Essays by Vivek Jayadeva, MD

Insights

Writing about psychiatry, psychotherapy, medication, and the conditions shaping how people think, feel, and live.

These essays examine clinical questions that do not always fit neatly into a diagnosis or a brief prescription encounter.

Editorial focus

Questions that deserve more time

Psychiatric symptoms rarely occur in isolation. Medication response, sleep, stress, relationships, physical health, technology use, and the demands of daily life may all affect what a person experiences and what treatment is likely to help.

The writing here explores those intersections without presenting a single prescribed way to live or reducing every difficulty to a medical diagnosis.

The purpose is to make psychiatric thinking more understandable while preserving the complexity of the person being considered.

Practice availability

The writing remains available while scheduling is paused

The Insights archive remains available as a professional and educational resource independent of current clinical availability.

Sattva Psychiatry is not currently accepting new patients. The practice is not maintaining a waiting list or providing an estimated reopening date.

Writing archive

Essays and clinical reflections

Browse current writing from Sattva Psychiatry.

Practice availability: Sattva Psychiatry is not currently accepting new patients or maintaining a waiting list.

Educational use: These essays provide general information and do not constitute medical advice, establish a physician-patient relationship, or replace individual evaluation.

Vivek Jayadeva Vivek Jayadeva

Why Multitasking Can Worsen Attention and Mental Fatigue

Multitasking feels efficient because it creates the sensation of movement. Messages get answered, tabs stay open, small items get touched, and the day appears full. What often goes unnoticed is that this kind of fullness can come at the cost of continuity.

The mind is usually not doing many things well at once. It is repeatedly leaving one task before it has fully become organized thought.

Most so-called multitasking is really rapid task-switching, and switching has a cost. Each shift requires the mind to disengage, reorient, recover context, and rebuild working memory around a new target. Those costs may seem small in isolation, but repeated often enough, they can shape the quality of the whole day: thinner concentration, more mental fatigue, more irritability, and more unfinished cognitive residue.

This matters clinically because the problem is not only reduced productivity. Repeated fragmentation can affect the texture of experience itself. A person who lives in constant switching may lose the feeling of sequence. Thoughts stay shorter. Emotions become easier to react from and harder to reflect on. Even rest may become less restorative because the mind has been trained toward interruption so often that it struggles to remain with one thing long enough to settle.

This is one reason many people feel mentally crowded even when they are not doing objectively extreme amounts of work. The crowding comes not only from workload, but from the number of open loops. Attention gets divided into partial starts, partial returns, and partial completions. Life becomes full of re-entry costs.

A careful psychiatric evaluation may be useful when distractibility, mental fatigue, irritability, avoidance, or difficulty completing tasks become persistent and hard to explain. These symptoms can reflect ADHD, anxiety, depression, sleep disruption, burnout, medication effects, workload strain, or the cumulative effects of chronic interruption. The right treatment depends on understanding which pattern is actually present.

The answer is not perfection or rigidity. It is to rebuild conditions under which continuity becomes possible again: fewer open channels, fewer parallel demands, more monotasking, more deliberate batching, and more protected time for deeper work. The mind generally works better when it is allowed to arrive somewhere before being asked to leave again.

A practical starting point is to pick one recurring part of the day and protect it from switching. One task, one window, one purpose, for a set period of time. The goal is not maximum output. It is to retrain the mind’s ability to stay.

“What multitasking erodes first is not efficiency, but continuity.”

References

  1. Monsell S. Task switching. Trends in Cognitive Sciences. 2003;7(3):134–140.
  2. Leroy S. Why is it so hard to do my work? The challenge of attention residue when switching between work tasks. Organizational Behavior and Human Decision Processes. 2009;109(2):168–181.
  3. Miller EK, Buschman TJ. Cortical circuits for the control of attention. Current Opinion in Neurobiology. 2013;23(2):216–222.
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Vivek Jayadeva Vivek Jayadeva

How Constant Availability Can Worsen Anxiety and Attention

Constant connectivity has a cost that is easy to miss because it rarely appears as a crisis. It more often shows up as thinning attention, shortened patience, shallower thought, and a nervous system that never fully stands down. Many people now live in a state of continuous low-grade readiness: always somewhat available, somewhat interrupted, and somewhat on call.

That is not just a cultural inconvenience. It can change the way the mind functions. When attention is repeatedly broken, continuity becomes harder to sustain. Thoughts stay shorter. Reflection is more easily replaced by reaction. The day may feel full without feeling coherent.

Over time, people may interpret this as a personal deficiency: poor discipline, weak focus, low motivation, or lack of self-control. Sometimes the better explanation is that the nervous system has adapted to chronic fragmentation.

This matters clinically because constant interruption can worsen anxiety, attention problems, irritability, sleep disruption, and emotional regulation. A person may rarely feel fully at rest, but also rarely feel fully engaged. The mind moves from cue to cue, demand to demand, message to message, without enough time for thought to deepen or emotion to settle.

The problem is not simply technology. It is the repeated training of attention toward interruption. A phone, inbox, or messaging platform does not only deliver information. It also creates a pattern of anticipatory readiness: the sense that something may need a response at any moment.

Connectivity also blurs an important distinction: the difference between contact and claim. A message may be only information, but it can feel like an immediate demand on attention, mood, and response time. Enough small demands accumulate, and the body begins to treat availability itself as a background obligation.

A careful psychiatric evaluation may be useful when distractibility, anxiety, irritability, insomnia, or mental fatigue become persistent and difficult to interpret. These symptoms can reflect ADHD, anxiety, depression, burnout, sleep disruption, medication effects, substance use, workload strain, or the cumulative effects of chronic interruption. The right treatment depends on understanding the pattern clearly.

Restoring steadiness does not require rejecting technology. It requires restoring conditions in which attention can gather itself again: fewer alerts, more monotasking, protected silence, clearer boundaries around response time, and more moments in which a signal can arrive without automatically becoming an obligation.

A practical starting point is to protect one 25-minute period each day in which nothing can reach you. No notifications, no parallel tabs, no checking between tasks. Treat it as training in mental continuity, not as a productivity trick. The point is to remember what your mind feels like when it is allowed to stay.

“What constant connectivity steals first is not time, but continuity.”

References

  1. Mark G, Gudith D, Klocke U. The cost of interrupted work: More speed and stress. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. 2008:107–110.
  2. Rosen LD, Carrier LM, Cheever NA. Facebook and texting made me do it: Media-induced task-switching while studying. Computers in Human Behavior. 2013;29(3):948–958.
  3. Kushlev K, Dunn EW. Checking email less frequently reduces stress. Computers in Human Behavior. 2015;43:220–228.
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Vivek Jayadeva Vivek Jayadeva

When Attention Problems Are Not Simply ADHD

Attention problems are one of the most common reasons adults begin to wonder whether they have ADHD. That question is often worth taking seriously. But attention is also affected by anxiety, depression, sleep disruption, chronic stress, medication side effects, medical conditions, substance use, trauma, and the constant interruption built into modern life.

This matters because poor attention is not only a productivity problem. It can affect emotional regulation, frustration tolerance, working memory, decision-making, and the ability to stay with a thought long enough to understand it clearly. When attention becomes fragmented, people may feel scattered, reactive, forgetful, inefficient, or mentally thin. They may also begin to interpret these difficulties as laziness or lack of discipline.

A careful psychiatric evaluation looks at attention in context. The goal is not simply to decide whether someone “has ADHD” or does not. The more useful question is often: what is interfering with attention, and what kind of treatment would actually fit?

For some adults, longstanding ADHD is part of the picture. For others, attention worsens during periods of anxiety, depression, burnout, sleep deprivation, grief, hormonal change, or excessive task-switching. In many cases, several factors are interacting at once. Treating the wrong problem can lead to frustration, unnecessary medication changes, or a continued sense that nothing is working.

Improving attention often begins with restoring the conditions under which continuity is possible: adequate sleep, fewer interruptions, realistic workload, treatment of anxiety or depression when present, and medication decisions that match the actual clinical picture. Small changes can matter, but they are most useful when guided by an accurate formulation.

A practical starting point is to protect one 20–30 minute period each day for uninterrupted attention. No notifications, no parallel tasks, no background stimulation. The goal is not just productivity. It is to rebuild the capacity to remain with one stream of experience long enough for thought to deepen.

If attention problems are persistent, worsening, or difficult to interpret, a psychiatric evaluation can help clarify whether the issue is ADHD, anxiety, depression, sleep, medication effects, stress physiology, or some combination of these factors.

Attention does not just shape performance. It shapes the kind of mind you have to live inside.

References

  1. Posner MI, Rothbart MK. Research on attention networks as a model for the integration of psychological science. Annual Review of Psychology. 2007;58:1–23.
  2. Smallwood J, Schooler JW. The science of mind wandering: Empirically navigating the stream of consciousness. Annual Review of Psychology. 2015;66:487–518.
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