I recently saw a video by a famous American-based Indian gastroenterologist-turned-YouTuber who spoke extensively on gut health and helped make concepts like intermittent fasting famous. He boasts an impressive 3.6 million followers. With such great influence, one would assume great responsibility as well.
Surprisingly, this particular video touched on OCD (obsessive compulsive disorder) — something far beyond the remit of his expertise. It was a fair attempt to highlight the struggles of OCD, but it was painfully clear he has no idea of the true cruelty of the condition.
I have seen patients whose battles with OCD have moved me to both tears and awe. OCD is not only intrusive in diagnostic criteria — it is unimaginable in real life.
To see these struggles simplified into a light-hearted skit was grating. Even more saddening was seeing the comments section flooded with people suddenly convinced they “have OCD too.” It reminded me of the wave of TikTok-driven self-diagnoses of tics and Tourette’s syndrome — performative, inaccurate, and ultimately harmful.
All of this was already unpalatable, but what truly prompted me to write was the claim that while selective serotonin reuptake inhibitors (SSRIs) can treat OCD, it is more important to consume serotonin-rich foods such as tofu and nuts.
The tiny hitch — or perhaps glaring oversight — is that while serotonin-rich food nourishes the body, the serotonin stays in the gut.
Just because the gut produces 90 per cent of the body’s serotonin does not mean that eating serotonin-containing food will make one happier. And it certainly does not mean it can treat an extremely complicated neuropsychiatric condition — one that psychiatrists and researchers have devoted their entire careers to understanding, and are still unravelling as we speak.
Why do I say so? Serotonin is a molecule that cannot cross the blood–brain barrier. So how is the serotonin from food — which stays in the gut and bloodstream — supposed to enter the brain and make any difference?
Tryptophan — the precursor of serotonin — can cross the blood–brain barrier, and yes, it is found in foods like tofu and nuts. It also happens to be the precursor of melatonin, which regulates sleep. That is why the age-old advice about drinking milk before bed contains a sliver of truth.
But even so, this does not transform food into psychiatric treatment. Neurotransmitters do not work that way. It is akin to saying that if you have a noradrenaline deficiency, you should eat more adrenal glands of animals.
I suppose the reason I am writing this is because psychiatry, much like any other medical specialty, is a highly specialised field. If a doctor would not dare make sweeping statements about cardiology or obstetrics and gynaecology — leaving those fields to those who have spent years specialising in them — then the same respect should be accorded to psychiatry.
We were once known as alienists. We are still sometimes called shrinks. Psychiatry is one of the younger branches of medicine, marked by misunderstanding and missteps — but also one of the fields that has transformed the most in the past century.
We now have subspecialties ranging from forensic psychiatry, which stands at the crossroads of medicine and the justice system in safeguarding society, to much lesser-known branches that are not yet formalised in Malaysia, such as Psychiatry in Learning Disability — a field spanning behavioural science, human communication, medicine, psychiatry, neurology, and advocacy. A subspecialty that holds the responsibility of safeguarding some of society’s most vulnerable individuals.
Our researchers work to unlock the mysteries of the mind and develop ways to ease the suffering created by broken neural circuits. And yes — we treat everyone from age five until the day they die, across multiple subspecialties.
Being a psychiatrist is not easy. Some days, we are the pharmacologist; some days, the therapist; some days, the advocate; and some days, the last person standing between a broken mind and a broken system.
And yet, time and time again, we are misunderstood. I still encounter people confusing psychiatrists with psychologists, psychiatry with counselling — including people within the healthcare system or those holding qualifications in health-related sciences.
I once read a published article in a local outlet claiming that trichotillomania should be treated with counselling. For the record, this is a psychiatric condition best managed by a psychiatrist alongside therapy. And no, we are not qualified counsellors; we are qualified medical doctors, though we often wear the counsellor’s hat when needed.
Those of us who sit with patients through the darkest corners of their minds know how sacred this work is. So when the world reduces OCD to quips and food lists, it hurts. Not because it insults our profession — but because it trivialises the suffering of the people we care for.
We are doctors who wear many hats. And behind every hat is the same hope: that people with mental illness will be seen, not simplified.
The author is a psychiatrist.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
