A DSM or checklist diagnosis will not get you there.
6
6
65
Just got a call from my Internist about a test result from yesterday afternoon. He has been my Internist for about 30 years. He is supposed to be working 4 days a week and here it is 5PM on Saturday. Are there many docs like this out this anymore?. They make a big difference.
7
5
65
@PeterHotez @bruce_y_lee @Forbes @JHUPress Incredible! How do Florida residents put up with this nonsense?.
15
2
51
A few thoughts on using quetiapine for sleep (still editing).
10
19
64
@JoanneBell5 @emily_fri And 5. - first day back at work and it feels like you never left. Inboxes full and a hectic make-up schedule. Seems like nothing happened while you were gone. Automatic irrational thought: "I can't take that much time off again".
0
1
60
Identity chart of a modern psychiatrist based on the ABPN and RCP links I have posted. Just a quick reference let me know if I missed some major milestone.
8
20
65
Listening to emergency psychiatry services lecture today. The interesting bottom line: “Somebody will always be mad at you if you do your job right”. That can be extended to acute care inpatient psychiatry and much of the rest of psychiatry as well.
5
9
63
Good review in an unexpected place. Borderline Personality Disorder: A Review
2
18
66
Psychiatry Colleagues:. Those fun loving antipsychiatrists are at it again. If you start getting nonsensical comments from a new account - I encourage you to block them immediately. Just consider it a robocall from a parallel universe.
9
8
57
"The idea that one etiological agent is the cause of one disease - developed from the study of infections and inherited disorders caused by single genes - is not applicable to the majority of diseases." . Robbins & Cotran - Pathological Basis of Disease 9th ed p. 32.
7
10
57
Good news for the old man today - I was successfully cardioverted at 2PM today after roughly 90 hours of atrial flutter (150-160 bpm) transitioning to atrial fibrillation at 74-140 bpm. Still looking at some rough weeks ahead but better for now.
14
2
58
They are hired to know the difference between acute psychosis and a stroke (or something else). And they need to be able to make that diagnosis - fast if they want to save lives and reduce disability.
6
4
58
Mask are required in 100% of Walmarts and 60% of states. Who knew that massive for-profit companies could make better public health decisions than governments elected by the people?.
5
11
54
Working on an article on antipsychiatry rhetoric. What trope/straw man etc. do you think is most important to refute?.
59
7
56
"DON'T TALK TO ME ABOUT COUNTERTRANSFERENCE - I WANT THAT PATIENT OUT OF MY ICU!"
4
6
54
Every time I call a young colleague about their patient I am impressed with their knowledge of that patient. That includes all of the relevant dimensions. The future of psychiatry is in good hands - there just needs to be a lot more of us.
2
2
57
Potentially ground breaking stuff - see also my most recent post of the paper or link from this. The brain rhythms that detach us from reality
3
17
60
Very good review:. Psychedelics as Transformative Therapeutics
1
14
61
In case there is any confusion:. "Medical necessity" - is an insurance company term. It has little to do with medicine and in most cases necessity. It can be a proprietary rule to deny care.
3
10
54
Have not seen this book discussed much. I found it well written, scholarly, with an excellent list of references (58 pages) by a well known expert.
1
2
61
Latest corporate intervention for physician burnout:. "Make a gratitude list every night". How can I - I am still finishing all of the documentation?.
6
10
58
Ridiculing people who died of C-19 and were antivaxxers and anti-maskers is bad form - plain and simple. Bring civility back and restart civilization. It starts with recognizing the value of a single human life.
3
8
59
Telepsychiatry Day One:. I never thought it would happen and yet here I am - into it in just a few days - not smooth so far and some theory to think about:
9
11
56
To ED docs: . Some of us (psychiatrists) are thinking of a response to address "psychogenic COVID". We need to know if there are a significant number of panicked people in the ED with mostly psychological symptoms. Are you seeing many?. Thanks.
7
6
56
Trazodone resuscitated: I have used it for monotherapy for depression, insomnia, and anxiety. Trazodone once-a-day: A formula for addressing challenges in antidepressant safety and tolerability.
10
9
58
Open Access:. Friston, K. Computational psychiatry: from synapses to sentience. Mol Psychiatry (2022).
0
16
52
My contribution to the ADHD controversy today. Some guideposts that I posted before but more readable. Real Psychiatry: ADHD - 28 Discussion Points
3
12
56
@RyanMarino Same thing with gun trafficking- it flows from US to cartels. Immigrants have nothing to do with it. And it is massive.
0
0
55
First blog post of the year on my layered psychiatry model that is rapidly becoming a cognitive neuroscience model - hope to write a review from that perspective. If you are not aware of pattern matching ref 3 is outstanding.
14
8
55
@jonathanstea Hence the weight lifting exhibition? . Reality check - people develop real diseases and disabilities as they age. Avoiding vaccines accelerates that process.
13
2
36
Alcohol as the "silent epidemic". This gets a lot of traction in the press but as a guy who takes family histories every day - everyone I talk with can tell me who in their family "died from alcohol.". It is not silent for the people and families that live with it every day.
0
7
51
Updated medication checklist for psychiatric medications. Designed to be printed on a single sheet front and back. Let me know if I missed anything that you are prescribing for psychiatric indications:.
15
15
54
First mention of 5HT and brain processes by Woolley and Shaw in 1954.
5
11
56
Inverted pyramid of medical expertise:. Nobody else in the world knows more than me about who needs inpatient psychiatric treatment. I was overruled by a non-physician tonight. Might have been pissed off but it is common. No quality in psychiatric treatment without MD input.
10
7
49
Latest version of my medication checklist is available. I use it for detailed evaluations where a person may not recall all of the medications they have taken over the past 10-40 years. Suggestions, corrections, additions welcome.
12
7
51
Boom! From Dr. Ghaemi:. How to mislead with meta-analysis: Lithium and suicide.
2
12
49
Another meta-analysis that confirms what we know - OK some of us:. Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood
0
15
52
Watching the Texas official press conference now. An appeal to emotion and religion. Attributing the incident to mental illness. No comment on the fact that other countries have as much mental illness and no mass shootings.
3
7
52
The Neglected Role of Psychotherapy for Treatment-Resistant Depression | American Journal of Psychiatry
4
11
43
Open Access: V. Important clinical consideration. Predictors of diagnostic conversion from major depression to bipolar disorder: a Swedish national longitudinal study | Psychological Medicine | Cambridge Core -
1
14
50
1988 Kodachrome - my first employment photo (shot with Konica 35 mm).
4
0
47
@dakhterakhter @dgmacarthur The lesson is that we have been far too casual about all respiratory viruses. The idea that you have to passively allow several mini epidemics in your school or place of business - should be long gone.
1
1
42
Don't know if others were aware of the passing of @CoyneoftheRealm a frequent poster here and elsewhere. Here is his obit
10
9
50
Reading the first 25 pages of the DSM-5 is very helpful. It allows you to immediately discard 90% of all of the critiques of DSM-5. And that leads me to wonder if the reviewers for those journals every read those pages.
4
6
49
@skdh "Some immigrants are trouble." I am sure people said the same thing about my immigrant ancestors from Ireland, Scandinavia, Holland, and Eastern Europe. A 150 yrs later it is compounded by climate change and fewer resources but it seems like the political rhetoric is the same.
14
1
44
Psychiatrists - looking for more suggestions to fill out my diagram. I could just keep going but thought I would cool off for a while.
9
6
46
A medical skill that is not talked about nearly enough these days - probably because there is no "evidence". Knowing when your patient is really ill - is more important than know about RCTs that will all be disproved by meta-analyses at some point.
5
9
44