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Psychiatry Blog

Discussing topics like how to find a psychiatrist, psychiatrist vs. counselor, what is psychotherapy, and much more.


​Our blog is meant to provide information and answers to common questions in psychiatry, cognitive behavioral therapy, mental illness, mental health professionals, talk therapy, psychologists, substance abuse, and anything else that would be helpful to those seeking mental health information. Knowing how to find a good psychiatrist, and what a licensed psychiatrist is will help you in your search.

Alcohol Assessment

11/24/2020

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Alcohol Assessment To Determine The Need For Medical Intervention

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Patients who suffer from alcohol use disorder (AUD) have a higher risk of losing control over when or how much you drink. They may also feel restless and irritable when they are not able to drink alcohol and have a tendency to continue using alcohol even when it begins to affect their health adversely.
Hence, there is a need for an alcohol assessment so that appropriate medical intervention can be recommended to the patient.

What is an alcohol assessment? 
The first step to receiving proper treatment for alcoholism is to recognize and accept that you have an alcohol use disorder. Most people find it difficult to escape the addiction as they are in denial about the true nature and extent of their alcohol intake. However, if you want to enjoy a healthy and fulfilling life, gaining independence from alcohol addiction is vital.

An alcohol assessment could be the first step towards this goal. Here are some symptoms that indicate a higher intensity of alcohol addiction and the need for prompt medical treatment.

Waking up at night 
If you wake up at night frequently to pass urine, it could be due to the increased consumption of alcohol.

Our body produces an anti-diuretic hormone that induces the kidneys to produce less volume of urine at night so that you do not have to go to the toilet frequently. However, alcohol can suppress the secretion of the anti-diuretic hormone, making your kidneys produce more urine due to which you have to get up at night frequently. [1]

Dryness 
Alcohol can dehydrate the body causing dryness of the skin and eyes. If you experience dry patches over your eyes the next morning, it could be a sign of excessive consumption. [2]

Poor sleep patterns 
Alcohol can interfere with the quality and duration of your sleep. It may prevent you from falling asleep causing an increase in the sleep latency period.
It can also prevent you from entering the deep phase of sleep called the REM phase. As a result, you will wake up feeling unrefreshed and drowsy. [3]

Impaired memory 
Alcohol can impact the cognitive functions of the brain. When consumed in excess, it may also affect your ability to recall any information or new skills you have learned. It can reduce your short-term memory to a great extent. [4]

Blackouts are also a common phenomenon linked to excessive alcohol consumption. Most heavy drinkers tend to lose track of what happened the previous night once they sober up. If you experience these symptoms frequently, there is a need to undergo proper medical treatment and counseling for alcohol addiction. [5]

Conclusion
An Alcohol assessment by a doctor can help you determine the extent of alcohol addiction or dependence. This will give you an idea of the amount or frequency of alcohol you consume, its adverse impact on your life, and how it has affected your personal life, career, and general well-being.

It will help you take the right steps toward alcohol treatment and improve the chances of successful outcomes.  Call us at 281-849-4080 to schedule an alcohol assessment with one of our board certified psychiatrists.

​References:
  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826793/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075667/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775419/
  4. https://pubmed.ncbi.nlm.nih.gov/15303630/
  5. https://www.webmd.com/mental-health/addiction/alcohol-abuse-self-test#1
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Impulse Control Disorder Symptoms

11/17/2020

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Impulse Control Disorder Symptoms – What are they?

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Impulse control disorders (ICD) refer to the conditions characterized by difficulty in controlling emotions and behaviors. The behavior of the patient often violates the rights of others and results in conflict with the law and societal norms.
The common forms of impulse control disorders include oppositional defiant disorders, conduct disorders, kleptomania, pyromania, and intermittent explosive disorders. These disorders tend to coexist in patients with alcoholism or addiction to recreational drugs. [1]
Also, men are slightly more prone to develop impulse control disorders than women. Here is a brief discussion about the common signs and symptoms of impulse control disorders.
​
Core Symptoms of impulse control disorders
The extent to which impulse control disorders share genetic, clinical, biological, and phenomenological features is not fully understood. Yet, several ICDs share a few core qualities as given below:
  • Diminished or complete lack of control over problematic behaviors
  • An insatiable craving or appetitive urge prior to the engagement in problematic behaviors
  • Repetitive engagement in violent or aggressive behaviors in spite of adverse consequences
  • A hedonic feeling or quality experienced while performing problematic behaviors
These features of impulse control behaviors have led to a description of these conditions being behavioral addictions.
These disorders appear to have clinical overlap with compulsive behaviors and possess the domain of impulsivity and compulsivity. However, compulsivity and impulsivity usually occur simultaneously or at different times, thereby complicating our understanding of their behaviors.

What are the common signs and symptoms of impulse control disorders?
The symptoms vary depending on the specific form of impulse control disorder a patient has. They may also show varying sets of symptoms depending on their age, gender, and the environment they are surrounded by. [2]
The symptoms of these conditions can be grouped under different categories such as physical, behavioral, psychosocial, and cognitive as discussed beneath. 
Physical symptoms:
  • Burn marks on patients who engage in fire-starting tendencies
  • Presence of multiple scars and injuries from engaging in violence or physical fights or due to the episodes of aggressive actions
  • History of sexually-transmitted diseases resulting from risky sexual behaviors
Behavioral symptoms:
  • Compulsive lying
  • Tendency for stealing
  • Participating in risky actions including sexual behaviors
  • Starting fires
  • Acting violently or aggressively against people including family members, animals, property, and objects
Psychosocial symptoms:
  • Agitation
  • Irritability
  • Anxiety
  • Depression
  • Isolating oneself from family and friends
  • A feeling of low self-worth
  • Frequent episodes of emotional detachment
Cognitive symptoms:
  • Acting on impulse
  • Lack of logical thinking behind actions and behaviors
  • Inability to remain calm and patient
  • Obsessive thinking
  • Compulsive thought pattern
These symptoms of impulse control disorders are more intense in patients with alcohol addiction. However, it has been found that proper treatment of ICDs together with counseling can help to control the aggressive and impulsive behaviors to a great extent. [3] [4]

Conclusion
Being aware of the symptoms of impulse control disorders can enable patients to seek appropriate medical intervention and prevent the harmful consequences related to the same. Find a psychiatrist near you for help. 
References:
  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3822522/
  2. https://www.resourcetreatmentcenter.com/behavioral/impulse-control/symptoms-effects/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895996/o
  4. https://americanaddictioncenters.org/co-occurring-disorders/impulse-control-disorder
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Addiction Treatment Near Me

11/10/2020

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The Ultimate Guide to Addiction Treatment

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I think we can all agree that:
 
Finding the BEST addiction treatment program is nearly impossible. You search for addiction treatment near me but just can't find the right place.
 
Or is it?
 
As it turns out, treating addiction is MUCH more effective when all of the care is customized to each patient.  It seems obvious right?  The problem is that this rarely ever happens, even when addiction centers make this claim.
 
So how is healthcare effectively customized?
 
It starts with careful planning to ensure top quality care from every aspect of treatment.  I will explain this in detail below. 
 
The treatment facility and all associated medical professionals play vital roles.  The location and treatment amenities must be energizing and motivating, but the quality of staff are even more important. 
 
Let’s start with therapists.  The American Psychological Association has agreed that the ability to bond or form a quality therapeutic alliance is one of the most important characteristics of a therapist.  While really good therapists can achieve this bond with a vast majority of patients, there are plenty of average therapists and difficult patients that will struggle to build an effective level of rapport.  This is particularly problematic within an inpatient addiction center as many facilities will not allow patients to choose their therapist.  Patients are assigned a therapist, and it is often impossible to switch, despite having a poor or non-existent therapeutic alliance.  This in itself can result in failed addiction treatment.  Therapists also have varying levels of expertise with each psycho-therapeutic modality.  Different modalities include cognitive therapy, interpersonal therapy, habit reversal therapy, etc.  Outpatient addiction treatment allows patients to determine the type of therapy used and an associated therapist with expertise in that treatment area.
 
While a therapeutic bond is important, addiction patients also need therapists with appropriate training.
 
That last sentence seems self-explanatory, but it isn’t.  Many addiction treatment facilities utilize licensed chemical dependency counselors (LCDC’s).  Quality LCDC’s are quite effective at teaching skills that support sobriety, and they have a strong role within the addiction field.  These chemical dependency counselors are very beneficial when utilized correctly, but they often aren’t.  LCDC’s should work effectively with licensed professional counselors (LPC’s) in addiction settings.  Quality LPC’s are not only trained in addiction but also in a broad range of therapeutic techniques to treat all mental health disorders. 
 
The ability to provide counseling across the spectrum of mental illness is vital to comprehensive addiction treatment.  The percentage of addiction patients with a serious mental illness ranges from 30-60%, depending on the research study that you read.  Pay attention to the bolded word above – serious.  The majority of the remaining patients without a serious mental illness experience a lower degree of symptoms or mental flaws that could benefit from counseling.  Actually, it is my opinion that we could all benefit from quality counseling. 
 
Treatment for addiction should thus include dedicated treatment with a LPC or even more experienced - PhD level therapist.  Many addiction treatment centers do not include such highly trained therapists or do not have enough to support the volume of patients.
 
In my experience, individual counseling with a LPC should start with 2-3 sessions/week for at least 3 weeks before decreasing frequency.  Patients need to build a firm foundation in therapy, so that the techniques can be practiced effectively outside of appointment times.  Relapses should prompt more frequent treatment.  Few inpatient centers will provide this level of care. 
 
Effective counseling is one of the most important aspects of addiction, but medication management is also vital for those requiring medical detoxification or treatment of a serious mental illness.
 
Medication management is typically the realm of a physician.  Any physician trained in addiction should be able to properly detox a patient and significantly reduce withdrawal symptoms.  Proper detoxification does not eliminate the risk of seizures or other side effects, but it does significantly reduce the severity and likelihood of complications.  Even with minimizing risks, some patients will encounter complications that may require medical hospitalization.  Many patients can be safely detoxed in an outpatient setting, but certain risk factors (like past withdrawal induced seizures) may require an inpatient center for 24/7 monitoring.
 
Detoxification is just the start of medication management.  As I mentioned earlier, 30-60% of patients with addiction have a comorbid serious mental illness.  The only type of physician well trained in identifying and treating the full range of mental illness is a psychiatrist, but not all addiction physicians are psychiatrists.    
 
Ideally, addiction patients in an inpatient setting should see an addiction physician (psychiatrist or not) for an initial evaluation to manage detoxification.  Once detoxification is complete, an evaluation should be scheduled with a psychiatrist to identify and manage any mental health issues.  The problem is that insurance companies will generally not pay for 2 evaluations during the same admission or with the same physician.  To obtain this level of care, the patient must utilize separate physicians for detox and a later psych evaluation or pay cash.  Insurance companies expect the initial detox evaluation to include all relevant mental health information.  The people making these decisions at insurance companies have obviously not attempted to perform a thorough psychiatric evaluation on someone experiencing substance withdrawal.  Imagine trying to obtain a detailed mental health history on someone with acute appendicitis.  It can’t be done well.  The same could be said for someone going through acute withdrawal and trying to accurately present a life history. 
 
Beyond having the proper personnel in LCDC’s, LPC’s, and a psychiatrist for individual sessions, most treatment facilities include group therapy.  Group therapy is led by a therapist, but peers are generally allowed to share their experiences.  While some peers will provide valuable support and additional sobriety skills, others can be disruptive.  I’ve seen many pleasant people leave group settings demoralized because of a peer’s behavior.  The counselor leading the group should be able to quickly enforce rules and boundaries.  Unfortunately, this is another area where insurance companies interfere with quality treatment.  Treatment facilities may not receive reimbursement if patients are not attending groups, so counselors often provide too many chances to the offender at the detriment of the group.  Another alternative would be having separate groups based on personalities, but this requires additional staff that facilities often cannot afford.
 
Individual therapy is not interchangeable with group therapy.  Insurance companies do not agree here either.  Many addiction treatment centers continue to use group therapy as the main source of counseling as it is more cost-effective.  This cost-cutting is to the detriment of the patient.  Individual counseling is a necessity to identify personal maladaptive behaviors, treat co-morbid conditions, and encourage individual growth.  Sadly, many treatment centers provide less than 1 individual therapy session/week.  Infrequent therapy is ineffective therapy.
 
Counseling and medication management are major aspects of addiction treatment, but there are other smaller considerations that can contribute to effective care. 
 
The environment and facility amenities significantly contribute to effective addiction treatment through elevating morale and maintaining motivation.  Between physician appointments, group therapy sessions, individual therapy, and other treatment modalities, there is a lot of concentration and personal growth packed into each day.  Over the course of 30-90 days, you can imagine how difficult it must be to continually stay motivated and focused.  This is less of a problem with outpatient addiction treatment as patients can maintain their hobbies and activities.  At inpatient centers, there should be enough fun activities, amenities, and exercise equipment to re-energize and relax from the intensity of each day.  Few provide many amenities, and the result is irritable patients that provide less than ideal effort.  Without sustained effort, treatment is less likely to be effective.
 

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​Now that we have discussed the important ingredients of treatment, let’s emphasize the positive and negative attributes of outpatient, partial hospitalization, and inpatient treatment programs.
 
Inpatient treatment centers are the most intensive forms of treatment that were originally designed for high risk patients.  They provide 24/7 monitoring, and the patient will live in the facility for an agreed upon time.  People that have had complicated withdrawals in the past (like seizures) should only detox in an inpatient center.  Inpatient centers often accept patients from all across the country and help to arrange flights.  Removing the addicted patient from his or her home environment should prevent easy relapses from known sources of substances.  It also makes it more difficult to abruptly leave treatment as family and friends are not nearby to interfere with treatment.  Patients that attempt to leave early with be met with internal interventions.  This level of care is also the easiest to set-up as the patient can only receive whatever treatment is available at the facility. 
 
The downsides of inpatient treatment begin with the inability to make major alterations in the care plan.  Each admitted patient replaces a discharged patient and similar treatments continue for better or worse.  Inpatient centers include living arrangements, food, and an abundance of staff.  To keep the facility relatively full, inpatient centers often utilize sales staff.  The sales team may be staffing many addiction centers, and they are unlikely to have actually seen more than one of them.  They are human and can make mistakes.  Once admitted to an inpatient treatment center it is quite difficult to abruptly change to an alternative treatment center.  This makes sense as the patient and their families spend a lot of time with interventions, coordinating with insurance companies, researching treatment centers, planning time away from work, finding child care, etc.  After extensive planning that includes many family and friends, few new patients will be able to convince their loved ones that it is in their best interest to leave and start the planning process again.  
 
Partial hospitalization or intensive outpatient programs are hybrid care programs that include the many resources of an inpatient treatment center but without the higher level of monitoring.  Some provide housing and meals.  None provide 24/7 monitoring by medical staff.  Many will accept patients straight into this level of care and others will require all patients to complete their inpatient program first.  Programs can vary significantly in how much care they provide and expected hours.  Some will provide detoxification services and others will not.  The similarities and differences between different partial hospitalization and intensive outpatient programs is so variable that it is hard to provide accurate, generalized positives and negatives.
 
Outpatient addiction treatment is certainly the most flexible and customizable.  Interested patients can choose their psychiatrist and counselors from the community.  Treatment providers can be abruptly changed if not fulfilling the needs of the patient.  Care can become more or less frequent based upon progress.  The detoxification process can be extended to allow a more comfortable withdrawal process.  Patients can continue to live at home.  They can continue or re-enter their career as soon as possible.  Permanent resources can be established nearby to ensure continued abstinence.  Family or marriage counseling can be added to help rebuild relationships and provide healing to affected loved ones.  Local group therapies can be continued long-term.  Sometimes it takes attending 10+ groups to find the ones where you fit in.
 
The problems with outpatient care is that it requires more planning and active engagement. This may require personally coordinating a treatment program between a couple mental health clinics.  Unmotivated patients may quit treatment abruptly whereas a distant inpatient center would perform their own interventions.  Relapsing with known nearby dealers is a common problem.
 
Regardless of the type of addiction treatment initially chosen, the goal should be effective integration into society.  This may include new living arrangements with family or friends.  When no other option is available, some patients will live in sober communities or halfway houses.
 
Even when customizing treatment, patient motivation and desire is the most important aspect of treatment.  The best resources in the world can be provided, but relapse is guaranteed when the patient is apathetic or refuses to be present in treatment.  For those waffling with the idea of abstinence, engaging with a therapist exceptionally trained in a therapeutic technique called motivational interviewing may be the impetus to the start of a sober/clean life.

Actionable tips:
  1. Who are the counselors and what are their individual areas of expertise? 
  2. Can counselors be individually selected or changed?
  3. How much experience do the counselors have?
  4. What are the topics for group therapy sessions and are they well monitored?
  5. How many individual therapy sessions with a LPC occur per week?
  6. Is there a psychiatrist on staff?
  7. Are full psychiatric re-evaluations performed?
  8. How many days does detoxification typically last and can it be extended?
  9. What amenities are on site?  Can I see recent photos?
  10. What restrictions does the facility have related to personal items and computer access?

The ultimate treatment for addiction is not generalized, so it is important to honestly assess and coordinate your treatment around your individualized needs.
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Mental Health Center

11/3/2020

16 Comments

 

5 Crucial Services Your Mental Health Center Provides


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If you have ever had the chance to visit a mental health center near you, you must have noticed different specialists treating different categories of people and diagnoses. The services your mental health center provides range from anxiety disorder treatments to family therapy. Here are five essential services you will likely find when you go in for mental health services.

Mental Health Diagnosis And Referral

The mental health center is not just for those with diagnosed mental health issues. Anybody that suspects they might be suffering from one can make an appointment and request assistance. They also provide support through the diagnosis and treatment. If they can’t provide the needed services, they can refer the patient directly to a different therapist who can help. For emergencies, you should dial 911 or head to an emergency department.

Special Mental Health Services

Regular therapists can’t always handle all mental health issues depending on the nature of the ailment. Patients with neurodegenerative conditions, personality disorders, intellectual disability, and extreme PTSD may need more specialized treatments and would need to be seen by a psychiatrist or psychologist. 

Digital Support

Not everyone can access a mental health center physically due to various challenges like disability, remote locations, or other constraints. Fortunately, most health centers offer digital support for such patients in the form of phone and online services. These are usually in the form virtual visit platform or website where they can get advice and support for minor mental health issues and even get prescriptions. 

Personal Mental Health Services

Not every patient will benefit from community health care services because some ailments require personalized care. These patients should reach out to a mental health provider like Your Family Psychiatrist who can provide personalized psychiatric care. 

Medication Support

Some patients require medications to help them treat or manage their mental health issues. Your psychiatrist can prescribe and manage the dosage and response to these medications. 

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