The Reluctant Psychiatrist

The Reluctant Psychiatrist

3 years ago

When I was a resident physician in training, I remember my excitement in mastering the principles of psychopharmacology. I was so eager to diagnose patients" problems and apply the right treatment.  The treatment plan consisted of addressing biologically correctable facets of the illness presentation and supportive psycho social therapies. This model neatly fit my medical training and the prevailing medical model. Over the years of my practice, I have given many presentations on new medications and disease states to physician groups.

As I age and hopefully become a wiser clinician, I find myself questioning the pure medical model for many psychiatric and chronic medical conditions. I am also more averse to the risks of various therapies for my patients. I am much more aware of temperamental differences among individuals. Many people are leading hard lives and have real existential challenges to their safety and existence. Some have been badly scarred at an early phase of their lives. I am happy that I can still maintain the medical model but apply it in a much more nuanced way that takes into account the patient's experience, individual variability, and possible alternative and holistic therapies.

"No sex please, I'm on antidepressants!"
"No sex please, I'm on antidepressants!"
3 years ago

Many people erroneously believe that being treated for depression means sacrificing a normal sex life. It is true that some antidepressants could impair libido and orgasmic phase of sexual activity...

ADHD in Marriage and Relationships
ADHD in Marriage and Relationships
1 year ago

By the time we are adults the condition we call ADHD in children morphs into a particular style of living and relating that the term itself does not imply at all. What was formerly a childhood lack...

ADHD communication style, before and after therapy
ADHD communication style, before and after therapy
3 years ago

Many people who start medication therapies to treat the core ADD/ADHD symptom notice subtle changes that are not always easy to accept or manage. The character style that was considered to be a pro...