PhD/PsyD Just a thread to post the weirdest/whackiest/dumbest mental health-related stuff you come across in the (social) media...

[Doctor Eliza]

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I think lived experience is an important piece of the conversation for sure (as a CBPR person and someone who's done both methods and theory work on it), but I think people sometimes don't realize that their experiences are only one datapoint and may not be representative beyond themselves (and even then are influenced by subjective recall, etc). People need to realize that sometimes they are an outlier.

So true. I also get really nervous/suspicious when people refer to "lived experience" in their professional advertising because in many cases it is expressing that they are comfortable with A LOT of self-disclosure off the bat. Also sometimes it seems to be a substitute for quality training. "I don't need all those pesky studies because I know what it is like to live with C-PTSD and AuDHD."

 

[chicandtoughness]

I thought we were all a little neurodivergent anyways so the Au is implied, right? 😍

 

[AcronymAllergy]

This particular expression of the phenomena is more specific to the VA, but in general people frequently report "anxiety" to describe any negative or uncomfortable emotion or even just feeling (e.g. stomach upset; "anxiety" resolved with recommended Tums). Someone with anxiety should be able to describe what event they are worried will happen and the expected negative consequences of that event, if they can't then usually it isn't anxiety. If it looks like anxiety but they can't do that, widen the differential (e.g. hyperthyroidism, early cognitive decline).

Yep. It's why with "anxiety" in particular, I always ask the patient to then actually describe what they're experiencing. In actuality, like I'm sure everyone here, I do this with pretty much any symptom; but there seems to be much less variability with "anger" or "depression."

On the (related) flip side, I can't count the number of times I've had someone deny "anxiety" but then endorse significant and chronic worry. It's why I've tweaked my interviewing over the years and almost never ask about "anxiety" outright anymore.

 

[Sanman]

I'm currently watching Dr. Shura's presentation on ADHD in VA: Diagnosis, Evaluation, and State of the Research.

No mention of AuDHD at all.

No mention of Santa Claus either.

I'd be all for a new term "MDDPTSD" to capture the extremely common 'comorbidity' between those two conditions.

Would serve as some defense against 'excellentologist' quality assurancers criticizing MH Suite plans for 'only' having a treatment plan of CPT for PTSD ("but what are you doing to treat their depression? Hmmmmmm?")

He did actually touch on Autism previously being a rule out for ADHD. Good talk that mimics much of my previous experience with ADHD evaluation.

He also mentioned neuropsych testing not being necessary and lack of familiarity with ADHD dx among licensed mental health providers.

 

[aim-agm]

He did actually touch on Autism previously being a rule out for ADHD. Good talk that mimics much of my previous experience with ADHD evaluation.

He also mentioned neuropsych testing not being necessary and lack of familiarity with ADHD dx among licensed mental health providers.

Where can one find this presentation?

 

[ForensicPsychFightClub]

Speaking of this. I have been too scared to ask in public because I've never heard it spoken in public, but how exactly does one pronounce this.
"ow-D-H-D?" "aw-D-H-D"? "A-U-D-H-D"?

Despite the fact that we don’t pronounce it “ow-tism”, I have always heard it pronounced “ow-D-H-D.” Or, more accurately, “Outie-H-D.” My mom is a big follower of pop psychology (out of misguided but very sweet attempts to build common interests with me) and this is how the term gets used in social media circles.

The mispronounciation always irks me but then again the whole term and how it is used irks me so maybe I am not the target demo.

 

[Fan_of_Meehl]

Where can one find this presentation?

I saw a link pop up on a 'MIRECC Presents' MS Teams channel. VA Mid-Atlantic MIRECC?

 

[cara susanna]

I wasn't able to attend the presentation, but I saw the slides and a lot of them I was like "PREACH!" Especially the "ADHD should be diagnosed like any other mental health diagnosis," the info about what a good evaluation entails, and the clarification that cognitive testing is not useful.

 

[R. Matey]

What's with people saying nervous system now when they seem to mean anxiety?

 

[R. Matey]

I pronounce it "I don't intend to diagnose or say this" but that's just me 🤷‍♂️

This is the only correct answer.

 

[futureapppsy2]

What's with people saying nervous system now when they seem to mean anxiety?

Vasovagal theory (ugh) 2.0?

 

[R. Matey]

Vasovagal theory (ugh) 2.0?

Ah, that makes total sense.

 

[Fan_of_Meehl]

Ah, that makes total sense.

'It's weird...I feel it in my body.'

'What, exactly, do you feel?'

'IT, man.'

'What are you anxious about?'

'What do you mean?'

'What, if anything, are you afraid of happening.'

'Everything, man...I'm afraid of everything, I worry all the time, about everything.'

'Give me an example'

'I don't know, I can't think. This is too much pressure, I just shut down, I just get triggered, I get overwhelmed...'

'Let's move on.'

 

[thewesternsky]

'It's weird...I feel it in my body.'

'What, exactly, do you feel?'

'IT, man.'

'What are you anxious about?'

'What do you mean?'

'What, if anything, are you afraid of happening.'

'Everything, man...I'm afraid of everything, I worry all the time, about everything.'

'Give me an example'

'I don't know, I can't think. This is too much pressure, I just shut down, I just get triggered, I get overwhelmed...'

'Let's move on.'

Where did you get a transcript of my recent assessment??! 🙁

 

[smalltownpsych]

I thought we were all a little neurodivergent anyways so the Au is implied, right? 😍

What? Not me! I’m exactly in the middle of the standard distribution on every measure of psychological functioning. How dare you accuse me of being different! 😁
Seriously though, I get it when my patients get confused by this stuff on the internet and just use it as an opportunity to educate them with some basic psych 101 info. What is really frustrating is when people with advanced degrees are spouting nonsense based on lack of knowledge of research or statistics or just about anything else it seems.

Fortunately my patients tend to be more open to thinking about this stuff and taking in new information than many professionals. Ultimately, that’s all I want the patient to do is develop critical thinking skills. Rational thought seems to be an across the board effective treatment. Gotta go with Ellis on that one.

 

[cara susanna]

I often wonder about other fields where actual professional expertise is completely disregarded in favor of what the lay people think. Doctors, probably? Lawyers?

 

[Fan_of_Meehl]

I often wonder about other fields where actual professional expertise is completely disregarded in favor of what the lay people think. Doctors, probably? Lawyers?

I came up with the following cynical saying/observation early in my career:

"Apparently, EVERYONE is a mental health expert/psychologist...until, that is, it's time to actually have to interact with and deal with a crazy person."

 

[chicandtoughness]

I often wonder about other fields where actual professional expertise is completely disregarded in favor of what the lay people think. Doctors, probably? Lawyers?

Nutrition.

 

[futureapppsy2]

I often wonder about other fields where actual professional expertise is completely disregarded in favor of what the lay people think. Doctors, probably? Lawyers?

Judging from Reddit, every profession, tbh

 

[futureapppsy2]

Nutrition.

But, but, but guy on Youtube told me to eat 5 million grams of protein per day, and I'd live forever!

 

[chicandtoughness]

But, but, but guy on Youtube told me to eat 5 million grams of protein per day, and I'd live forever!

Guy on Youtube also told you to infuse yourself with your son's blood, take metformin like it's a daily vitamin, and track your nocturnal emissions so.... get on it.

I'm a biohacking hater, in case it wasn't obvious.

 

[futureapppsy2]

Guy on Youtube also told you to infuse yourself with your son's blood, take metformin like it's a daily vitamin, and track your nocturnal emissions so.... get on it.

I'm a biohacking hater, in case it wasn't obvious.

So many of the diet/fitness Youtubers are just straight-up promoting 2000s pro-ana tips, too.

 

[WisNeuro]

But, but, but guy on Youtube told me to eat 5 million grams of protein per day, and I'd live forever!

Only if it's from raw meat.

 

[chicandtoughness]

So many of the diet/fitness Youtubers are just straight-up promoting 2000s pro-ana tips, too.

100%. I see my eating disorder self in all of them. It's honestly more accepted now because many of the biohackers are men who sound confident in their lies.

Unfortunately, it's also making them a lot of money from the grift, which makes me angry. No one was paying me and my 18-year-old cohort for coming up with cute things like the ABC diet and the Rainbow Diet 😡

 

[cara susanna]

Psychology peeps who watch The Pitt:

Everyone on social media is saying that Robby has an active plan for suicide. I just don't see it. I think that he probably has passive ideation and will be engaging in risky behavior where he's okay if he dies, but that's it. What do you think?

 

[RxPsych]

Psychology peeps who watch The Pitt:

Everyone on social media is saying that Robby has an active plan for suicide. I just don't see it. I think that he probably has passive ideation and will be engaging in risky behavior where he's okay if he dies, but that's it. What do you think?

Certainly doesn't seem like an active plan for suicide, though maybe I am not remembering specific scenes where this may be more clear. Right now, my perception is the same as yours.

While his plan of driving a long distance on a motorcycle with a certain vagueness about whether he is or is not coming back is suspicious, it isn't clear at this point to call it active, or even SI at all. Maybe he just wants to leave the environment he is in, wants to leave his job, etc. there are various reasons he could be vague other than SI.

 

[EnPsychlopedia]

I've seen a potential shift in r/therapists recently, where people are more openly criticizing EMDR, brainspotting, polyvagal theory, and BvDK. Still a long way to go, and the IFS fandom is still concerning, but it at least seems like the tides of the sub are ebbing for certain pseudosciences. I've also seen a lot more people recommending CPT and PE for PTSD, and CBT/ACT/DBT for other presenting concerns. So...maybe a little encouraging?

 

[cara susanna]

Oh my God, there are so many people who think that you can diagnose mental health disorders (specifically, PTSD) with brain imaging. Because "PTSD affects the brain."

 

[WisNeuro]

Oh my God, there are so many people who think that you can diagnose mental health disorders (specifically, PTSD) with brain imaging. Because "PTSD affects the brain."

I bet Amen can! /s

 

[oliversacks4thewin]

I bet Amen can! /s

He's too busy identifying "ring of fire" ADHD and it's six other cousins lol. /s

 

[Fan_of_Meehl]

Oh my God, there are so many people who think that you can diagnose mental health disorders (specifically, PTSD) with brain imaging. Because "PTSD affects the brain."

Ask them to cite a single mental disorder that DOESN'T "affect the brain," as it were.

This is what happens when you're so shallow in your analysis of the problem that you mistake tautological/circular reasoning for profundity.

 

[oliversacks4thewin]

Ask them to cite a single mental disorder that DOESN'T "affect the brain," as it were.

This is what happens when you're so shallow in your analysis of the problem that you mistake tautological/circular reasoning for profundity.

Not to be "that person" but I always love the conversations that arise from playing devil's advocate. Schizoid Personality Disorder. Not much on neuroimaging in the literature, last I checked. To be fair though, I use the condition for a number of counterpoints, because the population just don't show up for any research projects lol.

 

[ForensicPsychFightClub]

Not to be "that person" but I always love the conversations that arise from playing devil's advocate. Schizoid Personality Disorder. Not much on neuroimaging in the literature, last I checked. To be fair though, I use the condition for a number of counterpoints, because the population just don't show up for any research projects lol.

You aren’t wrong. I diagnosed someone with schizoid features a few months back - they likely had the whole disorder, but other stuff that was less personality based could be contributing to at least some of the symptoms - and when I went to look up treatment recs, got a big ol’ ‘No freaking clue’ in the lit. Some case studies suggest social skills groups might be helpful, but like - to me that stuff is for people who want to be social but lack the skills. I have no idea what to do for someone who lacks the desire to interact with others.

 

[Sanman]

You aren’t wrong. I diagnosed someone with schizoid features a few months back - they likely had the whole disorder, but other stuff that was less personality based could be contributing to at least some of the symptoms - and when I went to look up treatment recs, got a big ol’ ‘No freaking clue’ in the lit. Some case studies suggest social skills groups might be helpful, but like - to me that stuff is for people who want to be social but lack the skills. I have no idea what to do for someone who lacks the desire to interact with others.

I find Axis II disorders to be more informative than anything. No one is paying you to treat it, with the possible exception of borderline. Everything is focused on short term treatment nowadays.

 

[futureapppsy2]

I find Axis II disorders to be more informative than anything. No one is paying you to treat it, with the possible exception of borderline. Everything is focused on short term treatment nowadays.

Plus, borderline is AFAIK the only PD that consistently causes significant distress for the person with it, which makes them much more likely to seek and engage in treatment.

 

[cara susanna]

I've been reading a lot of people saying that women need more than 8 hrs sleep. Is that true? I can't find any actual research showing it.

 

[PsyDr]

I've been reading a lot of people saying that women need more than 8 hrs sleep. Is that true? I can't find any actual research showing it.

In 11 million nights observed, there was about a 30 minutes difference between women and men. Women seem more prone to a morning chronotype, and no one knows why. During and after pregnancy, that all changes.

Baker, F. C., et al. (2025). Sex Differences in Sleep. The Oxford Handbook of Sleep and Sleep Disorders. C. A. Espie, P. C. Zee and C. M. Morin, Oxford University Press: 0.

Fatima, Y., et al. (2016). "Exploring Gender Difference in Sleep Quality of Young Adults: Findings from a Large Population Study." Clin Med Res 14(3-4): 138-144.

Jonasdottir, S. S., et al. (2020). "Gender differences in nighttime sleep patterns and variability across the adult lifespan: a global-scale wearables study." Sleep 44(2).

 

[EnPsychlopedia]

I get so furious reading people who have no experience in defining diagnostic criteria, or with any form of validity research, wax eloquent about how diagnostic criteria are made. DSM has many problems, but these folks really think that criteria are only included if they are considered "billable." Have they never heard of OS or NOS diagnoses?

 

[chicandtoughness]

I've seen a potential shift in r/therapists recently, where people are more openly criticizing EMDR, brainspotting, polyvagal theory, and BvDK. Still a long way to go, and the IFS fandom is still concerning, but it at least seems like the tides of the sub are ebbing for certain pseudosciences. I've also seen a lot more people recommending CPT and PE for PTSD, and CBT/ACT/DBT for other presenting concerns. So...maybe a little encouraging?

Half of those posts are probably from me and my two alt accounts, but I'm doing my part 🫡

 

[WisNeuro]

I get so furious reading people who have no experience in defining diagnostic criteria, or with any form of validity research, wax eloquent about how diagnostic criteria are made. DSM has many problems, but these folks really think that criteria are only included if they are considered "billable." Have they never heard of OS or NOS diagnoses?

It's easier for them to think it's all some conspiracy by "Big Insurance." Same reason they think that all outcomes research is somehow funded by insurance companies. These people don't want to spend the cognitive energy to actually understand how things actually work. There is definitely overlap with conspiracy theorists and "do your own research" anti-vaccine types in that group.

 

[cara susanna]

I get so furious reading people who have no experience in defining diagnostic criteria, or with any form of validity research, wax eloquent about how diagnostic criteria are made. DSM has many problems, but these folks really think that criteria are only included if they are considered "billable." Have they never heard of OS or NOS diagnoses?

The CPTSD thread or something else?

 

[EnPsychlopedia]

The CPTSD thread or something else?

That one to some extent, but mostly the "what do you want to see in DSM-6" thread.

 

[cara susanna]

That one to some extent, but mostly the "what do you want to see in DSM-6" thread.

Oh yeah, I finally saw that one and eeeesh.

 

[cara susanna]

Got massively downvoted for saying that we can't know if a character on Bridgerton is autistic without a childhood history

 

[oliversacks4thewin]

Got massively downvoted for saying that we can't know if a character on Bridgerton is autistic without a childhood history

You know, I get the "fun" concept of armchair diagnosing fictional characters, but I feel like it undermines our professional area a bit, when we so readily engage in it. It's not like I'd turn to an endocrinologist and ask if Ross from Friends meets criteria for a diagnosis in their field. They'd tell me they'd need to conduct a full evaluation. Draw labs. Complete a full HPI. Why is our field any different?

 

[cara susanna]

You know, I get the "fun" concept of armchair diagnosing fictional characters, but I feel like it undermines our professional area a bit, when we so readily engage in it. It's not like I'd turn to an endocrinologist and ask if Ross from Friends meets criteria for a diagnosis in their field. They'd tell me they'd need to conduct a full evaluation. Draw labs. Complete a full HPI. Why is our field any different?

That's actually a really good point.

Like, this character is introverted, freaks out when her routine is disrupted, and has niche interests. Could it be autism? Sure, but it could also be a million other things! People don't get that checking off the criteria isn't the hard part, it's differential.

 

[AcronymAllergy]

That's actually a really good point.

Like, this character is introverted, freaks out when her routine is disrupted, and has niche interests. Could it be autism? Sure, but it could also be a million other things! People don't get that checking off the criteria isn't the hard part, it's differential.

Yep, as well as considering the base rate of symptoms, in isolation, in the general population. Sort of like the, "I sometimes zone out, sometimes procrastinate, and sometimes say things I regret, so I must have ADHD" approach.

 

[EnPsychlopedia]

Oh yeah, I finally saw that one and eeeesh.

The top minds of r/therapists have it all covered

 

[borne_before]

I saw this one the testing psychologist community facebook "19 yo male, struggling with sxs associated with adhd-pi that have gotten progressively worse since starting college. struggling with passing classes and have to drop several and move from a university to comm college and is still struggling." They then go onto describe a WAIS with average vci, wmi, and psi and high average wsi and fri. The poster then talks about parent ratings being not super confirming of adhd, but leaning toward sluggish cognitive tempo. Mom indicated that symptoms were present before age six.

Comments are driving me crazy. No discussion of parental over accommodation in high school. No discussion of the possibility of psychosis prodrome. No discussion of the kid just sitting in the dorm smoking weed all the live long day. Shoot, no actual discussion of (a) how ADHD would be impacting their current functioning and (b) also no mention of formal academic assessment skills. Even this psychologist had to take some bonehead classes (100 level math and english) at the local community college before being able to meet requirements for university.

Is this really the state of testing psychology? The testing psychologist community seems like a bunch of unserious people and dilettantes using testing for money instead of (a) describing, (b) explaining, (c) predicting, and (d) influincing outcomes.

 

[WisNeuro]

I saw this one the testing psychologist community facebook "19 yo male, struggling with sxs associated with adhd-pi that have gotten progressively worse since starting college. struggling with passing classes and have to drop several and move from a university to comm college and is still struggling." They then go onto describe a WAIS with average vci, wmi, and psi and high average wsi and fri. The poster then talks about parent ratings being not super confirming of adhd, but leaning toward sluggish cognitive tempo. Mom indicated that symptoms were present before age six.

Comments are driving me crazy. No discussion of parental over accommodation in high school. No discussion of the possibility of psychosis prodrome. No discussion of the kid just sitting in the dorm smoking weed all the live long day. Shoot, no actual discussion of (a) how ADHD would be impacting their current functioning and (b) also no mention of formal academic assessment skills. Even this psychologist had to take some bonehead classes (100 level math and english) at the local community college before being able to meet requirements for university.

Is this really the state of testing psychology? The testing psychologist community seems like a bunch of unserious people and dilettantes using testing for money instead of (a) describing, (b) explaining, (c) predicting, and (d) influincing outcomes.

It is the current state of Psychologists who engage in testing. It is not the current state of properly trained Neuropsychologists and Psychologists with an extensive psych assessment background. There is a reason that most of us have a carefully curated "Refer Out" list. My reputation is partially tied to the quality of providers I send patients to, so I only do that to people I know and trust.