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Common Questions

What is the New Psychiatry?
Over the past few decades, psychiatry and neurobiology have come together to offer far more ways to understand the mind and the brain.  As a medical doctor, I am able to evaluate the body-mind interaction better than ever before due to advances in psychiatry and neurobiology. Incredible findings discovered during the Decade of the Brain have become practical applications I use on a daily basis.  I share with you the most cutting edge treatments and ideas.  My approach is to collaborate with you to put together different treatments to get the best results.  I have an eclectic approach to care that I first practiced while working in major emergeny centers.  If something isn't working or is only partly effective, let's do something different!

Do I recommend psychiatric medications?
For some people, I recommend medicines.  The choice to use medications is always up to you.  I've seen these medications save lives.  As a psychiatrist, I was trained in both medication management and different types of psychotherapy along with more treatment options  Neurofeedback training has greatly added to my ability to help without medications or allow less medication to be effective.  EMDR and Brainspotting are effective ways to help people when  conventional talk therapy hasn't been effective.  Adding skills in meditation training and mindfulness has become a core skill that I encourage.  Neurofeedback training can help those who find it difficult or imposible to meditate to rewire their brain and make learning meditation and mindfulness possible.

Rigid thinking leads to seeing a world in black and white where there is only one right answer.  Some argue that all disorders of the mind should and can be treated with medicines.  Others argue psychiatric medicines are all bad.  I believe people should have choices and the information necessary to make those choices.  Some people benefit from psychotherapy, others from medication and others from biofeedback training or hypnosis.  Many people benefit from combining a variety of treatments.  There is no one size of treatment that fits all.

Why I have only 45 minute (or longer) appointments  
It takes time to get to really know people.  Since there is still no reliable diagnostic tool to understand the mind, I have to keep my mind open to other explanations for the problems I see.  Only by spending time with people can I see what I couldn't see in 15 minute "medicine checks".  People are complex.

Because I am a specialist, I have been trained in optimizing and combining treatments if indicated.  I believe it is my responsibility to share with you and educate you about your choices.  If I quote studies or discuss research theories with you, it is because I believe it is my duty to show you where I got my opinions so you will feel comfortable that I am not just "winging it" with your life.

Why I Often Order Laboratory Studies & Bloodwork
As a medical doctor, I medically evaluate all of the people I see to make sure there are no "medical mimics" that are being confused with a psychiatric disorder or complicating a psychiatric problem.  I have found that careful evaluations are essential to make sure that no illness or nutritional deficiency is being missed. 

I do a medication cross check via a computerized drug interaction program to help discern medicine interactions that could account for your symptoms.  I cross check all of your medicine and supplement interactions, not just the psychiatric medicines.

What About Hormones?
I am a certified North American Menopause Practicitioner so I am comfortable evaluating and treating hormone problems.  I use biologically identical agents to manage menopausal symptoms if hormone treatment is indicated.  I work in conjunction with your regular healthcare team. 

As a psychiatrist, the mood and cognitive effects of hormones on women is crucial to evaluate.  That's why I am one of the handful of psychiatrists in the country that has devoted the effort to becoming an expert in women's hormone issues by being credentialed as a North American Menopause Practicitioner for over 10 years.  Extensive training and testing were required to earn this title.

For women that cannot or choose to not use postmenopausal hormones, options exist.  Sometimes antidepressents are used but I have found that a non-medication option of neurofeedback training combined with meditation skills training can be very life restorative.