When Can I Stop My Medication?

When Can I Stop My Medication?

Despite being a very reasonable and simple request from my patients, I find this one of the more difficult questions to answer adequately. Why is this so? The answer lies in the reality that Psychiatry remains a relatively “soft”  science. As I have previously discussed, my discipline is not as clearly defined as found in specialties like endocrinology, cardiology, etc. I will do my best in providing some basic guidelines. More detailed information may be found at the American Psychiatric Association’s “Practice Guidelines.” If one suffers…

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When To Choose Medication and When To Choose Psychotherapy?

When To Choose Medication and When To Choose Psychotherapy?

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…

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Dealing With Adversity

Dealing With Adversity

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…

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Medical Marijuana: A Psycho-Historical Perspective

Medical Marijuana: A Psycho-Historical Perspective

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…

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Psychiatry and Psychotherapy Working Together

Psychiatry and Psychotherapy Working Together

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…

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You’re Not Crazy, You’re Sick

You’re Not Crazy, You’re Sick

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…

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Debunking our personal mythology

Debunking our personal mythology

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…

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Just say no…to negativity

Just say no…to negativity

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…

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The End Of Vocal Cords

The End Of Vocal Cords

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…

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Coping with Illness

Coping with Illness

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,…

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