Congratulations! You have finally decided to reach out and seek help for your emotional difficulties. I know that this was not an easy decision. Despite all of our 21stcentury know-how many of us still believe that psychiatric disorders reflect personal weakness and a failure of free will. As discussed in past discussions, the first step in treatment is obtaining the proper diagnosis. You are then faced with a most important decision; should you pursue psychiatric medication or embark on a…

We all deal with adversity. No one is spared. But one of the central challenges in a person’s transition from childhood to adulthood is learning how to cope with tough times. In this brief article I hope to highlight some of the wisdom I have learned from years of practicing my profession and living my life. Locus of control is a psychological concept that describes a core aspect of the human psyche, simply speaking, being in control. Anything that deprives…

As a practicing psychiatrist on the front line of treating patients with drug abuse problems I find myself totally befuddled by the current nationwide movement to make the “prescription” of the marijuana plant legal for a variety of medical ailments. To make matters worse, it appears that the medical marijuana movement is a veiled attempt at eventually legalizing the use of marijuana. Please don’t get me wrong, I am not opposed to the development of the active ingredients of the…

Of all the medical specialties, Psychiatry may be the most unique. For the most part, the science base of other medical specialties has been well established for decades. Sure, there are ongoing advances and sophistication in diagnostic and therapeutic capabilities in these specialties but the core science has remained essentially unchanged. For example, if I was a practicing endocrinologist, the clinical history and physical examination that I would pursue is rather straightforward and easily quantifiable. To add further scientific credence…

Psychiatry is a unique and challenging medical specialty. If I was a cardiologist and a patient presented with chest pain, I would have a number of objective tests at my disposal to evaluate this complaint. A patient presenting to a pulmonologist complaining of shortness of breath and exercise intolerance can be sent for a chest x-ray, pulmonary function tests or a finger oximetry reading. Currently, when a patient comes to a psychiatrist’s office complaining of “depression” there are no definitive…

Personal myths are ubiquitous. We all come out of childhood with our own unique complement of myths. What is a myth? A myth is nothing more than a false belief and in some cases an entire file cabinet of notions that are untrue. But there is a hitch; the myth holder is totally unaware of the invalidity of his/her myth(s)! So many of us go through our lives without the slightest insight that many of our core beliefs and self-concepts…

We are living in a world that is bombarding us with negative energies, whether it is the 6 o’clock news sharing the area’s crime, accidents and social scandals or the 24/7 availability of the worst events of the World Wide Web. We may not be able to control the content of the electronic media but we can elect to limit our exposure to it. I frequently urge my patients to limit their exposure to traumatic media and be on the…

I am concerned about an evolutionary process that will result in the atrophy (weakening and loss of function) of human beings’ vocal cords. We are just at the beginning of an era that will be marked by communication via electronic media at the expense of in person or vocal interaction. The telephone replaced letter writing while the cell phone has essentially taken over the former. Because the cell phone has alphanumeric keys it has now become easier (and cheaper) to…

Coming down with an illness is part of our human condition. We will all be tested at one time or another. Learning effective coping strategies becomes an integral part of recovery. I find it helpful to differentiate “illness” from what I call “sickness.”  The term illness refers to the physical nature of a disease process while the term sickness refers specifically to how one reacts to being ill.  In my experience as a practicing physician for more than 40 years,…

Every day people struggle with interpersonal relationships. But with Valentine’s Day on the horizon these struggles can become a prime focus. Just as all relationships have their special moments, they all also have the potential for problems – separation of responsibilities or lack of sexual intimacy to name a few. But one of the biggest issues couples struggle with in an intimate relationship is togetherness. Finding the balance for togetherness in an intimate relationship is like a balancing act. If…

Did you make any New Years resolutions this year? Are you still on track with the promises you made to “better yourself” this year?  Probably not – if you are like most of us, you had great intentions, but you won’t even make it past the end of January before you give up on them.  Why can’t we stick to those resolutions? We know they will help us become better people in some way – we’ll lose some weight, start…

I thought it would be helpful to share some of my thoughts on what is involved in the prescription of medications for psychiatric disorders. Many individuals are fearful of psychiatric medications because of concerns about: side effects the belief that medication may permanently alter their personality that they will develop physical dependence and need to stay on the medication forever that some medical harm will come from taking medications for mood disorders that taking a psychiatric medication will label them…

I thought that it would be helpful to jot down some of my thoughts and observations about the field of Psychiatry after almost 40 years of manning the front lines.  My field is one of the most unique medical disciplines. Unlike other specialists, psychiatrists cannot rely on objective laboratory tests or radiologic imagery to help with diagnosis and treatment planning. Psychiatrists have to rely exclusively on our patients’ subjective report and our subjective observations of how our patient presents their…

The word depression is used indiscriminately to describe a variety of mood states. When a psychiatrist utilizes this term it represents a clinical entity that requires medication and/or psychotherapy.   When asked why they are here to see me, my patients frequently state that they are feeling depressed. My task is to then determine what they mean by these words. The practice of psychiatry is a unique specialty. If an endocrinologist is consulted by a patient to determine if the individual…

I decided to write this piece after seeing yet another young patient suffering from a psychotic state directly related to regular use of marijuana (MJ). To see a capable, bright young person become so deeply disturbed because of marijuana effects is troubling to say the least. This individual had lost complete contact with reality and had to withdraw from his life to the safety of his family. Fortunately, many cases recover but some do not. Recovery can be a slow…

You are probably wondering why I chose such a puzzling title. It’s not that I truly believe that adolescents and puppy dogs have a lot in common. However, I believe that there is a lot to be learned from a comparison of the two. The puppy dog analogy stems from recent developments in our understanding ofteenage brain development. We had believed that the human brain was fully mature by the age of puberty, usually around thirteen. This meant that our…

Even the most peaceful and calm person experiences stress occasionally, but most people go through some degree of tension on a daily basis. Stressful events can produce symptoms of stress that vary from person to person, and can include: increases in blood pressure and heart rate digestive problems sleep disturbances compromised immune system fatigue headaches skin problems panic attacks decreased sex drive and much more! Because different people react to stress in different ways, to begin coping with stress you…

We hear so much today about Attention Deficit Hyperactive Disorder (ADHD) in children, but there isn’t much focus on the disorder in adults. It is known that in about 60% of children with the disorder, ADHD will continue into adulthood. This means that about 8 million adults in the U.S. have adult attention deficit hyperactive disorder. These individuals can have ADHD with out hyperactivity, ADHD with predominant hyperactivity, and ADHD where both inattention and hyperactivity are prominent. Sadly, because there…

We’ve all heard about how stress can affect people long after a trauma has occurred. Post-traumatic Stress Disorder (PTSD) can result after almost any event that is life-threatening, that causes intense fear, or that severely affects a person’s emotional well-being. Military veterans who have served in combat zones often return with PSTD and people who have witnessed or sustained a severe accident or physical injury can later be diagnosed with Post-traumatic Stress Disorder. In fact, getting a life-threatening medical diagnosis…

The late 20th century and early 21st century have given us technological wonders and instantaneous access to information on a scale that has never been seen before: the internet and the micro chip have changed the ways we communicate and experience the world around us. Where we once inhabited small, tightly knit communities these advances have literally brought the world to our doorsteps. As wonderful as that is, it can also be a challenge to filter through the numerous gadgets,…