Awais Aftab
@awaisaftab.bsky.social
Psychiatrist with philosophical interests | Conversations in Critical Psychiatry (Oxford University Press, 2024) | Psychiatry at the Margins www.psychiatrymargins.com
Psychology
39%
Philosophy
32%
Do all roads lead to mitochondria?
Palmer's "Brain Energy" makes a compelling case for the importance of metabolism in psychiatry but falls well short of a unifying theory
www.psychiatrymargins.com
Given all the discussion around metabolic psychiatry and Chris Palmer, thanks to RFK Jr’s bombastic claims on keto diet, this seems like a good moment to reshare my 2023 review of Palmer’s book “Brain Energy.”
www.psychiatrymargins.com/p/do-all-roa...
www.psychiatrymargins.com/p/do-all-roa...
Wow. Does it give any reason for deletion?
Reposted by Awais Aftab
I posted this to reddit, it received a lot of attention before being removed by mods (?) I guess the uncomfortable realities presented were too much for them.
Reposted by Awais Aftab
What Do We Owe the Insufferable?
When mental illness exhausts our emotional capacities
www.psychiatrymargins.com
Reading @awaisaftab.bsky.social's new blog post instead of listening to a psychoanalytic podcast. Check it out here:
What Do We Owe the Insufferable?
When mental illness exhausts our emotional capacities
www.psychiatrymargins.com
What Do We Owe the Insufferable?
When mental illness exhausts our emotional capacities
www.psychiatrymargins.com/p/what-do-we...
When mental illness exhausts our emotional capacities
www.psychiatrymargins.com/p/what-do-we...
Your brain on stimulants vs your brain on ADHD
There is more to what ADHD is than what stimulants do, and there is more to the clinical use of stimulants than the boundaries of ADHD
www.psychiatrymargins.com/p/adhd-beyon...
There is more to what ADHD is than what stimulants do, and there is more to the clinical use of stimulants than the boundaries of ADHD
www.psychiatrymargins.com/p/adhd-beyon...
ADHD Beyond Stimulants, and Stimulants Beyond ADHD
Your brain on stimulants vs your brain on ADHD
www.psychiatrymargins.com
Reposting for the Monday crowd 👇🏽
ADHD Beyond Stimulants, and Stimulants Beyond ADHD
Your brain on stimulants vs your brain on ADHD
www.psychiatrymargins.com
Your brain on stimulants vs your brain on ADHD
There is more to what ADHD is than what stimulants do, and there is more to the clinical use of stimulants than the boundaries of ADHD
www.psychiatrymargins.com/p/adhd-beyon...
There is more to what ADHD is than what stimulants do, and there is more to the clinical use of stimulants than the boundaries of ADHD
www.psychiatrymargins.com/p/adhd-beyon...
Antirealism Will Not Save the DSM From Empirical Inadequacy
What does the DSM say about the unobservable structure of psychopathology?
www.psychiatrymargins.com
I feel like sharing this post again…
Antirealism Will Not Save the DSM From Empirical Inadequacy
What does the DSM say about the unobservable structure of psychopathology?
www.psychiatrymargins.com/p/antirealis...
Antirealism Will Not Save the DSM From Empirical Inadequacy
What does the DSM say about the unobservable structure of psychopathology?
www.psychiatrymargins.com/p/antirealis...
Reposted by Awais Aftab
Can a Psychiatric Crisis Save Your Life? - by Awais Aftab
Madness as breakdown and breakthrough
www.psychiatrymargins.com
"Can a Psychiatric Crisis Save Your Life?" Texto interessante e bem equilibrado do @awaisaftab.bsky.social
www.psychiatrymargins.com/p/can-a-psyc...
www.psychiatrymargins.com/p/can-a-psyc...
Reconsidering Lithium as the Gold Standard for Bipolar Disorder: A Personal History
“Lithium is one of our tools but has no special status.”
www.psychiatrymargins.com
Reconsidering Lithium as the Gold Standard for Bipolar Disorder: A Personal History
“Lithium is one of our tools but has no special status.”
A guest post by Robert Haim Belmaker
www.psychiatrymargins.com/p/reconsider...
“Lithium is one of our tools but has no special status.”
A guest post by Robert Haim Belmaker
www.psychiatrymargins.com/p/reconsider...
Awais Aftab
@awaisaftab.bsky.social
· Jan 10
Can a Psychiatric Crisis Save Your Life?
Madness as breakdown and breakthrough
www.psychiatrymargins.com
Can a Psychiatric Crisis Save Your Life?
Madness as breakdown and breakthrough
www.psychiatrymargins.com/p/can-a-psyc...
Madness as breakdown and breakthrough
www.psychiatrymargins.com/p/can-a-psyc...
Reposted by Awais Aftab
Aidan Wright
@aidangcw.bsky.social
· Jan 6
Claudenfreude: the feeling you get when someone gets busted for using AI when they shouldn’t
h/t @ssweatt.bsky.social for coining it
h/t @ssweatt.bsky.social for coining it
Reposted by Awais Aftab
Miri Forbes
@miriforbes.bsky.social
· Jan 6
Just learned I've won the APA Distinguished Scientific Award for Early Career Contributions to Psychology in the area of psychopathology, and am feeling pretty delighted!! So grateful to @aidangcw.bsky.social for nominating me, and very proud of the work it's based on.
Awais Aftab
@awaisaftab.bsky.social
· Jan 3
Notable Links (Substack Edition) - Jan 3, 2026
And some personal media favorites from 2025
www.psychiatrymargins.com
My periodic round-up of interesting stuff I’ve read
(And some personal media favorites from 2025)
www.psychiatrymargins.com/p/notable-li...
(And some personal media favorites from 2025)
www.psychiatrymargins.com/p/notable-li...
Reposted by Awais Aftab
Jakub Kuchař
@jakubkuchar.bsky.social
· Jan 2
An Intro to Freud Is Not an Intro to Contemporary Psychoanalysis
Reviewing Paul Bloom on Freud and the unconscious
www.psychiatrymargins.com
I když Freud položil základy psychoanalýzy a dodnes je v psychoanalytických kruzích velmi důležitou figurou, současná psychoanalýza není pouze o něm. Akademická psychologie to bohužel nebere moc v potaz. @awaisaftab.bsky.social toto téma rozebírá v přiloženém textu.
Awais Aftab
@awaisaftab.bsky.social
· Dec 30
😢
Awais Aftab
@awaisaftab.bsky.social
· Dec 29
The All of Thine That Cannot Die: Farewell to Two Friends
In memory of Dan J. Stein and Lisa Wallace
www.psychiatrymargins.com/p/the-all-of...
In memory of Dan J. Stein and Lisa Wallace
www.psychiatrymargins.com/p/the-all-of...
The All of Thine That Cannot Die: Farewell to Two Friends
In memory of Dan J. Stein and Lisa Wallace
www.psychiatrymargins.com
It just occurred to me that this juxtaposition is almost an illustration of what Dan Oppenheimer had identified as the dynamic between the Scientist and the Survivor is his profile of me, except in this case both the Scientist and the Survivor were able to grow beyond the limitations of their roles.
Awais Aftab
@awaisaftab.bsky.social
· Dec 29
The All of Thine That Cannot Die: Farewell to Two Friends
In memory of Dan J. Stein and Lisa Wallace
www.psychiatrymargins.com
The All of Thine That Cannot Die: Farewell to Two Friends
In memory of Dan J. Stein and Lisa Wallace
www.psychiatrymargins.com/p/the-all-of...
In memory of Dan J. Stein and Lisa Wallace
www.psychiatrymargins.com/p/the-all-of...
Awais Aftab
@awaisaftab.bsky.social
· Dec 26
How the Citrus Cure for Scurvy Was Lost, and Lessons for the Science of Psychopathology
The copper-lined containers and the contexts that neutralize treatment
www.psychiatrymargins.com
How the Citrus Cure for Scurvy Was Lost, and Lessons for the Science of Psychopathology
The copper-lined containers and the contexts that neutralize treatment
www.psychiatrymargins.com/p/how-the-ci...
The copper-lined containers and the contexts that neutralize treatment
www.psychiatrymargins.com/p/how-the-ci...
Awais Aftab
@awaisaftab.bsky.social
· Dec 24
… but that is no excuse to tolerate imperfection, esp at this large scale of implementation, when we can easily do better. (/2)
Awais Aftab
@awaisaftab.bsky.social
· Dec 24
I should note though: if we created a version of PHQ-9 that didn’t have these interpretation issues, it will in all likelihood still correlate very highly with the current PHQ-9. Imperfect measures can still index symptom burden and track change with meaningful utility… (/1)
Awais Aftab
@awaisaftab.bsky.social
· Dec 23
Interpretation Issues With the Patient Health Questionnaire Instructions
This survey study assesses whether responses to the Patient Health Questionnaire reflect symptom frequency and severity.
jamanetwork.com
Cool study in JAMA Psychiatry confirms what many have suspected for a while: PHQ (depression questionnaire) instructions are widely misinterpreted by patients. It is unfortunate that a questionnaire as shitty as PHQ-9 has become so ingrained & ubiquitous
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Awais Aftab
@awaisaftab.bsky.social
· Dec 23
Why I'm Trying Psych Meds Again
and how I've changed my mind about their critics
www.sluggish.xyz
Why I'm Trying Psych Meds Again
and how I've changed my mind about their critics
An excellent post by Jesse Meadows
www.sluggish.xyz/p/why-im-try...
and how I've changed my mind about their critics
An excellent post by Jesse Meadows
www.sluggish.xyz/p/why-im-try...
Awais Aftab
@awaisaftab.bsky.social
· Dec 18
Antipsychotic tapering appears to help long-term in a new trial but not for the obvious reason
And considerable uncertainty remains
www.psychiatrymargins.com
Antipsychotic tapering appears to help long-term in a new trial but not for the obvious reason…
And considerable uncertainty remains
My discussion of the HAMLETT study by Sommer et al. (October 2025, JAMA Psychiatry)
www.psychiatrymargins.com/p/antipsycho...
And considerable uncertainty remains
My discussion of the HAMLETT study by Sommer et al. (October 2025, JAMA Psychiatry)
www.psychiatrymargins.com/p/antipsycho...
Awais Aftab
@awaisaftab.bsky.social
· Dec 15
Conversations in Critical Psychiatry | American Journal of Psychiatry Residents' Journal
PsychiatryOnline.org is the platform for all American Psychiatric Association Publishing journals, DSM, and bestselling textbooks, as well as APA Practice Guidelines, and continuing medical education.
psychiatryonline.org
A review of “Conversations in Critical Psychiatry” by Daniel Cohrs for the AJP Residents’ Journal. “The field’s conceptual terrain is rich, multifaceted, and contentious; the dialogue format allows for its exploration in a way that is both thoughtful & precise”
psychiatryonline.org/doi/full/10....
psychiatryonline.org/doi/full/10....
Awais Aftab
@awaisaftab.bsky.social
· Dec 14
If you’re convinced the cure is worse than the disease, it’s awfully tempting to also convince yourself that there was never an illness in the first place. Nowhere is this impulse more evident than in debates about psychopathology.
Awais Aftab
@awaisaftab.bsky.social
· Dec 13
Mixed Bag #25: Kinnon MacKinnon on Trans Identity and Medicine
a book, a concept, a person, an article, and a surprise item
www.psychiatrymargins.com
Mixed Bag #25: Kinnon MacKinnon on Trans Identity and Medicine
MacKinnon explores the topic using a book, a concept, a person, an article, and a surprise item
www.psychiatrymargins.com/p/mixed-bag-...
MacKinnon explores the topic using a book, a concept, a person, an article, and a surprise item
www.psychiatrymargins.com/p/mixed-bag-...
Awais Aftab
@awaisaftab.bsky.social
· Dec 11
What Other Diagnoses Could Learn From Autism’s Diagnostic Appeal
The role of cognitive-perceptual mechanistic explanations
www.psychiatrymargins.com
What Other Diagnoses Could Learn From Autism’s Diagnostic Appeal
The role of cognitive-perceptual mechanistic explanations
A response by Riva Stoudt to my autism differential diagnosis post
www.psychiatrymargins.com/p/what-other...
The role of cognitive-perceptual mechanistic explanations
A response by Riva Stoudt to my autism differential diagnosis post
www.psychiatrymargins.com/p/what-other...