Summary
In this podcast episode, the host interviews his friend Carl about his experience in medical school and his decision to pursue neurosurgery. Carl was part of the highly selective MD-PhD program, which allowed him to pursue both clinical medicine and research. He initially wanted to go into neurosurgery because of his interest in the brain and its functions. During his neurosurgery rotation, he had the opportunity to work with patients and study their brain function, which further solidified his interest in the field. The two also discussed their experiences in medical school and their early rotations, including Peter's brief interest in neurosurgery.
The context then shifts to Carl's decision to pursue psychiatry instead of neurosurgery to better understand the brain and emotions. He faced challenges in balancing his residency, lab work, and being a single dad but managed to make it work. The context discusses the use of electroconvulsive therapy (ECT) as a treatment for acute suicidal patients, but notes that its effects are temporary and not fully understood. Other brain stimulation treatments, such as vagus nerve stimulation and transcranial magnetic stimulation, have been approved for depression but have small and inconsistent effects.
The context then delves into the complexity of anxiety, which has different physiological, behavioral, and emotional components that may be controlled by different sets of neurons. Optogenetics, a technique that allows for precise control of neural activity, has been used to study these different components of anxiety in mice. The conversation also touches on autism, which often co-occurs with anxiety. The speaker explains that the social world is very complex and overwhelming for people with autism, which can lead to anxiety.
The conversation then moves to the genetic underpinnings of autism and the potential for optogenetics to be used in its treatment. The speaker also talks about their book, "Projections," which aims to make psychiatric conditions accessible and understandable to a wider audience through artistic and poetic writing. The speakers discuss the evolutionary basis for mental illness, specifically mania in bipolar disorder. They discuss the genetic links to bipolar disorder and the high prevalence of mania in recent immigrants.
The discussion also covers the possibility of depression and grief-like states in non-human primates and the absence of self-harm and suicide in other species. The lasting effects of early life trauma on mental illness, including depression and personality disorders, are also discussed. The conversation concludes with the promise of continuing the conversation on personality disorders and the use of psychedelics in treating mental illness. Overall, the podcast episode provides a comprehensive overview of various topics related to mental illness and the current state of research in the field.
