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Skip the focus group, let's just talk to pharma, pitch it as a combined formulation (Panbetteral) and retireEveryone needs Ozempic, Vit D, and Caplyta? (APA should create a focus group)
Skip the focus group, let's just talk to pharma, pitch it as a combined formulation (Panbetteral) and retireEveryone needs Ozempic, Vit D, and Caplyta? (APA should create a focus group)
Insurance doesn't pay for it outside of a handful of specific diagnoses.Doesn't have to be but how many parents and kids will voluntarily get rid of the automated baby sitter otherwise known as screen-time, and replace it with a healthy diet, exercise, daily mental exercise.....? Very few.
On a related tangent-about 50% of Americans have a vitamin D deficiency. I don't see 1 physician checking Vitamin D levels other than myself.
Yep. Vitamin D, much like HDL, appears to be a marker of health and not something that improves health when corrected with meds.Even when vitamin D is low, evidence isn’t really strong that supplementing back into “optimal” range confers much of a benefit, if at all.
That’s odd isn’t it? So you’re healthy simply by tanning in the sun?Yep. Vitamin D, much like HDL, appears to be a marker of health and not something that improves health when corrected with meds.
Until you get skin cancer...That’s odd isn’t it? So you’re healthy simply by tanning in the sun?
No I’m not talking about that I mean why is vitamin D a marker for health when all you need to do to increase it is tan?Until you get skin cancer...
No I’m not talking about that I mean why is vitamin D a marker for health when all you need to do to increase it is tan?
Skip the focus group, let's just talk to pharma, pitch it as a combined formulation (Panbetteral) and retire
Panbetteral Fulyeara, coming to a pharmacy near youMy contribution is make it LAI. I’ll take my 25% royalties for life now.
Perfect, we'll call it the COViD therapy and administer it to the general population...wait...Everyone needs Ozempic, Vit D, and Caplyta? (APA should create a focus group)
Or maybe instead of all these meds maybe stop being a fatty, watch what you eat, and walk around the block a few times a day. I know the term fatty is derogatory but seriously I got several patients that don't do anything healthy and expect pills to do everything for them. Wake them up, put them to sleep, make them feel good despite that they refuse to exercise or watch what they eat. Someone come up with a PC term for this type of person like someone who decided that Pseudoseizures was offensive so we'll instead call is P-NES as if that doesn't offend anyone.Perfect, we'll call it the COViD therapy and administer it to the general population...wait...
How dare you tell people to actively engage in their own health instead of taking a magic pill to fix them. What's next? Telling them they should look at screens less and actually socialize?Or maybe instead of all these meds maybe stop being a fatty, watch what you eat, and walk around the block a few times a day.
Exactly my point, and then the response ranges from "you're right. I got to take care of myself," to "WTF you're my doctor. I expect pills to do everything for me."How dare you tell people to actively engage in their own health instead of taking a magic pill to fix them. What's next? Telling them they should look at screens less and actually socialize?
Exactly my point, and then the response ranges from "you're right. I got to take care of myself," to "WTF you're my doctor. I expect pills to do everything for me."
Unfortunately the latter end of the spectrum isn't a rare 1% type of patient. But you bring this up and you get a lot of people getting offended. That's where I'm thinking WTF. "How dare you not enable their unhealthy lifestyle?"
It’s an epidemic. Let’s call it “listening to soma.” HuxleyanView attachment 373534
View attachment 373535
I check vit dDoesn't have to be but how many parents and kids will voluntarily get rid of the automated baby sitter otherwise known as screen-time, and replace it with a healthy diet, exercise, daily mental exercise.....? Very few.
On a related tangent-about 50% of Americans have a vitamin D deficiency. I don't see 1 physician checking Vitamin D levels other than myself.
Again, my prescription of touching grass would be highly beneficial for this patient population. "But going outside won't fix my weight problem." Oh, it will if you do it enough.Or maybe instead of all these meds maybe stop being a fatty, watch what you eat, and walk around the block a few times a day. I know the term fatty is derogatory but seriously I got several patients that don't do anything healthy and expect pills to do everything for them. Wake them up, put them to sleep, make them feel good despite that they refuse to exercise or watch what they eat. Someone come up with a PC term for this type of person like someone who decided that Pseudoseizures was offensive so we'll instead call is P-NES as if that doesn't offend anyone.
When your brain is wired to respond to threats and no threats are present, it starts to see threats where there are none, resulting in this constant state of distress in many people whose lives are otherwise perfect. These individuals would contend that they have too much stress in their life (though from an objective perspective these threats would seem minor). In truth, they need more stress that is appropriate to retrain their brain as to what actual threats need to be responded to.Yes. We've become more immature with poor distress tolerance over the subsequent years and generations.
When your brain is wired to respond to threats and no threats are present, it starts to see threats where there are none, resulting in this constant state of distress in many people whose lives are otherwise perfect. These individuals would contend that they have too much stress in their life (though from an objective perspective these threats would seem minor). In truth, they need more stress that is appropriate to retrain their brain as to what actual threats need to be responded to.
I'm generally kind to my patients. But that's more as a measure of someone who does not believe in free will. I think we respond to the world around us in more or less adapted ways based on our predispositions and experiences, but I think those responses aren't really within our control. Have to change the input to change the output. The input that would make most people normalize back to a more functional baseline would be a modicum of real, honest-to-God struggleLet’s not be charitable and give them the evolutionary biological justification. That may be a role in it but by definition so would literally every other person on the planet today compared to their predecessors 100 years ago. Yet the rest of the species manages to move forward. There are plenty of people who are carrying their weight. Let’s not make the pathology normal/baseline/expected imo. Simpler to state that they do not want to do the work because the long term rewards seem so trivial compared to the short term pleasures available at every turn every day in their life. Sure be generous and work with patients wherever they’re at in their journey but like you said if they had perspective with actual stress placed on them they might long for the days when they went to your proverb couch for a struggle session.
ADHD: I believe it is on the rise and significantly despite that the genepool hasn't changed. ADHD can be subject dependent. If you like what you do-increased dopamine. If you're exercising and being more physically active-increased dopamine. Increased dopamine means less ADHD.
Kids and more screentime-more ADHD
Kids these days have more screentime, work is more data driven then before and it will become more and more data driven as technology advances, and people are sitting on their butts all day long where as before most jobs required people be more physically active.
Of course ADHD is on the rise.
Don't believe me on the subject dependent thing? Get 100 heterosexual men with ADHD. Their job is to be to a bikini beauty model judge. You won't see too many ADHD symptoms in that group of judges as they stare at these physically attractive young women. Tell these same people to do physics and those same men will be suffering big time ADHD sx.
I'm 50. I remember in the late 80s all these warnings came out about excessive sun exposure but the message wasn't getting a fair amount of sunlight and then protection, but pretty much stay out of the sun period. It was backed by the American Dermatological whatever society or or Academy or whatever group. I remember as a kid people spent outdoors all day long as a cultural norm, and people were much more physically active in the outdoors.
Add to this, about the same time the hole in the ozone was a hot topic making fear of sun exposure more so and people were living longer so cancer awareness was up.
The FDA Vitamin D recommended guidelines haven't changed for decades and while I don't know exactly when they were written they were written long before the late 80s and haven't changed.
But the bottom line is whenever these FDA guidelines were written, people's vitamin D levels were likely, as a society, at different levels. They've never been updated.
Touch grass, eat grass, don’t smoke too much grassAgain, my prescription of touching grass would be highly beneficial for this patient population. "But going outside won't fix my weight problem." Oh, it will if you do it enough.
I mean…We are doing awesome guys! So much science! So much medicines! Yet our generation failing haha
“In an alarming trend, millennials, born between 1981 and 1996, have become the subject of a paradox: they are facing a faster decline in health compared to older generations despite a heightened awareness of fitness among younger people.
This perplexing phenomenon, initially identified in the United States, is now resonating across major Asian countries, including Korea, Hong Kong and Singapore, countering conventional expectations that the health-savvy younger generation would enjoy increased longevity.
According to a 2020 study by medical insurer Blue Cross Blue Shield in the United States, millennials face an accelerated deterioration in both physical and mental health, with conditions such as hypertension, high cholesterol, depression, and anxiety disorders appearing at an earlier age compared to older generations.”
Generational health paradox: Millennials are aging faster than boomers
HONG KONG - In an alarming trend, millennials, born between 1981 and 1996, have become the subject of a paradox: they are facing a faster decline in health compared to older generations despite a heightened awareness of fitness among younger people.m.koreatimes.co.kr
I mean…
The diet in the US is absolutely horrible. All food is created for lasting longer and being bigger without adding nutrients. Interesting enough a Coca Cola in France has real sugar while here it has a bunch of weird additives and high fructose corn syrup.
Our diets are horrible, social interaction is minimal even though, for us on psychiatry is luckily higher. But as a millennial I do feel more anxious going outside and making friends than for example my mom or people on her generation.
I feel we are indeed glued to our phones, slowly losing social skills and patience (instant gratification, Amazon anyone).
These are odd times and we weren’t evolutionary speaking, made for this. But as human we evolve into this and maybe one day we will find the new social construct that we will call normal.
There is an unexpected benefit to being married and having progeny as a male, people find you less scary and can talk/connect easier. I've made multiple new friends in the past 1-2 years but all are because we have children around the same age. I worry a lot about what it would be like for any male in his 30's or 40's to be single or not have kids. Associating toxicity with masculinity was a big mistake that will have significant consequences for women as well as men.its because its very awkward as an adult to approach someone with the intent of being their friend. Thats why so many adults experience isolation because the world we live in doesnt normalize platonic social interaction. I would say for men its even worse. If a guy approaches me and starts talking to me casually about sports and random stuff im thinking in my head "ok what does he want?". Its almost like a masculinity thing for men too. Outside of residency you also work with people form different generations, in different life stages and it can be harder to connect. I think females its a little less harder but still hard im sure. No one wants to go out and say publicly "hey im super lonely and have no friends, want to hang out?". And then if one person from the opposite gender approaches another, theres always the question of "is this person hitting on me?". I think societal norms couples with the increase in the influence of the internet/social media has caused a lot more social isolation. On a positive note, i have a lot of geri patients, and theres a FB group called "women over 50" that a lot of my people are in, and they have made great connections through there
I've taken on changing some hobbies so that I have more opportunities to meet other people (mostly other dudes, nature of the hobby) IRL. Still doesn't lead to a ton of interactions where I think the person might make a good friend (vs acquaintance I see at recurring activity but don't really want to hang out with outside of that activity.) But the few times I've met someone who actually seemed cool, I've done basically that "Hey it was fun (doing activity) with you, it'd be good to keep in touch or hang out some time, what's your number?" Feels like asking someone out on a date because that's basically what you're doing, minus romantic intent, haha. TBH it hasn't led to persistent friendships as of yet, mostly because the other dudes have legitimately very busy lives and don't even engage in (recurring activity) often.its because its very awkward as an adult to approach someone with the intent of being their friend. Thats why so many adults experience isolation because the world we live in doesnt normalize platonic social interaction. I would say for men its even worse. If a guy approaches me and starts talking to me casually about sports and random stuff im thinking in my head "ok what does he want?". Its almost like a masculinity thing for men too. Outside of residency you also work with people form different generations, in different life stages and it can be harder to connect. I think females its a little less harder but still hard im sure. No one wants to go out and say publicly "hey im super lonely and have no friends, want to hang out?". And then if one person from the opposite gender approaches another, theres always the question of "is this person hitting on me?". I think societal norms couples with the increase in the influence of the internet/social media has caused a lot more social isolation. On a positive note, i have a lot of geri patients, and theres a FB group called "women over 50" that a lot of my people are in, and they have made great connections through there
I think it would be really hard to make a platonic friend without a shared activity.yeah and thats another good point is everyones busy, so its really hard to make time with new friendships. As I get older I get more content with things too where by the time I get home I dont think about socializing, lol
And yea the married with kids people have excuses socialize with other families because sometimes theyre forced into it, lol.
I think of things like "bumble BFF" where people match other people for friends. The idea of me swiping through other guys profiles to see if theyre a friendship match for me just feels weird lol
I've taken on changing some hobbies so that I have more opportunities to meet other people (mostly other dudes, nature of the hobby) IRL. Still doesn't lead to a ton of interactions where I think the person might make a good friend (vs acquaintance I see at recurring activity but don't really want to hang out with outside of that activity.) But the few times I've met someone who actually seemed cool, I've done basically that "Hey it was fun (doing activity) with you, it'd be good to keep in touch or hang out some time, what's your number?" Feels like asking someone out on a date because that's basically what you're doing, minus romantic intent, haha. TBH it hasn't led to persistent friendships as of yet, mostly because the other dudes have legitimately very busy lives and don't even engage in (recurring activity) often.
Nothing at all--I keep regularly engaging in the activity and enjoying the company of most of the people there, even if I wouldn't really hang out with many of them outside of that context (just not much else in common in terms of ways of living aside from the hobby.)This sounds like the right way to go about it. But what's wrong with maintaining a casual friendship based only around that activity? Those can deepen over time but at least IME that doesn't necessarily happen quickly.
Forgot to respond to this one.There are plenty of people who are carrying their weight. Let’s not make the pathology normal/baseline/expected imo. Simpler to state that they do not want to do the work because the long term rewards seem so trivial compared to the short term pleasures available at every turn every day in their life.