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Treatment Philosophy
Psychological distress affects the whole person, from their thoughts and
emotions to their creative, spiritual and social lives. Together,
psychotherapy and medication can address the underlying causes of these
symptoms and help restore the freedom and joys of life.
I once had questions about these treatments that may be on your mind as
well. How can a chemical imbalance respond to talk therapy? Should
medication be used for symptoms of stress?
Some answers are now emerging as we gain a better understanding of how
the brain works. Brain functioning is not just determined by our genes but
can be altered by stress as well [1].
Amazingly, psychotherapy causes improvements in brain chemistry similar to
those brought about by psychiatric medication [2].
Combining these treatments can bring a fuller and more lasting recovery
than either alone [3].
Though combining psychotherapy with medication is often ideal, this is
not always the case, and some people need only one form of treatment. Most
people have a good idea of what is best for them. Sometimes a single cause
is found (such as a vitamin deficiency or seasonal changes) and a single
treatment is all that is needed.
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Protecting the Brain
The pictures above demonstrate how certain medications can protect the
brain and promote its growth. Our brains change over time, and both stress
and mental illness can injure brain cells.
The picture at left has fewer brain cells, which shows the effect of
untreated bipolar illness. To the right the brain cells are more plentiful
and healthy – the result of treatment with a mood stabilizer (Valproic Acid, or Depakote).
Other treatments that can protect the brain include antidepressants, pramipexole, and lithium [4].
Scientists used to believe our brains didn’t change in adulthood,
but new imaging techniques like the one above have taught us
otherwise. We also know that
activity can enhance the brain: learning to play piano or even to juggle
promotes growth in the brain. Other things you can do to protect the health
of your brain are described in health and
lifestyle and mental
exercise. More
information about the brain’s healing properties are
described in resilience.
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Medication
While medication can dramatically improve certain conditions, most
people have valid concerns that need to be answered before taking them,
such as:
"Will I have to take this for life?"
"Can this be addictive?"
"What are the side effects?"
"Does it carry long-term risks?"
"Will it change who I am?"
I share these concerns, and try to select treatments that relieve
suffering without unwanted effects.
In some cases, treatments are available which also improve physical
health. There are psychiatric medications that can reduce heart disease,
relieve chronic pain, and even protect brain cells from damage.
Certain vitamins and supplements also have physical and mental benefits,
and many people are interested in natural
therapies such as these. I work with people who seek
complimentary ways to healing by helping them better understand these
remedies.
It is important to consider how a medicine will affect you now as well
as down the road. For example, some kinds of depression (bipolar depression)
can get worse if antidepressants are used too long. Whenever possible I
recommend treatments that will not just help in the short term but will
improve physical and mental health for years to come.
Click here to
read profiles of individual medicines.
Click here to
read more about how the brain responds to medication.
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Psychotherapy
Each person is unique, so the approach I take in therapy is flexible and
responsive. Some people need only a few sessions to make the changes they
want in their lives. Other problems are long-standing and require more
exploration.
There are many kinds of therapy available; among those I offer are:
- Psychodynamic therapy:
an open-ended, explorative therapy.
- Interpersonal
psychotherapy: focuses on relationships, loss and life changes.
- Cognitive behavioral
therapy (CBT): an active, problem-solving approach.
- Dialectical
behavioral therapy (DBT): addresses mood swings, anger,
impulsiveness and self-harming behaviors.
I also collaborate with other therapists to provide medication for
patients who are in therapy elsewhere.
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