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Psychiatry is often misunderstood as “just prescribing medications.” In reality, it is one of the few specialties where brain, biology, behavior, and biochemistry  collide—sometimes with consequences that are subtle, and sometimes with consequences that are dangerous. Over the past two decades, my research and clinical work have focused on one recurring theme: medications do not act in isolation , and neither do patients. Two of my early publications—one on lamotrigine rash f

“If You’re Smart and Still Struggling, This Might Be Why” Many high-achieving professionals assume that if things feel hard, they must be doing something wrong. They’re not. Brains under pressure can look like: “I know what to do, I just can’t start” “I’m exhausted but can’t shut my mind off” “Why does everyone else seem to manage this better?” Often the issue isn’t motivation—it’s unrecognized ADHD, anxiety, mood disorders, burnout, or some unhelpful combination of the above

Introduction In 2011, We ( Rif El-Mallakh MD, Jeannie Roberts MD and myself, Anton Surja, MD ) introduced the concept of tardive dysphoria , a chronic, treatment-resistant depressive state that may emerge from long-term antidepressant use. Originally published in the Irish Journal of Psychological Medicine , 2011; March: Vol 28, issue 01, this hypothesis has gained renewed attention amidst growing concerns about the efficacy and risks of prolonged antidepressant therapy. De