Andrew Lechman

Psychiatry, Packers and a little electronic music; proud 3rd generation ukrainian

[Tyler Black, MD @tylerblack32]

🧵Borderline Personality Disorder (BPD) 🧵

Ask any person who has been even suggested to have BPD; they will uniformly tell you that they have been told to try DBT (Dialectical Behavioural Therapy). Reflexively recommended. "Gold standard."

This is not science-supported.

/1

[Andrew Lechman @Lechman21]

@chrisaikenmd this needs to be talked about more, still a lot of practitioners talking about how it INCREASES anxiety

[John Jackson @hissgoescobra]

More from the WSJ article.

[Chris Murphy 🟧 @ChrisMurphyCT]

We are fast becoming a banana republic, with two standards of justice. If you oppose the leader, you go to jail just for speech. If you're a loyalist, you get immunity for your crimes.

That's what happens in Iran - not the United States. This is a decision moment for America.

[Andrew Lechman @Lechman21]

I'm absolutely shocked

[Adam Schefter @AdamSchefter]

ESPN Sources: Cowboys are trading three-time All-Pro LB Micah Packers to the Green Bay Packers.

Parsons and the Packers already have reached agreement on a four-year, $188 million contract. @DavidMulugheta of @Athletesfirst had a hand in the trade and ultimately negotiating the record-breaking contract that includes $120 million fully guaranteed at signing and makes Parsons the highest-paid non-QB in NFL history.

[Adam Schefter @AdamSchefter]

ESPN Sources: Cowboys are trading three-time All-Pro LB Micah Packers to the Green Bay Packers.

Parsons and the Packers already have reached agreement on a four-year, $188 million contract. @DavidMulugheta of @Athletesfirst had a hand in the trade and ultimately negotiating the record-breaking contract that includes $120 million fully guaranteed at signing and makes Parsons the highest-paid non-QB in NFL history.

[Nicholas Fabiano, MD @NTFabiano]

Our paper was just published in the Canadian Medical Association Journal.

People with cannabis-induced psychosis are at a 241.6-fold higher risk of developing schizophrenia.

Cannabis from the 2000s is not the same as today.

[Andrew Lechman @Lechman21]

@DavidPuder Yeah thats a fair point. I think I'm pessimistic that making it a prescription overcomes the barriers that prevent patients from exercising. I do agree we need to be talking about it with patients more. The benefits are too good not to!

[Andrew Lechman @Lechman21]

@romyromy21_ Really happy you highlighted this because particularly in hospital settings this is a common refrain and justification for lack of validation. That being said there are cases where people are explicitly manipulative and appear to have bpd but have a more antisocial picture

[Andrew Lechman @Lechman21]

@DrMcFillin Dr McFillin are you familiar with projection?

[Anthony Scaramucci @Scaramucci]

Here is a recap of the Ukraine situation, for those choosing to reject propaganda and continue seeking truth:

December 1994, Ukraine agrees to give up its nuclear arsenal in return for security guarantees from the US, UK, France, China and Russia.

February 2014, Russia invades and subsequently annexes Crimea, President Obama does next to nothing. War through weakness.

July 2019, Trump admin withholds $250 million in military aid to Ukraine to apply pressure to investigate alleged corruption by Hunter and Joe Biden.

February 2022, Russia invades a weakened Ukraine, world expects Zelenskyy to flee and Kyiv to fall within days. Ukrainians fight bravely for 3+ years, inflict hundreds of thousands of casualties on Russian army, weaken Putin politically.

U.S. has sent ~$70 billion in outdated military equipment to Ukraine since start of war, providing opportunity for U.S. military to modernize its weaponry. We’ve sent an additional $30+ billion in budget support, $75 billion in ancillary appropriations related to war.

~50,000 Ukrainians have died defending their homeland, protecting U.S. and Western interests in the process. Meanwhile, the U.S. President and V.P. are calling democratically-elected Zelenskyy a dictator and berating him in Oval Office in pursuit of a financial payoff.

The U.S. should be thanking Ukrainians, who have fought for our common interests with only modest financial support from a country with a ~$30 trillion GDP.

America can and will reclaim its backbone again soon, with better policy and messaging from common sense moderates.

Slava Ukraina.

[Andrew Lechman @Lechman21]

@POTUS Weren't you the one showing emotion? I could hardly hear him over you and Vance

[Andrew Lechman @Lechman21]

@DoctorPerin Rule of thumb is patient, but its so dependent on the situation

[Andrew Lechman @Lechman21]

@elonmusk @CommunityNotes So what is your source then?

[Andrew Lechman @Lechman21]

@lesliecarpent15 @nytimes Not sure if this quote is hyperbole or sad. In psychiatry we routinely counsel our patients on this. Maybe this is more an american thing, i believe packaging in canada often displays this info kind of like cancer warnings on cigarettes

[Andrew Lechman @Lechman21]

@GrantHBrennerMD That they "analyze" everyone they meet

[Andrew Lechman @Lechman21]

@drjanaway Can you expand on why that would make people upset?

[Andrew Lechman @Lechman21]

"Narcissistic people send confusing messages to their friends and families: Their need for others is deep, but their love for them is shallow." - Nancy McWilliams

[Andrew Lechman @Lechman21]

@re_colston Even though I dont follow anyone who espouses those views, my page was full of "biden is dead" for the last week