How I think physicists can help psychiatric education3 min read

I believe that physicists can help with the education process of both clinicians and research psychiatrists. However, I can only go on my experience of being treated by psychiatrists and the papers I have read within the psychiatric literature. I have very little knowledge of how psychiatrists are trained or of psychiatric research culture.

This blog post was adapted from notes I sent to one of the editors when constructing my Lancet Psychiatry article in the May 2023 edition –“Lithium Story: Eight Guidelines, Eight Recommendations“.

Clinicians

It was clear to me during my lithium treatment that clinicians would be using words to describe certain practices, without understanding the meaning behind those words. For example, using the phrase “morning trough¹ level” to apply to a 12-hour level approximately halfway between peak and trough lithium concentrations in my bloodstream. I believe physicists can help clinicians to think about the meaning behind guidelines.

This is because I would argue that physicists are some of the best in the world at questioning previously held assumptions. Physics is really weird! Understanding concepts within the subject requires as much “unlearning” as it does “learning”. I suppose a good example would be questioning the conventional view of electrons orbiting the atom’s nucleus like a planetary system, to one based on probabilities.  Unlearning requires, I believe, an education in logic and the use of imagination.

Interaction between physicists and clinicians will, I hope, help clinicians to question their own understanding, and perhaps more importantly, know when to question the guidelines they are given to instigate the process of deeper understanding.

Researchers

Contrary to public perception, physics is the simplest of the sciences. The subject analyses the simplest systems using the simplest mathematical models (i.e. linear dynamics). Biology, on the other hand, studies the most complicated systems that obey the most complicated mathematical models (non-linear dynamics).

A physics education is, to put it simply, learning how to identify the simple within the complex mess that is reality. My physics education, which regularly combined experiment with theory, helped me to identify the patterns in data and know where to look for answers. I have experienced a culture where clarity and deeper understanding of concepts is seen as vitally important. This has allowed me to pick up on language that suggests gaps in the authors’ understanding.

Perhaps most importantly, and I think the most wonderful thing about learning physics, we are encouraged to celebrate when we are wrong. There is nothing more exciting than a re-written textbook, even to the author of the old one! This allowed me to have the confidence to tackle a problem I have felt way out of my depth in.

What is striking to me about the 1977 Amdisen paper I referenced in my Lancet psychiatry article is how similar it is to the style of most physics papers. Through carefully thought-out experiments and simulation, the pharmacokinetic properties of lithium are identified. Using this evidence, arguments on how it should be managed safely are made. Clear definitions are provided throughout the paper.

It is no surprise to me that it was this paper and the one that preceded it that first suggested the 12-hour standardised serum level that is now supposed to be used worldwide. It is arguable not much progress has been made since.

I hope that psychiatric researchers could benefit from exposure to a culture of encouragement to be wrong, where simulation and experiment are used together and where clarity of language is put above almost everything else.

I think that psychiatric researchers could help physicists too. There is a significant mental health problem in physics. From my experience, the biggest one was the lack of a support system. Studying physics is seen as so exciting that there is no reason anyone would feel down doing it. Mental health in physics research, put simply, isn’t properly recognised as a problem.

Any positions of pastoral care that existed in the physics department at my university were held by people who weren’t qualified to carry them out. They were either an administrator or a physicist. Exposure to research psychiatrists can help educate physicists about mental illness and the myths that surround it.

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