Ep. 012 - How to reverse weight gain from antipsychotic medication?
Ask A Psychiatrist
This episode deals with the question of weight gain from antipsychotic medication: I'm on 20 milligrams of olanzapine. It's helping me and I don't want to change it. The only thing is that I've gained a lot of weight that makes me feel very unattractive. I’ve spoken to my psychiatrist about it, but I haven't gotten any guidance on the matter. Are there any solutions to weight gain from this kind of medicine? Modern antipsychotic medications can be very helpful for some people. And they are less likely to cause neurological side effects, compared to their first-generation predecessors....
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Ep. 011 - What is akathisia, and how to stop it?
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What is akathisia? Akathisia is a relatively common medication side effect. Akathisia is a feeling of restlessness that many people find difficult to describe. Many people with akathisia say that it makes them feel like they would like to crawl out of their skin. What does akathisia feel like? Akathisia can be just an uncomfortable feeling. But for many people that feeling of restlessness translates into not being able to sit still. (Akathisia comes from Greek words that mean “not able to sit down”). It can involve fidgeting, or not being able to sit down or lie down for very long...
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Ep. 010 - Lack of insight into mental illness: Are there any new leads?
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This week’s listener question was “is there any new research about curing anosognosia?” Anosognosia is a medical term derived from Greek root words that mean “lack of disease knowledge.” Although anosognosia started off as a neurological concept, it's also very common for people with psychiatric conditions to have no awareness that their symptoms are unusual, or that they could indicate the presence of a mental illness. Emerging data suggest that impaired insight in mental illness might -- like neurological anosognosia -- involve those outer layers of the right side of the brain. It...
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Ep. 009 - Can Antidepressants Reduce Self-Harm?
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Can Antidepressants Reduce Self-Harm? Self-harm is a common behavior. About 1 in 8 children and up to 1 in 5 adolescents will deliberately injure themselves without suicidal intent. But even without suicidal intention, self-harm is an alarming and potentially dangerous behavior. Self-harm is a sign that something is wrong… but what’s the best way to help? It’s not uncommon for someone with self-harming behavior to be prescribed an antidepressant. Most of us would think that someone who is repeatedly harming themselves is very sad or depressed. So, it’s not surprising that doctors might...
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Ep. 008 - What is Cannabinoid Hyperemesis Syndrome?
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Cannabinoid Hyperemesis Syndrome (also called CHS) is the topic of this week’s episode. Melissa and Dr. Erik answer the question “How can something that’s an anti-vomiting medicine be the cause of a vomiting illness”? Cannabinoid hyperemesis syndrome involves symptoms like loss of appetite, stomach pain, nausea, and vomiting. Vomiting attacks come in waves or cycles. A vomiting attack can last many hours or several days and can be severe enough to cause dehydration or a host of other serious complications. Cannabinoid hyperemesis syndrome affects some people who use...
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Ep. 007 - Is it possible to prevent Alzheimer’s disease?
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In this episode, Melissa and Dr. Erik discuss Alzheimer’s disease and address the question of whether it’s possible to prevent Alzheimer’s disease. What is Alzheimer’s disease? Alzheimer’s disease is one of several causes of dementia. The American Psychiatric Association has renamed “dementia” and now refers to this type of condition as “Neurocognitive Disorder.” Either name refers to a decline in cognitive performance. “Cognition” is a broad term which can include things like: attention, decision-making, recognition of language, faces, or situations, learning, or...
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Ep. 006 - Are There Any Medications to Treat Alcoholism?
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At least 1 of every 20 adults has an alcohol use disorder. The average life expectancy of a person with alcohol use disorder is shortened by about 29 years.
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Ep. 005 - What is borderline personality disorder?
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This week’s podcast episode focuses on borderline personality disorder. Borderline personality disorder is a common condition Borderline personality disorder is relatively common. It’s a condition that currently affects about 1 out of every 60 people (). Up to 1 of every 20 people may be diagnosed with borderline personality disorder at some point in their lives (). “Borderline personality disorder” is a terrible name Dr. Messamore starts off by pointing out that the name of this condition – “borderline personality disorder” – is long overdue for change. It is based on...
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Ep. 004 - What is psychosis?
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Psychosis is a word that gets spoken a lot, but that gets discussed very little. About 1 of every 11 people will experience psychosis at some point in their lives. But even though it’s a common experience, we hardly ever talk about it. In this episode of Ask A Psychiatrist, Dr. Erik Messamore and Melissa Xenophontos discuss psychosis. Dr. Messamore explains what psychosis is, how it happens, and what to do about it. We learn that it’s easier to understand – and probably more accurate – to think of psychosis as a misperception syndrome. Psychosis by itself is not a standalone diagnosis....
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Ep. 003 - Does therapy help?
Ask A Psychiatrist
There are so many forms of therapy today that it can be hard to decide which is best for you. One of these types is “psychotherapy,” which sounds a lot scarier than it is. In this episode of “Ask a Psychiatrist” we learn about what psychotherapy is, how it can benefit your thought life, and why fears about undergoing psychotherapy still persist. Dr. Erik Messamore explains the history of psychotherapy and how Freud’s findings dominated professional psychiatric thinking for decades. After about the 1960s or so, Dr. Messamore explains, psychology underwent enormous strides to get us to...
info_outlineCan Antidepressants Reduce Self-Harm?
Self-harm is a common behavior. About 1 in 8 children and up to 1 in 5 adolescents will deliberately injure themselves without suicidal intent. But even without suicidal intention, self-harm is an alarming and potentially dangerous behavior. Self-harm is a sign that something is wrong… but what’s the best way to help?
It’s not uncommon for someone with self-harming behavior to be prescribed an antidepressant. Most of us would think that someone who is repeatedly harming themselves is very sad or depressed. So, it’s not surprising that doctors might prescribe an antidepressant. But it raises several questions like:
- What causes self-harming behavior?
- Can antidepressants reduce self-harming behavior?
- What are the risks?
- Are there any non-medication alternatives to treat self-harming behavior?
Melissa and Dr. Erik address these questions and more in this episode of Ask A Psychiatrist.
Episode highlights
2:10 – What do antidepressant medications do?
3:34 – The types of conditions that “antidepressants” can be useful to treat.
4:36 – Conditions that might be worsened by antidepressant medications.
5:35 – Some less-publicized side effects of antidepressant medications.
7:00 – Why it’s useful to know about the possible side effects of any medication.
8:32 – How feelings of numbness happen, and how numbness can drive self-harming behavior.
10:13 – Differences in medication response speak to differences in the cause of the symptoms that the medication was prescribed to treat.
11:36 – What we diagnose as “depression” has many different underlying causes.
12:59 – Are there differences in how children or adolescents respond to antidepressant medications?
14:13 – Antidepressant use in children or adolescents is associated with slightly but significantly increased risk for suicide.
16:04 – Could antidepressant medications increase self-harming behavior risk?
17:46 – What are the causes of self-harming behavior?
19:30 – Self-harming to regulate emotions.
23:09 – Self-harming to change the flow of a discussion or the power in a relationship.
24:49 – The limitations of antidepressant medication as a treatment for self-harming behavior.
26:10 – Are there ways to treat self-harming behavior that don’t involve medication?
Notable quotes
“I sometimes say that drugs don't know what they're supposed to do… It turns out that drugs like the antidepressant medications do many things beyond just maybe treating depression.”
“It's really helpful to know what the potential downsides are so that you don't mistake a side effect for the symptom of some illness and then get more medicine instead of less medicine.”
“If the room is dark, it could be because somebody turned off the light switch… it could be because there's no electricity running into the building… it could be because there are dark curtains over the lights and the windows. There are many pathways to darkness in a room. And there are probably equally many pathways to depression in a human being.”
“What we call depression is almost certainly a whole bunch of different underlying processes that have similar top-level symptoms. That the diversity is the most likely explanation for why some people get great results from a particular medicine while others get no results and others get worse.”
About the Podcast:
Dr. Erik Messamore is a board-certified psychiatric physician and PhD-level pharmacologist. He’s a consultant psychiatrist, researcher, lecturer, teacher, and solution-focused scholar currently affiliated with the Northeast Ohio Medical University in Rootstown, Ohio. He is joined on this podcast by Melissa Xenophontos, a journalist, radio producer and longtime mental health advocate.
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