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

[AbnormalPsych]

---

Members don't see this ad.

Less depresso...more espresso!

 

[cara susanna]

Less depresso...more espresso!

View attachment 405597

Y'know, all I can really feel about this is... impressed. Get that market, girl.

 

[Sanman]

Less depresso...more espresso!

View attachment 405597

I'd be really pissed if I showed up here as a client and there was no espresso maker in the office. I wanted more espresso!

 

[Shiori]

It's a pretty cute ad. I would only be worried because Sabrina regularly courts controversy.

 

[futureapppsy2]

Y'know, all I can really feel about this is... impressed. Get that market, girl.

Same—this is good marketing!

 

[borne_before]

Less depresso...more espresso!

View attachment 405597

Y'know, all I can really feel about this is... impressed. Get that market, girl.

I'd be really pissed if I showed up here as a client and there was no espresso maker in the office. I wanted more espresso!

It's a pretty cute ad. I would only be worried because Sabrina regularly courts controversy.

Same—this is good marketing!

I’ll stan for Sabrina Carpenter and my 3.5-year-old and I blast Man Child on the morning drive.

That said, is it odd that I really appreciate this ad? Our work doesn’t always have to feel so heavy or clinical. “Less depresso, more espresso” is cheeky, irreverent, and honestly kind of lovely. I dig it.

Clinically, I’ve found that I build the easiest rapport with patients who connect with my dry sarcasm and capacity for playful humor/irreverence. I use humor/sarcasm a lot to defuse or make some mental flexibility. As I age, I am becoming much more comfortable disclosing that I don't have everything figured out and making jabs at myself, sharing parenting failures, etc., with patients.

 

[borne_before]

Saw a post from @doctorperrin on X the other day that stuck with me. He wrote:

“My brother’s spiciest psychology take is that the rise in poor impulse control over the last thirty years came from the success of anti-smoking campaigns, because cigarettes used to manage and cover ADHD and anxiety symptoms.”

Obviously it’s not the explanation (or even that there is a increase), but I actually think there’s something to it? When something shifts on the scale of smoking cessation, millions of people quitting a stimulant they were using daily, there are bound to be some unintended consequences (externalities?).

I also think the thesis overlooks the behavioral ritual that goes along with smoking. Built in moments of pausing your day to go outside, lighting up, deep breathing, sensory engagement, etc. that go along with smoking (and to a lesser extent chewing tobacco). Multiple daily, addiction driven, mindful moments?

Contrast that with the rise Zyn pouches today. You don’t that get ritual, or pause, or any embodied experience. You just get the pharmacological hit, discreetly.

---

 

[cara susanna]

Saw a post from @doctorperrin on X the other day that stuck with me. He wrote:

“My brother’s spiciest psychology take is that the rise in poor impulse control over the last thirty years came from the success of anti-smoking campaigns, because cigarettes used to manage and cover ADHD and anxiety symptoms.”

Obviously it’s not the explanation (or even that there is a increase), but I actually think there’s something to it? When something shifts on the scale of smoking cessation, millions of people quitting a stimulant they were using daily, there are bound to be some unintended consequences (externalities?).

I also think the thesis overlooks the behavioral ritual that goes along with smoking. Built in moments of pausing your day to go outside, lighting up, deep breathing, sensory engagement, etc. that go along with smoking (and to a lesser extent chewing tobacco). Multiple daily, addiction driven, mindful moments?

Contrast that with the rise Zyn pouches today. You don’t that get ritual, or pause, or any embodied experience. You just get the pharmacological hit, discreetly.

---

Super curious about @Ollie123's take on this

 

[Ollie123]

Disclaimer: I've worked with some of the biggest players in this field, but only have one publication specifically on the intersection of ADHD and smoking.

I think its a relatively silly take in the grand scheme of things. For one, the meteoric rise in ADHD diagnosis most people reference is younger (i.e., elementary age) kids The average age of smoking initiation is around 13 and hasn't changed meaningfully since the 1980's - so long after ADHD symptoms typically emerge. Nicotine does have an impact on executive function, but the acute effects aren't actually that robust. The withdrawal effects (which would be expected to worsen symptoms) are actually often stronger than the acute effects, though pairing these head-to-head is methodologically challenging in humans so I'm not convinced that is definitively proven. I don't have data to back this up, but I'd strongly suspect this withdrawal effect gets especially complicated in adolescents - many are lighter smokers out of necessity (money, availability) so may not have substantive withdrawal symptoms. Restricted access (can't smoke around parents/teachers) is also going to mean withdrawal onset is often out of their control.

Is it possible some adults partly manage their ADHD symptoms through cigarette smoking? Sure, to a degree. Keep in mind though, that it is nicotine driving the effects of cigarette smoking on executive function. If their thesis was true, wouldn't we be expecting a dramatic DROP in ADHD since ~2012 and the rise of vaping? I haven't looked in a while, but that certainly isn't what I'm seeing.

If anything, I'd be more inclined to blame the increased prevalence of vaping (and the associated ebb and flow of nicotine withdrawal) for increases over the last 15ish years than reductions in smoking. In reality though, I think any link between these two is probably relatively subtle, context-dependent and the real culprits are infinitely more likely to be changes in parenting style, screen media use, sleep, etc.

 

[futureapppsy2]

Disclaimer: I've worked with some of the biggest players in this field, but only have one publication specifically on the intersection of ADHD and smoking.

I think its a relatively silly take in the grand scheme of things. For one, the meteoric rise in ADHD diagnosis most people reference is younger (i.e., elementary age) kids The average age of smoking initiation is around 13 and hasn't changed meaningfully since the 1980's - so long after ADHD symptoms typically emerge. Nicotine does have an impact on executive function, but the acute effects aren't actually that robust. The withdrawal effects (which would be expected to worsen symptoms) are actually often stronger than the acute effects, though pairing these head-to-head is methodologically challenging in humans so I'm not convinced that is definitively proven. I don't have data to back this up, but I'd strongly suspect this withdrawal effect gets especially complicated in adolescents - many are lighter smokers out of necessity (money, availability) so may not have substantive withdrawal symptoms. Restricted access (can't smoke around parents/teachers) is also going to mean withdrawal onset is often out of their control.

Is it possible some adults partly manage their ADHD symptoms through cigarette smoking? Sure, to a degree. Keep in mind though, that it is nicotine driving the effects of cigarette smoking on executive function. If their thesis was true, wouldn't we be expecting a dramatic DROP in ADHD since ~2012 and the rise of vaping? I haven't looked in a while, but that certainly isn't what I'm seeing.

If anything, I'd be more inclined to blame the increased prevalence of vaping (and the associated ebb and flow of nicotine withdrawal) for increases over the last 15ish years than reductions in smoking. In reality though, I think any link between these two is probably relatively subtle, context-dependent and the real culprits are infinitely more likely to be changes in parenting style, screen media use, sleep, etc.

Great answer; related question—has there started to be any good data out there on the mid/long term effects of vaping?

 

[Ollie123]

On ADHD symptoms or in general?

Either way, the answer is no. They've only really been popular for < 15 years in the US, which is about the minimum I'd consider "mid-term" for studying health effects on something like this. Effects accumulate over time so we really need decades of exposure to get a good understanding. So we're just now eeking into a time window where questions about mid/long-term effects can be asked. People are starting to ask them, but methodolgoically it is super-messy for a couple reasons. Dual use was/is incredibly common so a lot of people are smoking concurrently and/or transitioned from combustible tobacco use and parsing those two gets challenging. The devices themselves have also evolved enormously during that time, so the "health effects" of someone who consistently used the same ecig from 2010 to now (which - given how the marketplace has changed - is quite likely impossible) might well differ from someone using current devices. Dosing, e-liquid etc are also all far more customizable which makes the work really challenging. Someone might use a given device, with a specific liquid concentration, various flavor additives, may or may not keep these consistent for any meaningful period of time, may be smoking concurrently, in many jurisdictions marijuana/THC use is escalating dramatically and may or may not be vaped, etc.

Long story short, we're "starting" to see better papers on long-term effects but it is still inherently messy data in ways that are completely outside the control of the researcher. I'm near-certain the conclusion is going to be some form of "Vaping is better than smoking, but worse than not vaping" for obvious reasons, but my take is the jury is still out on where within that continuum we end up falling.

 

[WisNeuro]

Also, given the lack of regulation and loopholes in the "vape juice" market, wouldn't it be difficult to really study the effects given the wide variety of who knows what in these products?

 

[Ollie123]

100% part of the problem. Researchers are starting to do a better job cataloguing everything in the commercially available products, but its tough to keep up and impossible to cover the full spectrum of what is out there. There are some constituents that are relatively consistently available and I don't think it precludes discovering health effects either (cigarettes certainly aren't all identical either!) but it is just a lot more complicated. There are ways around this - some obviously have more market share than others so we can conceivably get a handle on the effects of the major players. My read is that there is less brand loyalty than there is with cigarettes though, so people constantly switching it up makes things harder.

I think (emphasis on think - this is pure speculation on my part and 100 different researchers will give you 100 different opinions) we're going to follow a course similar to the food/diet literature. We can generally say that reduced calorie intake relative to a standard american diet is probably good. We have a mediocre handle on "macros" (protein/fat/carbs) and how different ratios of these impacts metabolism and health, with good work on a few other nuanced topics (e.g., fiber). Then it becomes a complete **** show trying to understand the 323,964 other chemicals in food - some of which may be perfectly fine or even healthy, some of which may be utterly horrible for us, some of which vary from healthy to deadly depending on dose and all of which may interact with one another in ways we're never going to understand exactly because no one can afford to power a study to test an 18-way interaction. We can understand that in aggregate these are probably doing some damage (ultra-highly-processed food lit) but trying to sort out the exact reasons why is a monumental task.

 

[borne_before]

Also, given the lack of regulation and loopholes in the "vape juice" market, wouldn't it be difficult to really study the effects given the wide variety of who knows what in these products?

We see messed up lungs a lot in our pulm clinic from vaping.

 

[cara susanna]

The fact that there is even a subset of people who think that Elle Woods from Legally Blonde has autism imo proves that autism has now become defined by what the internet thinks it is, as opposed to what it actually is

 

[AcronymAllergy]

The fact that there is even a subset of people who think that Elle Woods from Legally Blonde has autism imo proves that autism has now become defined by what the internet thinks it is, as opposed to what it actually is

I don't even know what behaviors people would be keying in on to suggest she has autism. Her encyclopedic knowledge of fashion...?

 

[PsyDuck90]

The fact that there is even a subset of people who think that Elle Woods from Legally Blonde has autism imo proves that autism has now become defined by what the internet thinks it is, as opposed to what it actually is

…..what is the evidence they have for this? She’s like the antithesis of someone on the autism spectrum. Then again, my Instagram algorithm keeps feeding me “early signs of autism” reels of infants just being infants, so I guess anything I shouldn’t be too surprising.

 

[cara susanna]

Yeah, that's why I'm so baffled. She's, like, the opposite of autistic

 

[cara susanna]

I feel like the therapist sub is becoming more EBP-friendly? I've been seeing a lot of downvotes on anti-EBP and upvotes on pro-EBP comments. Or maybe it's just certain posts.

 

[Therapist4Chnge]

That must be nice. I just keep seeing (on state-level list-servs) a pretty regular referral ask of "EMDR or brainspotting". Everyone request makes our profession feel dumber.

 

[SchoolPsycho]

A friend just received an autism diagnosis for their 6 year old from a physician. Included in the packet of materials about "what to do next" was a list of "alternative" therapies to consider, including removing mercury from the child's bloodstream.

 

[cara susanna]

The therapist sub is currently arguing about the definition of trauma

 

[WisNeuro]

The therapist sub is currently arguing about the definition of trauma

Isn't that all that sub really is? A bunch of undertrained people making up their own definitions for words with established meanings? I don't think I ever saw anyone on that sub actually know or use the terms like gaslight or transference corrrectly.

 

[oliversacks4thewin]

Isn't that all that sub really is? A bunch of undertrained people making up their own definitions for words with established meanings? I don't think I ever saw anyone on that sub actually know or use the terms like gaslight or transference corrrectly.

"Stop trying to gaslight me into agreeing with your opinions! You know I hate when you do that personal transference onto me, because it totally triggers my day to day trauma." /s

How did I do? Am i able to fully blend in yet?

 

[Sanman]

The therapist sub is currently arguing about the definition of trauma

Trauma is, like, totally subjective. I was traumatized this morning by the cost of my Starbucks.

 

[EnPsychlopedia]

I don't think I ever saw anyone on that sub actually know or use the terms like gaslight or transference correctly.

They legitimately use “transference” and “countertransference” to mean “how the client feels about me” and “how i feel about the client.” I don’t think they are even aware that the original psychoanalytic definitions are “the client’s displacement of their maladaptive object relations onto me, such that I become a surrogate form of that object against which the client can struggle” and “the same thing in reverse.”

It drives me bananas when people use those terms the wrong way, not because I want to defend psychoanalytic concepts (indeed, I think psychoanalysis is abject pseudoscientific nonsense), but simply because I care about people actually utilizing proper psychological language to describe the therapeutic relationship.

 

[WisNeuro]

They legitimately use “transference” and “countertransference” to mean “how the client feels about me” and “how i feel about the client.” I don’t think they are even aware that the original psychoanalytic definitions are “the client’s displacement of their maladaptive object relations onto me, such that I become a surrogate form of that object against which the client can struggle” and “the same thing in reverse.”

It drives me bananas when people use those terms the wrong way, not because I want to defend psychoanalytic concepts (indeed, I think psychoanalysis is abject pseudoscientific nonsense), but simply because I care about people actually utilizing proper psychological language to describe the therapeutic relationship.

How dare you question their truth!!

 

[Therapist4Chnge]

Stop gaslighting them!!!

Just kidding, they need the honesty and for ppl to stop coddle them.

 

[borne_before]

Is “long covid” just another way of saying that a personality disorder is having an exacerbation?

 

[Therapist4Chnge]

I think self-diagnosed (akin to fibromyalgia) long covid should be looked at with some skepticism, but it can be a real diagnosis. The cardiac and pulmonary damage that can occur are probably the two of the most worrisome conditions. The impact of chronic stress and/or disrupted sleep can definitely contribute to some of the reported long COVID symptoms, like cognitive fog and physical fatigue.

 

[EnPsychlopedia]

The r/Pychiatry sub has a very new post from a resident asking about DID and the number of psychiatrists recommending materials from the ISSTD or affiliated individuals is concerning. That and the inevitable nod to psychoanalysis as an explanatory framework…

 

[R. Matey]

I think self-diagnosed (akin to fibromyalgia) long covid should be looked at with some skepticism, but it can be a real diagnosis. The cardiac and pulmonary damage that can occur are probably the two of the most worrisome conditions. The impact of chronic stress and/or disrupted sleep can definitely contribute to some of the reported long COVID symptoms, like cognitive fog and physical fatigue.

I think it was like 2 years ago? I went to a really great grand rounds about long covid and MH. Happy to share the link to the audio file to anyone who PM's me.

 

[EnPsychlopedia]

FYI, capitalism is the root cause of literally all mental illness, guys /s

 

[Sanman]

FYI, capitalism is the root cause of literally all mental illness, guys /s

This explains why only disability compensation can cure many symptoms of anxiety, depression, and PTSD.

 

[Fan_of_Meehl]

This explains why only disability compensation can cure many symptoms of anxiety, depression, amd PTSD.

In my experience, it makes them far, far, worse. (And permanent).

 

[EnPsychlopedia]

I would never go so far as to suggest that the excesses of capitalism do not affect how we experience stress, or that it hasn't created new behavioral demands that may somewhat (mildly-moderately) expand what we understand to be the boundaries of things like ADHD. And I'm as critical of the excesses of capitalism as anyone (hell, you could probably call me a social democrat [i.e., Nordic modelist/proponent of strong welfare capitalism funded by highly progressive taxes]), but if it were this simple I could just shut down my psychosis research and call it solved.

 

[oliversacks4thewin]

FYI, capitalism is the root cause of literally all mental illness, guys /s

Ahhh yes, I always read very closely on the monozygotic twin studies about the main effects of capitalism on symptom presentation. After all, that is what those research projects specifically aim to study. /s