Purple Day started with the curiosity and of a girl in eastern Canada, in the province of Nova Scotia, who had epilepsy. It soon became a world-wide success. Purple Day is now an international initiative and effort dedicated to increasing awareness about epilepsy around the globe. Why is it so important to create awareness around people with epilepsy?
The post Purple Day: a day for thinking about people with epilepsy appeared first on OUPblog.
Edward Shorter is the Jason A. Hannah Professor of the History of Medicine endowed chair at the University of Toronto School of Medicine as well as a Professor of Psychiatry. Max Fink has exensively contributed to the psychiatric community’s understanding of electroconvulsive therapy (ECT), pharmaco-electroencephalography (pharmaco-EEG), cannabis and the psychopathologies of catatonia, melancholia and mania. Together they wrote, Endocrine Psychiatry: Solving the Riddle of Melancholia, which traces the enthusiasm of biological efforts to solve the mystery of melancholia and proposes that a useful, and a potentially life-saving, connection between medicine and psychiatry has been lost. Below we have excerpted the preface which explains why endocrine psychiatry deserves a second look.
In the past hundred years, medicine has tried to acquire a scientific basis. Age-old prejudices and pointless procedures have been discarded in controlled study after study. Today, we take it for granted that the practice of medicine is evidence-based.
Yet in psychiatry the penetration of science has been imperfect. The discipline has swung wildly from fashion to fashion – from asylum care to psychoanalysis to lobotomy to psychopharmacology -without having an underlying scientific rationale for doing so. More than any other medical field, psychiatry has been guided by cultural preferences and political persuasions. We vaguely dislike the notion of “locking up” people or of shooting volts of electricity through their brains; we have a natural enlightened tropism toward psychotherapy and the enhancement of human reason and against the madness of unreason. None of these prejudices and preferences is in itself reprehensible, and all flow from a praiseworthy humanism. But prejudices and beliefs are not science. In a great disjunction, science and psychiatry have passed each other like two ships in the night.
Yet psychiatry cries out for science. To be sure, we can gauge the neurochemistry of the brain and assess its structures with the devices of neuroimaging. But the questions of clinical psychiatry are more complex than fluctuations in neurotransmitters or glucose uptake in the basal ganglia, where the brain gives up a few of its secrets. Is there no other way to gain a window to the brain and gauge is activity in psychiatric illness? Yes, there is. Another system, the endocrine system, sets the biological rhythms of the brain and body. Psychiatry was once fascinated with the endocrine system. Today, the adrenal and pituitary glands, and the hypothalamus within the brain, have lost their charm and arouse little interest.
Simultaneously, psychiatry also said adieu to another familiar historical concept, melancholia, as a diagnosis of severe depression. After the introduction of a new system of disease classification in 1980, the diagnosis of “major depression” – a heterogeneous assortment of varied illness entities and unhappiness states – swept in the field. This is very interesting: At the same time that psychiatric interest in neurotransmitters such as serotonin quickened, the discipline embraced such new illnesses as “major depression” and “bipolar disorder.” In understanding the seat of illness, there was a shift from the endocrine periphery to the neurotransmitter central, and in classification, there was a shift from such sturdy historical concepts as “melancholia” to the more faddish notions of “major depression” and “bipolar disorder.” These two shifts are related. In b
