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Antidepressants are not addictive.They may cause dependence, which simply means you need to avoid stopping the medicine abruptly, to avoid withdrawal symptoms. This is not unique to psychiatric medications, and not to be feared, but understood.As a psychiatrist who has prescribed antidepressants for over forty years, I have not seen “more harm than good” in my patients, nor read that in any of the medical literature. I can’t imagine how any physician in good conscience could prescribe a treatment, for any patient, if that were true. Please consider the source of negative comments.All prescription medications have potentially harmful side effects, and long term effects. That’s why they are available by prescription only.All of my patients have initiated contact with me to have an evaluation in my office. They are suffering from some psychiatric disorder, which is causing symptoms and dysfunction. That must be kept in mind when considering treatment. I don’t prescribe medications for people who have mild symptoms, or no symptoms.I spend at least one and one half hours with every new patient. Every one, for four decades. I do a thorough exam of their medical history, social history, family history, psychiatric history, medications, and so on. I take my responsibility very seriously, and take the trust of my patients extremely seriously. If some people are receiving less than optimal care, I strongly urge them to seek better care.Lastly, please keep in mind that the brain is the most complex organ of the body. It seems as though many people believe treatment of brain disorders, especially psychiatric disorders, is a trivial simple matter. It is not. If one is seeking optimal treatment, I recommend getting an evaluation with a psychiatrist who will spend a lot of time with each patient at each appointment.

“When will you come back?”Being in a medical school is pretty amazing. You go through a lot of exams, and learn a lot of things that lectures can never teach.So here’s what happened during my 6th sem exams.It was the day of Community medicine exam practical, and a part of the exam is to take a case from the hospital and present it.It is a social case, and 45 minutes are allotted for complete history taking, medical examination, and social history, along with a social diagnosis and social treatment.So as I was allotted the case, it said, “Leprosy, dermatology ward”This was a mini shock for me, because dermatology ward was a few kilometers from the department, and I had to go there, take medical and social history, complete the examination and get ready with the case in just 45 minutes!I rushed. Reached there as I was gasping for breaths. The resident there guided me to my patient and said, “Your time begins. Examiner will be here in 35 minutes”I took a look at my patient. He was in his late 20’s. I thought of an unconventional technique to take the case.What we generally do is to go to him and explain what we are here for, and start asking his details as we write them.For a change, I kept my pen and sheet aside, and went to him.I told him that I was going to talk to him. Get to know his case and learn. He agreed.I asked his name, where he was from, what he did. But I did not write it down. I went on talking.We then went on to talk about what brought him to the hospital, how the symptoms progressed and other relevant medical stuff.Since I was also supposed to take a social history, Which comprises of a SWOT analysis of the case, (For those who don’t know, SWOT is Strength, Weaknesses, Opportunities and Threats of the present case), I went on to talk about his personal life.To make it more casual, I asked his likes, dislikes, his food preferences, his habits. Everything That I could.As we went on to talk, I did not realize that we were friends now.He told me that he was newly married and that his wife is unaware about the disease. He has not told his parents about it either.Since we were talking , I told him that I personally believed that parents are a support in every case.“Par sir, wo chinta karenge” (But sir, they’ll get worried)“Worry is genuine. But this does not mean you devoid them of the knowledge about your disease! They should know about you. Moreover, If you take our medicine regularly, You’ll get cured and they’ll be able to tell an example in the community. This will spread further awareness!”“Should I tell my wife,too, sir?”“I think, you should. This relation is for a lifetime, and acceptance of truth is a part of it. Also, Hiding it is a stress for you, and once she knows, her support would be a strength!”We talked. A lot. It was only when I looked at my watch that I realized that I was late. only 10 minutes were left and I had to write the whole case sheet.I told him, “As a part pf my exam, I will now write your case. “, and I began writing the case.When I reached the family composition part in social history, my time was over. I got worried.Now here comes the amazing part: He saw that I was scared. He says,“ Sir, Don’t waste your time writing my whole family. I’ll tell your examiner that I’m Unmarried.”I was awestruck. Not only did he genuinely try to help me, he knew about how to take the case.Also, I really felt happy that the patient was thinking in favor of the doctor!I said,” No. I cannot do that. The case has to be genuine. He’s going to take some time, I’ll finish it. “, As I smiled!The examiner indeed took some time for the guy preceding me. I completed my case.As I was waiting for him to come to me, I saw my patient looking at me.“Aap wapas kab aaoge?” “When will you come back?”These lines are, till date, the most amazing words that I’ve heard from any patient.The gleam in his eyes made me a topper in my own eyes.The confidence with which I presented my case to the examiner following this cannot be described in words.Of Course, I scored well, But then, who cares!Some rewards surpass marks or quantification.I learnt two important lessons that day.First, that Communication will win you things: Be it hearts or marks. As Undergraduates, more than aspirations of being a super specialist in some branch, we should aspire to be good communicators first.And second, that how much the people around us know, and that we’ll never get to know that unless we talk to them.My patient knew more about case taking than myself.Everyone around us is knowledgeable in some way. Extracting that is our job.Have a great day!

I was working in the ER at a local hospital, which is also a trauma center and an academic teaching hospital. Patients with significant diagnosis or injury are often sent to the hospital where I worked for advanced care. One night we got notification that a patient was being sent to us with significant burns to the face, hands and upper torso. The patient was a child, about 12 years old. My job was to try to get information about the patient prior to their arrival so that we could have proper services in place. The kid’s medical needs were made clear, but no one seemed to have any information about the kid’s social history - parents names, address, insurance, emergency contact information, and things like that. I called the sending hospital and talked to the social worker in their ER, and she laid it all out for me…The kid had been given up for adoption at a young age by biological parents, but they were still in some form of contact with him/her. The adoptive parents were not available or aware of the situation because the child had gone to a foster home and they were not to have contact, legally. The foster parents were upset because their house had been damaged by the fire that injured the child, and would not be responding to the situation. I got the impression that the foster family had washed their hands of this kiddo. They were certainly not going to be traveling with the him/her to my ER. The only people in the transport vehicle with the kids were nurses and EMT’s (strangers). Whatever social history was needed would have to wait until the next business day when the courts could be contacted.So, let’s take a minute to count how many adults were refusing responsibility for this child:Biological parents : 2Adoptive parents: 2Foster parents: 2That’s 6 adults who were given the opportunity to do the right thing for this little person, and didn’t.Oh. Did I mention…The burns were sustained when the kid tried to commit suicide by setting him/herself on fire. The reason the kid was suicidal was because he/she didn’t feel like anyone cared.Turns out…he/she was right.When I saw that little face being wheeled through the ambulance bay doors, I started sobbing.Charred, blackened skin from the bellybutton to the eyebrows. Both hands completely burned and bandaged. It was horrific. But the worst part was the look on the child’s face. It wasn’t fear or pain I saw…just sadness.