Reacting To The Rise Of Anxiety, Microplastics & Antidepressants - Doctor Mike
Added: Jul 21, 2024
Dr. Mike discusses his role as an early adopter of evidence-based medicine on social media. He started during his residency training to counter the poor medical information being shared on television. While the democratization of health information sounds great in principle, it has led to confusion and conflicting messages for the average person. Dr. Mike believes this has encouraged healthier skepticism, with people now more likely to question the authenticity of information and seek sources. However, he notes that skepticism can sometimes go too far, leading to distrust of credentialed experts.
Cognitive Behavioral Therapy and Mental Health
Dr. Mike explains his training in cognitive behavioral therapy (CBT) during his family medicine education. While not officially certified, he received extensive training from behavioral specialists and psychiatrists. He discusses how CBT helps patients understand and combat anxiety from an evidence-based perspective. The highest level of evidence supports a combination of mental health therapy and medications for treating anxiety and depression. For mild cases, bibliotherapy or talking with a primary care physician may be sufficient. Dr. Mike often recommends the book "Feeling Good" by Dr. David Burns to his patients. He emphasizes that CBT is rational and practical, aiming to help patients regain control over their anxiety and depression rather than eliminating all symptoms.
ADHD and Its Diagnosis
Dr. Mike acknowledges an uptick in ADHD diagnoses, potentially due to increased recognition, patient requests, or performance enhancement motivations. He emphasizes that proper treatment for those truly struggling with ADHD is crucial for quality of life. Severe ADHD manifests as an inability to concentrate for more than seconds at a time, noticeable to others in various settings. Diagnosis often involves scoring systems completed by the patient and those around them. Dr. Mike notes that it's challenging to determine the exact causes of the increase in ADHD diagnoses, but suggests that constant stimulation from smartphones and social media may play a role in affecting neurophysiology.
SSRIs and Depression Treatment
Dr. Mike discusses the current state of SSRI prescriptions, noting that they are still widely used as a first-line treatment for major depressive disorder and generalized anxiety disorder. He addresses the controversy surrounding SSRIs, including misinformation about their mechanism of action. He explains that while the initial theory about serotonin deficiency causing depression has been disproven, new theories suggest that the body's adaptation to increased serotonin levels may be responsible for the medication's effectiveness. He emphasizes the importance of being transparent about what is known and unknown in medical science.
COVID-19 and Public Health Communication
Dr. Mike reflects on the challenges of practicing medicine in the wake of the COVID-19 pandemic. He discusses how public health agencies and medical professionals made communication errors, such as initially discouraging mask use and then changing recommendations. This led to public distrust and provided ammunition for those seeking to discredit scientific advice. He stresses the importance of clear, honest communication about evolving scientific understanding.
U.S. Healthcare System
Dr. Mike describes the U.S. healthcare system as a problematic hybrid of government-funded insurance, employer-provided insurance, and individual plans. He criticizes the profit-driven nature of the system, particularly the influence of private equity. He explains how quotas for patient visits can negatively impact care quality and how the system often fails to prioritize patient needs. He notes that young people increasingly rely on urgent care facilities due to difficulty accessing primary care, which can lead to suboptimal long-term health outcomes.
Microplastics and Environmental Health Concerns
Dr. Mike addresses concerns about microplastics in the human body, acknowledging their likely presence due to widespread pollution. He discusses the pervasiveness of PFAS chemicals in everyday products and the environment. While efforts are being made to reduce their use, avoiding exposure entirely is challenging. Dr. Mike emphasizes the importance of focusing on the "big boulders" of health - maintaining a healthy weight, eating a varied diet, exercising, sleeping well, and maintaining good mental health - rather than becoming overly anxious about every potential health threat.
Obesity and GLP-1 Medications
Dr. Mike discusses the potential impact of GLP-1 medications like Ozempic on obesity treatment. He notes that these drugs could benefit both individual health and the healthcare system by preventing obesity-related complications. However, he cautions that access to these medications is currently limited due to high costs and lack of insurance coverage. He expresses concern about the potential for stigma if weight loss is perceived as a simple choice, given that many people still can't afford or access these treatments. He hopes that the medications will become more widely available and affordable over time.
Health Influencers and Misinformation
Dr. Mike shares his experience interviewing Steven Gundry and critiques how some health influencers communicate information in ways that can be misleading. He emphasizes the importance of providing context and being willing to clarify or correct statements that may be misinterpreted. Hediscusses the challenge of making scientific information engaging without overselling or misrepresenting it. He expresses both appreciation for influencers like Andrew Huberman who have popularized health science discussions and concern about some of the irresponsible statements made on such platforms.
Dr. Mike's Approach to Medical Communication
Dr. Mike explains his commitment to providing accurate, evidence-based information on social media without "selling out" to promote questionable products or ideas. He continues to practice medicine part-time at a community health center, which he believes keeps him grounded and connected to real patient needs. He emphasizes the importance of maintaining integrity in health communication and hopes to inspire other influencers to do the same.
Balancing Personal Practice and Public Persona
Dr. Mike discusses how he manages being both a personal doctor and a public figure. He values the long-term relationships he has built with patients and the ability to address real-world health concerns that often differ from topics trending on social media. He finds practicing medicine humbling and rewarding, providing a valuable counterbalance to his online presence.
Conclusion
Throughout the conversation, Dr. Mike emphasizes the importance of evidence-based medicine, clear communication, and maintaining integrity in health information. He advocates for a balanced approach to health concerns, focusing on fundamental lifestyle factors while remaining open to new scientific developments.
