As a psychiatrist, I use the same core principles at every age: listen carefully, evaluate safety, consider medical and psychiatric causes, and build a plan with the patient and family when appropriate. What changes across the lifespan is how distress appears, who can provide useful information, which risks matter most, and how treatment must fit … Read more
When I evaluate possible ADHD, I do not start with the assumption that every attention problem is ADHD. I start with the pattern: when the difficulty began, where it occurs, how persistent it is, and what it disrupts. ADHD can affect attention, impulse control, organization, activity level, and emotional regulation, but anxiety, depression, trauma, poor … Read more
When someone comes to me with depression, one of the most important questions I ask is whether the lifetime history includes mania or hypomania. Depression can occur in both major depressive disorder and bipolar disorder. The current low mood may look similar, but a past episode of abnormally elevated or irritable mood and increased energy … Read more
When I meet a patient for an initial psychiatric evaluation, my job is to understand what is happening, how it affects daily life, what may be contributing, and which next step is most appropriate. The visit is a structured clinical conversation, not a test that a patient passes or fails. Sometimes I can establish a … Read more
When I discuss transcranial magnetic stimulation, or TMS, with a patient, I explain it as a noninvasive prescription treatment that uses repeated magnetic pulses to influence activity in targeted brain networks. It does not involve surgery or an implanted device. I also explain that TMS is not one universal treatment: devices, coil designs, targets, schedules, … Read more
When I manage psychiatric medication, I am not simply choosing a prescription. I am building and testing a clinical plan with the patient. I want to understand the diagnosis, the symptoms we are targeting, the effect on daily life, prior treatment, medical history, side effects, and what the patient is comfortable doing. Two people with … Read more
