Matching Up
On an episode of Seinfeld, George Costanza, well known for his numerous relationship break ups, laid claim to the phrase “it’s not you, it’s me.” It’s equally true though that “it’s not me, it’s you” may also apply. […]
There’s Always A Choice
Think about it, when we say we have no choice, what we’re really saying is there’s no good choice, no safe option that makes it easy for us to decide. Sometimes we’re confronted with having to choose between presenting evils or difficulties – an unenviable position to be in indeed, because it breeds feelings of powerlessness and a sensation of perceiving ourselves as trapped. How to proceed? Examine the possibilities before you and ask: “Of these lousy choices before me, [...]
I Get Questions… Many Questions
Q. I am seeing a 40 year man with Generalized Anxiety Disorder. Also describes self as an introvert. He is in the Technology field and in a leadership role which he does not like. There are many issues to be addressed, but was wanting to know your thoughts on any medications like Buspar that could help. He did try Lexapro several years ago, but did not like so discontinued. I have referred him to a psychiatrist. Are there better anti-depressant meds [...]
Rejected, Or Just Unchosen?
A couple of weeks ago I took on a client who has recently been downsized from his job. Since this happened, he has sent out resume after resume and has been called by a number of companies to come in for interviews. No offers yet. In our most recent session, it was obvious that he had been spending quite a bit of time reading between the lines as to why he hasn’t landed a job yet. […]
Assessing a Client for Bipolar Disorder: The 3 Best Questions to Get Started
There is not a mental disorder that generates more consternation when it comes to diagnostic assuredness than bipolar disorder, particularly on an initial evaluation. We clinicians are forever searching for better screening questions to more quickly hone in on a diagnosis, and of course, bipolar is no exception. But we shouldn’t act in haste simply to be more expeditious. I often emphasize when I’m training less experienced clinicians that just as Rome wasn’t built in a day, nailing down a [...]
Bridling Irrational Fear
Fear that we experience day-to-day is most often imagined. This is because in the mostly civilized society in which we live and function, we’re not often confronted by imminent danger and threat – mobilizing the flight-or-flight response. So when fear arises in non-dangerous situations, the emotional sensations that result are perception-driven and not governed by any objective reality, as we’re not actually in harm’s way. […]
OverPathologizing
One of the most common problems I encounter when consulting with people about their psychiatric medications is the utter lack of clear rationale for what they’ve been prescribed. The more medications I see on a client’s profile, the more inclined I am to believe that the prescriber has taken a reactive approach to pharmacologically treating this individual. The problem lies in thinking and believing that identifying a patient’s symptoms means having to […]
12 Tips For Finding A Suitable Therapist
I do a considerable amount of medication consultation, and one of the most often asked questions in these sessions is how to go about finding a therapist. Although there are numerous pursuable paths toward locating a psychotherapist or counselor, the more important issue is “goodness of fit,” simply, is this someone you can work with. The search can begin by just merely asking around. Start by asking friends or work colleagues if they’ve ever worked with a counselor; go online [...]
The Anatomy of a Medication Mess
Joe, I am 69 years old and live in San Francisco. I was on Prozac for over 20 years. In 2012, while on an African Safari, a trip of a lifetime, I noticed that I was disinterested and bored. Actually, I realized that I was depressed. I got a recommendation for a psychiatrist to get a new antidepressant. Here is a list of them that I've tried: Brintellix, Symbyax, Lamictal, Lexapro, Viibryd and Pristiq. Also in the past I tried [...]
Eschew Resolutions; Embrace Accountability
On January 4, the Today Show lead off with various and sundry self-improvement strategies -- all which could be accomplished within 30 days. I typically greet such recommendations with chuckles and a sort of bemused skepticism, as if we need a starting gate to launch us onto the path of self-improvement. We don't. The people I observe who are improving the most and the fastest are those who don't apply arbitrary time frames to their improvement, that is, they don't [...]