Reflections on Psychiatry & Psychology

A psychiatrist posed as a troubled teen to test AI therapy chatbots — and the results were alarming. Point Loma Clinic in San Diego explains why AI cannot safely replace licensed therapists, especially for vulnerable teens.

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.

Biofeedback teaches control over body functions. HRV biofeedback helps sync heart rate and breathing, boosting parasympathetic response, improving stress, anxiety, and self-regulation.

Study of 252 cocaine-dependent patients tested whether early therapeutic alliance predicts drug-treatment outcomes across several therapies. Alliance weakly predicted outcomes (better for depression than drug use). Design issues—many variables and mixed treatments—may have limited conclusions.

Decision-making uses limited mental energy (“decision fatigue”). As energy declines, resisting habitual substance use becomes harder. Recovery improves when people conserve mental energy by building routines, reducing temptations, planning ahead, and supporting decision capacity.

Biofeedback uses tech to monitor body signals like heart rate and muscle tension, helping you gain awareness and control, reducing stress, pain, anxiety, and other conditions.

Winston, long prone to anxiety, feared ALS after a referral. Therapy and meds eased his health anxiety and he thrived—until ALS was confirmed. He chose to focus on family, stayed positive, and kept in touch for refills until his death about 14 months later.

Carla, 48, battled anxiety and panic since 16, relying on long-term meds without therapy. Ketamine-assisted psychotherapy helped her confront childhood trauma, easing rigid thinking and accelerating recovery.

After quitting drugs, many feel bored because drugs flood the brain with dopamine, dulling natural rewards. With time and practice engaging in healthy activities, the brain can relearn to find pleasure in everyday life.

Hypervigilance to bodily sensations can trigger faster breathing and hyperventilation, lowering CO₂ and reducing oxygen delivery to tissues. This causes dizziness, tingling, and panic. Alcohol may give brief relief but worsens anxiety later; therapy can help.