Two Minds Blog

You are probably familiar with the idea that depression, anxiety, and other mental health conditions are caused by a " chemical imbalance " or a deficiency of certain neurotransmitters in the brain. This causal explanation became popular in the late 1980s and early 1990s, coinciding with the development of a new set of drugs that treat depression, selective serotonin reuptake inhibitors or SSRIs. The first of these was fluoxetine (aka Prozac or Sarafem: sold by Eli Lilly & Co.). Other drugs in the same class are sertraline (Zoloft: Pfizer), paroxetine (Paxil: GlaxoSmithKline), citalopram (Celexa: Lundbeck), escitalopram (Lexapro: Lundbeck & Forest Labs), and fluvoxamine* (Luvox: Solvay). It became convenient for providers to explain the benefits of antidepressant medication by talking about how they modified brain chemistry: These drugs increase the availability of naturally occurring serotonin neurotransmitter molecules in the brain, by slowing down a process in whic...

Professional burnout has been a major problem over the 3 years of the COVID-19 pandemic, leading to decreased job satisfaction , increased turnover among nurses, decreased quality of care for patients, and a net decrease in the total healthcare workforce due to resignations and retirements. Nursing work in particular is intense, high-stress, and emotionally demanding;  nursing students start to experience these stressors  early in their clinical training. The usual stresses of clinical practice worsened during COVID-19, due to more fear of infection , more risk of secondary trauma from seeing patients suffer or die, more work as clinics are short-staffed, less support as colleagues are distracted by their own challenges, and greater isolation as providers felt their own experiences to be more anomalous. Paradoxically, the public perception of nurses as "heroes" during the pandemic might have made traumatic experiences even harder to talk about when nurses' sense of th...