So what does all that mean? In short, you’ll never leave my office with just a diagnostic label and matching prescription. Your “diagnosis” will take into account biological, psychological, social, and even spiritual components (I use the term loosely to include one’s overall sense of peace and meaning in the universe)—and it will most certainly involve your beliefs and opinions, and perhaps those of your family, should you choose to involve them in your assessment. Your treatment begins with education about your illness and treatment options, culminating in a personalized package of interventions that you and I decide is best for you, including any combination of those listed below:
Psychiatric medication(s) prescribed with careful attention to possible side effects, potential drug-drug interactions, and risk for addiction, in combination with evidence-based cognitive-behavioral/dialectical behavior therapy skills including mindfulness, relaxation breathing, and visual imagery as well as meditation, exercise, yoga, etc.
Psychotherapy or “talk therapy” (individual, couples, family, or group therapies either with me or another therapist who works with us as a team). Did you know that research has clearly shown that psychotherapy is as powerful, and sometimes more effective than medication management? This is particularly the case for depressive and anxiety disorders, especially posttraumatic stress disorder, panic disorder, and obsessive-compulsive disorder. Some of the most effective and well-studied psychotherapies include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and interpersonal therapy (IPT) Click the following link for more information Talk Therapy )
Healthy Habits—likely all of us could do better in this arena (nutrition, exercise, sleep, avoidance of drugs/alcohol and other compulsive behaviors/addictions, etc.)—all of which can have a significant impact on problems that bring one to the attention of a psychiatrist, such as alcohol causing depression, anxiety, and anger; a high-carbohydrate diet aggravating mood swings; and inadequate sleep causing forgetfulness, depression, anxiety, and irritability.
Stress management—Did you know that 80% of all illnesses are related to chronic stress? How many of those unhealthy habits grew out of life stress? And how many of your illnesses are related to, or made worse by, your unhealthy habits? You can break that cycle by putting things back in balance—holistic balance. Remember, if any part of you is having problems, it can affect the rest of your parts (mental can affect the physical and/or the social and/or the spiritual and vice-versa.
Physical/Diagnostic Testing Measurement of your blood pressure and pulse Diagnostic laboratory tests including blood/urine tests to measure things like thyroid function (which can cause depression or anxiety if altered), liver and kidney function (to make sure that you can safely eliminate medications), vitamin levels that can affect thinking and mood, diabetes screening tests, red and white blood cell counts, etc. ECG (electrocardiogram) to make sure your heart is healthy in case we use a medication that could affect the heart or if you have a problem with anxiety that includes palpitations or skipped heartbeats, for example Brain imaging (CT scan of the head or MRI of the brain) if we are concerned about your thinking and memory or if you are having symptoms like hallucinations or a change in personality, for example EEG (electroencephalogram) or brain wave test in the event that you have neuropsychiatric symptoms that could be related to seizures.
Consultation with your primary care provider, therapist, or any other healthcare provider you identify—I want to work with your other providers as a team so that we treat you as a whole person. Sometimes I will suggest that you work with other experts to help you achieve your goals, such as other medical doctors or mental health specialists; nutritionists, acupuncturists, chiropractors, massage therapists, pastoral counselors, etc.