As I have been reading other psychiatrists’ blogs, I have seen heated discussions about involuntary hospitalization.  Many of these posts have focused on the legal aspects of commitment or have generalized from bad experiences to “all psychiatrists.”  I thought I might take a little time and tell the tale from my perspective.  I have also included some hints for patients wishing to avoid or obtain involuntary hospitalization.

Yesterday, I saw a movie that I had been wanting to see for a long time.  It is called “Big Fish.”  As I watched the movie, I was surprised with its wonderful presentation of the need for play in our lives and the need for a broader view of what is “true.”

I am becoming worried about the American way of life.  Worker productivity is going up and up.  Students are using (and sometimes abusing) stimulants so that they can study harder, take more hours of class, and make better grades.  Less time is used for “non-productive” activities like vacations, family time, recreation.  In short, more of us are discovering (and being victimized by) “efficiency.”

There has been a lot of discussion about the potential causes of the assassination attempt in Arizona.  Some of the input has been helpful, but much of it has been needlessly aggressive or defensive.  I think it might be helpful to have an enlightened discussion about this incident and how we might come to understand it.

For those few of you who have visited this blog over the past several months — thanks.  I have finally found my way back from the whirlwind of teaching, seeing patients, and doing research.  I hope to take a little time now and then to write some thoughts about psychiatry, psychology, neuroscience, and behavioral science and how these find their ways into our everyday lives.

The thoughts that have been occupying me lately have focussed on the behavioral science associated with political affiliation.  In short, how do people from different political backgrounds understand behavioral control?

Antidepressant medications come in many forms.  There are some that primarily increase serotonin levels in the brain, such as the serotonin specific reuptake inhibitors (SSRI’s).  Some elevate norepinephrine levels, such as desipramine and atomoxetine.  Some do both, for example venlafaxine and duloxetine.  Others are more unique in their mechanisms of action.  Bupropion increases dopamine levels, and mirtazepine blocks certain serotonin and norepinephrine receptors.  In short, antidepressants can produce their effects in a bewildering number of ways, some of which may be helpful to some people and some of which may be helpful to others.  Still, there are some practical things to know about how to take your medications and get the most out of them.

In my previous post, I noted that being able to submit (when appropriate) is important for socialization and building relationships.  However, many have problems that prevent them from assuming control of their lives (when appropriate) and making their thoughts, emotions, and wishes knows.  Some are generally submissive even when it is not appropriate.  Some are too often aggressive and ride rough-shod over others who they would like to have relationships with.  But many alternate between being passive (and storing up negative feelings against those they see as unfairly controlling their lives) and exploding with aggression when they can no longer tolerate the frustration of passivity.  The good news is that there is an alternative to passivity and aggression.  It is a middle road — assertiveness.

We live in a society where independence is highly valued.  On the other hand, we see daily what chaos can erupt from individuals, either singly or in groups, deciding that they do not have to consider others in their decisions and behaviors.  In navigating the straits between pursuing our own goals and adapting our behaviors to the needs of our community, we can err in either direction.  In this post, I would like to consider what I believe to be a very common error, the reluctance or inability to submit.

Our emotions are the spice of life.  They generally serve to enhance our experience, reinforce those that we would like to experience again, and steer us away from those that we would rather avoid in the future.  The absence of positive emotion (and sometimes even negative emotions) is one of the most distressing components of major depression.  Therefore, mental health professionals often pay close attention to their clients’ emotional range.  Can they be happy if they have a reason to?  Can they experience and appropriately express irritability and sadness under appropriate conditions?  If so, we often feel as if our clients have at least a foundation upon which to build a life of contentment — even if they have other problems that are currently standing in their way.

One emotion, however, needs special care and attention.  We encounter it commonly, and most of us express it daily at some point.  Still, in too great a concentration or when misused, it is toxic to our rationality, our relationships, and our capacity for contentedness.  That emotion is anger.

I like a good argument.  Sometimes I like arguments so much that I might play “the devil’s advocate” just to engage in the contest of wits.  I believe there is a place for this in society, but I also know that our society is getting more and more polarized.  This political, religious, philosophical, and international polarization may affect our interactions with family, friends, coworkers, and even strangers on the street.  Therefore, it is essential to know how to cool down the fires of conflict.