Case Presentation 7 year old boy with chief complaint of “frequent meltdowns”. Additional history: daily meltdowns (crying, hitting) with loud sounds or when asked to wear certain clothing; wants to make friends but poor boundaries and accidentally hurts peers at school when he is playing with them; hard time sitting during seat work at school […]
Depression in Adolescents
Major depression affects 6% of adolescents with an additional 5-10% presenting with sub-syndromal symptoms of depression. There is a 2:1 female:male ratio of major depression in adolescents. Teens frequently don’t present with the typical DSM criteria for Major Depressive Disorder (MDD). Common depressive symptoms in adolescents include: irritability (as opposed to reporting a sad mood), […]
Treatment for Depression Related to Pregnancy
Last week’s e-Weekly discussed the different depressive syndromes as related to pregnancy. This e-Weekly will go into detail about treatment for depression for a patient who is in the antepartum or postpartum period. The first step is to determine the level of impairment of the symptoms. Baby blues resolves on its own with support and […]
Depression related to pregnancy
Depression related to pregnancy is a common and potentially serious concern for both mom and the baby. It is therefore important to understand the various conditions and when it is important to have a clinical intervention. Postpartum Blues: Symptoms of mood lability, irritable mood, interpersonal hypersensitivity and tearfulness are common in the postpartum period and […]
Anxiety Disorders
Anxiety disorders are far and away one of the most frequent of mental health disorders. Often they are not recognized and/or treated within the context of the primary care setting, even though they tend to be chronic conditions that have significant impact on patients’ health and well-being. Anxiety is a universal and highly adaptive experience, […]
Nonsuicidal Self-Injury
Also known as self-injury and self-harm, nonsuicidal self-injury (NSSI) refers to the deliberate and direct alteration or destruction of healthy body tissue without suicidal intent. This can range from skin cutting or burning to amputation of body parts. There can be a cultural component to the self-injury. While NSSI acts are done without suicidal intention, […]
Important Drug Interactions Between Psychotropic Medications and Contraceptives
Contraceptives are commonly used in women of childbearing age, many of who are also taking psychotropic medications for mental health concerns. It is important to be aware of the interactions between contraceptives and certain psychotropic medications as well as the psychiatric side effects of contraceptives themselves. Contraceptives have synthetic estrogen, progesterone or a combination of […]
Expanded Services Available
We are excited to announce the expansion of patient and provider services through the SmartCare program pursuant to our revised contract with San Diego County Behavioral Health Services. Effective immediately, SmartCare will be adding the following expanded service capabilities: Telephone Consultations for Adult and Geriatric patients: While this service has previously been available for parents […]
Depression in Older Patients
Depression can occur in any patients as they age, even without a prior history of depression. Older individuals can present with mood symptoms that can seem to be part of the normal aging process, but it is important to assess for the possibility of a masked depression. Of note, there is an increased risk of […]
Treating Depression in Older Patients PART 2
In last week’s eWeekly article, we discussed the features to be aware of in evaluations of depression in older patients, including the influence of depression and/or cognitive impairment in increasing the risk of the other condition. This eWeekly addresses treatment of depression in older patients and how it might differ from treatment in younger adults. […]