‘Psychiatry at the Margins’ Celebrates Its First Birthday

Psychiatry at the Margins is one year old! The first post on this blog/newsletter was published on Nov 19, 2022. Since then, the readership and impact of the newsletter have grown substantially. I have been pleasantly surprised by the reception.

Some basic stats:

• Psychiatry at the Margins has more than 4,000 total subscribers.

• It is read in 50 US states and 96 countries.

• 114 posts have been published, which have generated a total of 356,406 views.

• Close to 3% of the subscribers are paid subscribers.

• 40 other Substack publications have recommended it.

Compared to big-name Substack publications, these are certainly rookie numbers. But given the specialized nature of this blog, my lack of interest in pandering to the lowest common denominator and engaging in polarizing discourse, and my hope to cultivate a more reflective form of engagement with complicated scientific and philosophical questions, these numbers are more than reassuring. I’d like to think that they also reflect a growing hunger among readers for content that goes beyond stereotypes (positive and negative) of psychiatry.

The success of this newsletter owes a great deal to the guest contributors and the interviewees. This would not have been possible without you. Thank you!

I’m also very grateful to those who have chosen to support the publication via paid subscriptions. If you’ve found the newsletter to be valuable and would like it to continue, please consider a paid subscription. Paid subscribers have access to some extra content and can comment on all posts. (If a paid subscription would be onerous for you, especially if you are a trainee or a patient/service user, just send me an email, and I’ll add you to the complimentary subscription list, no questions asked.)

Since a substantial proportion of subscribers have started following the newsletter in recent months, I hope you will use this anniversary to explore past content that you have not read before.

The top 10 posts according to the Substack algorithm are as follows:

The Case for Antidepressants in 2022

The Remaking of a Therapist

A New Reanalysis of STAR*D Data

Treatment Resistant Depression — A Collective Failure of Imagination

Psychiatric Diagnosis: A Reintroduction

Diagnosis as Self-Understanding & Self-Alienation

Antipsychiatry as an Analogue of Populism

Notable Links and Miscellanea - Aug 28, 2023

Serotonin strikes back

Reconsidering Involuntary Psychiatric Care: A Conversation with Rob Wipond (Part One)

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Here is a selection of ten more, highlighting the range of this newsletter:

1. To Test Or Not To Test: Medical Work-Up of Psychosis

2. Do all roads lead to mitochondria?

3. Advancing Neuroscientific Understanding of Brain-Behavior Relationship: A Conversation with Nicole C. Rust

4. Adventures in Personalized Psychopharmacology: A Conversation with David Mordecai

5. Health Communism — All Care For All People (Part 1)

6. Asking better questions about involuntary psychiatric care

7. Reflections on Canalization and Psychopathology

8. A Psychopharmacology Fit for Mad Liberation?

9. Mixed Bag #1: Adam DeVille on Psychoanalysis (the entire Mixed Bag series is worth exploring!)

10. Mark Solms and Sanneke de Haan on the Mind-Body Problem

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I still write for traditional academic journals, so here is a selection of five academic publications from the past 12 months that readers may find to be of interest. (Email me if you need access to any of them.)

• A Aftab, BG Druss. Addressing the Mental Health Crisis in Youth—Sick Individuals or Sick Societies?. JAMA Psychiatry

• A Aftab. Mental disorders in entangled brains. Philosophical Psychology (this was based on two Substack posts)

• P Zachar, K Banicki, A Aftab. Historical and Philosophical Considerations in Studying Psychopathology. Oxford Textbook of Psychopathology.

• A Aftab. Can the psychopathologized speak? Notes on social objectivity and psychiatric science. Philosophy, Psychiatry, & Psychology.

• A Aftab. What Should Clinicians Know About Palliative Psychopharmacology?. AMA Journal of Ethics

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I wrote in the very first post of this newsletter that I see myself as engaged in a two-fold mission:

i) To promote a philosophically-informed and scientific practice of psychiatry that robustly engages with the metaphysical, relational, and phenomenological dimensions of psychopathology

ii) To contextualize psychiatry within a broader pluralistic domain of mental healthcare and psy-disciplines, taking into account that it is only one disciplinary approach among other approaches and frameworks that remain essential and can’t necessarily be subsumed under medicine.

For the foreseeable future, I hope to continue this mission, and I am excited for what is to come.

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Some folks have used posts from Psychiatry at the Margins for educational purposes. If you are among them, I’d love to know more about your experience. Do reach out!

Comments are open to all subscribers.

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