Marcus from Tucson had tried three antidepressants over four years. His new psychiatrist did something the others had not. She wrote a real exercise depression prescription on a pad with her DEA number at the top: “Moderate-vigorous exercise, 150 minutes weekly, four sessions, beginning week one.” She also referred him to a behavioral health exercise … Read more
Hannah was 16, admitted to Cincinnati Children’s Hospital after months of restrictive eating that ended with a heart rate of 38 and a potassium of 2.7. Her parents, who had been begging her to eat for nearly a year, finally exhaled when she sat at the meal tray on day two and finished her oatmeal. … Read more
Marcus was twenty-one years old, a junior at the University of Cincinnati studying mechanical engineering, when his roommate noticed him whispering to a corner of their dorm room at three in the morning. Within six weeks, Marcus had stopped attending classes, accused his mother of poisoning the family dog, and barricaded himself in his bedroom … Read more
Jenna was thirty-four, an attorney in Austin, when she finally got the diagnosis that explained two decades of half-finished projects, lost keys, and panicked all-nighters. The psychiatrist prescribed a stimulant, which helped, and then said something Jenna did not expect. He said the medication was the floor, not the ceiling. He said she would still … Read more
The Question Patients Ask at the End of Therapy By the time someone has done meaningful mental health care and is approaching the end of a treatment chapter, the question hovering over the last few sessions is rarely “did this work?” It is something more anxious: “what happens when I stop?” The implicit fear is that everything … Read more
Devon Pritchard had spent four years as a Cincinnati firefighter before the depression became something he could no longer outrun on a treadmill or drown at a craft brewery. The 33-year-old had failed sertraline, escitalopram, duloxetine, and a six-month trial of bupropion that gave him insomnia. His psychiatrist at the University of Cincinnati Medical Center … Read more
Dr. Priya Reddy was an emergency medicine resident at a Boston teaching hospital, two years out from board certification, when her panic attacks crossed a line. She had managed them through medical school with therapy and a low-dose SSRI. The night a charge nurse found her hyperventilating in the supply closet during a mass-casualty drill, … Read more
Eleanor, a 62-year-old retired schoolteacher from Asheville, North Carolina, had been in the geriatric psychiatry unit for nine days with a diagnosis of severe major depression. She would not eat. She would not speak. She lay in the same position for hours, her right arm raised slightly off the mattress as if she had been … Read more
A Real Day in an Intensive Outpatient Program People hear the words “intensive outpatient program” and picture something between rehab and weekly therapy without a clear sense of what actually happens during the program day. The vagueness keeps many patients from accepting a step-up referral when their mental health care needs more than standard outpatient can deliver. … Read more
Priya was a software product manager in Seattle, two years into a job she once loved and now resented, when her therapist suggested she try a guided walk on Bainbridge Island. She protested politely. She had hiked plenty. The therapist clarified that this was different. It was a three-hour walk that covered less than half … Read more