Treatment Philosophy

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Welcome! When you come to see me as a new patient, the first visit is usually an

introduction where we can learn about each other, ask questions, and figure out if we

would be a good fit in working together toward your treatment goals. You will receive an

individual evaluation based on your history, symptoms, and goals. I will give you my

best recommendations based on research, science, and your individual situation. My

recommendations may include psychotherapy, lifestyle recommendations, starting a

new medication, or changing or stopping a prior medication. We will discuss this and

together, we will figure out the next steps. Your thoughts, emotions, and life

circumstances are important factors that affect your mood, so I like to spend part of our

time together discussing these things.

I’d like to share some thoughts about medications and my treatment philosophy. I

receive many questions about controlled medications such as stimulants (Adderall,

Ritalin) and benzodiazepines (Xanax, Klonopin, Ativan, Valium) and medications

commonly used for sleep (Ambien, Restoril, Lunesta). Stimulants are sometimes used

to treat Attention Deficit Hyperactivity Disorder (ADHD). In the past few years, the use of

this diagnosis for adults has exploded by several thousand percent and the condition is

frequently being over-diagnosed. In reality, only a very small percentage of adults meet

the clinical criteria for ADHD, and stimulants should be reserved for severe cases

because the risks often outweigh the benefits. Many of us have traits of ADHD or may

have other conditions that have symptoms similar to ADHD. For this reason, I

recommend a thorough evaluation, and in some cases, neuropsychological testing.

Education, cognitive and behavioral skills training, psychotherapy, mindfulness are all

important parts of a holistic treatment approach to ADHD.

Benzodiazepines such as Xanax, are sometimes used to treat anxiety. They can be

effective when used short-term and appropriately. However, long term use of

benzodiazepines can create more problems, as they can lead to dependence,

tolerance, and withdrawal symptoms. Withdrawal symptoms can range from feeling

tired, or increased anxiety as the medication wears off, to symptoms as severe as

seizures, coma, and death. Benzodiazepines can also numb you to normal emotions

and with time, may make you lose confidence in your own ability to manage anxiety.

Sedatives are not the best choice for sleep problems since they work less well over time

with repeated use. Some can cause similar problems as benzodiazepines can, as well

as produce hallucinations, delusions and sleep related behavior, like eating or driving

during sleep. They also can disrupt your body’s natural sleep rhythm.

Because of the risks associated with these medications, I will discuss safer treatment

alternatives as well as holistic ways to manage these conditions. If we do decide to use

controlled medications, I would always want to do this in the safest way possible to

provide the best care for you.