Why psychiatric illness strikes young (and what to do about it)

Back from the Abyss: Psychiatry in Stories

Craig Heacock MD

Psychiatry, Bipolar, Suicide, Depression, Ketamine, Psychotherapy, Science, Psychedelics, Health & Fitness, Addiction, Medicine, Psychology, Mental Health

4.8 • 452 Ratings

🗓️ 29 December 2022

⏱️ 17 minutes

🔗️ Recording | iTunes | RSS

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Summary

Most medical illnesses appear later in life, as organ systems fail and the decades of wear and tear eventually erode the body's innate homeostatic mechanisms. Psychiatric illness, however, is profoundly different. Here Dr. H explores six central reasons why serious psychiatric illness tends to appear in mid to late adolescence.These factors include:•Leaving the tribe•Contagion and heightened peer influence•Early existential life crises•Developmental brain changes•Sleep depri...

Transcript

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0:00.0	Welcome to Back from the Abyss. I'm Dr. Craig Hecock. Today's episode is based on a talk I recently gave at Colorado State University. I thought
0:22.7	maybe I'd flesh it out, work on it a little more, and then present it to all of you. This is
0:28.9	why psychiatric illness strikes young. There's so many surprises in med school. And maybe the biggest
0:37.3	surprise, doctors take care of sick people, and often very, very sick people.
0:44.6	This hits a lot of third-year med students like a ton of bricks, and they quickly plot their way toward a specialty where they won't have to take care of a bunch of sick and dying people,
0:55.5	you know, to one of the less messy, less deathly, less overwhelming specialties.
1:01.1	Another big surprise for many med students.
1:04.2	Doctors mostly take care of older people, like me.
1:09.9	And even older. Go figure. It shouldn't actually be that big of a
1:14.9	surprise, though. Our bodies are remarkably, even shockingly resilient to use and abuse and disease
1:21.4	and injury, and it typically takes a long time, decades before most organs and body systems begin to fall apart.
1:30.3	But a very different reality exists in psychiatry. The mind, the psyche, they most commonly
1:38.4	fall apart during adolescence and the emergence into adulthood between the mid-teens, early 20s.
1:45.0	Why does almost all severe psychiatric illness,
1:49.0	including first episodes of psychosis and mania and disabling depression,
1:55.0	why do they all appear so young during this relatively small window of time. Here are six major reasons why
2:04.4	psychiatric illness strikes down emerging adults in the prime of their lives. Three are psychosocial,
2:10.9	three are genetic slash biological. And this strikes me as an interesting split because the
2:16.6	studies of identical twins separated at birth
2:19.2	indicate that for most primary psychiatric illness, including unipolar and bipolar depression, schizophrenia,
2:28.1	schizophrenia, schizophrenic disorder, psychiatric illnesses are typically about 50-50, 50% genetic, and 50% environmental-slas-psocial.
2:39.8	So what are the genetic and environmental factors that are manifesting during adolescence and
	...

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