Ravi Philip Rajkumar

Professor of Psychiatry, JIPMER, Puducherry. All views and opinions expressed are my own.

[Ravi Philip Rajkumar @RaviPRajkumar1]

@RianKMD Hard agree based on clinical experience.

In terms of desirable effects, there's nothing it can do that other benzodiazepines can't do better and more safely.

Has a very high potential for abuse and dependence even with relatively short use.

We're better off without it.

[Ravi Philip Rajkumar @RaviPRajkumar1]

One of the greatest evils of our times is our inability to think in non-binary ways. Everything is either "wonderful" or "evil nonsense". There is no middle. We are living through a silent epidemic of culturally- (and media-) induced borderline personality organization.

[Ravi Philip Rajkumar @RaviPRajkumar1]

Words to live by. When a psychiatric term becomes fashionable, or is diluted by cultural osmosis and misrepresentation, it ends up doing a great deal of harm and very little good. (Cf. the same thing a couple of generations ago with "anal retentive", "inferiority complex", etc.)

[Allen Frances @AllenFrancesMD]

6 most over-used terms o hate are:
"On the autistic spectrum"
"ADHD"
"A little bit bipolar"
"Trauma-informed therapy"
"Multiple personality"
"Borderline"

Any psych diagnosis or treatment that suddenly becomes extremely popular is a fad likely to do much more harm than good.

[Ravi Philip Rajkumar @RaviPRajkumar1]

There has been much interest in the links between gut-the brain axis and depression. What if enteric glial cells were an important link in a causal chain connecting gut-brain axis dysfunction and depression?

https://t.co/zWU1Bjq8Cj

[Ravi Philip Rajkumar @RaviPRajkumar1]

Are there direct or indirect relationships between infectious diseases and mood disorders? I attempt to address this question using the GBD data for 204 countries and territories:

https://t.co/d1zqCmH2xc

[Ravi Philip Rajkumar @RaviPRajkumar1]

@psychgeist52 Looks very dodgy to me. The vast majority of patients with probable C-PTSD (or the older "DES-NOS") have many of the features that are erroneously assigned a "no" in that table. A developmental perspective on personality disorders is much needed...

[Ravi Philip Rajkumar @RaviPRajkumar1]

I've often heard depression referred to (dismissively) as the "common cold" of mental disorders.

But what if there was an actual causal relationship between upper respiratory infections and mood disorders? 🤔

[Ravi Philip Rajkumar @RaviPRajkumar1]

@nsnadeemsarwar Sure, please DM me on any day from Monday onwards - am a bit busy this weekend.

[Ravi Philip Rajkumar @RaviPRajkumar1]

@dawso007 Good points. Breggin's books do fall into the "brain damage" camp, but he has libertarian political leanings (https://t.co/J1ghMFbB6Q) that almost certainly colour his views.

[Ravi Philip Rajkumar @RaviPRajkumar1]

In view of the recent kerfuffles about serotonin and antidepressants (the return of the repressed!) this might be of interest to some:

https://t.co/xbjPnZ38TY

[Ravi Philip Rajkumar @RaviPRajkumar1]

@dawso007 (b) can be exemplified by the work of, say, Jay Adams in the 1970s, but it is enjoying an online renaissance in recent times.

[Ravi Philip Rajkumar @RaviPRajkumar1]

@dawso007 There is also
a) a libertarian strand of rhetoric popularized by Szasz and Breggin, based on valuing (overvaluing?) individual freedom and autonomy
b) a religious strain (seen in conservative Evangelical and Catholic circles) based on mental illness being due to sin, etc.

[Ravi Philip Rajkumar @RaviPRajkumar1]

@najeijames This is a very good study. Congratulations! (And honestly, this is a question that needs addressing in my own country - professional and parental opinions and preferences often differ.)

[Ravi Philip Rajkumar @RaviPRajkumar1]

Wanted: a "general" theory of attachment that would build on and supplement (or perhaps even supplant) the "special" ones we have to date.

[Ravi Philip Rajkumar @RaviPRajkumar1]

@ProfRobHoward There is actually a lot of space between "Depression is an illness as defined in DSM-5, period" and the views presented in that blog post. Unfortunately, in our age of clickbait, hot takes and all-or-none, black-or-white thinking, few are willing to explore it... ☹️

[Ravi Philip Rajkumar @RaviPRajkumar1]

@Mental_Elf The fuss about the Moncrieff et al. paper is a textbook example of a storm in a teacup. The original paper was mediocre, and simply set up a strawman to throw punches at - but the exaggerated responses to it are revealing. 😀

[Ravi Philip Rajkumar @RaviPRajkumar1]

@MarkLRuffalo That said, if the "disorder" being alluded to in the original tweet is a victim of "diagnostic bracket creep", then the argument is valid. Changes in criteria and in the looseness with which they are applied can also lead to inflated estimates of prevalence.

[Ravi Philip Rajkumar @RaviPRajkumar1]

@MarkLRuffalo Something that often gets ignored in these discussions is the role of life expectancy / demographics. When adjusting for life expectancy, the incidence of depression in the "developed world" is not all that different from what it is in the "developing world".

[Ravi Philip Rajkumar @RaviPRajkumar1]

A fascinating study which dovetails neatly into the "defensive model of depression" paper I have been meaning to write for ages, but never get down to actually writing (😅)

[Andrew Devendorf, PhD @AndrewDevendorf]

Check out our new study!

"Framing depression as a functional signal, not a disease: Rationale and initial randomized controlled trial"

We found a strengths-based framing of depression is better than a disease framing on hope & stigma.

🧵1/5
https://t.co/402mnnedJb

[Ravi Philip Rajkumar @RaviPRajkumar1]

Social media is a good servant, but a terrible master. It can be an invaluable aid to effective communication and dissemination of information if mastered; but if it enslaves us, the effect on our psychological and social well-being can be catastrophic.