Frequently Asked Questions
Why do most psychiatrists only prescribe medication and not also do therapy?
In the mid-1980's the health insurance industry realized that it was very costly to pay physicians to do both medication management as well as psychotherapy. They started paying physicians only to do medication management and instead patients would have to see psychologists, social workers, or licensed counselors for therapy. Unlike many of my colleagues I do not consider this an unusual arrangement. It is quite analogous to seeing an orthopedist for medical treatment of a musculoskeletal injury and also seeing a physical therapist for recovery and rehabilitation of the injury. Psychiatric illness is a chemical and hormonal brain injury which is addressed with medication, and therapy helps a patient regain their ability to function after this injury.
Shouldn't I stop taking my medication if I have a cold or the flu?
Whenever possible medication for psychiatric illness should never be interrupted in order to avoid relapse or worsening of symptoms. When one is fighting off an infection such as a cold or flu, one is even more vulnerable to feeling depressed, therefore it is best to continue taking your medication.
Can I drink alcohol while I'm on medication?
Someone who is in recovery of addiction to any substance should not have any alcohol. For others I recommend admittedly a very strict limit of two servings of alcohol per week. One serving is either a 12 ounce beer, a 5 ounce glass of wine, or a 1 1/2 ounce shot or liquor such as in a mixed drink. Alcohol is a central nervous system depressant, so even moderate amounts, even infrequently, could worsen depression. Alcohol also has negative effects on sleep, despite the common myth that it improves sleep; it may hasten the onset of sleep but then sleep is light, easily interrupted, and non-restorative. There are also potentially dangerous interactions between alcohol and any psychiatric medication.
Should I avoid caffeine while taking medication?
Too much caffeine can interfere with how your body processes medications and make them less effective or worsen their side effects. Even moderate caffeine may worsen the symptoms of Anxiety Disorders. I recommend no more than three servings a day, and also none after 2-3 PM, in order to avoid interference with sleep.
How can I get better sleep?
Following good sleep hygiene is essential for recovery from psychiatric illness. This starts with having a regular sleep time every night and a regular wake time every morning; this keeps your body in a rhythm that promotes better sleep. Alcohol, caffeine after mid-afternoon, or heavy meals too close to bedtime can also interfere with sleep. Heavy exercise too close to bedtime may also interfere with sleep but for some people it improves sleep. Regular exercise in general is very helpful for a good night's sleep. Screens with bright displays, such as smart phones, tablets, laptops, PC's and certain e-readers should be avoided in the late evening since they promote wakefulness.