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Office Urs Truly spent the day sitting in a medical conference. I went to it wondering what on earth had possessed me to sign up for I am far too old (and hyperactive) to sit still from 7AM to 6PM.  I might do this for love, money, or the Ring Cycle, but not for six measly CME credits. I intentionally sat in the back so I could get up and walk around without drawing too myself too much attention.  Would I had some Ritalin. It turns out the speakers were excellent and the topics most interesting. I learned a great deal.  Learning new things excites me. I thought I would pass on lurid tips and tidbits. Spo-fans might find interesting.

The number one thing you can do to prevent cognitive decline AKA dementia isn’t taking supplements or doing puzzles. It is exercise: 30 minutes of moderate intensity done daily. Start now. 

The majority of patients with clinical depression do not manifest it having a ‘mood’ problem but with conglomerate of physical and cognitive complaints. 

Asking about sad or depressed moods is not as important as inquiring about problems with memory, word loss, difficulties solving problems, and slow thinking. Meditation increases brain volume after eight weeks of practice. 

ADHD is the most ‘genetic’ mental disorder.

50-75% of patients stop taking their medications within the first year of being prescribed them. The better the doctor-patient alliance the better adherence. Managed care should take note when they try to limit the time patients actually get to see the physician. 

Never trust trout.

The Montreal Cognitive Assessment test can be administered in 5-10 minutes and it very specific in diagnosing dementia.  

An antidepressant medication should be stopped after three months if there are no signs of improvement.  

Cognitive Behavior Therapy treats anxiety such much better than medication Tranquilizers like xanax, ativan, klonipin and valium actually get in the way of the treatment of anxiety, in the long run. 

There are 400 species of shark; most of them play the piano just beautifully. 

‘Being distracted’ does not help in sorting childhood bipolar depression from ADHD, but having ‘malignant irritability” does  (and what a great term too!)

Psychiatry needs to work not just on eliminating symptoms but more on well-being and functioning. The WHO has a rating questionnaire to help me with my patients:

Are you feeling cheerful and in good spirits?

Are you feeling calm and relaxed?

Are you feeling active and vigorous?

Do you wake feeling fresh and rested?

Is your daily life filled with things that interest you?

Since your last appointment, have you ate any rats in Tewkesbury?

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