Psychiatry and Chronic Pain

Pain affects nearly 100 million people and is one of the most common complaints made to primary care providers by their patients. More than 20% of all medical visits are pain-related. Consistent with a biopsychosocial model of illness, individuals with chronic pain often report that the pain interferes with their ability to engage in occupational […]

Medical Differential for Patient Presenting with Depressive Symptoms

When a patient, especially one without a history of depression, presents with depressive symptoms, it is important to consider if those symptoms are a result of another medical condition. Depressive symptoms that are more likely to be in this category include:  Fatigue/low energy  Trouble initiating or maintaining sleep  Hypersomnia  Significant change in […]

“My child can’t focus. What does that mean?”

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 […]


It used to be thought that obsessive-compulsive disorder (OCD) was rare, but it is more common than originally thought. The prevalence is between 2-3% worldwide and it affects males and females equally. Symptoms usually present between childhood and early adulthood, with 75% of patients having symptoms before the age of 18. OCD can be a […]

Treating Co-Morbid Depression and Coronary Artery Disease

Coronary Artery Disease is the leading cause of death in the United States and is one of the main contributors to the global burden of disease. One in four patients with coronary artery disease also suffer from depression, which adds to the risk of recurrent myocardial infarction and death. Guidelines exist to urge primary care […]

Premenstrual Dysphoric Disorder

Approximately 75% of women experience premenstrual changes – increased irritability, tension, depressed mood, breast tenderness and bloating – commonly referred to as premenstrual syndrome (PMS). About 5-10% of women experience far more substantial premenstrual mood symptoms known as premenstrual dysphoric disorder (PMDD). PMDD symptoms includes moderate to severe depressed mood, irritability, mood lability, anxiety, anger, […]

Is it Menopause or Depression?

Females in their 40s and 50s often present to their primary care providers with new-onset depressive symptoms. It can be difficult to assess if the symptoms are part of menopause/perimenopause or if they represent a new onset depressive disorder. One complicating factor is that menopause can independently increase the risk of onset of a depressive […]

Is There a Link Between Vitamin D Deficiency and Depression?

There has been a lot of discussion recently in the scientific world and the 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 related to pregnancy

Depression related to pregnancy is a common and potentially serious concern.  Therefore, it is important to understand the various conditions and when it is important to have a clinical intervention. Postpartum Blues: Symptoms of mood lability, irritability, interpersonal hypersensitivity and tearfulness are common in the postpartum period and are commonly known as the postpartum “blues”. […]

Long Term Effects of Childhood Bullying

A recent article in JAMA Psychiatry brings to the forefront an ongoing important topic – the long-term effects of childhood bullying, particularly on a person’s mental health. Bullying at a young age puts people at a higher risk for developing depression and other psychiatric conditions requiring treatment by young adulthood compared to people who were […]