The Reluctant Psychiatrist

The Reluctant Psychiatrist

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.

2 years ago
2 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...

2 years ago

You have been working hard all week and really look forward to going out with your fiancé to a nice restaurant and enjoying yourself. She has not seen you all week and is excited about findi...

2 years ago

Recently a patient whom I had not seen for almost a year showed up in my office demanding that her antidepressant prescriptions be filled for another year. She made it clear that she had no interes...

2 years ago

The FDA's approval of esketamine (which is a derivative of the anesthetic drug ketamine) for treatment of depression has been hailed as a ‘game changer’ in the treatment of major de...

2 years ago

When a physician claims a holistic/ integrative approach to medical care, she usually faces either admiration or incredulity and disgust. I can attest to that from personal experience and my additi...

2 years ago

ADHD-affected individuals often have trouble reading for long periods. Many report trouble concentrating, experience headaches, sleepiness, and restlessness while attempting to read. The problem is...