Psychiatric Medications – Only one Tool in the Treatment Toolbox

In the treatment of psychiatric disorders, medication is only one part of a treatment plan. Medications can be very helpful in reducing symptoms of depression and anxiety as well as bipolar disorders and psychotic disorders. Medications that are appropriately prescribed and monitored by a psychiatric mental health provider provide an important role but psychotherapy as well as mind body practices i.e meditation, mindfulness practice and relaxation work  complete the treatment picture.

Often, patients ask me if I can only prescribe anti-anxiety medication such as Xanax, Klonopin and/or Ativan. These medications are benzodiazepines.  They should only be used for panic attacks or extreme stress as an adjunct medication The use of benzodiazapines can cause a patient to develop dependency on the medication since they are very effective in diminishing anxiety. However, a skilled practitioner will limit the use of these medications and use them only as an adjunct to other treatment.   In general, antidepressants do a much better job and are far safer  in the treatment anxiety and depression.

It is important that psychiatric medications be prescribed and monitored by a psychiatrist or a psychiatric nurse practitioner since adjustments in dosage will invariably need to be made. A general practitioner, although well meaning, may not adjust medication as needed.

Learning new things during prolonged isolation

This  time of prolonged pandemic is a great time to learn new things – There are so many opportunities, thanks to the internet – for example, there’s a You Tube video for just about anything you can imagine – or never imagined. If you ever wanted to learn a musical instrument, now is time to do that – or if you want to write or paint or garden – yes, NOW is the time.

I’m awed by the possibilities – cooking, baking, reading, clutter clearing, dancing, pilates, yoga, meditation, new hobbies – the list in endless.

All it takes is your curiosity and your willingness to try something new. Depression and anxiety can get in your way now.  We can control many more things than we think-   Think outside the box  – We don’t need to fall deeper into our fears – cognitive behavioral therapy can help with that – and guess what?  good therapists are doing online sessions –

Go for it.  Be courageous in a time of uncertainty

The world around us

Okay, so we are all ( i hope) sequestered in our homes.  We are privileged to be homebound – and we need to remember that when we forget.  Long walks are doing wonders for me – yes, I have a dog and that helps but it restores my soul every time I venture out into nature. Allow yourself to walk mindfully- fully present in your surroundings – paying full attention to life happening around you – the new buds, the music coming from the birds – the spring sun on your face – and here in Santa Fe, the blissful silence.  Put your phone away – forgot the emails and the texting – Enjoy the day that was given to you – never promised.  Breathe in and breathe out-  The present moment is all any of us have – be in it

Managing Anxiety in the Midst of a Crisis: Coronavirus

In just a very short time, peoples’ lives have changed dramatically.  We are either self-sequestering at home or we are quarantined.  Businesses and restaurants are closed.  We are socially isolated and even trips to grocery stores are fraught with worry.  Should we be wearing a mask and gloves to pick out our food?  What if someone gets too close in the check out aisle?   An activity that used to be on “automatic” and even pleasurable has now become about protecting ourselves from a potentially deadly virus.

Some suggestions on how to manage your anxiety.

  1.  Watch or listen the news but only for a short period of time and then turn it off.
  2. Borrow the concept of Hygge from the Danes.  Hygee is all about making ourselves cozy – drinking a cup of tea or cocoa, cooking and baking comforting foods, lighting candles in the house for their beauty, enjoying the outdoors, walking mindfully
  3. Read a book you’ve always wanted to read but have been too busy to read
  4. Crafts – if you’re so inspire, knit, needlepoint, crochet, collage,
  5. Any creative endeavor you enjoy – painting, writing, playing music
  6. Deep, mindful breathing and quiet moments of meditation –
  7. Mindfulness practice – enjoy each moment you have by noticing everything and everyone you love around you.
  8. Reach out to others by phone or social media -we are all in this together
  9. Remember that this can be a time of anxiety or a time of reflection and gratitude.  You have a choice on how you respond
  10. Bake bread – kneading is good for the soul
  11. Make your home environment as beautiful as you can.  Clutter or mess can contribute to anxiety.
  12. Embrace your life and be grateful for everyone and everything you have.

Stresses on Teens in Today’s World

Today’s teens are faced with many stresses that other generations have not experienced. Often, the demands on teens can be overwhelming. Social media posts can lead to feelings of inadequacy or low self esteem. It may seem as if everyone else is doing better than the teen who’s reading the post.  It’s well known that bullying occurs on social media and tragically, teens who are bullied can become desperate and even lead to suicidal thoughts.

Other issues facing a teen today include substance abuse, transgender issues or gender dysphoria, vaping, school pressures, excessive use of texting, Twitter and Instagram, dating or “hook-up” apps and peer pressures.

Anxiety disorders in teens have been on the rise along with depression. It’s important to recognize when your teenager would benefit from professional help. Symptoms, like fatigue and moodiness can be misinterpreted as normal when they may be an indication of depression, Panic disorder and social anxiety have also increased in teens. Self destructive behaviors such as cutting are a sign of anguish and anxiety.

The good news is that individual and group counseling can help. If it is appropriate, medications i.e., antidepressants can significantly improve mood disorders and lessen anxiety.

Teenage years have always been turbulent but today’s teen has more challenges than other generations. There is no substitute for listening, support and understanding.


EMDR: What is it and How can it help you?

EMDR, or Eye Movement Desensitization and Reprocessing, is a non-invasive therapy approach in which early memories or incidents that are held in the nervous system are processed. The therapist and the client identify a difficult or traumatic memory or incident that is still impacting the client in the present and the memory or incident is then processed using eye movements. The processing of the memory allows the release of the memory and a more positive state of mind is achieved. EMDR has the potential to achieve results in much less time than it might take in “talk therapy.” The American Psychiatric Association identifies EMDR as the #1 treatment of post traumatic stress disorder. Although very effective for PTSD, EMDR is also effective for many issues including panic disorder, anxiety, depression as well as many other clinical issues

Loss of A Beloved Pet

loss of a beloved dogThe loss of a pet can be devastating. Animals love us wholeheartedly – something that we cannot find often in human relationships. The connection between a human and an animal is profound. We feel connected and loved. Losing that relationship can be an agonizing experience and often the loss is not validated by others who simply have never had a pet or who just don’t understand the significance of the loss. The grieving process is the same as if one has lost a significant other – a spouse, a family member, a close friend. Losing a pet can result in one feeling alone and isolated – misunderstood.

EMDR can be helpful when one has lost a pet – particularly if the loss is experienced intensely as is often the case. The combination of supportive counseling and EMDR is ideal in helping the individual manage the intense grief. Another option is participating in a group specifically focused for people who have lost their beloved pets.

In addition, individuals who are dealing with illness of a pet or an aging pet often struggle with anticipatory grief. A group that consists of others in the same situation can be very helpful to lessen the anxiety that accompanies the dread of losing one’s animal.

Death is a part of life – we all know that intellectually. However, when we lose someone significant – a person or an animal who we have loved and who has loved us, we mourn. Grief is normal but we don’t have to do it alone.