Demian Gitnacht, MD, MPH, FAAFP

There is a particular kind of suffering that rarely receives attention because, from the outside, everything appears perfectly intact. The career is stable. The marriage looks healthy. The children are cared for. Bills are paid on time. Friends describe the person as successful, responsible, dependable, and accomplished. Social media displays vacations, birthdays, celebrations, and smiling photographs framed beneath restaurant lighting and sunset skies. And yet, for many people, the moment...

There is a moment many people struggling with gambling addiction know intimately, although very few ever talk about it out loud. It is not the moment they win. It is not even the moment they lose. It is the drive home afterward. The hands gripping the steering wheel tighter than usual. The stomach hollow. The mind replaying every decision in violent detail while the unbearable mental math begins before the car even leaves the parking garage. “If I had just walked away.” “If I had bet...

There is a moment that happens so subtly most people do not notice it at first. It is two in the morning. The room is dark except for the glow of a screen illuminating half a face. One video becomes three. Three becomes twenty minutes. Twenty minutes becomes an hour. The mind says this is the last one, but the finger keeps scrolling anyway, searching for something more intense, more novel, more stimulating. Eventually the screen turns off, but the nervous system does not. There is no real...