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Addiction/Substance Abuse

Addiction/Substance Abuse

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Drug addiction is a chronic disease denoted by drug seeking and use that is compulsive, or hard to control, despite unbearable outcomes. However, addiction can be treated and successfully managed. Addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences. The initial decision to take drugs is voluntary for most people, but repeated drug use can lead to brain changes that challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs. These brain changes can be persistent, which is why drug addiction is considered a “relapsing” disease—people in recovery from drug use disorders are at increased risk for returning to drug use even after years of not taking the drug.

It’s common for a person to relapse, but relapse doesn’t mean that treatment doesn’t work. As with other chronic health conditions, treatment should be ongoing and should be adjusted based on how the patient responds. Treatment plans need to be reviewed often and modified to fit the patient’s changing needs.

Most drugs affect the brain’s “reward circuit,” causing euphoria as well as flooding it with the chemical messenger dopamine. A properly functioning reward system motivates a person to repeat behaviors needed to thrive, such as eating and spending time with loved ones. Surges of dopamine in the reward circuit cause the reinforcement of pleasurable but unhealthy behaviors like taking drugs, leading people to repeat the behavior again and again.

As a person continues to use drugs, the brain adapts by reducing the ability of cells in the reward circuit to respond to it. This reduces the high that the person feels compared to the high they felt when first taking the drug—an effect known as tolerance. They might take more of the drug to try and achieve the same high. These brain adaptations often lead to the person becoming less and less able to derive pleasure from other things they once enjoyed, like food, sex, or social activities.

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Bipolar Disorder

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Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, and energized behavior (known as manic episodes) to very sad, “down,” or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

  • Bipolar I Disorder—defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.
  • Bipolar II Disorder—defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.
  • Cyclothymic Disorder (also called cyclothymia)—defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.
  • Other Specified and Unspecified Bipolar and Related Disorders—defined by bipolar disorder symptoms that do not match the three categories listed above.
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Psychotherapy

Psychotherapy

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Psychotherapy, or talk therapy, is a way to help people with a broad variety of mental illnesses and emotional difficulties. Psychotherapy can help eliminate or control troubling symptoms so a person can function better and can increase well-being and healing.

Problems helped by psychotherapy include difficulties in coping with daily life; the impact of trauma, medical illness or loss, like the death of a loved one; and specific mental disorders, like depression or anxiety. There are several different types of psychotherapy and some types may work better with certain problems or issues. Psychotherapy may be used in combination with medication or other therapies.

Psychotherapy is often used in combination with medication to treat mental health conditions. In some circumstances medication may be clearly useful and in others psychotherapy may be the best option. For many people combined medication and psychotherapy treatment is better than either alone. Healthy lifestyle improvements, such as good nutrition, regular exercise and adequate sleep, can be important in supporting recovery and overall wellness.

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Psychiatric Consultation

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A psychiatric consultation is a comprehensive evaluation of the psychological, biological, medical and social causes of emotional distress. Together, we will review your current stresses and problems and any past medical or psychiatric conditions. This information, as well as any necessary medical records and laboratory tests, will lead to the formulation of a comprehensive treatment plan.

A psychiatric consultation can help you understand the sources of problems from three points of view: biological (i.e. heredity, hormones, nutrition, and physical illness), psychological (i.e. current life stressors, childhood experiences), and social (i.e. cultural differences, family relationships, prejudice). It is this capacity to evaluate the causes of emotional distress from each of these perspectives that makes psychiatry unique. Many people find that a psychiatric consultation gives them a new perspective and hope for the future.

A simple psychiatric consultation takes two to three sessions. In order to make this short period of time as productive as possible, please gather together all of your records and recollections of previous treatments before the first session. Part of this process includes filling out a comprehensive patient survey.

A comprehensive psychiatric consultation takes at least four sessions. It may also involve time speaking with previous care providers or other clinicians at Eximous integrated health solutions. Generally, there is some staff time to gather medical records. Also, staff may chart this information graphically so that we can identify patterns of response or partial response (in a Life Chart). Gathering and analyzing this information may take many hours.

Generally two thirds of a consultation will be spent reviewing the nature of your problems, their origins, and the course of any previous treatment. The last third of a consultation is devoted to discussing the assessment of your difficulties, and any recommendations our doctors have for treatment.

Many patients are referred for psychiatric consultation by therapists who wonder if psychiatric medications might benefit their patients. A careful evaluation of this question is usually part of psychiatric consultation; however a consultation is much more than just an assessment for medications. Our commitment as your consultant is to review all the reasonable alternative treatments, their likely benefits and any possible risks associated with these treatments.A good psychiatric consultation requires expertise.

Medication Review

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Sleep Problems

Sleep problems

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Sleep problems, including snoring, sleep apnea, insomnia, sleep deprivation, and restless legs syndrome, are common. Good sleep is necessary for better health and can affect hormone levels, mood and weight. A sleep disorder is a condition that frequently impacts your ability to get enough quality sleep. While it’s normal to occasionally experience difficulties sleeping, it’s not normal to regularly have problems getting to sleep at night, to wake up feeling exhausted, or to feel sleepy during the day.

Frequently having trouble sleeping can be a frustrating and debilitating experience. You sleep badly at night which leaves you feeling dead-tired in the morning and whatever energy you have quickly drains away throughout the day. But then, no matter how exhausted you feel at night, you still have trouble sleeping. Therefore, the cycle begins again, taking a serious toll on your mood, energy, efficiency and ability to handle stress. Ignoring sleep problems and disorders can damage your physical health and lead to weight gain, accidents, impaired job performance, memory problems, and put a strain on your relationships. If you want to feel your best, stay healthy, and perform up to your potential, quality sleep is a necessity, not a luxury.

Even if you’ve struggled with sleep problems for so long that it seems normal, you can still learn to sleep better. You can start by tracking your symptoms and sleep patterns, and then making healthy changes to your daytime habits and bedtime routine. If self-help doesn’t do the trick, you can turn to sleep specialists who are trained in sleep medicine. Together, you can identify the underlying causes of your sleeping problem and find ways to improve your sleep and quality of life.

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