Our Blog:  Reflections on Psychiatry & Psychology

The glymphatic system is a brain-wide waste-clearance pathway where CSF flows along vessels, exchanges with interstitial fluid via astrocytes, and drains metabolites. It is driven by vascular pulsation and enhanced during sleep. Dysfunction—linked to poor sleep or vascular issues—may promote buildup of proteins like amyloid-β and contribute to neurologic disease.

AI is reshaping mental health care by expanding access, improving diagnosis, and enabling personalized treatment. While early results are promising, concerns remain about safety, bias, privacy, and loss of human connection. Experts emphasize AI should augment—not replace—clinicians.

tDCS is a noninvasive brain stimulation that modulates cortical activity via weak currents, promoting plasticity. Evidence is strongest for depression (~33% response vs 17% sham), especially as adjunct therapy. It’s well tolerated but investigational; effects in other disorders are uncertain.

A clinical case study on how integrated ketamine therapy and psychiatric care at Point Loma Clinic enabled early detection of a shift from depression to bipolar disorder. Patient Background: Treatment-Resistant Depression and a History of Mood Instability Joe is in his mid-fifties, an accomplished attorney who has been suffering from recurrent depression since his early adulthood. The depression was difficult to treat; many different medications have been tried, including mo

Prescription nutraceuticals sometimes used in psychiatry include Deplin and EnLyte (L-methylfolate formulations that support neurotransmitter production) and Vascepa and Lovaza (omega-3 fatty acids). They are not antidepressants but may be added to treatment to support mood and overall brain health.

Researchers found that amyloid plaques in Alzheimer’s brains trap lithium, creating early lithium deficiency that may contribute to disease onset. In mice, low lithium worsened plaques and memory loss, while low-dose lithium orotate improved them. Human studies are still needed.

Ketamine and postpartum depression: A landmark BMJ study found that a single dose of esketamine after childbirth reduced postpartum depression by 75% in at-risk mothers. Learn what this means for prenatal depression treatment and maternal mental health.

"Taking traditional medication was like wading through mud—constantly struggling to stay clean. Ketamine, however, felt like walking in gentle rain; any mud simply washes away."

Psychedelic psychiatry is moving from fringe research to mainstream clinical practice. An overview of psilocybin, MDMA, and ketamine — including benefits, risks, and what the evidence supports.

If multiple antidepressants haven't worked for you, you're not alone and you're not out of options. Why Antidepressants Fail: Lessons from the STAR*D Study Treatment-resistant depression (TRD) is a complex challenge in mental health, characterized by patients' inadequate response to standard antidepressant therapies. The landmark STAR*D study, which extensively evaluated treatment strategies for depression, revealed that a significant percentage of individuals do not respond

OCD is often diagnosed late (6–10 years) due to varied symptoms and stigma. Depression frequently co-occurs and may obscure OCD. Standard treatment is ERP plus SSRIs; other medications may be added. Emerging evidence suggests ketamine may help treatment-resistant OCD.

Stress and bipolar disorder (BD) interact bidirectionally. Stress, particularly in early life, appears to have lasting effects and marks for early onset of BD, although the exact mechanism is poorly understood. The relationship of stress to the onset of the disorder and its course has implications for treatment and management — and perhaps even prevention.

Zurzuvae, the first FDA-approved oral pill for postpartum depression, is taken for 14 days and can reduce symptoms within days. Costing about $15,900, access may be limited despite its rapid action compared with traditional antidepressants.

The “988 Lifeline” service was launched in July 2022, progressing from the narrow focus on suicide prevention as the “National Suicide Prevention Lifeline” to a wider attention of forms of acute distress (and also requiring a much simpler dial code). A recent study on 988 Lifeline reveals that while it has received millions of calls, texts, and online messages, it might not be living up to its full potential. The researchers found that people dealing with severe psychologic

In areas where cannabis is legal, more young people are driving under its influence than alcohol. Misconceptions about impairment, lack of clear THC limits, and normalization of use raise road safety concerns, highlighting the need to balance legalization with prevention.

Zuranolone (Zurzuvae) is the first oral GABA-modulating antidepressant for postpartum depression. Taken for 14 days, it can improve symptoms within 3 days; benefits may last weeks. Common side effects include drowsiness and dizziness.

Nutraceuticals—herbs and vitamins like ashwagandha, kava, chamomile, and CBD—may ease mild anxiety but aren’t a substitute for professional treatment. Consult a healthcare provider.

Cocaine blocks dopamine reuptake in the brain’s reward pathway, causing short-lived euphoria and repeated dosing. It raises heart rate and blood pressure and can cause paranoia, psychosis, heart attack, stroke, and overdose. Mixing with alcohol forms toxic cocaethylene.

Drugs disrupt brain homeostasis by hijacking the dopamine-based reward system, producing powerful reinforcement and cravings. Repeated use causes brain adaptations, impaired impulse control, and stress-driven relapse. Genetics and environment increase risk, but recovery is possible through strengthened top-down control.

Bipolar II disorder alternates between depression and hypomania but is hard to diagnose because patients often enjoy or fail to recognize hypomania and seek help only during depression. Recollections may be distorted, so collateral history from others is often crucial for accurate diagnosis.