When you hear the term “behavioral health specialist,” you might picture someone who helps with mental health problems, but the field is much broader and more diverse than many realize. Behavioral health focuses on how a person’s thoughts, feelings, and actions affect their overall well-being. This includes conditions like anxiety, depression, substance use, trauma, ADHD, and many other issues that can influence daily life. The professionals who work in this field come from different backgrounds and levels of training, but all share one goal which is to help people live healthier, more balanced lives.

Understanding Behavioral Health
Behavioral health looks at the connection between how we act and how we feel physically, mentally, and emotionally. It includes mental health care, substance use treatment, and even behavioral changes that affect physical health, such as managing stress, improving sleep, or breaking unhealthy habits. Behavioral health specialists play a key role in helping people improve both mind and body.

For example, someone struggling with anxiety may see a behavioral health specialist to learn coping skills or explore medication options. Another person battling addiction may work with several specialists who focus on different aspects of recovery. No matter the issue, behavioral health professionals help patients understand their behaviors, make healthier choices, and feel more in control of their lives.

Types of Behavioral Health Specialists
There are many kinds of professionals who work within behavioral health. Each type of specialist offers a different perspective and skill set, and they often work together to create the best outcomes for patients.

Psychiatrists are medical doctors who specialize in mental health. They complete medical school and residency training focused on diagnosing, treating, and preventing mental illness. Psychiatrists can prescribe medications and manage complex conditions that may involve both mental and physical symptoms. They use evidence-based treatments that may include psychotherapy, medication, or a combination of both. Psychiatrists often oversee treatment teams, especially for patients with severe depression, bipolar disorder, schizophrenia, or substance use disorders.

Psychologists hold doctoral degrees in psychology (PhD or PsyD) and are experts in psychological testing, assessment, and therapy. They do not attend medical school and generally cannot prescribe medication in most states, though they often collaborate with psychiatrists when medication is needed. Psychologists specialize in therapy methods such as cognitive behavioral therapy, which helps patients identify and change negative thought patterns.

Licensed Professional Counselors (LPCs) and Licensed Clinical Social Workers (LCSWs) are trained to provide therapy and counseling. They often help people with anxiety, depression, relationship problems, grief, or trauma. These professionals usually hold master’s degrees in counseling, psychology, or social work. They may work independently in private practice or as part of a larger treatment team.

Marriage and Family Therapists (MFTs) focus specifically on the dynamics between couples and family members. They help clients improve communication, resolve conflict, and build stronger relationships. Because family systems can deeply affect emotional health, MFTs often play an important role in overall behavioral wellness.

Substance Use Counselors specialize in helping people recover from addiction. They provide counseling, relapse prevention strategies, and support for individuals and families affected by substance use. Many work in rehabilitation centers or outpatient clinics.

Other professionals such as behavioral analysts, school psychologists, and case managers may also be part of the behavioral health system, providing specialized services for unique needs.

How These Specialists Work Together
In many cases, patients benefit from a team-based approach. For example, someone with depression may receive therapy from a counselor, medication management from a psychiatrist, and testing from a psychologist. Collaboration ensures that all aspects of a person’s health are addressed.

Behavioral health specialists often share information and coordinate care to create a comprehensive treatment plan. This integrated model has been shown to improve outcomes, especially for patients with chronic conditions or multiple stressors affecting their well-being.

Why Psychiatrists Are the Leading Experts
While each behavioral health specialist plays a valuable role, psychiatrists are considered the leading experts in the field. This is because their medical training allows them to understand both the biological and psychological factors behind mental illness. They are uniquely qualified to identify when symptoms may have a physical cause, such as thyroid issues, vitamin deficiencies, or medication side effects that mimic depression or anxiety.

Psychiatrists also manage complex medication regimens and monitor for interactions or side effects. For patients with severe mental illness, medication can be lifesaving and requires close supervision from a physician who understands brain chemistry and body systems.

Beyond medication, psychiatrists are trained in psychotherapy and can combine talk therapy with medical treatment when appropriate. This dual perspective allows for a more complete understanding of how thoughts, emotions, and biology interact.

In addition, psychiatrists often lead multidisciplinary teams, helping to guide treatment direction and ensure continuity of care. Their expertise is particularly vital when other specialists encounter cases that involve risk of suicide, psychosis, or co-occurring medical disorders.

When to See a Behavioral Health Specialist
People may seek help from a behavioral health specialist for many reasons. These include persistent sadness or anxiety, difficulty concentrating, changes in sleep or appetite, loss of motivation, or trouble managing stress. Others may seek help for substance use, trauma recovery, or struggles with anger, relationships, or self-esteem.

Seeing a behavioral health specialist is not a sign of weakness. It is an act of strength and self-awareness. The earlier someone seeks help, the more effective treatment usually is. For individuals unsure of where to start, a psychiatrist can serve as a first point of contact. Because psychiatrists can diagnose medical and psychological causes, they can determine which type of specialist or combination of specialists will be most helpful.

The Importance of Access to Behavioral Health Care
Behavioral health affects every aspect of life, from work performance to relationships to physical health. Unfortunately, many people delay seeking help because they are unsure whom to turn to or fear being judged. Understanding the different types of behavioral health specialists and knowing that psychiatrists provide the highest level of expertise can empower people to make informed choices about their care.

Effective behavioral health treatment can restore hope, strengthen relationships, and improve overall quality of life. Whether through therapy, medication, or a combination of approaches, the right support can help individuals take back control of their mental and emotional well-being.

In the end, behavioral health specialists are guides on the journey toward balance. Among them, psychiatrists serve as the medical leaders who bring together science, compassion, and clinical skill to help people heal and thrive.

When people talk about anxiety, it often sounds like a simple word for nervousness, but for many people in Cypress, anxiety feels like a constant storm that never fully clears. It might start as a racing heart beat before a meeting, a stomach that twists before picking up the kids, or nights spent staring at the ceiling long after everyone else is asleep. For others, it’s more complicated like a mixture of panic attacks, obsessive thoughts, or a fear that something bad is always about to happen.

One of our patients once described it as “living with the gas pedal pressed halfway down all the time.” She tried deep breathing, herbal teas, and advice from friends who meant well but didn’t understand how relentless anxiety can be. By the time she came to Your Family Psychiatrist in Cypress, she felt exhausted from trying to appear calm while battling her own mind.

At Your Family Psychiatrist, we understand that anxiety is more than just stress. It’s a powerful emotion shaped by brain chemistry, past experiences, and genetics. In Cypress, many of our patients juggle demanding jobs, busy commutes, and family responsibilities that leave little time to reset. Over time, the body’s alarm system starts misfiring. The same system meant to protect you from danger begins to activate even when you’re safe. That’s where specialized care makes all the difference.

Our approach begins with listening. We take time to understand when your anxiety started, what triggers it, and how it affects your life. Some people have clear patterns, like anxiety that spikes before social events or after arguments. Others describe a general sense of unease that never goes away. Once we understand your story, we create a plan designed around you.

Sometimes anxiety treatment involves medication to rebalance brain chemistry and quiet constant worry. Other times, it involves therapy focused on understanding thought patterns that feed anxiety. We often combine both approaches because medication can calm the physical symptoms while therapy teaches long-term coping tools. The goal is not just to get through the day but to regain control of your life.

A patient named Jordan (anonymized), a Cypress resident and small business owner, once shared how anxiety made even small tasks overwhelming. He found himself unable to send emails or make phone calls because his mind kept imagining the worst outcome. After working with our psychiatrist, he learned how his thoughts were linked to physical tension. Over a few months, the combination of therapy and medication helped him regain confidence and enjoy his work again.

Cypress is a growing community, full of families and professionals who often carry more stress than they realize. The fast pace of modern life doesn’t give much room for reflection. At Your Family Psychiatrist, we help patients slow down and rebuild a sense of calm. We teach skills that fit into real life like breathing techniques you can use before a meeting, cognitive tools to stop runaway thoughts, and ways to manage sleep when your mind refuses to rest.

Our clinic also specializes in treating anxiety that is complicated by other conditions, such as depression, ADHD, OCD, or trauma. Many people come to us after trying to treat anxiety with other physicians, only to find the anxiety keeps coming back. When anxiety is linked to deeper emotional or biological factors, it often needs a coordinated plan led by a psychiatrist who understands how the brain and mind interact.

If you live in or around Cypress, you don’t have to face anxiety alone. Every day, we help people rediscover the calm they thought was gone. Over time, moments that once caused panic can become manageable again, and sleep can feel peaceful. Life in Cypress can feel fast and demanding, but with the right support, you can learn to meet each day with a sense of balance and control.

When you are ready to start feeling like yourself again, we are here to help right here in Cypress.  Schedule now.

Everyone experiences difficult emotions or troubling thoughts at times. Feeling sad, anxious, angry, or guilty occasionally is a normal aspect of being human. When these feelings become overwhelming, persistent, or begin to affect your daily life, it may be time to reach out for help. Talking to a mental health professional can make a tremendous difference in how you understand yourself, manage stress, and regain balance.

Understanding Unwelcome Thoughts and Emotions
Unwelcome thoughts and emotions are those that seem to appear without your control and cause discomfort, guilt, fear, or distress. They can take many forms, such as intrusive memories, excessive worry, self-critical thoughts, or sudden waves of sadness or anger. Sometimes, these thoughts repeat in your mind even when you try to push them away.

It is important to know that having uncomfortable or negative thoughts does not mean you are weak, “crazy,” or broken. The brain is wired to notice danger and solve problems, which can lead to repetitive or exaggerated thinking patterns under stress. When these thoughts or emotions begin to interfere with sleep, relationships, work, or self-esteem, it may signal that your mental health needs attention.

Recognizing When It’s Time to Talk to a Professional
People often delay seeking help because they think they should handle things independently. In reality, mental health care is no different from physical health care. You would not hesitate to see a doctor for persistent pain or an infection, and the same principle applies to your emotional health.

You may benefit from speaking with a psychiatrist, psychologist, or therapist if you notice any of the following signs:

1. Persistent sadness or anxiety
2. Loss of interest in activities
3. Sleep or appetite changes
4. Difficulty concentrating
5. Excessive guilt or hopelessness
6. Avoidance of tasks or activities
7. Unwanted or distressing thoughts rarely cease
8. Thoughts of self-harm or suicide

These symptoms don’t have to all be present. Even one persistent or distressing symptom is reason enough to reach out for professional support.

Why Professional Help Matters
Mental health professionals are trained to recognize patterns that may not be obvious to you. They can help you understand where your emotions come from, what triggers your distress, and what steps can reduce your suffering. Talking with a psychiatrist or therapist does not mean you have to take medication, although it can be helpful in certain cases. It simply means you are giving yourself permission to heal and learn healthier ways to cope.

Early treatment often prevents problems from becoming more serious. For example, addressing ongoing anxiety early can reduce the risk of developing depression or panic attacks later. Similarly, therapy can help people identify thinking patterns that lead to feelings of guilt or shame.

What to Expect During an Appointment
At your first visit, a psychiatrist or therapist will ask about your symptoms, background, stressors, and goals. You can be open and honest. Discussions are confidential. Together, you will explore what has been troubling you and create a plan for support. That plan might include talk therapy, coping techniques, lifestyle changes, and possibly medication if symptoms are severe.

Many people describe a sense of relief just from sharing their thoughts in a nonjudgmental space. You may start to see progress within a few weeks as you learn new ways to think about and respond to your emotions.

When Thoughts Feel Dangerous or Overwhelming
​If you ever have thoughts of harming yourself or believe you might be unsafe, seek immediate help. You can call or text 988 in the United States to reach the Suicide and Crisis Lifeline, or go to your nearest emergency room. These services are available 24 hours a day and can connect you to people who will listen and guide you to safety.
Reaching out in a crisis is not a sign of weakness. It is an act of strength and self-preservation. Many people who have reached this point go on to recover and lead fulfilling, meaningful lives.

Taking the First Step
Sometimes the hardest part of seeking help is making that first call. You may wonder if your problems are “serious enough.” You don’t have to wait until things feel unbearable. If your thoughts or emotions are interfering with your happiness, relationships, or ability to function day-to-day, that is reason enough to reach out.
Talking to a professional can help you gain insight, build resilience, and develop practical tools to manage stress and uncertainty. It is an investment in your health and your future.

Basketball isn’t just a sport. It’s a powerful tool for improving your mental health. Whether you’re shooting hoops alone at the park, playing in a weekend league, or cheering for your favorite team, basketball can positively influence your mood, confidence, focus, and social connections. As a psychiatrist, I often encourage physical activity as part of a balanced approach to mental health. Basketball, in particular, combines physical movement, teamwork, and cognitive engagement in a way that strengthens both the body and the mind.

Exercise and the Brain: The Science Behind the Boost
When you play basketball, your heart rate increases, pumping more oxygen-rich blood to your brain. This stimulates the release of neurotransmitters such as dopamine, serotonin, and endorphins, which are chemicals that help regulate mood and reduce anxiety and depression. Regular physical activity like basketball has been shown in numerous studies to increase the size of the hippocampus which is the part of the brain responsible for memory and emotional regulation.

A 2018 review published in The Lancet Psychiatry found that individuals who engaged in team sports reported 43% fewer days of poor mental health compared to those who were inactive. Basketball stands out because it’s both aerobic (increasing cardiovascular health) and anaerobic (building muscle strength), providing a dual benefit for overall brain function and stress management.

Reducing Stress and Anxiety
Basketball is an effective stress reliever. The repetitive dribbling, running, and shooting help release built-up tension in the body, similar to mindfulness practices. The game demands focus, whether on the ball, your opponent, or the next play, which naturally pulls attention away from worries or intrusive thoughts.

When stress hormones like cortisol rise, physical activity helps bring them down. Over time, this lowers baseline anxiety levels. Even 20–30 minutes of play can lead to noticeable improvements in relaxation and mood.

Boosting Self-Esteem and Confidence
Basketball promotes confidence through small, measurable achievements like making a shot, improving your free-throw percentage, or learning to play better defense. Each success gives your brain a reward in the form of dopamine, reinforcing motivation and self-worth.

For teens and adults alike, developing basketball skills fosters a sense of mastery. This sense of control over your own growth can translate to other areas of life, helping you approach challenges with more optimism and persistence. In therapeutic settings, structured sports participation has been shown to reduce symptoms of low self-esteem and even aid recovery from depression.

Social Connection and Belonging
Basketball is inherently social. Whether it’s a local league, school team, or a group of friends at the gym, playing basketball creates an opportunity for connection and belonging which are key ingredients for good mental health.

Loneliness is one of the most common contributors to depression and anxiety. Team sports counteract this by building community. Players learn trust, communication, and cooperation. Sharing victories, setbacks, and teamwork fosters emotional bonds that provide a sense of support and accountability. Studies have shown that people who engage in team activities tend to have lower rates of social isolation and a stronger sense of identity.

Improving Focus and Emotional Regulation
Basketball requires intense concentration and fast decision-making. Players must process complex information quickly like reading defenders, tracking the clock, or adjusting strategy on the fly. This kind of mental stimulation strengthens executive functioning, including attention, problem-solving, and emotional control.

In individuals with attention difficulties or ADHD, sports like basketball can help improve focus by channeling hyperactivity into structured, goal-oriented movement. The sport’s fast-paced nature trains the brain to filter distractions and sustain concentration which are skills that can carry over into school, work, and daily life.

Helping with Depression
Depression often leads to withdrawal, fatigue, and negative thinking. Basketball combats these symptoms on multiple levels. Physical activity releases endorphins, which elevate mood naturally. The sense of accomplishment from improving one’s game builds confidence while social interaction offers support and encouragement.

Research published in JAMA Psychiatry found that consistent physical activity can reduce the risk of developing depression by up to 30%. Basketball’s combination of movement, teamwork, and enjoyment makes it an ideal outlet for managing depressive symptoms and preventing relapse.

Emotional Expression and Stress Release
Basketball provides a healthy way to channel emotion. The physical intensity allows for the safe release of frustration or anger. The sport also promotes self-expression. Learning to manage emotions on the court (for instance, staying calm after a missed shot or foul) teaches emotional regulation, a critical component of long-term mental health.

Sleep and Recovery Benefits
Good mental health depends heavily on restorative sleep. Regular basketball play helps normalize sleep cycles by burning energy, reducing anxiety, and stabilizing mood-related hormones. People who exercise regularly tend to fall asleep faster, stay asleep longer, and wake feeling more refreshed.

Encouraging Healthy Habits and Routine
Routine is vital for mental stability, especially for individuals managing anxiety or depression. Scheduling basketball games or practices creates structure and predictability, which are psychologically grounding. Additionally, participating in sports often encourages healthier nutrition, hydration, and time management habits.

Basketball and Youth Mental Health
For children and teenagers, basketball offers additional benefits. It teaches emotional discipline, teamwork, and perseverance. Adolescents who participate in team sports are less likely to engage in risky behaviors, such as substance use, and tend to report higher academic motivation and self-esteem.

A 2020 study in Frontiers in Psychology noted that teens in organized sports displayed better emotional regulation and social functioning compared to those who didn’t participate. For youth struggling with anxiety or social awkwardness, the basketball court can become a place of acceptance and growth.

Basketball as a Mindfulness Practice
Many players describe basketball as a “flow state,” where time seems to slow down and all focus is on the game. This experience mirrors mindfulness meditation, where awareness is centered on the present moment without judgment. Mindfulness helps quiet rumination, enhance concentration, and reduce anxiety.

Integrating Basketball into Your Mental Health Plan
If you’re struggling with anxiety, depression, or chronic stress, basketball can be an important part of your mental health toolkit, but it shouldn’t replace therapy or medication when needed. Instead, it complements them. A psychiatrist or therapist can help design a treatment plan that includes physical activity as part of your recovery strategy.

Tips for getting started:

• Begin with short sessions like 10 to 15 minutes of shooting.
• Focus on enjoyment, not performance.
• Play with others for added motivation and social benefit.
• Set realistic goals for improvement.
• Stay hydrated and stretch to prevent injury.

Conclusion
Basketball offers far more than just physical fitness. It strengthens the mind, builds community, and enhances emotional resilience. From boosting mood and focus to reducing stress and loneliness, the psychological benefits are well-documented. Whether you play competitively or casually, basketball can help you cultivate a stronger, more balanced mental state.

It’s a question many people ask themselves when they start to struggle with emotions, thoughts, or behaviors: “What is wrong with me?” This feeling can be frightening, especially when symptoms begin to interfere with work, relationships, or everyday life. Experiencing mental health symptoms does not mean something is permanently “wrong” with you. It means your mind and body are sending signals that deserve attention. A psychiatrist’s role is to help you make sense of these signals, identify possible causes, and work with you toward healing.

Common Psychiatric Symptoms People Experience
Psychiatric symptoms come in many forms, and it’s normal to wonder whether they point to a specific diagnosis. Here are some of the most common experiences people report:

• Persistent sadness or loss of interest – Feeling down most days, no longer enjoying things you once loved, or struggling to find motivation.
• Excessive worry or panic – Constant anxiety, racing thoughts, restlessness, or sudden panic attacks.
• Changes in sleep – Trouble falling asleep, waking too often, or sleeping much more than usual are frequently linked to both depression and anxiety.
• Irritability or mood swings – Quick changes in mood, frustration over small things, or feeling “on edge” could point to underlying stress, bipolar disorder, or other mood conditions.
• Difficulty concentrating – Trouble focusing, forgetfulness, or feeling mentally “foggy” can be related to depression, ADHD, or anxiety.
• Physical complaints without clear cause – Headaches, stomachaches, or unexplained pain sometimes stem from psychological stress.
• Withdrawal from others – Avoiding friends, family, or activities may be a way of coping with overwhelming emotions but can worsen loneliness and sadness.

​These symptoms overlap across different conditions, which is why a professional evaluation is so important. What feels like “just stress” could be depression. What looks like ADHD might be anxiety. Untangling these patterns requires a trained eye.

Pinpointing the Underlying Cause
When people ask, “What is wrong with me?” they are usually searching for clarity. Psychiatric symptoms rarely exist in isolation. They often have multiple contributing factors, such as:

• Biological factors – Brain chemistry, genetics, medical conditions, or side effects of medications.
• Psychological factors – Past trauma, negative thought patterns, or difficulty managing stress.
• Social factors – Relationship struggles, financial stress, isolation, or lack of support.

A psychiatrist takes all of these into account. Rather than assuming there is a single simple explanation, the goal is to understand how these layers interact and lead to the symptoms you are experiencing.

What a Psychiatric Evaluation Looks Like
Many people feel nervous before their first psychiatric appointment, often imagining it will be cold or judgmental. In reality, a psychiatric evaluation is designed to be supportive, structured, and thorough.

Here’s what you can expect:

1. Detailed conversation – The psychiatrist will ask about your current symptoms, how long they’ve been present, and how they affect your daily life.
2. Personal history – You may be asked about past medical issues, family history of mental health conditions, substance use, and any significant life events.
3. Mental status exam – This involves observing your mood, thinking patterns, memory, attention, and overall emotional state.
4. Collaborative discussion – Rather than just labeling you, the psychiatrist will share possible explanations for your symptoms and discuss treatment options that fit your situation.

The evaluation is not about being judged. It’s about being heard. Many patients say it’s the first time someone has truly listened to the details of their struggles without minimizing them.

How a Psychiatrist Can Help

A psychiatrist’s role goes beyond diagnosis. Once an understanding of your symptoms is formed, the psychiatrist can:

• Offer treatments such as medications, therapy referrals, or lifestyle strategies.
• Provide clarity by explaining how different symptoms fit together.
• Develop a plan to address immediate struggles while building long-term coping strategies.
• Work as a partner in your recovery, adjusting the plan as your needs change.

​Treatment can be as simple as learning stress-management techniques or as structured as combining medication with therapy. The goal is always to reduce suffering and improve quality of life.

Feeling Heard and Starting the Path Forward
Asking “What is wrong with me?” is not a sign of weakness. It’s a sign of self-awareness and courage. When you sit down with a psychiatrist, you are giving yourself the chance to turn confusion into clarity. The evaluation process can leave you feeling understood and validated, often for the first time in a long while.

With that foundation, you can begin the journey toward better mental health. One that includes hope, direction, and practical solutions. You don’t have to keep guessing about your symptoms or fighting them alone. Help is available, and with the right guidance, it is possible to move from feeling “wrong” to feeling whole again.

Zoloft (sertraline) is a commonly prescribed antidepressant in the class of selective serotonin reuptake inhibitors (SSRIs). It is used to treat depression and anxiety disorders that include panic disorder, generalized anxiety disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). While many patients benefit from Zoloft, some notice changes in their sleep patterns. One of the most frequent concerns is insomnia, but the medication can also cause the opposite problem, sedation. Understanding both effects is important for anyone considering or currently taking this medication.

How Zoloft Can Cause Insomnia

1. Stimulation of serotonin receptors
Zoloft increases serotonin levels in the brain. While serotonin helps regulate mood, it also plays a role in wakefulness and the sleep-wake cycle. By boosting serotonin activity, Zoloft may create a state of increased alertness, especially early in treatment.

2. Activation effects
Some patients feel more “energized” or “wired” when starting Zoloft. This activation can make it harder to fall asleep at night, especially if the dose is taken later in the day. Patients often benefit from taking the medication in the morning if they have any activation effects.

3. Impact on REM sleep
SSRIs, including Zoloft, can reduce the amount of rapid eye movement (REM) sleep. REM is the stage of sleep linked with dreaming and memory consolidation. Reducing REM can leave patients feeling like their sleep is lighter, less refreshing, and more disrupted.

4. Dose-related effects
Higher doses of Zoloft are more likely to cause insomnia. A person may tolerate a low dose well but develop sleep difficulties when the dose is increased.

5. Anxiety and initial adjustment
When people start Zoloft, the first few weeks may bring temporary side effects like jitteriness, restlessness, or increased anxiety. These effects often improve with time but can interfere with falling or staying asleep in the beginning.

Why Zoloft Can Also Cause Sedation
Interestingly, Zoloft does not affect every patient the same way. For some, the medication has a calming effect that leads to daytime drowsiness or fatigue.

1. Individual differences in brain chemistry
Not everyone processes serotonin changes in the same way. In some people, the increase in serotonin can promote relaxation and sleepiness instead of stimulation.

2. Other neurotransmitters involved
While Zoloft mainly affects serotonin, it can also influence dopamine and norepinephrine slightly. Shifts in these systems may slow down mental and physical activity, leading to sedation.

3. Interaction with other medications
If a patient takes Zoloft with other medicines that cause drowsiness, such as antihistamines, pain medications, or sleep aids, the sedative effects may become stronger.

4. Timing of the dose
If taken at night, some patients find Zoloft helps them fall asleep because of its sedating qualities. Sometimes it improves the quality of sleep and increases the presence of "weird dreams".

Managing Sleep Side Effects
If Zoloft is causing insomnia or sedation, there are strategies that can help:

• Adjust the timing: Taking Zoloft in the morning can reduce insomnia, while taking it at night may help if sedation is the issue.
• Dose adjustments: Sometimes lowering the dose reduces side effects without losing effectiveness.  Some need to be started at a lower dose to build up their tolerance to the medication side effects.
• Lifestyle changes: Good sleep hygiene including consistent bedtimes, avoiding caffeine in the evening, and limiting screen use before bed can improve sleep quality.
• Doctor guidance: For persistent problems, a physician may recommend adding a short-term sleep aid, changing the antidepressant, or trying behavioral therapy for insomnia.

Key Takeaway
Zoloft can affect sleep in two very different ways. For some, it causes insomnia by increasing alertness and altering sleep cycles. For others, it leads to sedation and daytime fatigue. These differences come down to individual brain chemistry, dosage, and timing. If you notice sleep changes while taking Zoloft, do not stop the medication on your own. Talk with your prescribing physician about strategies to minimize side effects or how to properly switch from one medication to the next.

Many people consider starting therapy but feel unsure about what to say once they’re in the room. It’s a common concern: “What if I don’t know what to talk about?” or “What if I just sit in silence?” Therapy doesn’t come with a script, and there are countless meaningful paths of conversation. The most important part is showing up with openness and honesty.

This article will guide you through topics that are helpful to bring up in therapy, why they matter, and how they can help you move toward your goals. Whether you’re starting therapy for the first time or returning after a break, understanding what you can talk about may ease the anxiety of beginning the process.

Why It’s Normal to Feel Unsure About What to Say
When meeting a therapist, you might worry about being judged, saying the “wrong” thing, or not having anything “serious enough” to discuss. These thoughts are normal. Therapy is different from most conversations. It is private, non-judgmental, and focused entirely on you.

Your therapist isn’t expecting perfection. They do expect honesty, curiosity, and sometimes even confusion. Not knowing where to start is part of the process, and talking about not knowing what to talk about can actually be a powerful entry point.

Topics That Often Come Up in Therapy

1. Your Current Symptoms or Stressors
Many people begin therapy because of symptoms like anxiety, sadness, irritability, or sleep difficulties. Bringing these up directly helps your therapist understand your situation.

• How long have you felt this way?
• When are the symptoms better or worse?
• What impact are they having on your daily life?

Even if you feel vague discomfort like being “stuck” or “not yourself, that’s worth mentioning.

2. Life Events and Transitions
Major changes often lead people to therapy. Examples include:

• Moving, starting a new job, or changing schools
• Ending or beginning a relationship
• Becoming a parent
• Retirement or loss of a loved one

Transitions can stir up emotions, even when they are positive. Therapy offers a space to reflect, adapt, and grow through change.

3. Past Experiences
Sometimes our past shapes the way we think and act today. If certain memories, family dynamics, or earlier experiences come to mind, bringing them up can be important.

• Childhood events
• Past traumas
• Early relationships or losses

Your therapist won’t push you to share more than you’re ready for, but when you choose to explore the past, it often sheds light on current patterns.

4. Relationships
Romantic, family, friendships, or work-related relationships are central to emotional health. In therapy, you can discuss:

• Conflicts and communication struggles
• Feelings of loneliness or disconnection
• Patterns you notice repeating in different relationships

Talking about how you relate to others can help you better understand yourself and improve those connections.

5. Thoughts and Beliefs
Therapy is a place to explore how your thoughts influence your emotions and actions. You might notice:

• Self-critical or perfectionistic thoughts
• Worry or rumination
• Beliefs about yourself, others, or the world that hold you back

Your therapist can help you reframe unhelpful thinking patterns and build a healthier mindset.

6. Coping Skills
Some patients come to therapy because their current coping strategies aren’t working, or they feel unhealthy (such as overeating, drinking, or avoiding responsibilities). Therapy helps you explore new strategies to manage stress more effectively.

7. Goals and Aspirations
Therapy isn’t only about problems. It’s also about growth. You might want to discuss:

• Personal or career goals
• Improving self-confidence
• Strengthening relationships
• Building healthier habits

Setting and tracking goals in therapy can provide structure and a sense of progress.

8. Self-Understanding
Many people use therapy as a tool for self-discovery. Questions like “Who am I?” or “What do I really want?” are valuable to explore. Your therapist can guide you in understanding your identity, values, and priorities.

9. Emotions You Don’t Understand
Sometimes feelings surface without clear reasons. You may notice sudden sadness, anger, or anxiety. Bringing these to therapy, even if they seem “irrational,” can uncover deeper insights about yourself.

10. Patterns of Behavior
Do you notice yourself repeating certain cycles? Maybe you push people away when they get close, procrastinate until the last minute, or sabotage your own success. Therapy can help identify patterns and change them.

How to Decide What to Bring Up
Here are some strategies to prepare for sessions:

• Keep a journal: Write down thoughts, moods, or events between sessions.
• Notice triggers: Pay attention to moments when emotions spike.
• Bring questions: Even asking, “Why do I feel this way?” is valuable.
• Trust the process: Sometimes the most important discussions emerge naturally in the moment.

What If You Don’t Know What to Say?
This is a common situation, especially at the beginning. Some options include:

• Talk about your day or week.
• Share a recent dream.
• Reflect on what it’s like to be in therapy.
• Explore silence—sometimes not talking reveals just as much.

Remember: you don’t need to prepare a script. Therapy is about showing up as you are.

Sensitive Topics You Can Bring Up
You may hesitate to discuss certain issues, but therapy is designed for openness. Topics often include:

• Sexual concerns
• Addictions or compulsive behaviors
• Feelings of shame or guilt
• Thoughts of self-harm (which should always be shared for your safety)

Your therapist’s role is to support, not judge.

The Role of Trust in Choosing What to Talk About
At first, you might not feel comfortable sharing everything. That’s normal. As trust builds, you’ll likely find it easier to bring up sensitive or vulnerable topics. Therapy is a journey, and what you share may evolve over time.

Examples of First-Session Topics
If you’re starting therapy and wondering what to say in the very first session, here are useful entry points:

• Why you decided to seek therapy now
• What you hope to gain from therapy
• Any symptoms or struggles you’ve noticed recently
• Your background including family, relationships, work, health

The first session is about laying the groundwork. You don’t need to tell your entire life story right away.

Why Talking Matters
Therapy works because it provides a structured, safe space to explore thoughts and emotions. Research consistently shows that talking about difficulties like naming them out loud reduces distress and improves clarity.

By verbalizing your experience, you can:

• Gain perspective on challenges
• Feel less isolated
• Identify choices and solutions you hadn’t considered
• Strengthen resilience

When Therapy Feels Stuck
Sometimes you may feel therapy isn’t moving forward. If that happens:

• Talk directly about feeling stuck.
• Share if you feel misunderstood.
• Revisit your goals with your therapist.

Open communication keeps therapy effective.

Therapy as a Collaborative Process
What you talk about is your choice, but therapy is most powerful when it’s collaborative. Your therapist will listen, ask questions, and sometimes challenge you. The combination of your openness and your therapist’s guidance creates change.

The question “What should I talk about in therapy?” doesn’t have one single answer. You can talk about your feelings, relationships, past experiences, future goals, or even your uncertainty about what to say. The important part is showing up honestly and being willing to explore.

Therapy is not about being “interesting” or “perfect”. It’s about being real. Over time, you’ll find that the process naturally guides you toward the conversations you need most.
​

Will a Psychiatrist Prescribe Medication on the First Visit?
One of the most common questions people have before meeting a psychiatrist is: “Will I get medication right away?” The answer is that often, yes but not always. Whether medication is prescribed at your first visit depends on how clear the diagnosis is, your personal medical history, and possible risks.

When Medication May Be Prescribed at the First Visit
If your symptoms point clearly to a condition such as depression, anxiety, ADHD, or bipolar disorder and there are no major health concerns that would make medication high risk, your psychiatrist may recommend starting medication right away. This approach allows you to begin feeling better as soon as possible instead of waiting weeks or months.

When a Psychiatrist May Wait Before Prescribing
In some situations, things are not as straightforward. A psychiatrist may hold off on prescribing medication if:

• The diagnosis is unclear. Sometimes symptoms overlap between conditions. In this case, your psychiatrist may recommend further testing such as a psychological evaluation or referral to a neurologist or endocrinologist to rule out other causes.
• Medical risks are present. For example, stimulants for ADHD may affect the heart. If you have a heart condition, your psychiatrist may need cardiology clearance before prescribing. Similarly, if treatments like TMS (transcranial magnetic stimulation) are being considered, your psychiatrist may need input from a neurologist.

Why Psychiatrists Take This Approach
Psychiatrists want you to improve as quickly as possible, but we also have to make sure that treatment is safe. Starting medication without the right precautions could put you at risk. By taking the time to check on possible medical issues, we balance speed of treatment with your long-term health.

What to Expect at Your First Appointment

• A detailed conversation about your symptoms, history, and goals.
• A review of your medical history and any current medications.
• A discussion about whether starting medication right away is the best option or if more evaluation is needed.

Many people do receive medication at their first psychiatry visit, especially when the diagnosis is clear and the risks are low. If more information is needed or there are medical concerns, your psychiatrist may take extra steps to ensure your safety. Either way, the goal is the same: to help you feel better as quickly and safely as possible.

Generic Availability and Cost
Abilify, brand name for aripiprazole, is available in generic form. Generics usually cost less and are covered more easily by insurance, so Abilify is more affordable for many patients. Vraylar is the brand name for cariprazine and currently does not have a generic version available in the United States. This makes Vraylar usually more expensive, but manufacturer coupons are available here to make it more affordable.  A valid commercial insurance plan is required for the coupon to work.

FDA-Approved Uses
Abilify is approved by the FDA to treat several conditions. These include schizophrenia, manic or mixed episodes in bipolar disorder, irritability in children with autism, and as an add-on treatment for major depressive disorder. It is also sometimes used to help with tic disorders.

Vraylar is FDA-approved for schizophrenia, manic or mixed episodes of bipolar I disorder, and depressive episodes of bipolar I disorder. In addition, it was recently approved as an add-on treatment for major depressive disorder.

How They Work
Both medications belong to the “atypical neuroleptic” group. They work by balancing brain chemicals, particularly dopamine and serotonin, but they do so in slightly different ways.

Abilify works as a partial agonist at dopamine D2 and D3 receptors. This means it can increase dopamine activity when levels are too low and reduce it when levels are too high. It also affects serotonin receptors which helps with mood regulation.

Vraylar works in a similar way but has a stronger effect on D3 receptors than Abilify. Since D3 receptors are linked to mood, motivation, and cognitive function, this difference may explain why some people respond better to Vraylar. Like Abilify, it also interacts with serotonin receptors to help balance mood and thought processes.

Benefits
Abilify can reduce hallucinations, delusions, and mood swings in people with schizophrenia and bipolar disorder. It is also effective at reducing irritability in autism and can boost the effectiveness of antidepressants in people with major depression. 

Vraylar is effective at controlling psychotic symptoms in schizophrenia, stabilizing mood during manic or mixed episodes, and improving depressive symptoms in bipolar disorder. 

Dosage and Administration
Abilify comes in several forms including tablets, an oral solution, orally disintegrating tablets, and injections. The specific dose depends on the condition being treated, and doctors typically start with a low dose and increase from there. The most common and cost effective tablets range from 2mg - 30mg. Depression and agitation symptoms are most commonly dosed on the lower end of the spectrum. Bipolar disorder and psychosis often require higher doses.

Vraylar is available as capsules that are taken once daily. Dosing usually begins at a low level and is gradually adjusted based on the patient’s response and tolerance. Vraylar capsules start at 1.5 - 6mg.  There are fewer dose options with Vraylar.

Common Side Effects and Safety
Both medications have the potential for side effects, though the exact experience varies from person to person.

For Abilify, common side effects include restlessness (known as akathisia), insomnia, nausea, constipation, dizziness, and sedation. Some people may also experience mild weight gain. Less common but more serious risks include movement disorders such as tardive dyskinesia, a rare but serious condition called neuroleptic malignant syndrome, and changes in impulse control such as compulsive gambling or spending. Abilify may also affect blood sugar and cholesterol levels, so physicians often monitor these over time.

For Vraylar, the most common side effects include restlessness, nausea, insomnia, fatigue, dizziness, and constipation. Some patients may feel more sedated or notice tremors. Vraylar has long-lasting active ingredients, so its effects can remain for weeks even after stopping or adjusting the dose. There is also a small, less understood risk of vision changes such as cataracts, so sporadic eye exams may be recommended. Vraylar on average has fewer side effects. The development of Vraylar is believed to be from adapting Abilify to make it more user-friendly.

Putting It All Together
When comparing the two, some clear differences stand out. Abilify has the advantage of being available in generic form which usually makes it more affordable and accessible. It also has a longer track record of use with approvals for schizophrenia, bipolar disorder, autism-related irritability, and as an add-on for depression.

Vraylar, although brand-only and more expensive, brings newer options to the table. It is approved for schizophrenia, both manic and depressive phases of bipolar I disorder, and as an add-on for use in major depressive disorder. Its stronger action at D3 receptors may give it an edge in treating certain symptoms like motivation and mood regulation.

Tourette’s Syndrome is a neurological condition that causes people to have tics that are sudden and involuntary. These tics can range from simple eye blinking to more complex sounds. While many people with Tourette’s live full, successful lives, the condition is often misunderstood. One major source of misunderstanding is how it’s shown in movies.

Films can shape how the public views Tourette’s. Some portrayals are sensitive and realistic, while others rely on stereotypes or use the condition as a punchline. Below is a look at several movies that have featured Tourette’s, with an eye toward accuracy and impact.

1. The Tic Code (1998)
Portrayal: This film follows a young boy with Tourette’s who dreams of becoming a jazz pianist. The story is inspired by the life of musician and actor Gregory Hines. The boy struggles with social acceptance but finds understanding and mentorship from an adult musician who also has Tourette’s.

Accuracy: Fairly accurate. It shows both motor and vocal tics, the social challenges, and the need for understanding rather than judgment.

Impact: Positive. The movie treats the characters with dignity, shows their talents beyond the condition, and encourages compassion.

2. Front of the Class (2008)
Portrayal: Based on the true story of Brad Cohen, this movie tells how a man with Tourette’s overcame years of misunderstanding to become a beloved teacher. His journey includes moments of rejection during job interviews, as well as the acceptance and support he receives.

Accuracy: Highly accurate in showing the persistence of tics, the social stigma, and the determination it takes to succeed.

Impact: Very positive. It’s an inspiring story that helps viewers see that people with Tourette’s can achieve their goals with the right support.

3. Niagara, Niagara (1997)
Portrayal: This drama centers on a young woman with Tourette’s who embarks on a road trip. The character’s tics and outbursts are shown as part of her life but do not define her.

Accuracy: Fairly accurate depiction of tics, though the film is more about the character’s emotional journey than medical details.

Impact: Mildly positive. It does not educate viewers much on Tourette's.

4. Deuce Bigalow: Male Gigolo (1999)
Portrayal: Features a character whose Tourette’s is utilized for comedy with exaggerated and constant shouting of inappropriate words (coprolalia).

Accuracy: Very inaccurate. Coprolalia affects only about 10% of people with Tourette’s, yet the movie suggests it’s the defining symptom.

Impact: Negative. While some viewers might laugh, this portrayal reinforces harmful stereotypes and may cause people to misunderstand what Tourette’s really is.

5. Motherless Brooklyn (2019)
Portrayal: Edward Norton plays a private detective in the 1950's who has Tourette’s. His tics are woven into his speech and movements, sometimes disrupting conversations, but the character is shown as intelligent, resourceful, and capable.

Accuracy: Reasonably accurate though the tics are sometimes more dramatic than most experience.

Impact: Mostly positive. The film avoids mocking the character and shows him as a skilled professional. Some moments still lean on the tics for dramatic effect.

6. Phoebe in Wonderland (2008)
Portrayal: While not strictly about Tourette’s, this movie portrays a young girl who exhibits obsessive and tic-like behaviors. Her struggles with fitting in and being misunderstood parallel the experiences of some with Tourette’s.

Accuracy: Somewhat accurate in showing social isolation and misunderstanding though it blends symptoms from different conditions.

Impact: Neutral to positive. It encourages empathy but may leave viewers unclear on the differences between Tourette’s and other conditions.

Understanding the Bigger Picture
Movies influence public opinion. Positive portrayals can lead to understanding, compassion, and inclusion for those with Tourette’s. Negative portrayals like inappropriate language or exaggerated tics can make life harder by spreading stereotypes.

When you meet someone with Tourette’s, remember:

• Not all tics are vocal or obvious.
• Stress, excitement, and fatigue can make tics more noticeable.
• People with Tourette’s are more than their symptoms. They have unique talents, personalities, and dreams.

Do you have a favorite movie that portrays Tourette's that I missed?  Please leave it in the comment section for me to look into.  What was your favorite movie from the list?

You’re not just “tired.” Postpartum insomnia is when you regularly struggling to initiate sleep or can't stay asleep when your baby is sleeping. It’s common, real, and treatable.

Quick story: At 3:17 a.m., Maya stared at the ceiling while her newborn finally slept. Her body ached, her mind raced (“Did I latch right? Did I miss a feeding?”), and every creak sounded like a cry. By sunrise, she’d slept maybe an hour, again. If this feels familiar, you’re not alone, and there’s a plan that helps.
​

​Postpartum insomnia means trouble falling asleep, staying asleep, or waking too early that results in daytime fatigue or fog. It’s different from normal newborn sleep disruptions because it persists even when you have the chance to sleep. It is often driven by stress, pain, hormonal shifts, and “wired-but-tired” hyperarousal.
​

​Good sleep protects mood, attention, and healing. It also helps to solidify memories and knowledge. Persistent insomnia increases the risk for postpartum depression and anxiety.
​

Cognitive Behavioral Therapy for Insomnia (CBT-I) is the gold-standard, medication-free treatment. It teaches stimulus control (retraining the bed for sleep), sleep scheduling, relaxation skills, and how to quiet “what-if” thoughts. Trials in the perinatal and postpartum period show meaningful improvements in insomnia, and treating insomnia during pregnancy can also decrease the odds of depression. Ask about a therapist trained in CBT-I.

Medication can be a short-term bridge while CBT-I and routines take hold. Life with a newborn is a significant transition period which is hard enough without insomnia.  Get individualized care with your clinician.

General safety principles

• Use the lowest effective dose, for the shortest time, and dose right after the last evening feed to minimize infant exposure.
• Monitor your baby for unusual sleepiness or poor feeding.
• Do not bed-share if you’ve taken any sedating medicine.

Often-considered options:

• “Z-drugs” (short-acting sleep aids):
  • Zolpidem and zopiclone/eszopiclone pass into breast milk in small amounts and are commonly considered for short-term use with infant monitoring. Some experts prefer these during breastfeeding while others advise caution due to limited data. This is an important discussion point with your physician.
• Short-acting benzodiazepines:
  • Lorazepam/oxazepam are generally preferred if a benzodiazepine is needed because they’re shorter-acting and appear in low levels in milk. Always monitor the infant after use. Avoid long-acting benzodiazepines.
• Sedating antidepressants:
  • Trazodone or mirtazapine at bedtime can help sleep and mood. Both have low milk levels in available reports. 
• Antihistamines:
  • Doxylamine or hydroxyzine in occasional small doses may be compatible with breastfeeding but can cause infant drowsiness and might reduce milk supply early on. Use sparingly and with guidance.
• Melatonin:
  • Data is limited. Some guidance allows cautious use with monitoring, but it isn’t first-line in breastfeeding.

Safety: Whenever you’ve taken a sedating medication, do not bed-share. The risk of sleep-related infant death is much higher when a caregiver is fatigued or has taken sedating medicines. Use a separate, safe sleep surface for baby in your room.
​

Call your clinician soon if:

• You can’t sleep most nights for 2+ weeks,
• You feel increasing anxiety, irritability, or hopelessness, or
• You suspect thyroid issues (racing heart, heat intolerance, tremor, insomnia).

Urgent red flags (seek same-day help or go to the ER / call 988):

• Thoughts of harming yourself or the baby
• Mania or psychosis (feeling wired with no sleep, racing thoughts, paranoia, hearing/seeing things, severe confusion). Postpartum psychosis is rare (~1–2 in 1,000 births) but a medical emergency.

​24/7 help: Call/text 988 (Suicide & Crisis Lifeline) or the National Maternal Mental Health Hotline: 1-833-TLC-MAMA (1-833-852-6262)

Postpartum insomnia is common and treatable. With the right mix of structure, support, and targeted therapy, most new parents sleep better within days to weeks. If you’re struggling, you deserve help now.  Contact your family physician or schedule an appointment with us quickly.

OCD (Obsessive-Compulsive Disorder) is generally considered neurodivergent, but this classification does depend on how you define "neurodivergence."

What is Neurodivergence?
Neurodivergence refers to brain functioning that diverges from what is considered “typical” or “neurotypical.” It often includes:

• Autism
• ADHD
• Dyslexia
• Tourette’s
• OCD
• Other developmental, cognitive, or psychiatric differences

The term is not a medical diagnosis. It is a social concept meant to destigmatize and normalize differences in brain function.

Why OCD Can Be Considered Neurodivergent

1. Atypical Brain Functioning:
   Neuroimaging studies show that OCD involves differences in brain circuits, especially those related to decision-making, error detection, and emotional regulation.
2. Chronic and Developmental:
   OCD often begins in childhood or adolescence and persists chronically, influencing thought patterns, behaviors, and functioning.
3. Different Experience of the World:
   People with OCD often experience intrusive thoughts and feel compelled to perform routines. This impacts how they interact with the environment and regulate emotions which are key features of neurodivergence.
4. Community Inclusion:
   Many neurodiversity advocates and mental health professionals include OCD within the neurodivergent umbrella.

Discrepancy
Some professionals and advocates differentiate between neurodevelopmental disorders (like autism or ADHD) and mental illnesses (like OCD or depression). While OCD is often grouped under neurodivergence for advocacy purposes, its classification is still debated in academic and clinical circles.

Bottom Line

• Yes, OCD is widely recognized as a form of neurodivergence.
• This perspective helps promote compassion, inclusion, and support for those with OCD.
• Whether it’s "officially" neurodivergent depends on the framework being used.

​Unsure if your child has OCD?  Take the child OCD quiz.

What You Need to Know About These ADHD Medications
If you or your child has been diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD), you've likely heard of the two popular medications Concerta and Adderall. Both are stimulant medications commonly prescribed to manage the symptoms of ADHD, but they have key differences in how they work, how long they last, and how they're used. If you have not been diagnosed, learn about how to know if you have ADHD.

In this article, we’ll explore the differences and similarities between Concerta and Adderall, including how they work in the brain, what age groups they’re approved for, and how effective they are. Understanding the details of Concerta vs Adderall can help you make an informed decision with your psychiatrist.

What Is ADHD?
ADHD is a common neurodevelopmental disorder that affects both children and adults. It’s characterized by symptoms of inattention, hyperactivity, and impulsivity. According to different studies, about 7-10% of children in the U.S. between the ages of 3 and 17 have ADHD. Among adults, the prevalence is estimated to be around 4-5%. This means that you can grow out of ADHD.

The stimulant medications Concerta and Adderall are considered first-line treatment options for ADHD. Research shows more than 75% of children with ADHD experience significant improvement in symptoms with the right stimulant medication.

Concerta vs Adderall: Mechanism of Action
Although both Concerta and Adderall are stimulants, they have different active ingredients and work slightly differently in the brain.

Concerta contains methylphenidate which increases levels of dopamine and norepinephrine in the brain. These are two chemicals that help regulate attention, motivation, and impulse control. Methylphenidate works by blocking the reuptake (or recycling) of these chemicals, allowing them to stay active longer in the brain.

Adderall contains a combination of amphetamine salts  (dextroamphetamine and levoamphetamine). It increases dopamine and norepinephrine by both blocking reuptake and promoting the release of these chemicals into the brain. This dual action can sometimes lead to a more noticeable boost in alertness and energy.

FDA Approvals and Age Ranges
Both Concerta and Adderall are approved by the U.S. Food and Drug Administration (FDA) to treat ADHD, but they differ slightly in their approved uses and age ranges.

• Concerta
  • Active Ingredient: Methylphenidate hydrochloride (extended-release)
  • FDA Approval: ADHD treatment in children ages 6 and older, adolescents, and adults up to age 65
  • Form: Extended-release tablet (once-daily dosing) or capsule
• Adderall
  • Active Ingredient: Mixed amphetamine salts (immediate-release and extended-release versions available)
  • FDA Approval: Approved for ADHD treatment in children ages 3 and older (immediate-release) and children ages 6 and older (extended-release)
  • Form: Immediate-release (taken 1–3 times daily) or extended-release (once-daily capsule)

Duration of Action
The duration of these medications can impact daily functioning, school performance, and even sleep.

• Concerta typically lasts 9 to 12 hours, providing consistent symptom control through the school or workday. It's designed to mimic a three-times-daily dosing pattern through a special delivery system in the tablet or capsule.
• Adderall XR (extended-release) lasts about 8 hours, while Adderall IR (immediate-release) lasts about 4 hours and often requires a second dose after lunch.

Effectiveness: What the Research Says
When comparing Concerta vs Adderall, studies show that both medications are effective in reducing the core symptoms of ADHD, but individual response to each medication varies.

• A head-to-head study published in the journal Pediatrics found that Adderall XR and Concerta provided similar overall benefits, but some individuals responded better to one than the other.
• About 50% of patients who don’t respond well to one stimulant will respond to the other.  This highlights the importance of trying different medications with your psychiatrist.
• Another study found that parents and teachers noticed significant improvements in behavior and academic performance with both medications.
• Some studies show that Concerta is slightly better tolerated in children and adolescents when compared to Adderall.
• Some studies show that Adderall is more effective in adults when compared to Concerta.

Side Effects to Consider
Although Concerta and Adderall are generally safe when taken as prescribed, they can cause side effects. Most side effects are mild and tend to lessen over time.

Common side effects include:

• Decreased appetite
• Insomnia
• Headache
• Irritability
• Stomachaches
• Increased heart rate or blood pressure

More serious side effects are rare but can include mood swings, tics, or cardiovascular issues in those with underlying health conditions. Always talk to a doctor before starting, stopping, or changing a stimulant medication.

Which One Is Better?
There is no one-size-fits-all answer when it comes to choosing between Concerta vs Adderall. Some individuals respond better to methylphenidate (Concerta) while others do better with amphetamines (Adderall). Factors like duration of symptom coverage, side effect profile, co-existing health conditions, and even insurance coverage can influence the best choice.

Your psychiatrist may recommend trying one medication for a few weeks and then switching if it doesn’t provide the desired benefits or causes unwanted side effects.

Generic Options and Cost

• Concerta has a generic version in methylphenidate ER. Some patients report that generics don’t always perform identically to the brand name Concerta.
• Adderall also has generic versions available for both IR and XR formulations. These tend to be slightly more affordable, but both are commonly covered by insurance.

Be sure to discuss cost and coverage with your pharmacist or doctor if affordability is a concern.

ADHD Treatment: Medication Is Only One Part
While Concerta and Adderall can make a dramatic difference in managing ADHD symptoms, the best outcomes occur when medication is combined with therapy, educational support, and healthy lifestyles. This include regular exercise, consistent sleep, time management skills, and mindfulness techniques.

Only about 50% of children with ADHD receive behavioral treatment alongside medication even though combining both is recommended by most professional guidelines.

Final Thoughts: Concerta vs Adderall
Choosing between Concerta and Adderall is an important decision that depends on your individual needs, how your body responds, and your daily schedule. Both are highly effective ADHD medications with years of research and millions of success stories behind them.

If you’re unsure which is right for you or your child, a consultation with a psychiatrist can help guide the process. It may take some time and adjustment, but finding the right treatment can dramatically improve focus, behavior, relationships, and overall quality of life.

If you haven't been diagnosed but believe you have symptoms, reach out to a local psychiatrist and get an ADHD test performed.  

What is childhood OCD?
Obsessive‑Compulsive Disorder (OCD) in children involves unwanted, repetitive thoughts (obsessions) and/or repetitive behaviors or mental rituals (compulsions) that cause distress or interfere with daily life. Common examples include excessive hand‑washing, checking, counting, arranging, hoarding, or intrusive worrying thoughts like fear of harm or contamination. You can read more about the types of OCD here.

How common is OCD in children?

• OCD affects about 1 - 2% (and possibly up to 3%) of children.
• It often begins between ages 7 and 12, with a peak around age 10–11.
• Childhood OCD is slightly more common in boys than girls.
• Only a small percentage of untreated childhood OCD goes away on its own.

Why consider a quiz?
Online screening tools (like the Children’s Yale–Brown scale or other simple parent measures) can help identify behaviors that suggest OCD. These are not diagnostic, but they can help you decide if a full evaluation by a child psychiatrist may be helpful. When not properly addressed, OCD is likely to get worse.

Does My Child Have OCD? (Quiz – 18 Items)

Instructions: Think about your child’s behavior over the past month. Answer Yes or No to each item. 

A. Obsessions

1. Does your child experience persistent, upsetting thoughts or images that they can’t stop thinking about (e.g., germs, harm, order)?
2. Do your child express worries that something bad will happen unless they repeat something or perform a task?
3. Do these thoughts cause visible distress?
4. Is your child afraid of contamination (germs) and talk about it often?
5. Does your child ask the same questions over and over to feel reassured?

B. Compulsions

1. Does your child wash or clean much more often than expected?
2. Does your child re‑arrange or reorder objects to feel “just right”?
3. Does your child need to count or repeat words until it feels correct?
4. Does your child check things repeatedly (doors, lights, schoolwork)?
5. Does your child hoard or refuse to throw things away?
6. Does your child feel the need to touch or avoid objects in a specific way?
7. Does your child repeat actions until it feels perfect (rewriting homework)?

C. Impact on daily life

1. Do the thoughts or behaviors take up more than an hour per day or disrupt daily life?
2. Does your child struggle when routines change or unexpected events occur?
3. Does your child avoid normal activities out of fear of triggers?
4. Do necessary behaviors cause problems at school (e.g. late arrival)?
5. Have hobbies or fun activities become less important than the routines or rituals?
6. Have family members needed to change routines to reduce your child’s anxiety?

Scoring guidance (simple):

• If your child has Yes to 3 or more obsession items or 3 or more compulsion items plus at least one “Yes” on the impact questions (13–18), it's suggestive of possible OCD that may require professional evaluation.
• Even a few “Yes” answers in the first section may warrant attention if distress is worsening.

What happens next?
If your answers suggest possible OCD, you might consider seeking an evaluation with a child psychiatrist. Child psychiatrists may use additional tools like the Children’s Yale–Brown Obsessive‑Compulsive Scale (CY‑BOCS) or the Obsessive Compulsive Inventory Child version to assess severity and plan treatment.

Effective treatments include Cognitive Behavioral Therapy (CBT) and often medications like SSRIs under careful supervision. Family involvement is also a key part of treatment for children.

Why early detection matters

• Delays in treatment are common and can mean more severe symptoms later on.
• With early intervention and support, many children improve and achieve symptom improvement or complete remission.
• The stigma around OCD is decreasing. Many celebrities have come forward as having OCD.

✅ Disclaimer
This OCD quiz is not a diagnostic tool. It cannot confirm whether your child has OCD. Only a licensed professional like a child psychiatrist can make and confirm a diagnosis.

If you’ve ever had a cup of coffee and felt more focused, you’ve experienced the effects of caffeine.  Caffeine is a stimulant that can affect the brain in powerful ways. Did you know that caffeine can also help some people with ADHD (Attention-Deficit/Hyperactivity Disorder) feel more calm and focused? While it’s not a substitute for prescription treatment, caffeine shares some similarities with medications used for ADHD. Let’s take a closer look at why caffeine sometimes helps and what its limits are.

What Is ADHD?
ADHD is a condition that affects how the brain regulates attention, activity levels, and self-control. People with ADHD often struggle with:

• Staying focused
• Sitting still
• Managing impulses
• Completing tasks

These symptoms are connected to certain brain chemicals including dopamine and norepinephrine that affect alertness, motivation, and decision-making.

How Caffeine Works in the Brain
Caffeine is a stimulant, which means it speeds up certain processes in the brain. It works in several ways, including:

• Blocking adenosine receptors: normally make you feel sleepy
• Increasing dopamine levels: the same brain chemical that helps with motivation, focus, and reward
• Boosting norepinephrine: involved in alertness and attention

This increase in brain activity can temporarily improve focus, reaction time, and mental energy. That’s why caffeine is often considered a nootropic which is a term used for substances that may enhance brain function.

Way Caffeine Helps Some People with ADHD

Some people with ADHD report:

• Feeling calmer, not more jittery, after caffeine
• Being able to focus on one task at a time
• Experiencing less impulsivity

This may seem strange, because how can a stimulant calm someone down? With ADHD, the brain often under-functions in key areas, and mild stimulation can help it work more efficiently.

Why Caffeine Is Less Effective than ADHD Medications
While caffeine can improve focus for some people with ADHD, it’s not nearly as effective or reliable as FDA approved prescription medications. Here is why:

• Weaker effect: Caffeine increases dopamine slightly but not enough to correct the brain chemistry imbalance found with ADHD.
• Shorter duration: Caffeine wears off quickly and often causes a “crash” afterward.
• Tolerance builds fast: Regular use can make caffeine less effective over time.
• Unpredictable side effects: Too much caffeine can lead to anxiety, jitters, insomnia, or heart palpitations.

ADHD medications are formulated, dosed, and monitored for consistent results with fewer ups and downs.

Is Caffeine Safe for People with ADHD?
In small amounts, caffeine is generally safe for most teens and adults. For those with ADHD, it should be used with caution:

• Avoid mixing with prescription stimulants with caffeine as it can increase heart rate and anxiety
• Don’t rely on caffeine alone for ADHD symptoms
• Watch for worsening sleep, as poor rest can make ADHD symptoms worse
• Limit sugary drinks like sodas or energy drinks which can cause a sugar crash

For young children, caffeine is usually not recommended.

Summary
​Caffeine can offer mild, short-term help with ADHD symptoms because it acts on the same brain chemicals as ADHD medications. It is considered a nootropic which is fancy terminology for a substance that may enhance focus and alertness. It’s not as effective, long-lasting, or clearly dosed like FDA-approved ADHD treatments.

If you or your child is struggling with attention, hyperactivity, or impulsiveness, it’s worth talking to a psychiatrist. A professional evaluation and a personalized treatment plan can make a major difference in everyday life.

Yes! Elon Musk has publicly stated that he has Autism.  He specifically mentioned the term Asperger's on May 8, 2021 during his opening monologue on Saturday Night Live (SNL). Elon Musk said, "I'm actually making history tonight as the first person with Asperger's to host SNL or at least the first to admit it."

He followed up his SNL quote with "I know I sometimes say or post strange things, but that's just how my brain works."

At a TED Talk, Elon Musk shared more insight into his Autism diagnosis with "The social cues were not intuitive....I would just tend to take things very literally."

What this Means in Medical Terms
The term "Asperger's syndrome" is no longer an official diagnosis in the current DSM5 diagnostic manual.  The term was absorbed with Autism into the diagnosis of Autism Spectrum Disorder.  

Why This Matters
When a high profile celebrity like Elon Musk openly discusses a mental health diagnosis, it can help reduce stigma and raise public awareness.  His openness encourages acceptance and may empower others to embrace their mental health condition.  

Disclaimer: No one at Your Family Psychiatrist is treating or diagnosing Elon Musk with any condition. We can not confirm nor deny any of his claims. This article is quoting Elon Musk himself regarding his personal disclosures.  

Depression in children under age 12 is a serious mental health concern that can have lifelong consequences. Parents and healthcare professionals often feel torn between the risks and benefits of antidepressant medications in young patients, but the evidence shows that these medications can be life-changing when used thoughtfully.

Prozac (Fluoxetine): The Only FDA-Approved Antidepressant for Depression Under Age 12
Among all antidepressants, fluoxetine (Prozac) is currently the only medication approved by the U.S. Food and Drug Administration (FDA) for treating major depressive disorder in children under the age of 12. This indication by the FDA was granted in 2003.  This means that we are currently at 22+ years without an additional medication option.

Other antidepressants, while not FDA-approved for depression in this age group, have also been studied:

• Zoloft (sertraline): 2 positive studies under age 12
• Celexa (citalopram): 1 positive study under age 12
• Paxil (paroxetine): 3 negative studies
• Lexapro (escitalopram): 1 negative study

These results indicate that while Prozac leads the way, other medications may provide significant benefit. Working with a child psychiatrist to understand the research and the many options is important.  Note that Lexapro is FDA approved for depression between the ages of 12-17.  It is the only other antidepressant FDA approved younger than age 18. Other options are certainly used off-label, but selection of an alternative is very nuanced.  

How Effective Are Antidepressants in Children?
The effectiveness of antidepressants is very encouraging, especially when combined with therapy. A notable study involving adolescents with moderate to severe depression found that after 36 weeks an impressive 86% of participants receiving both an antidepressant and cognitive behavioral therapy (CBT) responded to treatment. This combination remains the gold standard for improving mood, functioning, and preventing relapse in children.

Suicide Risk: What the Numbers Really Say
One of the most discussed concerns around antidepressant use in children is the risk of suicidal thoughts or behaviors. It is crucial to interpret this data accurately.

• The lifetime prevalence of a suicide attempt among depressed adolescents is approximately 4.1%.
• No single antidepressant has an adjusted relative risk above 1.0 for suicide attempts. This means that no medication has been shown to increase the overall risk of a suicide attempt when statistical adjustments are made. The study that supported this data had over 35,000 youth enrolled.
• Suicide attempts rose in the general population after the 2004 FDA black box warning was added to antidepressants. The warning led to a sharp drop in prescriptions, and many patients who needed treatment discontinued their medications. This correlated with a spike in suicide attempts and hospitalizations. This paradox highlights a critical point. Untreated depression is far more dangerous than properly monitored antidepressant use.

Long-Term Risks of Untreated Depression
Beyond short-term mood symptoms, depression in childhood can have long-term consequences. One study found that early-onset depression in males was associated with a significantly increased risk of never having children later in life. This suggests potential lifelong impairments in relationships and functioning when mood disorders go untreated.

What If the First Medication Doesn’t Work?
It’s relatively common for the first antidepressant to be partially effective or even ineffective. One high-quality study looked at teens who didn’t respond to their initial SSRI and found no statistically significant difference in response rates when switching to either a second SSRI or to venlafaxine (Effexor). This means that both options are reasonable, and decisions can be based on side effect profiles, patient history, and other factors.

A Positive Outlook on Medication for Depression
Antidepressants are not a cure-all, but they are one of the most powerful tools we have to treat depression in children and adolescents. When used correctly, they can improve quality of life, reduce symptoms, and prevent long-term complications. It’s essential to monitor side effects and assess risks carefully. The larger truth is that the risks of untreated depression often outweigh the risks of treatment. With careful evaluation and compassionate care, children struggling with depression can thrive, and antidepressants can help them get there, especially when used in combination with talk therapy.

If you are a parent or guardian and believe your child may be experiencing depression, please reach out to a local child psychiatrist for an evaluation.  

Klonopin (clonazepam) and Xanax (alprazolam) are both benzodiazepines used to treat anxiety and panic disorders. While they work in similar ways, they differ in how quickly they start working, how long they last, and how likely they are to cause dependence and withdrawal. Choosing the right medication depends on several factors including symptom type, treatment goals, and medical history.

FDA-Approved Uses
Klonopin and Xanax are both approved by the U.S. Food and Drug Administration (FDA), but for slightly different conditions.

• Klonopin is approved for:
  • Panic disorder
  • Seizure disorders (e.g., absence seizures, Lennox-Gastaut syndrome)
• Xanax is approved for:
  • Generalized anxiety disorder (GAD)
  • Panic disorder, with or without agoraphobia

Both are also commonly prescribed off-label for other anxiety-related conditions, including social anxiety and sleep disturbances.

Duration of Action and Onset
One of the key differences between Klonopin and Xanax is how long their effects last.

• Klonopin is a long-acting benzodiazepine. It begins working within about 1 hour and can last 6 to 12 hours. Its half-life (the time it takes the body to eliminate half the drug) ranges from 20 to 60 hours, which means it stays in your system longer and may provide more consistent symptom relief.
• Xanax is a short-acting benzodiazepine. It starts working within 30 to 60 minutes and typically lasts 4 to 6 hours. Its half-life is around 11 hours, meaning it wears off more quickly and may require more frequent dosing throughout the day.

With these differences, Klonopin may be better suited for patients needing long-term, steady relief while Xanax is often used for sudden or acute anxiety episodes.

Mechanism of Action
Both Klonopin and Xanax enhance the effects of a calming brain chemical called gamma-aminobutyric acid (GABA). By increasing GABA activity, these medications reduce the overactivity in the brain that causes anxiety, panic, and muscle tension. Although they work through the same process, the speed and duration of their effects differ, which can influence a doctor’s decision about which to prescribe.

Side Effects
Like all medications, Klonopin and Xanax can cause side effects. Many are similar because both are benzodiazepines.

Common side effects of both include:

• Drowsiness
• Dizziness
• Fatigue
• Impaired memory
• Trouble concentrating
• Poor coordination
• Dry mouth

Some side effects are more likely depending on the medication’s timing and duration.

• Klonopin may cause prolonged sedation or grogginess, especially in the morning even if taken at night. Because of its long half-life, it may lead to steady but subtle cognitive slowing in older adults.
• Xanax may cause more noticeable sedation soon after taking a dose. It wears off quickly with some patients experiencing rebound anxiety. This is where symptoms return worse than before when the drug wears off.

Risk of Dependence and Abuse
Both medications carry a risk of dependence when used regularly. Xanax tends to have a higher abuse potential.

• Xanax acts quickly and strongly which can make it feel more rewarding to some. This increases the chance of psychological dependence. Its short duration also leads to a higher risk of withdrawal symptoms which can begin within hours of a missed dose. Withdrawal may include anxiety, insomnia, irritability, shaking, or, in rare cases, seizures.
• Klonopin, with its slower onset and longer duration tends to cause a more gradual withdrawal process. While still habit-forming, it may be less likely to cause intense cravings or severe withdrawal symptoms when tapered under medical supervision.

With these risks, both drugs are classified as Schedule IV controlled substances in the United States.

Safety Warnings
Both Klonopin and Xanax carry serious warnings and should only be taken under close medical supervision.

• Black box warning (highest FDA warning): Combining either medication with opioids can result in extreme sedation, slowed breathing, coma, or death.
• Do not stop suddenly when taken regularly. Abrupt discontinuation can lead to dangerous withdrawal symptoms including seizures. Tapering should always be done slowly with medical guidance.
• Avoid alcohol. Combining benzodiazepines with alcohol increases sedation and risk of overdose.
• Use caution in elderly adults. Both medications can increase the risk of falls, confusion, and memory problems.
• Not for long-term use. These medications are typically prescribed short-term unless other options have failed.

When to Consider Each Medication
While both medications can be helpful, one may be more appropriate than the other depending on the individual situation.

Klonopin may be a better choice if:

• You need steady symptom relief throughout the day
• You experience panic attacks regularly and unpredictably
• You’ve had issues with rebound anxiety from shorter-acting medications

Xanax may be a better choice if:

• You need fast relief for occasional panic attacks
• Your anxiety is short-term or situation-based
• You are taking the medication only as needed rather than on a schedule

Conclusion
Klonopin and Xanax are both effective treatments for anxiety and panic when used correctly. They share a similar mechanism of action but differ in how long they last, how quickly they work, and how likely they are to cause dependence or withdrawal. Klonopin’s long duration may be more helpful for ongoing anxiety, while Xanax’s fast relief is often used for acute episodes.

Both medications have significant risks if misused and are not recommended for long-term use without close medical supervision. If you’re struggling with anxiety or panic symptoms, speak with a local psychiatrist.
​

Understanding and Overcoming the Mind-Body Connection
When 14-year-old Emily started blinking excessively during her final exams, her parents chalked it up to allergies. As time passed, the blinking turned into shoulder shrugs, grunts, and occasional jerky movements which all worsened when she was stressed. After months of concern, a visit to a psychiatrist revealed a surprising discovery: anxiety-related tics.

Emily's story is not uncommon. Many people experience involuntary movements or sounds known as tics, especially during times of high stress or anxiety. These tics can range from subtle muscle twitches to noticeable vocal outbursts, and they often go undiagnosed.

What Are Anxiety Tics?
Tics are sudden, repetitive, non-rhythmic movements or vocalizations that can be difficult or impossible to control. They can occur in the context of several conditions, but many are linked to stress and anxiety.

While tics are most often associated with Tourette Syndrome, they can also be stress-related or transient, especially in children and teens.

Examples of Motor Tics:

• Eye blinking
• Facial grimacing
• Shoulder shrugging
• Head jerking
• Arm movements

Examples of Vocal Tics:

• Throat clearing
• Sniffing
• Humming
• Grunting
• Repeating certain words or phrases

Are Anxiety Tics Common?
Yes. According to the CDC, approximately 1 in 50 children in the U.S. has a tic disorder with many cases connected to anxiety or emotional distress.

A 2021 study published in JAMA Neurology found that stress is one of the most frequently reported triggers. The same study noted a rise in stress-induced tic behaviors in adolescents following the COVID-19 pandemic, especially among girls.

Tics aren’t limited to children. Adults with generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), or panic disorder may also experience tics as part of their symptoms.

What Causes Anxiety Tics?
The exact cause of anxiety tics isn't fully understood, but researchers believe it's a combination of neurological, genetic, and psychological factors.

1. Neurological Sensitivity
The brain circuits that regulate movement and emotion, basal ganglia and dopamine pathways, are often overactive in individuals with tics. Stress can increase this activity which makes the body more reactive.

2. Anxiety and Overarousal
Anxiety puts the body in a state of "fight or flight." This heightened arousal increases muscle tension and sensitivity which can make tics worse or create them.

3. Genetics
Tics and anxiety often run in families. If a parent or sibling has experienced them, the risk is higher.

4. Psychological Stress
Major life changes, school pressure, family conflict, or trauma can trigger or worsen tics. Many children experience their first tics during times of high emotional stress.

How Are Anxiety Tics Diagnosed?
There is no single test for anxiety tics, but a thorough evaluation by a psychiatrist or neurologist can help determine the cause and rule out other conditions like:

• Tourette Syndrome
• Chronic Tic Disorder
• OCD
• Autism Spectrum Disorder (ASD)
• ADHD
• Functional Neurological Symptom Disorder

The psychiatrist may ask:

• When did the tics begin?
• Do they change over time?
• Are they worse in stressful situations?
• Do you feel relief after the tic?
• Are there any other symptoms?

It’s also important to assess for co-occurring conditions. Up to 50% of people with tics also have ADHD, and up to 40% have anxiety or OCD according to the Tourette Association of America.

Are Anxiety Tics Permanent?
In many cases, no. Anxiety-related tics are often temporary, especially in children. With the right treatment and emotional support, they tend to fade or resolve over time.

If left untreated, they can worsen or become part of a more chronic condition.

Treatment Options for Anxiety Tics
Treatment is available and effective. A combined approach involving both psychiatric care and therapy often leads to the best outcomes.

1. Cognitive Behavioral Therapy (CBT)
CBT is the gold standard for anxiety and related tics. It helps patients:

• Identify and reduce triggers
• Learn relaxation techniques
• Challenge unhelpful thought patterns
• Practice Habit Reversal Training (HRT) to manage tics

In fact, the Comprehensive Behavioral Intervention for Tics (CBIT) has been shown to reduce tic severity by 30–50% in multiple studies.

2. Medication Options
If tics are interfering with school, work, or relationships, medications can be helpful. Options include:
For Anxiety:

• SSRIs (e.g., sertraline, fluoxetine)
• Buspirone
• Hydroxyzine (for short-term use)

For Tics:

• Guanfacine (also treats ADHD and anxiety)
• Clonidine (especially for children)
• Risperidone or aripiprazole (used for more severe or chronic cases)

Medication is not always necessary, but in moderate to severe cases, it can significantly improve quality of life.

Supplements for Anxiety Tics
Some people prefer natural options, especially as a first step. While not a substitute for medical care, the following supplements have shown promise:

• Magnesium: May reduce muscle tension and tics; often used before bedtime
• L-Theanine: Found in green tea, promotes calmness
• Omega-3 fatty acids: Supports brain health and mood regulation
• Vitamin B6: Important for nervous system function

Always consult your psychiatrist before starting supplements, especially if you’re already taking medications.

Natural Strategies for Managing Tics
Here are a few simple things that can make a big difference:

1. Mindfulness and Meditation
These practices help calm the nervous system and improve awareness of physical sensations. Apps like Calm, Headspace, and Insight Timer can guide beginners.

2. Regular Exercise
Physical activity reduces anxiety and channels energy in a healthy way. It also promotes better sleep.

3. Sleep Hygiene
Poor sleep can make tics much worse. Stick to a consistent bedtime, reduce screen time at night, and keep the bedroom cool and quiet.

4. Avoiding Triggers
Caffeine, video game overstimulation, and sugar may increase tic frequency in some people. Keeping a journal can help track patterns.

5. Supportive Environments
Children with anxiety tics do best in calm, predictable environments. Praise efforts, not outcomes, and avoid drawing attention to the tics.

Working with a Psychiatrist and Counselor
Managing anxiety tics is not a one-person job. It takes a team approach, and that starts with the right professionals.

Why a Psychiatrist Matters:

• Diagnoses the root cause (e.g., anxiety vs. neurological)
• Provides medication if needed
• Coordinates care with therapists and primary care providers

Why a Counselor Matters:

• Provides a safe space to talk about fears, frustrations, or bullying
• Offers strategies to manage anxiety in daily life
• Helps the entire family system adjust and support healing

The combination of medication and therapy is often more effective than either alone.

A Message of Hope
Tics can be frustrating, embarrassing, and scary, but they are manageable. Emily, the teenager from the beginning of this article, began therapy, worked with a child psychiatrist, and started a small dose of guanfacine. Within three months, her tics had reduced by 80%, and she felt more confident at school.

Thousands of children, teens, and adults just like her experience anxiety-related tics and recover.

If you or your child is experiencing tics that may be linked to anxiety, don’t wait. The earlier you seek help, the better.

At Your Family Psychiatrist, we offer psychiatric evaluations and treatment plans for children, teens, and adults with anxiety, tics, and other mental health concerns. Our collaborative care model ensures you get comprehensive support from a caring team of professionals.

Request your appointment online today.

If you’re thinking about starting ketamine treatment for depression, anxiety, or suicidal thoughts, you might have questions about how it shows up on drug tests, especially if you have to take drug tests for work, legal reasons, or medical procedures. One common question we hear from patients is, “Does ketamine show up on a 12-panel drug test?”

What Is a 12-Panel Drug Test?
A 12-panel drug test is a common type of urine drug screening used by employers, legal systems, rehab centers, and medical providers. It screens for 12 different types of drugs or drug classes.

Here’s what a standard 12-panel test usually checks for:

1. Amphetamines (e.g., Adderall)
2. Barbiturates
3. Benzodiazepines (e.g., Xanax, Valium)
4. Cocaine
5. Marijuana (THC)
6. Methadone
7. Methamphetamines
8. Opiates (e.g., heroin, morphine)
9. Phencyclidine (PCP)
10. Propoxyphene (a pain medication)
11. MDMA (Ecstasy)
12. Tricyclic Antidepressants (TCAs)
13. Possibly Buprenorphine (becoming more common)

Ketamine is not typically included on a standard 12-panel drug test. It can be detected if the test is specially designed to look for it, such as in expanded panels or when specifically requested.

Will Ketamine Show Up on a Drug Test?
Most standard drug screens do not test for ketamine unless the test is customized to include it. In workplace or routine legal settings, ketamine is usually not part of the drug testing panel. Some advanced or expanded drug panels, such as 14-, 16-, or 18-panel tests might include it.

Detection window for ketamine in urine:

• Ketamine can usually be detected in urine for 2 to 4 days after use.
• In chronic use or high-dose scenarios, it may be detected for up to 2 weeks.

If you're concerned about drug testing and are using ketamine as part of a prescribed treatment plan, it's important to tell your employer or testing agency in advance (if needed), and have documentation from your provider.

Can Ketamine Cause a False Positive?
While rare, ketamine may cause a false positive for PCP (phencyclidine) due to the chemical similarities between the two substances. This is most likely to happen on older or less specific urine drug tests.

If a false positive occurs, a GC/MS (gas chromatography/mass spectrometry) confirmatory test will clarify the results and show the difference between ketamine and PCP. These confirmatory tests are highly accurate and typically follow any positive result from an initial screen.

Is Ketamine Safe?
Ketamine was first approved in the 1970s as a surgical anesthetic. In recent years, it has been used in much lower doses to treat mental health conditions, especially when traditional antidepressants have failed.

That said, ketamine is not risk-free. Potential side effects include:

• Dissociation (feeling disconnected from reality or the body)
• Dizziness or nausea
• Increased blood pressure
• Headaches
• Temporary anxiety or confusion

When used medically and under supervision, psychiatric oversight, the risk of serious side effects is low.

Ketamine also has the potential for misuse or addiction. In clinical settings, dosages are controlled and patients are carefully monitored. Clinics ensure that ketamine is used safely and only for appropriate mental health indications.

Why Is Ketamine Used for Mental Health?
Ketamine is different from most other psychiatric medications. It acts on NMDA receptors in the brain instead of the serotonin or dopamine systems like many antidepressants.

This different mechanism allows ketamine to work much faster than traditional medications, often in hours or days, rather than weeks.

Ketamine has shown powerful results in treating:
​
1. Treatment-Resistant Depression
According to research from the American Journal of Psychiatry, about 60-70+% of patients with treatment-resistant depression experience significant improvement after ketamine treatment.

2. Suicidal Thoughts
One of ketamine’s most impressive benefits is its ability to rapidly reduce suicidal thinking. In a 2020 study published in JAMA Psychiatry, patients receiving ketamine reported a significant drop in suicidal thoughts within 24 hours of their first dose.

3. Anxiety
While ketamine is not officially FDA-approved for anxiety, growing research supports its benefit for conditions like generalized anxiety disorder and social anxiety. One study from Neuropsychopharmacology showed that patients with social anxiety disorder experienced long-lasting relief after a single dose.

Is It Worth the Risk?
Mental health conditions like depression, suicidality, and anxiety can be life-threatening. For patients who haven’t responded to traditional treatments, ketamine offers a new and promising path forward.

Benefits of Ketamine Therapy:

• Rapid improvement in mood
• Reduction of suicidal thoughts
• Improvement in quality of life
• Increased motivation and energy
• May reduce the need for long-term hospitalization or ER visits

Over 80% of patients with treatment-resistant depression see some improvement with ketamine, according to multiple clinical trials. When combined with psychotherapy (known as ketamine-assisted therapy), the benefits can be even greater and longer-lasting.

Key Takeaways

• Ketamine does not show up on a standard 12-panel drug test, but it may appear on expanded drug panels.
• It can occasionally cause a false positive for PCP, though confirmatory testing can clarify this.
• Ketamine is used under medical supervision for treatment-resistant depression, suicidal thoughts, and anxiety.
• Research shows 60-80+% of patients improve, often within hours to days.
• Risks include dissociation, nausea, dizziness, and, in rare cases, psychological dependency.
• Ketamine therapy should always be guided by a trained medical provider or psychiatrist.

Mental health treatment is deeply personal. For many patients, ketamine offers hope after years of frustration. While it’s not the right fit for everyone, it has changed and even saved many lives.