/soapbox on

Emoji’s should be accepted paralinguistic communication in textual transmission. When we speak, our affective prosody communicates so much we miss in text

/soapbox off

Love it!

Absolutely! In some diagnoses it can occur early on and it’s an incredibly socially distressing experience. Treatment and palliation of these symptoms matters so much, I am often frustrated by the nihilistic attitude towards attempted treatment.

But especially in more advanced dementia it’s very difficult to distinguish. I’m not sure a perfect distinction matters, if it were necessary to treat I would mostly approach the same way anyway. The localization and literature on the symptom is fascinating

I do distinguish between them but I think there is a continuum. I tend to use the term pathological laughing and crying (PLC) for pedantic reasons, but there are definitely cases where there is congruence of emotion and display but maybe way out of proportion on the display

Even here, most of us start with serotonergic agents first. SSRIs can be effective, the onset is quicker than for depression — days instead of weeks, and probably because it’s more driven by direct modulation of serotonin neurotransmission

I spent an embarrassingly long time trying to figure out what sorts of manuscripts were constructed with cardboard

Some people who think care is going to be easier to navigate and quicker outside of the VA are in for a painfully rude awakening. The VA does a fantastic job on so many things and has excellent reviews by their patients at rates higher than most health systems.

Disclaimer: not legal advice

Goodness. Hope you’re safe, Jeff. The videos look really bad

We moved tables one time and the treasurer can’t speak of tablegate without a content warning first

Sending me