Ultraviolet

[Ultraviolet @Missonixo]

@jonathanstea @ProfRobHoward The stigma about addiction is one of the worst things.

[Ultraviolet @Missonixo]

@finnishgunners I agree. It should be used swiftly and without a second thought.

[Dr. Jonathan N. Stea @jonathanstea]

To understand mental health misinformation, we need to go directly to its sources, which lie within the wellness community, anti-psychiatry movement, and mental health professions themselves.

For those unfamiliar, this is the CCHR, a branch of the cult of Scientology:

[Ultraviolet @Missonixo]

@DrAnnieHickox They have wayyyyy too much time on their hands.

[the human anachronism™️ @FullAsMuchHeart]

@nightlightra1n @_space_punk_ regular CBT not given by a specialist is ineffective for OCD, but specialized CBT which includes ERP is fantastic.

[Sam @samthom90]

@AshCurryOcd Do not be fooled by what is said on a fancy website. You can’t do a CBT training course in two days, especially with OCD. Always ask for proof of qualifications and accreditations.

[Ultraviolet @Missonixo]

@AshCurryOcd Very helpful information.
You must be proud of your work!

[Ultraviolet @Missonixo]

@GeorgeKirov1 @tylerblack32 Who needs a brain, when they have so much spleen?

[Ultraviolet @Missonixo]

@tillytog01 @RecoveryDoctor @markhoro They’re the real victims!

[Awais Aftab @awaisaftab]

Clinical Staging, Early Intervention, and Youth Mental Health: An Interview with Patrick McGorry (@PatMcGorry )

How do we intelligently connect multifactorial, pluripotential syndromes to treatment decisions?

https://t.co/HEpnhtL2Ur

[Dr. Jonathan N. Stea @jonathanstea]

This anti-vax movement has a lot of things that I love: star power, science denial, and hipster appeal.

Cause Penny-farthings and handlebar mustaches are cool, but nothing is more vintage than dying of Rubella.

- Stephen Colbert

[Dr Sanil Rege FRANZCP | MRCPsych @sanilrege]

‘Injury’ and ‘Healing’ Are the Wrong Story for the Brain🚨🚨

We hear
“SSRIs causes irreversible injury”
“My brain is injured from X “
“The brain will take years to heal”

The words “injury” and “healing” make sense for cuts, fractures, and infections.

They make far less sense for many brain-based conditions.

Because the brain doesn’t organise experience in a simple damage → repair → done sequence.

The brain is about change 👉more network reorganisation, learning, and integration into the self-model.

For example in chronic pain, once symptoms outlast expected tissue healing time, something important happens.

Activity in somatosensory regions (where pain is processed) begins to functionally couple with the default mode network - the network involved in self-referential thinking and identity.

The pain is no longer just a signal from tissue.

It becomes part of the self-model.

This is well described in chronic pain neuroimaging studies and helps explain why the experience persists even when the original injury has resolved.

When we continue to frame such states purely in terms of “injury” and “healing,” we may unintentionally reinforce a loop where the person is searching for a fix to something the brain has already integrated into identity.

Not because they are imagining it.

But because the brain is doing exactly what it evolved to do:
embed persistent signals into the story of the self.

This is where the injury–healing dichotomy can become a trap - clinically and psychologically.

The solution is to help the person step outside the injury–healing frame and understand the problem as one of network reorganisation and learned brain patterns, not ongoing damage.

This does not mean the condition is psychosomatic or that biology is ignored ; rather, it recognises that the initial trigger is often different from what later sustains the suffering, as seen in chronic pain, Long COVID, fibromyalgia, and protracted antidepressant withdrawal.

It is about integrating biology + psychological aspects ( predictive processing; network understanding ; nociplastic and neuroplastic changes.…etc).

[Eric Topol @EricTopol]

Discovery of a maladaptive heart-brain-immune system loop after a heart attack, and the ability to modulate it
https://t.co/Czr26OPPrN

[Ultraviolet @Missonixo]

@JasonPalmer1971 @DrAnnieHickox @LadyRimbaud @JRBneuropsiq Sone people say they find it helpful but I don’t think we should give it credibility as a valid intervention.
Don’t need it when I’ve got my Ouija board..

[Om Prakash, MD @ompsychiatrist]

Antidepressants and Severe Depression

Q & A for Public 🧵

Q1. Do antidepressants work in severe depression?

Yes. The strongest evidence comes from a large network meta-analysis of 522 randomized controlled trials involving more than 116,000 adults, which found that all commonly used antidepressants were more effective than placebo in major depressive disorder (Cipriani et al., The Lancet, 2018). While average effect sizes were modest, they were consistent and clinically meaningful, particularly relevant in moderate to severe illness.

Q2. Critics claim these benefits are “statistical illusions.” Is that accurate?

No. That claim overreaches.
Concerns about blinding, expectancy effects, and publication bias are legitimate and widely acknowledged in psychiatry. However, antidepressant efficacy has been demonstrated across multiple analytic approaches and independent datasets. The persistence of benefit across sensitivity analyses argues against the idea that results are purely artifacts (Cipriani et al., The Lancet, 2018; Hieronymus et al., Molecular Psychiatry, 2016).

Q3. Are antidepressants ineffective in mild depression?

Often, yes. Patient-level analyses of FDA trial data show minimal benefit in mild depression, where psychosocial interventions are usually preferred. The same analyses, however, demonstrate clinically meaningful symptom reduction in severe depression, with differences large enough to matter in practice (Fournier et al., PLoS Medicine, 2010). This distinction is broadly accepted in clinical guidelines.

Q4. What does the evidence say about suicide risk?

Risk depends on age and timing. Regulatory reviews show an increased risk of suicidal thoughts and behaviour in children and adolescents, particularly early in treatment, which led to the FDA black-box warning (Stone et al., BMJ, 2009). In adults, randomized and observational studies generally show no increase in suicide risk and some large population studies report lower rates of suicide attempts among treated patients after adjustment for illness severity (Khan et al., Archives of General Psychiatry, 2003; Coupland et al., BMJ, 2015).

Q5. Did antidepressant safety warnings have unintended consequences?

Possibly. After antidepressant prescribing declined following regulatory warnings, several population-level studies observed rises in suicide attempts among young people. These studies are ecological and cannot establish causation but the temporal association has raised concerns about reduced access to effective treatment (Gibbons et al., American Journal of Psychiatry, 2007; Lu et al., BMJ, 2014).

Q6. Are antidepressants better than psychotherapy?

This is the wrong comparison. Meta-analyses show antidepressants and evidence-based psychotherapies have similar short-term efficacy. However, in moderate to severe depression, combined treatment is superior, leading to faster improvement and lower relapse rates. This integrated approach is recommended by major international guidelines (Cuijpers et al., World Psychiatry, 2014; Cuijpers et al., Lancet Psychiatry, 2020).

Q7. Do antidepressants reduce relapse in the long term?

Yes, for recurrent or severe depression. Maintenance antidepressant therapy reduces relapse risk by approximately 50–70% compared with discontinuation, especially in patients with multiple prior episodes (Geddes et al., The Lancet, 2003; Glue et al., Nature Reviews Drug Discovery, 2010).

Q8. Are antidepressants driving rising mental health problems, and are psychiatrists ignoring their harms?

No. There is no credible evidence that antidepressants drive rising mental health problems. Increases in depression disability are largely linked to social stressors such as inequality, trauma, substance use & pandemics. Psychiatry does not ignore harms. Its modern practice emphasises informed consent, close monitoring and regular review. Antidepressants are not for everyone but they remain effective for many people with severe depression.

[Ultraviolet @Missonixo]

@chrisaikenmd Amazing!

[Ultraviolet @Missonixo]

@FarewellSSRI @danascullyshair @tillytog01 @stimimi I don’t try to make this place my identity.

[Ultraviolet @Missonixo]

@FarewellSSRI @danascullyshair @tillytog01 @stimimi I don’t try to make this place my identity.

[Ultraviolet @Missonixo]

@JRBneuropsiq @LadyRimbaud Maybe it’s a case of fake it til you make it, and by repeatedly posing as liberals they believe that’s all they have to do.

[Ultraviolet @Missonixo]

@jonathanstea That’s a very odd hobby they have.
Stay safe!