Psychiatry, the medical specialty dedicated to mental health, encompasses a vast array of disorders, treatments, and research areas. The Journal of Clinical Psychiatry provides comprehensive insights into the field, from the latest research findings to clinical best practices. Our expert editors ensure that content is evidence-based, relevant, and cutting-edge, serving as a valuable resource for psychiatrists seeking to enhance their knowledge, skills, and patient care outcomes.
<\/p>\n\n\n\n\n\";s:10:\"post_title\";s:55:\"Dr Michael Asbach on the Evolution of PAs in Psychiatry\";s:12:\"post_excerpt\";s:287:\"Physician Assistant Dr. Michael Asbach addresses workforce solutions in psychiatry, from PA training and autonomous collaboration models to recent UK policy debates. Learn how interdisciplinary teams can expand access, reduce burnout, and optimize outcomes in behavioral health settings.\";s:11:\"post_status\";s:7:\"publish\";s:14:\"comment_status\";s:6:\"closed\";s:11:\"ping_status\";s:6:\"closed\";s:13:\"post_password\";s:0:\"\";s:9:\"post_name\";s:36:\"ep5-pas-in-psychiatry-michael-asbach\";s:7:\"to_ping\";s:0:\"\";s:6:\"pinged\";s:0:\"\";s:13:\"post_modified\";s:19:\"2025-12-30 06:53:39\";s:17:\"post_modified_gmt\";s:19:\"2025-12-30 12:53:39\";s:21:\"post_content_filtered\";s:0:\"\";s:11:\"post_parent\";i:0;s:4:\"guid\";s:38:\"https:\/\/www.psychiatrist.com\/?p=224057\";s:10:\"menu_order\";i:0;s:9:\"post_type\";s:4:\"post\";s:14:\"post_mime_type\";s:0:\"\";s:13:\"comment_count\";s:1:\"0\";s:6:\"filter\";s:3:\"raw\";}i:1;O:7:\"WP_Post\":24:{s:2:\"ID\";i:224495;s:11:\"post_author\";s:6:\"107961\";s:9:\"post_date\";s:19:\"2025-12-29 08:37:54\";s:13:\"post_date_gmt\";s:19:\"2025-12-29 14:37:54\";s:12:\"post_content\";s:6308:\"The tropes about profanity are as old as swearing itself.<\/span>\r\n\r\n\u201cIt reveals a lack of class.\u201d<\/span>\r\n\r\n\u201cIt shows low intelligence.\u201d<\/span>\r\n\r\n\u201cIt exposes a lack of imagination.\u201d<\/span>\r\n\r\nSociety\u2019s conditioned us to regulate our language so much that lawmakers and regulators have mandated warnings on movies and music that include it.<\/span>\r\n\r\nBut an <\/span>interesting new study<\/span><\/a> out of England\u2019s Keele University offers up a new take, hinting that swearing at just the right moment might help us perform better physically.<\/span>\r\n\r\n\u201cThis new research shows how swearing gives us a boost by putting us in a more disinhibited state that helps individuals feel more focused, confident, and overcome internal constraints. It verifies our theory that swearing can act as a simple, low-cost psychological tool that helps people not hold back and go for it a little more,\u201d Keele\u2019s Richard Stephens, BSc, explained. \u201cIn short, swearing helps us to stop overthinking and start doing.\u201d<\/span>\r\n
December 30, 2025Methodology<\/b><\/h3>\r\nIn a paper published in American Psychologist, the authors report that repeating a self-selected swear word during a short, intense strength task consistently boosted performance. The result, they argue, appears to work not by revving up the body\u2019s physiology, but by relaxing the psychological restraints that normally hold us back.<\/span>\r\n\r\nStephens and his research team conducted two preregistered experiments involving nearly 200 participants. They then merged those results with data from a previous study, bringing the total sample to 300 adults.<\/span>\r\n\r\nAcross all three studies, participants completed a \u201cchair push-up\u201d task while repeatedly saying either a swear word of their choosing or a neutral word.<\/span>\r\n\r\nThe results displayed striking consistency. On average, participants held the position longer when swearing than when using a random, neutral word. The performance boost remained modest \u2013 but reliable \u2013 adding up to a 10% bump in endurance in some trials.<\/span>\r\n
Exploring Explanations<\/b><\/h3>\r\nEarlier studies had hinted that swearing might enhance strength by boosting one\u2019s heart rate or triggering stress-related physiological arousal. But this new study threatens to upend those assumptions.<\/span>\r\n\r\nThe authors instead point to a psychological mechanism they call \u201cstate disinhibition.\u201d It appears to represent a temporary shift away from self-restraint and toward more uninhibited (and action-oriented) behavior.<\/span>\r\n\r\nTo test that theory, the researchers looked at a range of psychological factors historically tied to disinhibition, including flow (the feeling of being fully absorbed in an activity), distraction from self-doubt, and self-confidence. And while each individual experiment produced mixed results, the overall analysis told a simple story.<\/span>\r\n\r\nWhen researchers combined the data from all three studies, they noticed increases in flow, lower cognitive distraction, and higher self-confidence. Simply put, swearing didn\u2019t help because it was funny. It helped, they insist, because it seemed to quiet internal brakes.<\/span>\r\n
Implications<\/b><\/h3>\r\nThe findings align with previous research that revealed that vocal expressions, from grunts to shouts, can boost one\u2019s physical strength. But the authors add that swearing might be uniquely effective because it carries emotional and social weight. Using taboo language briefly disrupts the norms we live with every day, which could make us less self-conscious and more willing to push ourselves.<\/span>\r\n\r\nBut the researchers warn against reading too much into what they found. They focused on short, intense tasks. And they didn\u2019t look at long-term training outcomes or complex athletic performance.<\/span>\r\n\r\nEven so, the authors argue that the practical implications are worth considering. Swearing is free, widely accessible, and requires no special equipment or training. Whether its sports and rehabilitation to situations that demand assertiveness or courage, a well-timed expletive could provide a small (yet meaningful) psychological edge.<\/span>\r\n\r\n\u201cThese effects could have valuable applications in sport, rehabilitation, and any situation that calls for courage or assertiveness,\u201d Stephens added. \u201cIn this way, swearing could serve as an accessible way to unlock our full potential when peak performance is needed.\u201d\u202f\u00a0<\/span>\r\n\r\nObviously, that doesn\u2019t mean clinics or gyms should start encouraging profanity as official policy. Social norms remain relevant. And swearing can be inappropriate or harmful in the wrong setting. But the research suggests that, in private or controlled situations, breaking linguistic rules might help people break through mental barriers.<\/span>\r\n\r\nSometimes, the data suggest, strength isn\u2019t about more than raw muscle. It\u2019s about permission. Permission to not hold back.<\/span>\r\n
Further Reading<\/b><\/h3>\r\nProfanity Can Sometimes Be the Best Medicine<\/b><\/a>\r\n\r\nHuman Speech Runs on a Global Rhythm<\/b><\/a>\r\n\r\nHow Does Singing Help Aphasia Patients Find Their Voices?<\/b><\/a>\";s:10:\"post_title\";s:30:\"Could Swearing Be Good For Us?\";s:12:\"post_excerpt\";s:108:\"A new study suggests that swearing at the right moment can modestly but reliably boost physical performance.\";s:11:\"post_status\";s:7:\"publish\";s:14:\"comment_status\";s:6:\"closed\";s:11:\"ping_status\";s:6:\"closed\";s:13:\"post_password\";s:0:\"\";s:9:\"post_name\";s:29:\"could-swearing-be-good-for-us\";s:7:\"to_ping\";s:0:\"\";s:6:\"pinged\";s:0:\"\";s:13:\"post_modified\";s:19:\"2025-12-29 08:37:54\";s:17:\"post_modified_gmt\";s:19:\"2025-12-29 14:37:54\";s:21:\"post_content_filtered\";s:0:\"\";s:11:\"post_parent\";i:0;s:4:\"guid\";s:58:\"https:\/\/www.psychiatrist.com\/?post_type=news&p=224495\";s:10:\"menu_order\";i:0;s:9:\"post_type\";s:4:\"news\";s:14:\"post_mime_type\";s:0:\"\";s:13:\"comment_count\";s:1:\"0\";s:6:\"filter\";s:3:\"raw\";}i:2;O:7:\"WP_Post\":24:{s:2:\"ID\";i:224449;s:11:\"post_author\";s:6:\"107961\";s:9:\"post_date\";s:19:\"2025-12-24 07:26:55\";s:13:\"post_date_gmt\";s:19:\"2025-12-24 13:26:55\";s:12:\"post_content\";s:7295:\"It\u2019s as bad as we think it is.<\/span>\r\n\r\nThat\u2019s the unsettling sentiment from a new <\/span>Gallup poll<\/span><\/a> that exposes a clear erosion in how Americans view their own mental health. For the first time in the long-running survey, fewer than a third of U.S. adults describe their mental health as \u201cexcellent.\u201d The revelation underscores a disturbing trend that started with the Covid pandemic.<\/span>\r\n\r\nThe West Health-Gallup Center on Healthcare in America<\/span><\/a>, which conducted the survey between Nov. 3-25, found that only 29% of adults were willing to grade their own mental health as excellent. Another 43% felt they had \u201cgood\u201d mental health. The 72% total positive rate ranked three percentage points lower than the organization\u2019s previous record low.<\/span>\r\n
Pandemic Ripple Effects<\/b><\/h3>\r\nBefore the pandemic, Americans\u2019 mental health ratings had held surprisingly steady. Between 2001 and 2019, at least 42% of adults consistently rated their mental well-being as excellent. But that figure fell off a cliff in late 2020 \u2013 roughly eight months into the life-changing lockdowns that upended the lives of virtually all Americans. Since then, the numbers continue to fall.<\/span>\r\n\r\n
![\"Line](\"https:\/\/www.psychiatrist.com\/wp-content\/uploads\/2025\/12\/Trend-in-U.S.-Adults-Mental-Health-Ratings-300x256.png\")
\r\n\r\nThe deterioration in sentiment is hardly isolated. It\u2019s infected nearly every major demographic.<\/span>\r\n\r\n \t
A Silver Lining<\/b><\/h3>\r\nIt\u2019s perhaps not so surprising then, that more Americans are looking for professional help. Nearly a quarter of the adults surveyed said that they\u2019ve visited a mental health professional in the past year. And 8% of them reported more than 10 visits.<\/span>\r\n\r\nAnd even though Americans\u2019 trust in their doctors remains stable, a growing number of adults seek out a second opinion.<\/span>\r\n\r\nConfidence in doctors tends to rise with age. Nearly 77% of those 65 and older trust their doctors. That\u2019s better than the less than 60% of adults under 50 who feel the same.<\/span>\r\n\r\nDemocrats are also much more likely than Republicans (or independents) to trust medical advice \u2013 without verification.<\/span>\r\n
Losing Faith in the System<\/b><\/h3>\r\nThe discouraging survey appears on the heels of a similar report on the mental health care system itself.<\/span>\r\n\r\nThe recent <\/span>National Alliance on Mental Illness (NAMI) poll<\/span><\/a>, conducted in partnership with Ipsos, found that most Americans think Congress isn\u2019t doping enough to tackle the nation\u2019s mental health challenges. They also overwhelmingly oppose <\/span>federal cuts<\/span><\/a> to core services such as supportive housing, Medicaid coverage, suicide prevention programs, and the 988 Suicide & Crisis Lifeline.<\/span>\r\n\r\nMore specifically, nearly three in four adults oppose cuts to federal mental health jobs and programs. And strong majorities insist such cuts would make things worse. Consequently, about 83% of those surveyed support protecting Medicaid funding to help people access mental health care.<\/span>\r\n\r\nNearly two-thirds of Americans believe Congress isn\u2019t doing enough to address mental health needs. They share a similar conviction about the federal government, who they feel spends too little on mental health resources overall.<\/span>\r\n\r\nThe prevailing sentiment suggests that while Americans labor under increased mental health pressure, they also want policymakers in Washington to do something about it.<\/span>\r\n\r\n\u201cPeople are worried about their finances, their housing, and the uncertainty around them, including what kind of mental health care and support will be there for them moving forward,\u201d NAMI CEO Daniel H. Gillison Jr. said. \u201cWith the strain on the country\u2019s mental health system growing more dire, we have to come together and provide the resources that our communities need. We urge policymakers to act quickly to keep mental health care and services within reach for people who need it.\u201d<\/span>\r\n
Further Reading<\/b><\/h3>\r\nMental Health Progress Stalls At A Crossroads<\/b><\/a>\r\n\r\nNew Medicaid Work Rules Threaten Mental Health Coverage<\/b><\/a>\r\n\r\nTrump, HHS Link Tylenol to Autism. Experts Push Back.<\/b><\/a>\";s:10:\"post_title\";s:48:\"Americans\u2019 Mental Health Ratings Hit a New Low\";s:12:\"post_excerpt\";s:136:\"New polls show that Americans rate their mental health at a record low while they have little faith in lawmakers to do anything to help.\";s:11:\"post_status\";s:7:\"publish\";s:14:\"comment_status\";s:6:\"closed\";s:11:\"ping_status\";s:6:\"closed\";s:13:\"post_password\";s:0:\"\";s:9:\"post_name\";s:45:\"americans-mental-health-ratings-hit-a-new-low\";s:7:\"to_ping\";s:0:\"\";s:6:\"pinged\";s:0:\"\";s:13:\"post_modified\";s:19:\"2025-12-30 10:17:28\";s:17:\"post_modified_gmt\";s:19:\"2025-12-30 16:17:28\";s:21:\"post_content_filtered\";s:0:\"\";s:11:\"post_parent\";i:0;s:4:\"guid\";s:58:\"https:\/\/www.psychiatrist.com\/?post_type=news&p=224449\";s:10:\"menu_order\";i:0;s:9:\"post_type\";s:4:\"news\";s:14:\"post_mime_type\";s:0:\"\";s:13:\"comment_count\";s:1:\"0\";s:6:\"filter\";s:3:\"raw\";}i:3;O:7:\"WP_Post\":24:{s:2:\"ID\";i:224438;s:11:\"post_author\";s:6:\"107961\";s:9:\"post_date\";s:19:\"2025-12-22 11:33:51\";s:13:\"post_date_gmt\";s:19:\"2025-12-22 17:33:51\";s:12:\"post_content\";s:6401:\"\u201cWant to hang out after work?\u201d<\/span>\r\n\r\nIt\u2019s an everyday offhand gesture. Such invitations to ramp up around the holidays. Whether it\u2019s as casual as an intimate lunch with a co-worker or as formal as a crowded office party, the social pressure this time of year can be overwhelming to some.<\/span>\r\n\r\nNow, new research confirms that simple social invites such as these can trigger a chain reaction that can either boost employee morale or drain it completely.<\/span>\r\n\r\nA <\/span>new paper<\/span><\/a> in Personnel Psychology reports that workplace social invitations can elicit positive and negative reactions \u2013 often at the same time. The only difference, the study\u2019s authors insist, isn\u2019t the initial invite, but how employees respond to it.<\/span>\r\n\r\nThe international research team shifts attention away from after-work socializing as a leisure activity and instead focuses on the invitation as a distinct workplace event. The authors argue that being invited can spark competing \u201cresource gain\u201d and \u201cresource loss\u201d spirals. It can either fuel engagement and gratitude for some workers, while stirring up exhaustion, stress, and even withdrawal for others.<\/span>\r\n
The Good,<\/b><\/h3>\r\nSocial invitations can serve as a powerful signal of inclusion. Employees who receive are normally grateful, seeing it as a gesture of belonging and goodwill.<\/span>\r\n\r\nAcross a series of experiments and field studies in Taiwan and the United States, the researchers look at how this sense of gratitude played out in the office. They found that gratitude translated into higher organization-based self-esteem \u2013 a sense that one is respected and valued.<\/span>\r\n\r\nConsequently, that boost made employees more likely to engage in organizational citizenship behaviors, such as helping colleagues or exceeding their formal responsibilities.<\/span>\r\n\r\nPut simply, for many workers, a simple invitation kicks off an encouraging feedback loop. Feeling appreciated encourages self-worth, which spurs on greater cooperation and generosity on the job. And these effects cropped up even before any socializing ever took place. Just being invited appeared to be enough to shift behavior.<\/span>\r\n
And the Bad.<\/b><\/h3>\r\nBut that same invitation can also act as a stressor. Unlike voluntary leisure activities, invitations arrive unannounced and demand a response. In an instant, employees must weigh competing concerns. Do they have the energy? What are the ramifications of refusal? How will it look to others?<\/span>\r\n\r\nThe researchers discovered that these moments of snap judgment, spurred on by social pressure and uncertainty, often stirred up a lot of stress. As a result, that stress led to emotional exhaustion and a mental withdrawal from workplace interactions.<\/span>\r\n\r\nIt\u2019s worth noting that the paper\u2019s authors observed these consequences regardless of whether employees accepted the invitation. Simply receiving was all it took to tax emotional resources, particularly when workers felt unsure how to respond to begin with.<\/span>\r\n
Who Thrives? Who Struggles?<\/b><\/h3>\r\nInterpersonal self-efficacy repeatedly steered how employees responded. Workers more confident in navigating social interactions seemed to be better equipped to handle invitations without stressing out about it. They trusted their ability to respond tactfully, set boundaries, and manage relationships, which served as a buffer against exhaustion and stress.<\/span>\r\n\r\nEmployees with lower interpersonal self-efficacy, on the other hand, appeared to be much more vulnerable. Invitations came across as more threatening, felt more like a burden, and ramped up the likelihood of workplace disengagement.<\/span>\r\n\r\nNotably, interpersonal self-efficacy didn\u2019t significantly pave the way toward feelings of gratitude. Instead, it played a more protective role, tamping down stress rather than amplifying the emotional upside.<\/span>\r\n
Rethinking \u2018Fun\u2019 at the Office<\/b><\/h3>\r\nTaken together, the findings muddy the waters around an enduring belief of organizational psychology: that socializing at work is ultimately a good thing. And while many studies have reinforced the restorative power of after-work socialization, this data show that the social calculus begins earlier. And it can cut both ways.<\/span>\r\n\r\nThe authors contend that organizations embrace a more cautious approach to social participation in after-hours activities. What feels like inclusion to one employee might feel more like a dreaded obligation to another. That\u2019s especially true in cultures or teams where declining is frowned upon.<\/span>\r\n\r\nThe study also illustrates an often-overlooked truth about the modern workplace (as fluid as it is of late). Emotional labor doesn\u2019t begin and end with one\u2019s formal responsibilities. Even friendly gestures come with hidden costs, particularly for employees already juggling heavy workloads, caregiving responsibilities, or social anxiety.<\/span>\r\n\r\nIn an era of hybrid work and heightened concern about employee well-being, the research offers a timely reminder. Social connection matters. But autonomy does, too.<\/span>\r\n
Further Reading<\/b><\/h3>\r\nEmployee Mental Health is a Global Issue<\/b><\/a>\r\n\r\nFaking It At Work Is Harder Than It Looks<\/b><\/a>\r\n\r\nEmployees Still Hesitant to Discuss Mental Health<\/b><\/a>\";s:10:\"post_title\";s:52:\"When a Simple Invite Becomes a Workplace Stress Test\";s:12:\"post_excerpt\";s:140:\"New research shows that even casual workplace social invitations can stress employees out, based on how they experience the original invite.\";s:11:\"post_status\";s:7:\"publish\";s:14:\"comment_status\";s:6:\"closed\";s:11:\"ping_status\";s:6:\"closed\";s:13:\"post_password\";s:0:\"\";s:9:\"post_name\";s:52:\"when-a-simple-invite-becomes-a-workplace-stress-test\";s:7:\"to_ping\";s:0:\"\";s:6:\"pinged\";s:0:\"\";s:13:\"post_modified\";s:19:\"2025-12-22 11:33:51\";s:17:\"post_modified_gmt\";s:19:\"2025-12-22 17:33:51\";s:21:\"post_content_filtered\";s:0:\"\";s:11:\"post_parent\";i:0;s:4:\"guid\";s:58:\"https:\/\/www.psychiatrist.com\/?post_type=news&p=224438\";s:10:\"menu_order\";i:0;s:9:\"post_type\";s:4:\"news\";s:14:\"post_mime_type\";s:0:\"\";s:13:\"comment_count\";s:1:\"0\";s:6:\"filter\";s:3:\"raw\";}i:4;O:7:\"WP_Post\":24:{s:2:\"ID\";i:224114;s:11:\"post_author\";s:6:\"108377\";s:9:\"post_date\";s:19:\"2025-12-16 04:00:53\";s:13:\"post_date_gmt\";s:19:\"2025-12-16 10:00:53\";s:12:\"post_content\";s:7588:\"E<\/strong>thical decision-making within the realm of mental health care represents an evolving challenge.1 <\/sup>Psychiatrists frequently contend with conflicting ethical principles, particularly when confronted with patients exhibiting acute psychiatric symptoms.2 <\/sup>Considerations of respect for autonomy, beneficence, nonmaleficence, and justice must be meticulously evaluated in each case to arrive at a normative ethical conclusion concerning a therapeutic intervention.3 <\/sup>This report scrutinizes a scenario in which a psychiatrist strategically used a patient\u2019s internalized fear of extremism to redirect behavior during a manic episode. While such interventions may facilitate immediate behavioral modification, they simultaneously engender a plethora of ethical dilemmas, which were thoroughly deliberated.\r\n
Case Report<\/h3>\r\nMr A, a 50-year-old man with a history of depression, experienced a manic switch triggered by antidepressant medication. During this episode, he developed intense religious fervor, disseminating his views through YouTube videos and WhatsApp speeches. He formed a group called Pure Islam, which led to conflict within his local community. Mr A challenged established religious leaders and argued with fellow Muslims, asserting that they were misguided. In light of his problematic behaviors, he was admitted to a psychiatric facility; however, he subsequently discharged himself against medical advice and adamantly refused to adhere to prescribed medications.\r\n\r\nDespite his reluctance to engage in pharmacologic treatment, Mr A consented to attend sessions with his psychiatrist, with whom he had previously cultivated a positive rapport during his depressive episodes. The psychiatrist, also a practicing Muslim, listened to Mr A\u2019s beliefs, including those questioning the psychiatrist\u2019s own faith. Instead of directly confronting the patient\u2019s beliefs, the psychiatrist gently educated Mr A about the potential consequences of using language like \u201cPure Islam,\u201d explaining that such terms are often associated with extremist groups and could attract the attention of security agencies. This approach resonated with Mr A, who subsequently became more receptive to treatment and medication. He also expressed his gratitude to the psychiatrist for safeguarding him from potential legal predicaments by furnishing him with judicious counsel.\r\n
Discussion<\/h3>\r\nThis clinical scenario engenders a multitude of intricate ethical dilemmas regarding the manner in which the attending psychiatrist influenced alterations in the patient\u2019s behavior. The approach adopted by the psychiatrist involved leveraging the prevailing anxieties associated with extremism and security concerns to persuade the patient to cease his excessive religious proclamations, which were precipitating numerous issues both within the family and the broader community. The psychiatrist\u2019s awareness that Muslims frequently contend with the apprehension of being unjustly categorized as extremists\u2014a legitimate concern in an atmosphere increasingly characterized by Islamophobia and discriminatory discourse\u2014shaped his therapeutic methodology.4 <\/sup>Furthermore, his elucidation that extremist factions within Islam often manipulate the notion of pure Islam to rationalize their actions and ideologies, predicated on a selective interpretation of Islamic texts and historical narratives, resonated profoundly with the patient.5 <\/sup>Consequently, he acquiesced to cease his public religious proclamations and conveyed his gratitude to the psychiatrist.\r\n\r\nHerein lies the question: Was the psychiatrist\u2019s conduct ethical? From the principle of beneficence, one can contend that the paramount ethical obligation of the psychiatrist in this scenario was to act in the best interests of the patient. Mr A\u2019s behaviors were inflicting considerable distress upon both his family and the broader community, while simultaneously exposing him to the risk of involuntary treatment and potential legal repercussions. By meticulously weighing these factors, the psychiatrist succeeded in persuading Mr A to modify his conduct and embrace treatment, thereby potentially averting harm to himself and others. The established rapport with the patient may have facilitated this persuasive intervention.\r\n\r\nHowever, one might contend that this approach was manipulative. By exploiting the internal fears that stem from societal biases and prejudices, the psychiatrist undermined the autonomy of the patient, who possesses the right to express his beliefs as he sees fit. Moreover, such therapeutic interventions during manic episodes may precipitate or exacerbate paranoia, leading to further behavioral complications. If such a scenario arises, it could be construed as an act of maleficence. One could also argue that in these circumstances, rather than capitalizing on the patient\u2019s internal fears for therapeutic gain, the psychiatrist should endeavor to delve more profoundly into the religious convictions of the patient, fostering a better understanding of the underlying psychosociospiritual factors that drive such behaviors. Furthermore, the psychiatrist might communicate the potential social and legal ramifications of his actions without explicitly invoking the fear of being labeled an extremist.\r\n\r\nNevertheless, one must also acknowledge that mania, as a severe psychiatric condition, significantly impairs the patient\u2019s judgment and impulse control. In this context, the patient\u2019s capacity to comprehend such communication and to engage in genuinely autonomous decision making is questionable. The psychiatrist\u2019s intervention may have been successful precisely because it tapped into a preexisting fear, a fear that persisted even amid the manic excitement.\r\n
Conclusion<\/h3>\r\nTherapeutic interventions in acute mania necessitate a nuanced equilibrium between upholding ethical principles and addressing the immediate needs of the patient. While capitalizing on a patient\u2019s preexisting fears can be a pragmatic and efficacious strategy, conducted with a spirit of beneficence, it also requires meticulous consideration, as it may contravene the principles of autonomy and nonmaleficence. Mental health professionals should remain acutely aware of these ethical quandaries while seeking therapeutic solutions in analogous circumstances.\r\n
Article Information<\/h2>\r\nPublished Online: <\/strong>December 16, 2025. https:\/\/doi.org\/10.4088\/PCC.25cr04034<\/a>\r\n\u00a9 2025 Physicians Postgraduate Press, Inc.\r\nPrim Care Companion CNS Disord 2025;27(6):25cr04034\r\n<\/em>Submitted: <\/strong>June 27, 2025; accepted September 12, 2025.\r\nTo Cite: <\/strong>Uvais NA. The fine line: balancing pragmatism and ethics in the management of acute mania. Prim Care Companion CNS Disord <\/em>2025;27(6):25cr04034.\r\nAuthor Affiliation: <\/strong>Department of Psychiatry, Iqraa International Hospital and Research Centre, Calicut, India.\r\nCorresponding Author: <\/strong>N. A. Uvais, MBBS, DPM, FRSPH, FRSB, Department of Psychiatry, Iqraa International Hospital and Research Centre, Calicut, India ([email protected]<\/a>).\r\nRelevant Financial Relationships: <\/strong>None.\r\nFunding\/Support: <\/strong>None.\r\nAdditional Information: <\/strong>Patient information has been de-identified to protect anonymity.\";s:10:\"post_title\";s:79:\"The Fine Line: Balancing Pragmatism and Ethics in the Management of Acute Mania\";s:12:\"post_excerpt\";s:121:\"A psychiatrist strategically used a patient's internalized fear of extremism to redirect behavior during a manic episode.\";s:11:\"post_status\";s:7:\"publish\";s:14:\"comment_status\";s:6:\"closed\";s:11:\"ping_status\";s:6:\"closed\";s:13:\"post_password\";s:0:\"\";s:9:\"post_name\";s:50:\"balancing-pragmatism-ethics-management-acute-mania\";s:7:\"to_ping\";s:0:\"\";s:6:\"pinged\";s:0:\"\";s:13:\"post_modified\";s:19:\"2025-12-16 08:53:08\";s:17:\"post_modified_gmt\";s:19:\"2025-12-16 14:53:08\";s:21:\"post_content_filtered\";s:0:\"\";s:11:\"post_parent\";i:0;s:4:\"guid\";s:38:\"https:\/\/www.psychiatrist.com\/?p=224114\";s:10:\"menu_order\";i:0;s:9:\"post_type\";s:4:\"post\";s:14:\"post_mime_type\";s:0:\"\";s:13:\"comment_count\";s:1:\"0\";s:6:\"filter\";s:3:\"raw\";}i:5;O:7:\"WP_Post\":24:{s:2:\"ID\";i:223966;s:11:\"post_author\";s:6:\"107961\";s:9:\"post_date\";s:19:\"2025-12-08 12:06:57\";s:13:\"post_date_gmt\";s:19:\"2025-12-08 18:06:57\";s:12:\"post_content\";s:6845:\"Five years ago, a global pandemic yanked the fringe concept of working from home into the mainstream. Now, as so many companies try to get their workers back into the office, new research out of Australia hints that <\/span>where<\/span><\/i> we work\u2014and how far we travel to get there \u2013 might influence us more than we thought.<\/span>\r\n\r\nA team of University of Melbourne researchers report that long commute times threaten the mental health of men already battling mental health issues. While working from home boosts\u00a0 women with similar struggles.<\/span>\r\n\r\nThe <\/span>study<\/span><\/a>, appearing in <\/span>Social Science & Medicine<\/span><\/i>, relies on 18 years of national panel data. It also appears to be the first to clear up whether mental-health gains from remote work stem from working at home itself. Or if the commute is the problem.<\/span>\r\n
Small Commute Effects. But Only for Men.<\/b><\/h3>\r\nUsing data from the <\/span>Household, Income and Labour Dynamics in Australia<\/span><\/a> (HILDA) Survey, the researchers looked at working adults between 2002 and 2019. Despite a steady rise in commuting times over those years, the average Australian worker didn\u2019t seem to suffer much in terms of mental health as commute lengths grew.<\/span>\r\n\r\nBut the averages \u2013 at least in this case \u2013 are deceiving. When the team applied <\/span>unconditional quantile regression<\/span><\/a>, they uncovered a pocket of weakness. For men below the median of the mental-health distribution, longer commutes dramatically aggravated psychological wellbeing. For men with higher baseline mental health, commute times didn\u2019t matter.<\/span>\r\n\r\nIt made a real difference, however modest. An extra 30 minutes of commuting forecast a drop equivalent to a 2% reduction in household income. The effect, the authors suggest, could reflect the stress of traffic, road congestion, and Australia\u2019s car-heavy commute culture. It\u2019s worth noting that nearly three-quarters of the nation\u2019s workers must drive to the office.<\/span>\r\n
Remote Work Helps Women Most.<\/b><\/h3>\r\nOn the other hand, Australian women \u2013 unlike their UK counterparts, where similar studies revealed notable negative ramifications \u2013 displayed no mental-health penalty from longer commutes.\u00a0<\/span>\r\n\r\nThe authors suggest that Australia\u2019s more generous childcare subsidies might shield mothers from the pressures that magnify commuting stress elsewhere. Childcare costs<\/a> in Australia consume roughly half the household budget share paid by British families.<\/span>\r\n
Working From Home<\/b><\/h3>\r\nThe study\u2019s most striking finding concerns working from home. Simply having a remote option wasn\u2019t enough. The benefits appeared only when employees spent at least half their working hours at home.<\/span>\r\n\r\nFor women with low mental health to start with, the gains shocked the researchers. Working from home between 50% and 75% of the time boosted mental-health scores by about 0.2 standard deviations. That\u2019s an improvement that works out to a 15% jump in household income. Ironically, women working almost entirely from home didn\u2019t experience the same effect. The researchers figure that it suggests that remote work works best when it\u2019s substantial, but not total.<\/span>\r\n\r\nMen, however, didn\u2019t enjoy any statistically reliable mental-health benefits from working from home. While they might <\/span>indirectly<\/span><\/i> benefit from avoiding a stressful commute, working from home itself doesn\u2019t seem to do much for their well-being.<\/span>\r\n
So, What Gives?<\/b><\/h3>\r\nGender norms around care and work probably exert some influence here. Women more often handle household coordination, so schedule flexibility can make a much bigger difference. In that context, remote work might ease the daily burdens unrelated to employment itself.<\/span>\r\n\r\nFor men, stress appears more tied to the commute than the job. And because Australian men remain less likely to seek mental-health help, the authors\u00a0 posit that their stress might build up without intervention \u2013 especially among those already struggling.<\/span>\r\n
A Case for a More Targeted Remote-Work Policy<\/b><\/h3>\r\nThe study\u2019s central message appears to be that we can\u2019t really assess the value of remote work just by looking at the averages. For workers with stable mental health, long commutes or remote work doesn\u2019t do much. But for workers with poor mental health, policy and workplace design make a huge difference.<\/span>\r\n\r\nThe findings suggest that remote work isn\u2019t simply a lifestyle perk. But it\u2019s not a panacea, either.<\/span>\r\n\r\nInstead, well-designed hybrid models could serve as targeted mental-health interventions for the workers who need them most.<\/span>\r\n\r\nAs the battle over return-to-office mandates rages on, the authors argue that flexibility for vulnerable workers could offer measurable mental-health protection..<\/span>\r\n
Further Reading<\/b><\/h3>\r\nWork Hours, Sleep Sufficiency, and Prevalence of Depression Among Full-Time Employees<\/b><\/a>\r\n\r\nEmployee Mental Health is a Global Issue<\/b><\/a>\r\n\r\nWork It Boomers: Delaying Retirement May Slow Cognitive Decline<\/b><\/a>\";s:10:\"post_title\";s:51:\"Remote Work Helps Women. Shorter Commutes Help Men.\";s:12:\"post_excerpt\";s:117:\"An Australian study shows long commutes harm struggling men, while hybrid remote work boosts women\u2019s mental health.\";s:11:\"post_status\";s:7:\"publish\";s:14:\"comment_status\";s:6:\"closed\";s:11:\"ping_status\";s:6:\"closed\";s:13:\"post_password\";s:0:\"\";s:9:\"post_name\";s:49:\"remote-work-helps-women-shorter-commutes-help-men\";s:7:\"to_ping\";s:0:\"\";s:6:\"pinged\";s:0:\"\";s:13:\"post_modified\";s:19:\"2025-12-12 14:58:14\";s:17:\"post_modified_gmt\";s:19:\"2025-12-12 20:58:14\";s:21:\"post_content_filtered\";s:0:\"\";s:11:\"post_parent\";i:0;s:4:\"guid\";s:58:\"https:\/\/www.psychiatrist.com\/?post_type=news&p=223966\";s:10:\"menu_order\";i:0;s:9:\"post_type\";s:4:\"news\";s:14:\"post_mime_type\";s:0:\"\";s:13:\"comment_count\";s:1:\"0\";s:6:\"filter\";s:3:\"raw\";}}"
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