Psychiatry at the Margins | Awais Aftab | Substack

Who Gets to Define Human Suffering?

As psychiatry concedes long-standing criticisms of diagnosis, a deeper question emerges: What now justifies its authority over human suffering?

How Bad Are Things?

One “advantage” of working in psychiatry is getting a window into an otherwise invisible world of really miserable people. I work in a wealthy, mostly-white college town consistently ra…

Mental Wealth

TL;DR • When it comes to mental health, our society approaches it like we did with physical health 50 years ago. We only think about it when something goes wrong. • To the wider public, mental heal…

Computational Psychiatry Needs Systems Neuroscience

This piece was originally published in The Transmitter. I am adapting it here with some additional context for readers of this newsletter.

Pluralistic: Three more AI psychoses (12 Mar 2026) – Pluralistic: Daily links from Cory Doctorow

"AI psychosis" is one of those terms that is incredibly useful and also almost certainly going to be deprecated in smart circles in short order because it is: a) useful; b) easily colloquialized to describe related phenomena; and c) adjacent to medical issues, and there's a group of people who feel very strongly any metaphor that implicates human health is intrinsically stigmatizing and must be replaced with an awkward, lengthy phrase that no one can remember and only insiders understand.

Madness and Enterprise: Psychiatry, Economic Reason, and the Emergence of Pathological Value

Uncovers a powerful relationship between pathology and money: beginning in the nineteenth century, the severity of mental illness was measured against a patient’s economic productivity.  Madness and Enterprise reveals the economic norms embedded within psychiatric thinking about mental illness in the North Atlantic world. Over the course of the nineteenth century, various forms of madness were subjected to a style of psychiatric reasoning that was preoccupied with money. Psychiatrists across Western Europe and the United States attributed financial and even moral value to an array of pathological conditions, such that some mental disorders were seen as financial assets and others as economic liabilities. By turning to economic conduct and asking whether potential patients appeared capable of managing their financial affairs or even generating wealth, psychiatrists could often bypass diagnostic uncertainties about a person’s mental state. Through an exploration of the intertwined histories of psychiatry and economic thought, Nima Bassiri shows how this relationship transformed the very idea of value in the modern North Atlantic, as the most common forms of social valuation—moral value, medical value, and economic value—were rendered equivalent and interchangeable. If what was good and what was healthy were increasingly conflated with what was remunerative (and vice versa), then a conceptual space opened through which madness itself could be converted into an economic form and subsequently redeemed—and even revered.

Who listens when mental health struggles disrupt daily life?

Ask a Bangladeshi newspaper reader to picture a mental health story. Perhaps a psychiatrist’s quote comes to mind, a helpline number, or a headline about a student’s death.

Occurrence of Psychosis and Bipolar Disorder in Individuals With ADHD Treated With Stimulants

This systematic review and meta-analysis evaluates the association between psychosis or bipolar disorder and stimulant treatment among individuals with attention-deficit/hyperactivity disorder.

Leading Innovation in Psychiatric Treatment | Alto Neuroscience

We leverage brain biology to develop personalized medicines, helping patients get better faster.

It is time for a community approach to mental health

Abolitionists and mental health advocates in the US are working to replace both police and psychiatry by reimagining how we respond to mental health crisis.

Working remotely, coworking spaces, and mental health - bitquabit

This should be a hard blog post to write–after all, it’s the one where I openly admit I had an emotional breakdown and saw a mental health professional–but it’s actually easy. And it’s easy because it has a good ending: facing long odds and a frustrating situation, I ended up turning everything around and getting a place where I love my job and I’m a happy person again.