In general, the stats measuring mental health markers are up, but I would think what you are seeing is probably more specific to your population.
definitely more cannabis. Ive yet to have a young patient not using cannabis in months.
I'm seeing that too, but not enough yet to declare a trend like ADHD.
omg yes. more than once that has happened. They are convinced having ASD is the cause of their woes. And when you tell them it isnt ASD it doesnt go well. Had one tell me that i didnt understand ASD because the criteria was created by white males and females present differently
This is my life. So frustrating.
Yes they got all that from TikTok. Most illness criteria is by white males.
It's interesting, I work physically in a small to medium size town, politcally conservative area and cannabis use now seems about the same as 10-20 years ago. Maybe slightly more but not much. I do remote consulting to a larger metro, politcally extrememly liberal, and the MDs and social workers I interface with see tons of patients using cannabis. I specifically notice my recommendations to pursue sobriety from cannabis in this area are met with a sort of shock and surprise from treatment providers, like it's just the new normal and why would I worry about patients and cannabis use.
Frequent occurrence here, as well. As with pretty much any diagnosis, there are ASD forums where these patients get all of their "facts" (echo chamber of people without ASD telling each other they all have ASD.)
If you happen to have any solid references in mind, I'd greatly appreciate a link/title/etc.
Yes but we have standardized testing for this. I'm not going to diagnose based on feelings
Is the physical sensitivity more prevalent in boys? Seems like it's also been very common in the girls I've seen who are on the spectrum and in a couple cases was actually the biggest thing that tipped us off to them likely being autistic.
And frats
Yes but why does the treatment for this have to be meds?
I have always found this argument circular as the initial issue was a discrepancy in prevalence between genders which lead to an argument that females were being missed so they expanded the case definition of the disease itself and found that could address the prevalence issue somewhat. But then you have essentially created a new disease category that was not derived from an understanding of the pathophysiology or any type of effort to develop a consistent disease model that captures the clinical reality, but rather one that is driven by other unrelated and fairly ridiculous aims. The increase in autism overall is also clearly partly driven by a loosening of the case definition and it is unfortunate that at a time when we have an ever increasing neuroscientific understanding of autism we are using neither objective measures of brain function nor even high quality psychological research to drive the science and practice of diagnosis, but rather a consumer driven approach by allowing a group of people who likely don't have autism but would like to have autism to decide what it should be and who it should include. There is no hope except to make a new category and take better care of it.
I mean I definitely agree, but there is very little energy to pushback against stakeholder communities. I guess I don't think we should constantly make new categories but retain one category that denotes a construct within disability theory that has a broad definition and and few medical implications and allow people to identify with it at will (we can call that 'neurodiverse') and then have a much stricter biomedical diagnosis and if we had taken this approach sooner we could have called it autism but that ship has sailed. If we called multifactorial congenital disorder of social learning maybe nobody on TikTok will notice.
Patients admitted to our inpatient unit get a level checked and I'd say 90%+ that I've seen are started on chole or ergo depending on level. Doesn't seem to stop them coming back to the ER, but at least their labs look better on recheck.
I have this conversation around once every 2 weeks. Usually it is just somebody with poor social skills or a few eccentricities that wants to believe they've got some special reason for being a little off. The most frustrating thing is the kids that, when I talk with their parents, I find out all of their unusual behaviors are relatively new in onset, many of whom have managed to trick their therapists into believing they have the diagnosis based on superficial behaviors alone.
Much of mental illness is caused by a dissonance between society and the patient moreso than being inherent. If you took away the internet access of 90% of these patients for a couple of years they'd probably be fine. I wish I could just prescribe that they get their face out of a screen and touch grass sometimes. Like, at the rate I'm going this career is going to turn me into a Luddite
Insurance seldom covers it. Do you want to have that long discussion with patients or just blindly encourage some Vit D supplementation?
There's still farm land out there that Bill Gates hasn't bought yet. Take a page out of my playbook.
I frequently have to remind my patients that we probably learn more every time we get a new electronic device than a primitive human learned in their entire adult life due to the static nature of society and technology in primitive times. The information and sensory overload just isn't something our brains were evolved to handle, in my opinion. Most tolerate it, but by accident, not design. Those that struggle with the pace, structure, loneliness, and demands of the modern world would probably do just fine, and possibly even thrive, in an early agrarian society.
With depression yes. With COVID, MS, and several other disorders there's data showing if you have good levels it could prevent the problem in the first place although once you got it, correcting it may only somewhat improve outcomes. E.g. MS. That's such a terrible disease to begin with, and correcting Vitamin D after the patient has it might not do much, but given how bad MS is and that the data is nice with it preventing it, and that half the US population has a deficiency, Vitamin D IMHO should be part of the annual physical exam. Again, not just MS but other potentially lethal health problems such as COVID.
I love technology. I just am fully aware that, much like cheese, it is likely terrible for my health
Eh, I've seen mixed results. Most of the time it's probably incidental, but I have had a small number of patients who had pretty remarkable improvements with supplementation that I think was probably beyond what I'd expect from starting 20mg of prozac or 15mg of remeron. From what I recall though, all of them had true deficiency (levels in the single digits). Interestingly, there's also some evidence that vitamin D supplementation can cause issues with antipsychotic efficacy d/t increasing metabolism of CYP3A4:
www.ncbi.nlm.nih.gov
www.ncbi.nlm.nih.gov
