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 psychosocial 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.

1 year ago
1 year ago

I saw the young man for the first time last month. He could not sit still for more than a few seconds and was constantly fidgeting. His life was a classic example of setbacks and unfulfilled dreams...

1 year 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...

1 year 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...

1 year 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...

1 year ago

Low frustration tolerance is a hallmark of the ADHD sufferers. The scenario goes something like this: You are trying to focus on completing your expense report, and the guy from the next cubicle in...

1 year ago

One of the more challenging aspects of my my work as a psychiatrist is when patients with good intentions come in to the office with a self-diagnosis of ADHD.  They are completely convinced af...