Devon was 22, a junior at Arizona State, the kind of student who built mechanical keyboards and ran a Discord server for indie game devs. He had used cannabis since high school. The change began the week he switched from flower to a 92 percent THC concentrate his roommate brought back from a Phoenix dispensary. … Read more
Margaret was 71, a retired librarian in Tucson, Arizona, who had been on lithium for forty-three years for bipolar I disorder. Her psychiatrist had retired the previous winter, and her primary care physician inherited the prescription without much review. In late August, during a heatwave, her cardiologist added lisinopril for blood pressure and a low-dose … Read more
Marisol was nineteen, a sophomore at the University of Denver, when her residence director found her unconscious on the bathroom floor. Her roommate had called twice that week, worried. Marisol had stopped going to the dining hall in November. By February, she weighed 78 pounds. The paramedics noted a heart rate of 32 beats per … Read more
The Question You Have Been Afraid to Ask You drink to calm your anxiety. Three beers and the racing thoughts slow down. A glass of wine and the tightness in your chest loosens. The alcohol works. That is the problem. It works so well that you have started to depend on it. Now you wake … Read more
Caleb sat on the edge of the bed in a treatment centre in Phoenix, Arizona, on the morning of his second day off oxycodone, sweating through a t-shirt he had already changed twice. He was thirty-four. He had been taking forty milligrams of oxycodone three times a day for the better part of seven years, … Read more
Rachel, a 38-year-old graphic designer in Portland, Oregon, came home from the emergency veterinary clinic on a Wednesday night without her cat. Mochi had been with her for fourteen years, longer than any romantic relationship, longer than any apartment, longer than any job. Rachel cried so hard in the parking lot that the vet tech … Read more
Hannah Quigley washed her hands until they bled. The 27-year-old graphic designer from Saint Paul had developed contamination OCD after a hospital stay in 2022, and by spring 2025 she was spending 11 hours a day on rituals: showering 90 minutes, scrubbing doorknobs with bleach. Her outpatient ERP therapist tried for nine months. Her psychiatrist … Read more
Maya Reynolds, fourteen, sat in the children’s emergency department in Newark on a Tuesday night, holding her mother’s hand and waiting. Maya had told her school counselor that morning that she had been thinking about her stepfather’s pistol for the last week, that she had Googled how to load it, and that she had stood … Read more
By the time Tomas turned twenty, his parents in Toledo, Ohio, had not slept a full night in nearly three years. Their son, who had been diagnosed with profound autism and intellectual disability at age two, had become physically dangerous to himself and to them. He weighed two hundred and ten pounds. He could no … Read more
The Discharge Most Patients Are Not Ready For The American psychiatric emergency department is a remarkable but limited intervention. It can keep a person alive through a crisis, run urgent labs and toxicology, restart medications, and sometimes negotiate an inpatient admission. What it cannot do is provide the kind of continuous mental health care a recovering patient … Read more