Post Traumatic Stress Disorder 10/18/2018

Post Traumatic Stress Disorder (PTSD) is a mental disorder than can occur after a person is exposed to a traumatic event. It is classified as a “trauma and stress-related disorder” in the DSM-5. It used to be thought that PTSD only occurred in combat situations but it is now known that it can occur as […]

Co-Morbid Depression and ADHD – Assessment and Treatment Strategies 10/11/2018

Independently, Major Depressive Disorder (MDD) and Attention-Deficit Hyperactivity Disorder (ADHD) are two of the most commonly diagnosed psychiatric conditions. Additionally, many people who have concerns about depression and/or ADHD present first in the primary care setting. It is not uncommon for these disorders to present together, which can have implications for assessment, treatment and outcomes. […]

Evaluation and Management of Perimenopausal Depression 10/4/2018

Perimenopause is defined as the early and late menopause transition stages as well as early menopause. This typically lasts 4-8 years. It has been identified as a vulnerable time for development of depressive symptoms and major depressive episodes. It is therefore important for providers in primary care to be aware of the risk of depressive […]

Maximizing Efficacy of Antidepressants 9/27/2018

Antidepressant medications, most commonly the selective serotonin reuptake inhibitors (SSRIs), are frequently prescribed by primary care providers for depression, anxiety, and impulse control disorders. There are some important guiding principles to keep in mind when prescribing these medications, which can dramatically improve a patient’s response to treatment and ensure ongoing safety. Here is a review […]

Treatment of Insomnia in Anxiety Disorders 9/20/2018

Insomnia is a common symptom in anxiety disorders, in fact it is a criteria for several DSM 5 Anxiety Disorders. It is important to inquire about sleep disturbance as part of the assessment for anxiety disorders, especially because there is clear evidence that the presence of insomnia in anxiety disorders is associated with increased morbidity. […]

ADHD in Adults 9/6/2018

Attention-deficit/hyperactivity disorder (ADHD) affects about one-third of adults who had ADHD in childhood. It can be difficult to diagnose because of the overlap in symptoms of adult ADHD with depression, anxiety and substance abuse, and reliance of the patient’s self report of symptoms. Studies of self-referral suggest that only 1/3 – ½ of adults who […]

Is There a Link Between Vitamin D Deficiency and Depression? 8/30/2018

There has been a lot of discussion recently in the scientific world and lay press about the prevalence and consequences of vitamin D deficiency. As part of that discussion, there has been a suggestion that vitamin D deficiency could contribute to depression and that vitamin D supplementation could be a viable treatment option for depression. […]

“My child can’t focus. What does that mean?” 8/23/2018

Many children and adolescents present to their primary care provider’s office with concerns about inattention, poor focus or poor concentration. Since the primary care provider’s office is typically the first stop, it is important to be comfortable further evaluating the presenting problem, identifying associated symptoms, determining the diagnosis and implementing the best treatment plan. Many […]

Depression in Adolescents 8/16/2018

The prevalence of Major Depression Disorder (MDD) in adolescents is 6%, with an additional 5-10% of teens presenting with sub-syndromal symptoms of depression. There is a 2:1 female:male ratio for MDD in adolescents. Teens frequently don’t necessarily present with the typical DSM criteria for MDD. Common depressive symptoms in adolescents include: irritability (as opposed to […]