Perhaps the stigma is because it ruins lives.

Great information! Depression and suicidal thoughts are serious mental health concerns that require appropriate and timely intervention. Acutely suicidal patients often require immediate, intensive care to ensure their safety and stabilize their mental health. It's a shame that new lifesaving treatment which was approved, isn't used because of money. Many thanks for the very helpful video Dr. Garrett! 🙌❤👍

I dislike how many health instututions aim to save money by focusing on the short term and not long term treatment effects and how they relate to the patient's quality of life.

You forgot to mention Lithium. It removes suicidal urges. It works well for my Major Depression with suicidal thoughts and behaviours.

Stigma didn't cross my mind in considering ECT. Brain damage did. So glad I never did it.

Doctor, we don't have strong evidence for hospitalization (involuntary or otherwise), but the simple fact remains we are giving folks a chance to opportunities and social support that they may not otherwise have. I've seen patients have 1 or 2 meaningful chats with the aides / techs and even the lowly entry level workers were able to connect and build confidence and give some glimmer of hope. Safety planning is also extremely effective, and everyone should be dc with one of those.

Insurance and money are the biggest road blocks to getting treatment. I have a low cost way to treat certain Cluster B Personality Disorders and certain instances of PTSD permanently using a therapy method I discovered about 7 years ago. Sadly I do not have the social/academic/financial clout to publish a research paper on it. I feel like I caught lightning in a bottle.

You need to change the title of this bc its harmful to people in need of care. I worked inpatient on a locked psychiatric unit for 10 years and am now a psych np for 11 years. The benefit of inpatient care is rapid med changes with 24 hour support to aid in side effects or withdrawal symptoms med changes and acute symptoms, group therapy, individual psychiatric care daily, individual therapy daily and nursing and mental health worker contact and support 24/7 . Not to mention having an individual social worker assigned to assist with your specific aftercare needs. There is huge stigma around mental health care period.. let alone being inpatient. Inpatient care has helped millions of pts in desperate times . Ive seen it daily and would never have pursued my psych aprn if that wasnt the case. Ect is helpful for some pts. I was thrilled when esketamine came out but like you said its not being used.

Emotional pain is the worst kind of pain with physical pain You can usually go to a doctor And get relief but not when It comes to mental illness You just live in pain Antidepressants or therapy Are just a bandage

Interesting video, I can understand why patients might be reluctant to have ECT, given what it involves, as a patient myself and a psychiatrist. I’m fascinated as to why ECT is so effective, which no doubt it is, I think our only understanding is that it causes release of serotonin/dopamine/noradrenaline, or maybe our understanding has improved & I’m not aware. Seems to me that medication should be tried first, including usual choices for depression & then stimulants in case of undiagnosed adhd underlying depression, emotional dysregulation and impulsivity. Then ketamine. Then ECT as final option, given risks for memory/cognition. I agree lithium is an option but it’s not good for long term physical health, same with atypical antipsychotics.

Hello Dr. Rossi, can you please make a video on Tianeptine?... it's in the TCA class of medications but doesn't have it's characteristic side effects of anticholinergic, antihistaminergic, cardiovascular etc.... It's mechanism of action is also completely different, and there seems to be a relative lack of awareness about this drug, especially in the USA where this is sold as supplement 😑... Would be great if you can explain the mechanism, side effects, efficacy, dosing etc.... BTW I'm from India, and this drug is widely available to use as an Antidepressant

Stigma is a very bad thing , even in so-called 1st world countries.

I’m going to be a psych np in the future, maybe someday ketamine treatment will be available but I will never recommend ect

SSRI not effective for this, MAOI took away all my suicidal thoughts And gave me PSSD why use ECT if there is MAOI