After 13 fruitless months of treatment, I had all but given up hope of helping Sharon, a 43-year-old, house-bound (nearly bed-bound), anxious, irritable, and severely depressed woman. She had come to me using 10 medications, including a pair each of antipsychotics, benzodiazepines, stimulants, and antihypertensives plus insulin. I thought that her nearly complete failure to […]
Looks Almost Like Psychosis Nancy is a 39-year-old married, employed mother of one very precocious three-year-old girl. She had been in psychotherapy for seven years when she was referred for evaluation of her mood disturbances. As it turns out, Nancy had had severe postpartum depression (almost to the point of psychosis), which was never evaluated […]
18-year-old female freshman in 2012 who presents with rapid cycling bipolar type 1, suicidal at times, insomnia, exhaustion, insomnia, memory issues, tremor, PMS. Atypical presentation: visual and auditory hallucinations/illusions, depersonalization, synthesia; responds well to benzos. Medication failure: Lithium, Lamictal, Seroquel, Xanax, BCP. Chronic sinusitis, ETOH seizures-TLE-like, cataplexy/REM Latency. Diet: High glycemic index. After treatment: 13 […]
Samantha, a 14-year old girl, was brought to my office by her mother. When I first saw her, she was withdrawn, barely made eye contact, and had her headphones in even as she was answering my questions. She was depressed, had been diagnosed with ADD, and an anxiety disorder, but her mother did not want […]
Top Student Sidetracked by OCD Despite being handsome, tall, personable, and a top student at Yale, Mark was silently struggling with an intense need to count to 100 every time he had a “bad thought”. This he told himself, reduced the thoughts from taking over. What’s more, he had difficulty socializing with his friends, without […]
Bill is a 27-year-old physicist with bipolar SAD, type A. He agreed to take lithium, which eliminated his springtime hypomania, but only partially alleviated his winter depression. Light therapy was added with good results. After three years, Bill married, and two years later he and his wife decided to move to a farm, which is […]
High Functioning Businesswoman When Janine first came to see me she was 35 years old, and had just delivered her third child. As a former businesswoman, her transition to full time mom had been very rocky. One of the first things she said to me was, “I was high functioning until 3 years ago.” I was […]
The Importance of Context and the Limits of Medication Every health care provider has had experiences that were so powerful that they have forever transformed his or her thinking and approach to patients. The following was such a case. It demonstrated a number of things to me, including the importance of context, the limitations of […]
Severe OCD since 4th Grade John was a very bright young fellow who was heading off to an Ivy League university in the fall. He was suffering from very severe OCD since 4th grade. He had tried Cognitive Behavioral Therapy, however it didn’t help. He refused exposure and response prevention therapy. Eventually, his OCD became […]
19 Year Old with Depression and Panic Attacks Brody had a recurrence of panic disorder after 20 symptom-free years. Brody was a funny really warm-hearted young man. When I first met him, 29 years ago, he was 19. He was sent to me after he had been hospitalized for depression and panic attacks. He was […]