I have been practicing psychiatry for 27 years. I did my Internship in Internal Medicine, then transferred to Psychiatry. I believe in being a human being first, physician second and psychiatrist third.
While family history is useful in diagnosis and treatment, every one is unique. No two people will respond to the same treatment. Even identical twins can have different illnesses and require different treatments. In my practice,
Standard of Care.
We also we start with standard of care and for many people, that is all that is needed. But at least one-third of people have an inadequate response or no response at all. If you have not had a full remission to treatment, your have a much higher chance of relapsing and much more quickly. For instance, people who have even one symptom of depression remaining will relapse 7 times faster than those that have no symptoms remaining.
We always start with FDA approved treatment options. However, if you happen to have less than a full response, we will consider many other options, both medical and non-medical. There are many safe options which have research but became generic before the research and FDA approval could be completed. We then use medications that may not br FDA approved for that condition, but are approved for other conditions. so they are known to be safe.
While medications are very important, you often get better results when you combine them with other treatments.
Psychotherapy. Whether you utilize Cognitive Behavioral Therapy, Behavioral Activation Therapy, Dialectical Behavioral Therapy, Psychodynamic Therapy, Family Therapy, Marital Therapy, or others, they are a very important part of most treatment regiments.
Self Care. While everyone knows that certain activities are important, it is still vital to actually do them.
1. Getting adequate sleep. Adequate sleep restores neurotransmitters that are vital do dealing with daytime stress. Without adequate sleep, no treatment will work.
2. Balanced diet. At times, nutritional deficiencies can cause depression and anxiety. While supplements are only occasionally helpful, a balanced diet is vital..
3. Learning how to manage stressors. Wether you utilize Meditation, Relaxing Walks with a partner, or Psychotherapy it is vital to find a way to decrease stress.
4. Staying away from drugs and excess alcohol. Drugs and excessive alcohol will sabotage every form of treatment. If you find yourself using these to "relax", seek help immediately.
Exercise. We all know it's important, research shows it's really important. 30 minutes of vigorous exercise 5 days per week has amazing antidepressant effect. While this is hard to achieve, exercise every 2-3 days per week has strong clinical effect.
Obesity is 50% of depression load.
If you are obese, it can be very difficult to get well on medications alone. Fat creates inflammation which makes all illnesses, including mood, much harder to treat. So losing weight, which can be challenging, is vital to good mental and physical health.
Emergency phone (or if Office Number temporarily out of service) 303-908-7123
Larry O. Sanders, MD. PC