I am trained as an adult psychiatrist. Adolescence is a time when many common mental disorders have their onset. It is also of course a time when people are transformed from dependent children into independent adults. In this affluent community it is also a time of enormous psychosocial pressure to achieve that together with other developmental pressures and changes can sadly lead to the development of many symptoms and problems in otherwise well functioning young people. I believe in helping young people to be caring, responsible and thoughtful about their own bodies and minds as well as the world around them. I have traveled with my teenage children to Tanzania, Peru and Brazil to do volunteer work.
Another group of patients I focus on in my practice are those individuals of any age who have combined substance use and psychiatric challenges. I have been interested in the way substances of abuse effect the brain since medical school when I wrote my thesis on the brain reward system. Compulsive patterns of drug and alcohol use as well as other compulsive behaviors are uniquely challenging to live with and to treat. I am a strong believer in twelve step programs and encourage patients to participate and work with a sponsor. This provides an aspect of treatment that simply cannot be offered in a doctor’s office: fellowship, mutual support from peers and honest confrontations.
I have a special interest in geriatric psychiatry. This includes the group of patients who are enjoying and are challenged by retirement as well as the very old and frail. I have found that working with frail elderly in their own environment, in collaboration with their families and caregivers, to be a very effective way to offer symptom relief for people whose ability to function independently has become limited. Depression, anxiety, dementia and delirium are common and challenging problems and the opportunity to make a real difference in people’s lives is very exciting. The present generation of assisted living and nursing home residents is not one that has rarely had a positive experience of mental health care or much comfort with psychological self expression. They of course can suffer just as awfully. This is particularly painful to observe when other abilities have begun to fade. It never ceases to amaze me however that relief from psychiatric symptoms in the very old population can lead to remarkable overall improvements.