INSTRUCTIONS,
HELPFUL INFORMATION,
AND RESOURCES
FOR MY PATIENTS
Safety first. Always. If you are unsafe for any reason please seek emergency help.
Go to the ER or call 911 if you can't otherwise get and stay safe from harm.
At the beginning of treatment you should ALWAYS discuss your mental health symptoms with your primary care provider. On occasion, the entire cause of your symptoms turns out to be medical. And often medical problems can cause your mental health to worsen. So your primary care provider must do a thorough medical evaluation to look for any medical cause or anything contributing to your symptoms. They have been trained for this and know which diagnostic tests to run.
Learn all you can
---Learn about the conditions you have been diagnosed with and things that can help. At this site, you can type any condition into the search bar. You can also look at the list of conditions and other information below it. https://www.psychiatry.org/patients-families
---Also important for safety. Read all your prescribing information thoroughly so you know everything you need to about your medications. This comes with your medication. If there is even a slight risk that you could become pregnant, you should pay particular attention to that information regarding the medication. Many medications are safe to take in pregnancy and it is common to continue treatment. But some medications can be dangerous. So you should consult with psychiatry and obstetrics for a safety evaluation. I highly recommend that all who could possibly conceive a pregnancy consider being on a highly effective form of contraception and to discuss with their PCP and their gynecologist.
-You can look here for information about your medication https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications
-Supplement information https://www.webmd.com/vitamins/index
-You can enter all medications you take here and check for interactions https://www.webmd.com/interaction-checker/default.htm
-If you have questions or concerns about your medications, schedule an appointment with me ASAP.
TALK TO A PROFESSIONAL WEEKLY
READ THIS! Why and how does therapy work? Why is it important? https://www.apa.org/topics/psychotherapy/understanding#:~:text=Psychotherapy%20helps%20people%20understand%20that,school%2C%20or%20thinking%20more%20positively
I recommend that you see a counselor/coach/or therapist *weekly*. This should typically continue until your mental health professional tells you otherwise. That does not mean that you are stuck with someone that you don't click with. I always say that providers of all types, myself included, are like shoes. If you wear them a few times and they don't fit, you should not keep wearing them just because. Mental health professionals have no problem with you switching to someone that you can flow better with and recognize that it is more important that you get the help you need.
While there are similarities, and for the most part your sessions will involve talking about your concerns and getting guidance on how to cope and tools; there are differences in training, state licensing, and insurance coverage between counselors, coaches, therapists, psychologists and the like. So it is helpful to know their credentials and background. You can ask them before your visit.
It may be difficult to find a professional that takes your insurance and/or your employer's "EAP program" (ask HR at work about this) who is accepting new clients. Don't give up after calling 1 or 2. Work your way down the list until you find someone. If you call everyone on the list and truly cannot find one at this time, you may want to consider paying out of pocket if you are really struggling. Some health savings account programs will allow you to use those funds for payment of costs including co-pays so check with them and see what is possible. And remember that virtual platforms often offer weekly therapy or coaching. Some take insurance and others do not. If you have trouble finding one that is covered by your insurance, call your insurance company and ask for help. Sometimes their databases are hard to search and it is easier to ask a human if you can.
Another important type of therapy is group therapy https://www.apa.org/topics/psychotherapy/group-therapy . Groups are helpful in that you can participate with a group of your peers who have had the same problems that you are coping with. For example some group types include; grief, divorce, single parenting, addiction, depression, anxiety, etc. You can check with local hospital systems, medical clinics, psychiatric programs, and similar entities. You can search online for local in person or virtual groups.
If you have a problem with addiction or a family member does you may want to consider your local "Anonymous" programs:
Start today! Right now even! In the Rooms has online group meeting all day long on a variety of topics https://www.intherooms.com/home/
Alcoholics Anonymous (AA) https://www.aa.org/
SMART Recovery (non-religious)
https://www.smartrecovery.org/
Gamblers Anonymous (GA) https://www.gamblersanonymous.org/ga/
Al-anon is for family members of those with addiction problems
SHOULD I TAKE MEDICATION FOR MY MOOD?
The most common thing I hear from my patients a few weeks or months after starting medication is that they only wish they had started treatment a lot sooner. Usually they say this with tears of relief and joy in their eyes. It's bittersweet. They did not have to suffer from their symptoms for so long. They did not have to work SO HARD EVERY DAY to keep on keeping on. They did not have to pull up those bootstraps constantly to get through moment to moment coping with all they had to handle.
They also tell me their only regret about treatment is letting things go on for so long untreated. That it really has helped. That it makes everything so much easier with that support for their mood. Yes, it is always worth trying therapy if you are not certain that you want to be on medication. As I say here, I always recommend weekly therapy anyway. But if you are not improving with therapy alone pretty fast (off medication), you may want to think about being on treatment with medication for at least 9-12m. Studies have shown us that stopping sooner, most patients will start to feel the same symptoms as before. And while you are taking medication, that is a great time to learn the tools and skills you need like those here. That way you have them in place when you do stop. Then you will know how to manage your moods with, or without medication. When ready to stop, you should work with your prescriber on a weaning plan. Your dose is gradually decreased over time so that you don't have significant withdrawal symptoms and so that you gradually adjust to being off the mood support the medication provides. However, you would never want to start unless you felt 100% certain that it was the right thing for you. And, I hate to see people suffer year after year, decade after decade without help that makes things easier. If you want to try without medication it is critical that you modify your lifestyle drastically so that you are doing all the other things. What can make this difficult is that when you are having problems with your mood, often you have very little motivation, energy, focus, ....all the things we need to launch such a huge effort. If you are on the fence about taking medication, I want you to have the benefit of knowing this information as you make decisions about how to proceed. The decision is always up to YOU. I will support your decision regardless of if you decide medication is for you or not. You CAN continue to see me for visits to check in. That way you have access to ask me any questions you have about treatment. You can do all the other things listed on this website for now and I know that it will help in some way. If you find that isn't working, I suggest you schedule a follow up soon to talk it out and consider medication again.
It is very important that you know about your prescriptions and that you take them as directed.
ALWAYS Read the med information document that comes with it every time you get a new bottle, even if you have been on it for a long time. There are important side effects, interactions, and instructions on how to take the medication. You need to know this information. The information may change over time. If you have strange symptoms, if you have not learned the side effects of your medication, you may not recognize it as a serious side effect that you should report to us for your own safety. So reading and knowing that information is really important. It also helps to know which common side effects that are not harmful, so that you know what can be expected when you start medication.
IT IS VERY IMPORTANT THAT YOU ARE AWARE OF ANY WARNINGS REGARDING THE MEDICATION.
THESE ARE GENERALLY CALLED "BLACK BOX WARNINGS".
READ THE LABEL EVERY TIME YOU TAKE A PILL OUT
Always take a moment to check the label on the bottle too to be sure you are taking it correctly. Sometimes when you start at a lower dose and then increase it over time, with subsequent refills we will increase the strength of your tablet or capsule and drop you back down to 1 daily. So making sure you are taking the right dose is important for your safety.
On most platforms, you will eventually see your list and info for each med on your profile. If you do not have access to the medication information yet, WebMD is a great resource to look it up.
You can and should always check interactions between medications and can easily do so there.
And remember, every time you see a medical provider you should make sure they have your complete list of prescriptions, over the counter meds, vitamins, supplements, herbals, alternative therapies, etc. so that they can check for interactions. For this same reason it is always best to use the same pharmacy for all prescriptions when possible. And you should also check for interactions yourself by running them through the interaction checker on WebMD. This is very important for your safety. Please update us anytime you stop or start anything you take.
HOW TO START NEW MEDICATIONS OR CHANGE DOSES
When you start a new medication for your mood, or change doses, make sure you plan ahead. You should plan this when you have a day or two when you do not have to work, drive, operate heavy machinery, care for small children, or make important decisions. Sometimes when you start a new medication for your mood you may feel extra fatigue, wooziness, "out of it", or have nausea, headache, etc.. Typically these side effects go away or you get used to them within a few days. Let us know if any red flag or significantly bothersome side effects occur. But you want to know this and plan ahead, so that you can be safe and have time to adjust.
Many medications for mood may take a few weeks to a few months to feel effects or the full effects. I heard someone describe it as having to get through the forest to the other side. So don't expect to magically feel better as soon as you start. It is a process. The non-medication interventions discussed below start pretty quickly though! So focus on maximizing your use of these tools and ramping up to living the healthiest lifestyle you can. Get started on learning about your conditions and how to manage symptoms. Get into counseling/coaching/therapy/groups right away. They too will help tremendously. Remember, you cannot build a house with only a hammer. And medication alone may help, but to get better in a big way, you need to make some big life changes. It sounds like a lot, but trust me that the little things add up, so keep doing as much as you can to get better every day. One day you will see that things are much improved and it was worth all of the effort.
SPECIFIC SIDE EFFECTS AND INTERACTIONS TO BE CONCERNED WITH
If you have any side effects that bother you a lot, you should always let us know right away. There are some that are particularly concerning that you need to know about so that you know to stop your medication, seek medical care immediately, and then let us know right after. That would include:
SEROTONIN SYNDROME (click here to read more on this)
SEIZURES
NEW , UNUSUAL or WORSENING SUICIDAL FEELINGS
UNUSUAL RASHES
SEEK HELP IMMEDIATELY!
It is also important that you know that EXCESSIVE SEDATION can occur.
LIMIT DRIVING OPERATING HEAVY MACHINERY AND OTHER ACTIVITIES REQUIRING ALERTNESS!
REPRODUCTION AND FERTILITY
If you are attempting to become pregnant, are or think you may be pregnant, are having sex without any or inadequate contraception, or you are breastfeeding or planning to, it is important for you to know that some medications can cause harm to a fetus, or you, when pregnant. Certain medications are safer to use in pregnancy. But others may cause serious pregnancy complications. I always recommend that everyone prevent unplanned pregnancy. This is true regardless of which partner is carrying the baby. Having a pregnancy that is unplanned at minimum creates many layers of complexity in your life. And when you are coping with uncontrolled symptoms of anxiety, depression, etc. having an unplanned pregnancy can sometimes cause your life to get very stressful. So everyone should be ready, very prepared and plan ahead for conception when the time is right. That does not always happen. Actually most pregnancies are unplanned. So it is important that if you are at risk of becoming pregnant that you are using a highly effective form of birth control. Talk with your primary care provider, gynecologist, or urologist about the most effective ways to prevent an unplanned pregnancy for your specific needs and about how to achieve a safe health conception when you are ready. And if you may or do become pregnant or plan to start breastfeeding, you should always speak to your primary care provider and all specialists like me about this ASAP. Your prescriptions, over the counter preparations, vitamins, supplements, herbals and alternative therapies should be discussed as some may not be safe to continue taking. If you are planning to become pregnant, you may need to stop or switch certain medications. And those who are pregnant had safer treatment options to choose from. So you don't have to stop treatment in most cases which helps you stay on your path to mental and physical wellness.
WHAT IF MY MEDICATION IS NOT WORKING?
Like I mentioned above, it takes a few months to reach optimal effect. That is why in many cases we increase your dose after a week or so to get you there faster when we can. But sometimes the first, second, third, etc. medication you try does not work well. The good thing is that there is a very long list of medications to try. There are different categories to try too. And sometimes certain medications can be combined for better effect. It is important for you to know this because we don't want you to feel like things are hopeless if the first thing we try does not work. Getting on the right medication plan for you can sometimes be a process. It is important to stick with it so that eventually things can get better. And if you try a few medications and they do not work, sometimes you will then qualify for more advanced treatments. As we work through the process, we will make adjustments and consider referring you for more advanced care and treatments if you are not improving.
RECOMMENDED VITAMINS AND SUPPLEMENTS
It is always best to get vitamins, minerals, fatty acids, pre/probiotics, etc. from your diet.
If you do not get enough from the foods you eat, it may be necessary to take supplements.
Unfortunately, on average, the human diet is FAR from optimal.
So often supplements are needed.
Talk to your primary care provider to see if you need lab tests to determine if you have any deficiencies.
In particular, I recommend the following because deficiencies may cause mental and physical health symptoms:
- B Complex vitamin daily for better brain and nerve function
-B12 1000mcg daily for better brain and nerve function
(If you are over 50, vegan (or trend vegan), have altered digestion from chronic illness, have anemia, or take certain medications (PPIs, H2-blockers, metformin, you should consider taking 5000mcg daily)
-vitamin D3 For better energy, brain functioning and sleep
take 4000-5000units daily on days when you are exposed to sunlight. On dark days, take 2 of those.
-magnesium threonate for better mood, sleep, focus, attention Take daily as directed on the label. Dose varies depending on product.
-essential fatty acids EPA/DHA Take daily as directed on the label. Dose varies depending on product.
-melatonin for sleep support 1 to 5mg (10mg for significant trouble falling asleep) take each day after sunset
-take prebiotics and probiotics every day if you cannot eat sufficient amounts in your diet....and most people can't
we are talking large volumes of fresh vegetables mostly green and some fruits for your prebiotic intake
and large amounts of probiotic foods (kombucha, vegan or goats milk yogurt, goat cheeses, fermented foods, etc.)
How much of those are you truly getting in your diet?
You should be getting a lot! But if you can not or are not, take a supplement.
helps with brain and nervous system health, immune support and for digestion
look for high quality products
probiotics should be refrigerated
SUPPORTING YOUR MICROBIOME (microbiota)
WITH INTAKE OF PRE AND PRO BIOTICS
IS VERY VERY IMPORTANT FOR JUST ABOUT EVERY BODY SYSTEM AND FUNCTION!
Basically all that we are inside, everything our body does, is built upon the structure of our microbiome made up of microbiota.
Do you "feel it in your gut"? Pay attention to that mind-gut connection.
And learn more about the importance of your microbiome below.
TOOLS ARE ESSENTIAL
One of the most important things you can do is to fill your mental tool box with the right equipment to help you live your best life. Mental tools are things like learning ways to change negative thinking patterns (CBT, DBT), breathing exercises/breathwork, meditation, stream of thought journaling, music/art therapeutics, laughter therapy, etc.
It is best to learn about these tools in a session with a professional so that you have information customized and prioritized for your own unique needs. But, if you can't see someone very soon, there are lots of things you can learn before that appointment. So don't delay! Start building your toolbox today.
And if you are a Cerebral.com client, you can access many tools in your app and on the website when you are logged in. So check out the great stuff there too!
Important resources with links to videos and articles are below.
"IF YOU CHANGE YOUR BRAIN,
YOU WILL CHANGE YOUR LIFE."
Dr Daniel Amen, neuropsychiatrist
IF YOU DON'T CONTROL YOUR MIND,
YOUR MIND WILL CONTROL YOU.
It is interesting to think about how our thoughts, good and bad, can sometimes become our reality. And consider this; We have been taught many things from birth. Our families, communities, and the world have all provided us with specific prescribed lessons that are common in our cultures. But, who has ever taught you to control your mind?
Most likely your answer is no-one. There usually is no formal education on how to control our brain, so that it is not controlling us. And without proper training, our thoughts can be like puppies running around and chewing up things and making a huge mess. An untrained mind can do the exact same thing with your life and your spirit. It can be very destructive.
That is not to say that one should use mind control to make abusive situations acceptable. Nor should we train our minds to do other unhealthy things. But we can shift our patterns of thinking so that we are behaving, speaking, coping, and thinking in healthy ways. But how do we start taking control of our thoughts so that we can do better for ourselves? Keep reading to learn more.
"Fight, flight, hide, or play dead" is a simple way to explain that there are various ways organisms, including humans, might respond to perceived threats. Each of the four options represents a different strategy for dealing with danger:
Fight: This involves confronting the threat directly and attempting to overcome or defeat it. It's an aggressive response aimed at protecting oneself.
Flight: This response involves escaping or avoiding the threat. It's a defensive strategy focused on creating distance from the danger.
Hide: Hiding is a strategy where the individual seeks cover or concealment to avoid detection by the threat. It's a more passive approach to self-preservation.
Play Dead: This response, also known as "playing possum," involves feigning death or helplessness. Some animals, when facing a predator, may go limp and appear lifeless, hoping that the threat will lose interest and leave.
These responses are part of the body's natural stress response and can be observed in various animals, including humans. The specific response chosen depends on factors such as the nature of the threat, the individual's assessment of their ability to cope, and the environment. Additionally, the fight/flight/hide/play dead response is not always a conscious decision; it often occurs automatically and is influenced by the autonomic nervous system.
Why is this important? Consider that if you are walking in the woods and you encounter a poisonous snake, your mind and body will automatically go into this protective state. That is great when you are in true danger. You need this for your well-being.
But what happens to many people is we are being triggered by known situations, and sometime unknown situations that cause us to want to:
~>fight with people physically or verbally
~>run away from people and situations
~>avoid things we may want and need like jobs or schooling
~>isolate ourselves from others
YET WE ARE IN NO REAL DANGER!
Having this kind of response to things when we are not in real danger can really mess up our lives. We can miss out on really important or wonderful things.
For example someone might:
X really want to go on a fun vacation - but can't get on a plane
X want to have a specific career path but can't start or complete a program or go to work
X not be able to have a partner, friend, be close to family (that are healthy for us)
And sometimes when triggered (and sometimes for no reason) people may have negative thinking about themselves, others, situations, and things. Negativity can be toxic and also VERY HARMFUL to us and our lives.
Learning to control our thoughts and minds is a critical life skill.
So how do we do this?
Consider this, there is only so much "real estate" in our brain for our thoughts at any given time. In other words, while the brain is capable of processing multiple thoughts simultaneously, our conscious awareness usually is more focused on one thought or task at a time. And when we have anxiety/panic inducing or negative thinking, often our brains are hyperfocused on these. We can leverage this!
Imagine your brain is a stage for thoughts. Typically we will have one performance on stage at a time. Well, often when we are triggered that performer is a BAD ACTOR! That thought has to go. CLOSE THE CURTAINS AND TURN OFF THE SPOTLIGHT! We need to get that stuff off the stage PRONTO. And we need to make room for thoughts that are helpful useful calming and positive.
Step one is to learn to be mindful so that you can recognize these thoughts. When you are really upset, you won't need this skill because the problem thoughts will be top of mind. But we want start learning to catch these thoughts early on before they grow and cause us to start mentally spinning in circles. So on a regular basis, check in with yourself. Ask yourself what is on your mind's stage. Doing this exercise will help you to be able to notice BAD ACTORS while they are auditioning and long before your whole production is riding on them. That does not mean that even when you do this well you will always be able to head these off at the pass. And if you don't recognize these intrusive thoughts early on, no worries. You can always catch up. But save yourself a lot of stress and learn to be monitoring your thoughts on the regular.
When you do recognize stressful anxious panicky or negative thoughts, the best thing to do is take a moment to reboot. When your computer goes haywire, you press and hold that power button. You can do that with your brain too. Either visualize or actually take your fingers and press on your forehead. While you do this, take some nice slow deep cleansing breaths. The 4 seconds X 4 Box Breathing exercise works great. Breathe in 4 secs. Hold 4 seconds. Out 4 seconds. Hold 4 seconds. Do this a few times until you feel your body and mind start to relax at least a little.
After that you should take a moment to consider what the negative thought was and develop a counter thought that is calming soothing and positive. For example, if someone is afraid to fly, up in the air, and they hit a little turbulence, what will they think? THE PLANE IS GOING TO CRASH!!! WE ARE ALL GOING TO DIE!!! They may even start to have a panic attack which can be problematic at that time for sure! So a good counter to that is, "It's just like a speed bump. It's just like a speed bump. It's just like a speed bump." They can repeat that thought over and over in their head to "crowd out" the bad thought so to speak. You may have heard of Cognitive Behavioral Therapy techniques (CBT). It may have seemed very unclear exactly what this is. But programming your brain in this manner is CBT. And clinical studies have proven that CBT is very effective.
And here is the cool thing. You most likely won't have to spend the next 3 and a half hours doing this. Our brains are very fickle. Once we are calmed down so the thought is not growing and taking over, our brain will in short order (a few minutes) start thinking of different things that are just normal thoughts because whatever we were stressing about is no longer taking center stage in our life. Now that you have this very important tool in your wellness toolbox you will be able to take solid control of your brain and thinking so that you can have better control of your emotions and life.
Sometimes it's hard to determine what our minds are up to. To figure out what your mind is doing and to figure out life problems that are bothering you, read my blog post on Stream of Thought Journaling
To stop a panic attack in it's tracks read my blog post Panic No More
Learn more about Cognitive Behavioral Therapy Techniques here
https://www.youtube.com/watch?v=aAVGyRMS3gE
Dialectical Behavioral Therapy (DBT) typical involves being in therapy with someone who is a DBT specialist and sometimes a structured program with multiple professionals. So, you should consider connecting with this type of professional and enrolling in a program. This is particularly true if you have; a lot of conflict or relationship problems, frequent negative thinking patterns, difficulty controlling emotions or impulses, problems with drugs or alcohol, post traumatic stress disorder, borderline personality, suicidality or self harming behaviors, eating disorders, body dysmorphia, and the like. Until you are able to get established with a therapist or program, you can begin to learn about some DBT skills.
Learn about Dialectical Behavioral Therapy Techniques here
https://www.youtube.com/watch?v=wkxOICjG2is&list=PL4Qw4-tlRJe-T2l5MtFOsLkTIkfZqjobY
This is a great book that is helpful in learning DBT skills; The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, ... by Matthew McKay PhD (Author), Jeffrey C. Wood PsyD (Author), Jeffrey Brantley MD (Author) https://a.co/d/4h0t5nA
MINDFULNESS AND MEDITATION
TedTalk on Mindfulness/Mindful Living
https://youtu.be/IeblJdB2-Vo
Mindfulness Article Psychology Today
https://www.psychologytoday.com/us/basics/mindfulness
https://www.youtube.com/watch?v=m8rRzTtP7Tc
https://www.youtube.com/watch?v=uqGTphrGHi4
BREATHING EXERCISES AND BREATHWORK
Breathing exercises for anxiety
https://www.youtube.com/watch?v=sJ04nsiz_M0
ADEQUATE QUALITY SLEEP
One of the single most important things we can do is to get adequate quality sleep. Sleep routines and sleeping in a cool, dark quiet room are all essential. Sleep procrastination is a huge problem in our modern society. Devices steal our hours of rest nearly every night. It is critical that we learn and practice good sleep hygiene. The National Sleep Foundation has excellent articles to help you with whatever sleep challenge you may encounter. https://www.thensf.org/sleep-health-topics/
Next time you can't fall asleep, try the Sleep Talk Down Meditation
https://www.youtube.com/watch?v=69o0P7s8GHE
FOOD REALLY IS MEDICINE
"You are what you eat." "An apple a day keeps the doctor away." "Food is medicine." There is a reason that there are so many old adages about healthy eating and it is because they are absolutely true. If you investigate the healthiest of diets, most sources will say that it is a whole food, plant based, unprocessed organic diet rich in prebiotics and probiotics. Period. End of discussion. While this may be true, it is a lot easier to say that than to do it. What I recommend my clients do is simple. 1) Start where you are. Look back over the past few typical days and write down everything you have eaten. 2) Identify just one simple thing to change in the direction of an optimal diet. 3) Do that for a week or two. Keep doing it or tweak what is not working. 4) Then, do this again. Then, do it again. And again. Before you know it, your diet will be much healthier and you will be feeling better. Our brains simply do not function well on a diet that is unhealthy. That includes our mental health. Optimizing your diet is critical to achieving your mental health goals.
Changing Your Diet Can Help Tamp Down Depression, Boost Mood
https://www.npr.org/sections/thesalt/2019/10/09/768665411/changing-your-diet-can-help-tamp-down-depression-boost-mood
https://www.webmd.com/food-recipes/features/the-whole-foods-diet
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/organic-food/art-20043880
Will the real whole grain please stand up?
https://health.clevelandclinic.org/the-whole-truth-about-whole-grains/
https://asm.org/Articles/2020/February/Of-Microbes-and-Mental-Health-Eating-for-Mental-We
To gluten or not to gluten?
https://gundrymd.com/gluten-free-foods/
https://www.health.harvard.edu/staying-healthy/ditch-the-gluten-improve-your-health
“IF YOU DON’T MAKE TIME FOR EXERCISE, YOU’LL PROBABLY HAVE TO MAKE TIME FOR ILLNESS.”
Robin Sharma
GET OUTSIDE IN THE SUN, GET MOVING, AND GET SOCIAL FOR YOUR MENTAL HEALTH
Exercise to help mental health
https://www.smithsonianmag.com/science-nature/how-exercise-boosts-the-brain-and-improves-mental-health-180979511/
Why sunlight is so good for you
https://time.com/4888327/why-sunlight-is-so-good-for-you/
Sun lamps to improve winter mood
https://health.clevelandclinic.org/are-sun-lamps-best-to-improve-your-winter-mood/
The health benefits of socializing
RX; ART AND LAUGHTER
Art and music therapy seem to help with brain disorders. Scientists want to know why
https://www.npr.org/sections/health-shots/2022/02/19/1081263873/mental-health-art-therapy
Humor in Psychiatry: Lessons From Neuroscience, Psychopathology, and Treatment Research
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.681903/full
The Hilarious World of Depression American Public Media
https://podcasts.apple.com/gb/podcast/the-hilarious-world-of-depression/id1181589175
ENVISION YOUR FUTURE, SET GOALS, AND NEVER GIVE UP
It's hard to get where you want to be if you don't know where you are going. Set some time aside to sit with yourself so you have some time alone to think about your future. What do you want it to look like? You can write down your thoughts, draw pictures, make a collage. Set your intentions in a tangible way so that you can have something to remind you every day of your hopes and dreams. Once you have a vision of what you want your life to look like, set long term goals. Break those down into smaller short term goals. Use the SMART goal format so that they will be effective. Your vision and goals do not have to be elaborate, fancy, or expensive. Sometimes living a simple life is the most direct route to finding joy in every day. But your vision and goals should reflect YOU and what YOU want out of your life. It is also important to remember that your vision should and must change over time. After all living a full life means that things change all the time.
I highly recommend the Mel Robbins Podcast for highly valuable information on transformative life changes and even just a few techniques to get you started if you not ready for big change.
You can find her on multiple platforms like Spodify by checking out her website here https://www.melrobbins.com/
It is important that you set goals for your mental health as part of your treatment plan. It is important that you consider that we are all part of your team and here to support you in achieving your best life. Communicating with us when you have any questions, concerns, or problems is very important. If anything changes regarding your health, symptoms, or your ability to follow your treatment plan, you should schedule an appointment with to discuss any changes necessary. Attending your medication management and counseling/coaching/therapy appointments is very important. When things come up, please reschedule as soon as possible so you stay on track and so that the appointment spot can be used by someone else in need if you can't make it. If you have any concerns before your visit, schedule a sooner appointment. Don't let problems build up if your appointment is not happening very soon.
It is very helpful in monitoring your progress if you calculate your assessment questionnaires regularly (every 2- 4 weeks) to make sure that you are feeling better over time. You should record your responses and scores so that you can watch them over time. For your treatment to be considered successful, your scores should be reduced by 80% or be in the normal range. On certain platforms, you can often find assessments in your profile when logged in to your account/portal.
If you cannot access them, please do these assessments before every visit and share the results with me.:
https://patient.info/doctor/patient-health-questionnaire-phq-9
https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7
https://qxmd.com/calculate/calculator_820/insomnia-severity-index-isi
PCL Trauma
https://www.bu.edu/wheelock/files/2018/05/PTSD-checklist-Adult.pdf
Various tools to evaluate substance use of all kinds
https://www.masspartnership.com/pdf/CommonlyUsedSUDScreeningInstruments.pdf
STAY IN TOUCH
It happens often enough that plans don't work out, right? Treatment of your mental health is no exception. I really want my patients to know that if you are unhappy with your treatment plan, let me know! Sure, we need to give things a little time to work. And like I mentioned above many medications can take a few weeks to see results. The full potential of many medications for mental wellness may take up to 12 weeks to see the full effects. But, if you have high bother side effects you can't tolerate, or your feel you are not improving over time, or you are unhappy for ANY reason, let me know. You believing in the effectiveness of your treatment plan will directly impact the outcome. If you don't believe in it or trust in it, we need to change it. Or, you most likely will not get better. Remember, if you have any concerns at all, communicating them is very important. Just reach out and let me know. When contacting me always just ask me to call you back. Unless you are specifically logged into a medical account on a platform or portal, your information is not protected with security measures to protect your healthcare privacy. So never leave any other information about your medications, symptoms, or other personal healthcare concerns on text or voicemail.
My direct line 617-500-5767
Remember that chat, email , and voicemail are not monitored 24/7 and not an emergency service.
I typically check messages during my scheduled working hours during the week.
So if you are having an emergency seek care immediately by dialing 911 and or going to your nearest hospital for evaluation.
I LOOK FORWARD TO SEEING YOU NEXT TIME!
Typically I will schedule your next appointment with you at the end of your visit so that we can be sure to check in after a specific period of time depending on where you are in your treatment plan. You should be able to see your list of appointments when logged in on your profile. If you don't see your next appointment or need to change it, usually you can do this when logged into your account. If you can't get an appoint as soon as you need it, have me call you and we will find a time that works. Until we meet again, make sure you begin working on the things listed above, and read the blog posts here so that you will be taking the steps needed to feel better and improve your mood.
This will help you to achieve YOUR goals for optimal mental and physical health and wellness.