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MENTAL WELLNESS

 

I don't just treat mental illness, I help develop mental wellness.  This is more than just minimizing suffering.  It’s also about recognizing your strengths and living life purposely, authentically, and joyously.  Mental wellness can be thought of as maximizing happiness, calmness, sleep, activity, and nutrition.  My job is utilizing an integrative approach, through medicine, therapy, and holistic care, to help you get the most from the five pillars below.

DO YOU PRESCRIBE MEDICATIONS?

 

            Yes.  As a board-certified psychiatrist and medical doctor, I have the ability to prescribe medications, but I do so conservatively, judiciously, and usually short-term.  It is very important for doctors to spend adequate time understanding an individual’s life and emotional suffering before prescribing psychiatric medications.  It’s also necessary for doctors to fully explain the many short-term and long-term risks these medications may pose, as well as discuss evidence-based alternatives, such as therapy, lifestyle optimization, and herbal/vitamin supplementation.  If you feel your doctor has not adequately understood you nor explained the risks and alternatives to medications, perhaps my treatment philosophy will resonate with you.  In my experience, psychiatric medications should seldom be used long-term and are better thought of as a short-term bridge to some of the other work we can do together.  I am not anti-medication, I am for their rational use. 

            I have also developed a sub-specialty in helping people to safely and comfortably come off of benzodiazepines.

DO YOU PRESCRIBE BENZODIAZEPINES ?

 

            Benzodiazepines, like Xanax, Klonopin, Valium, and Ativan, should generally only be prescribed short-term (less than 4 weeks).  Unfortunately, these medications have been widely prescribed long-term, often without a full discussion of the serious long-term risks these medication pose to the patient.  As I result, I see many patients who were prescribed benzodiazepines at a time in their lives when anxiety or insomnia was a problem, only to find the dosage slowly increasing through time, and side effects like depression, brain fog, loss of energy, and cognitive slowing more prominent.  In addition to these well-established risks, emerging evidence suggest benzodiazepines may significantly increase the risk of memory problems and, for many people, can worsen anxiety and sleep over time.  Because of this, I only prescribe benzodiazepines as part of a tapering program.  If you feel you may be dependent on benzodiazepines, the good news is there are several evidence-based approaches to coming off them slowly, safely, and comfortably, as well as treating the underlying anxiety and insomnia. 

 

WHAT IS INVOLVED IN TAPERING, ALSO KNOWN AS DE-PRESCRIBING?

Tapering (also known as de-prescribing) is the planned and medically supervised process of reducing or stopping psychiatric medication for which existing or potential harms outweigh existing or potential benefits.  De-prescribing can be considered when medications are causing unwanted side effects or are no longer needed.  It is important to note that there is no "one size fits all way" of de-prescribing, as the individual patient's preferences, values, overall health and functioning need to be considered in order to create and supervise an individualized de-prescribing plan.

DO YOU PRESCRIBE STIMULANTS?

          

          As a general rule, I do not prescribe stimulant medication like Adderall and Ritalin, as I feel that exposure to the many long-term risks of stimulants tend to outweigh their benefits. 

DO YOU DO THERAPY?

 

           Yes.  It’s been my absolute joy to help people achieve the happiness, calmness, and purposefulness that can result from the work done in therapy.  However, I currently have no therapy appointments available.  I see many patients who are already doing therapy with someone else.  I encourage this and would like to be in communication and collaboration with your therapist.  I may also recommend a therapist based on your individual needs. 

IN ADDITION TO MEDICATION, WHAT ELSE DO YOU OFFER?

 

         As a psychiatrist, I am trained in all aspects of mental healthcare and wellness, from the biological to the psychological.  In addition to therapy and medications, there are other services I provide.  Low mood and anxiety can be hallmarks of several general medical conditions.  Before deciding on treatment, we’ll first evaluate and test for these medical conditions, as they are often readily treatable. 

         You may be surprised to learn that scientific studies haves shown that many complementary and holistic treatments for mental health are at least as effective as medication.  These include herbal, vitamin, and over-the-counter supplements, meditation, breathwork, as well as specific changes in diet and exercise.  I practice evidence-based medicine and will only recommend a treatment if there is solid scientific research behind it. 

DO YOU TREAT CHILDREN?

 

            I do not treat children (under 18 years old). 

DO YOU TREAT SENIORS (OVER 65yo)?

 

            Unfortunately, Medicare regulations do not allow me to see any patient who is Medicare eligible. 

WHAT CAN I EXPECT ON MY FIRST VISIT?

 

            First, I practice a “no-typing” policy during sessions, meaning that I strive to be fully present, with my attention focused on you rather than typing on a computer.  In order to encourage an open and honest dialogue, anything we talk about is under the strictest of confidentiality and this is something I take very seriously.  We’ll explore your emotional health, your physical health, relationships, and environment, as well as an examination of your sources of strength, resiliency, and quality of life. 

IS THERE ANYTHING I SHOULD DO BEFORE WE MEET?

 

            First, let’s have a brief (~5min) phone conversation to make sure I’m the right person for you to see.  If we decide to meet, be sure to bring in all your medications (either a list with dosages and frequency or the actual pill bottles) and any recent laboratory results so we can discuss them accurately.   You can also fill out the initial visit form under the "forms" tab and email it to me before our first visit.  This way, I can read it before we meet so that we can focus all our time together on you, rather than filling out and reviewing forms. 

WILL I RECEIVE A PSYCHIATRIC DIAGNOSIS?

 

         I tend to avoid diagnostic labels (“General Anxiety Disorder”, “Major Depressive Disorder”, etc.).  I find that such labels do not help me better understand you and your individual suffering.  As you may have noticed, if you go to see three different psychiatrists, you are likely to get three different diagnoses.  This is because the criteria for these diagnostic labels are largely subjective and too generalized to accurately reflect an individual’s suffering.  I have never met two patients with a diagnosis of “Major Depressive Disorder” who suffer in the same way or for the same cause.  I believe these labels can be a distraction from understanding your individual experience, so I tend to avoid them.    

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