As an adult psychiatrist, I fully understand the trepidation many young adults experience when transitioning from meeting with their child psychiatrist to using a psychiatrist that specializes in psychiatric care for adults.
Do You Need To Switch?
If you have an excellent psychiatrist that treats children, teens and adults, it probably isn’t necessary to make any changes. If your doctor does focus their practice on children and teenagers, however, it is best to find someone that specializes in adult psychiatry.
Some health plans also will require that you make the transition to an adult psychiatrist, although this transition usually doesn’t have to occur on the day of your 18th birthday. It’s often recommended to make the switch before you turn 19 or in some cases, the plan will allow you to keep your psychiatrist until you turn 21.
As you get older, your psychiatric needs can change, especially once you’ve completed puberty and your body and brain become fully developed. Adult psychiatric treatment plans can be different than those for children, and a psychiatrist that specializes in helping adults can be beneficial as you head into adulthood. Here are a few tips to help make this process a bit easier.
1. Start Early
Don't wait until the last minute to start the transition process. Begin discussing the change with your child psychiatrist well in advance, ideally a year or more before you'll need to switch.
2. Ask for Recommendations
Your child psychiatrist likely knows of trusted adult psychiatrists to whom they can refer you. They can help guide you to someone who will be a good fit for your needs. You also could ask your primary care physician or even trusted friends or family for recommendations.
3. Involve Parents or Guardians
If you're comfortable doing so, involve your parents or guardians in the process. They can provide emotional support and help manage the logistics of the transition. While you are becoming more independent, complete independence doesn’t have to end after you blow out the candles on your 18th birthday cake. Trusted adults can offer excellent advice and support if you need it.
4. Understand Your Diagnosis and Treatment
Make sure you have a clear understanding of your diagnosis, treatment plan, and medications before you transition. Ask your child psychiatrist to explain anything you're unclear about. I am a huge advocate for educating yourself about any mental or physical health issues – knowledge is power, and it helps you advocate for yourself and your needs.
5. Get Copies of Your Medical Records
Request a copy of your medical records, including mental health diagnoses, treatment plans, and medication histories. Provide these to your new psychiatrist to ensure continuity of care.
6. Prepare for Your First Appointment
Before your first appointment with your new psychiatrist, make a list of questions, concerns, and any symptoms you want to discuss. It’s always a good idea to compile a list of questions when meeting with any healthcare provider and be sure to take some notes during your appointment.
7. Be Open & Honest
During your initial appointments, be as open and honest as you can about your feelings, symptoms, and any concerns. This will help your new psychiatrist understand your situation and provide the best possible care.
8. Be Patient
Building a new relationship takes time. It might take a few sessions for you to feel comfortable with your new psychiatrist. As you move from adolescence to adulthood, your physical body changes and this can necessitate changes in your psychiatric care. When it comes to trying out new treatment options, it’s also wise to keep in mind that it does take time for treatment to work, so try to be patient with this process as well.
9. Stay Consistent
Keep up with regular appointments and follow the treatment plan laid out by your new psychiatrist. Consistency is key in managing mental health conditions. Stay consistent with any medications as well, as changing your dosage on your own or stopping medications can have serious consequences. If you have concerns about your medications, schedule an appointment with your doctor.
10. Advocate for Yourself
If something doesn't feel right, speak up. You know yourself best, and it's important for you to be active in your treatment plan. This can be tough for young adults, but always keep in mind that this is your life and your health. You have a right to proper care and a right to ask questions and voice concerns.
Do You Need An Adult Psychologist?
Again, the same criteria may apply as to whether or not you need to transition to using an adult psychologist or therapist. Psychiatrists are medical doctors and the only mental health professionals that can provide you with prescriptions for medications to treat mental illnesses.
However, while medications can be highly effective at treating mental health disorders, I find that the best treatment plans are those that also include regular visits with a therapist or psychologists. Learning strategies to help cope with symptoms is essential and talk therapy can help make day-to-day life and the transition into adulthood much easier.
Need An Adult Psychiatrist? Contact My Office
I provide adult psychiatric services for a wide range of mental health conditions. If you need an anxiety psychiatrist, addiction psychiatrist, ADHD psychiatrist, depression psychiatrist or bipolar disorder psychiatrist, these are just a few of the issues I treat.
Additionally, I also provide telepsychiatry services, which can be a convenient option for many patients. Using a virtual psychiatrist can be less stressful and save time, but it also can be extremely convenient for young adults. If you are attending college away from home, for example, we can still meet and continue treatment without waiting until you are home for vacation or breaks.
Remember, transitioning to an adult psychiatrist is a big step towards independence and self-management in mental health. While it may be challenging at times, it's an important part of your journey.
If you or a loved one is experiencing symptoms of bipolar disorder, finding a psychiatrist specializing in bipolar disorder can be the first step toward an easier, happier life. There are many treatment options available, and while it can take time to find the best options for you, help is available, and treatment can be successful. Let’s take a look at this illness and share some tips that can help you manage this condition.
Bipolar Disorder Is Stigmatize
Bipolar disorder tends to be one of the most misunderstood psychiatric disorders, often portrayed unrealistically in TV shows and movies. One of the biggest misconceptions is that people with this illness are dangerous and violent, although this is rarely the case.
Typically, when a person with bipolar disorder exhibits violent or aggressive behavior, there are many factors in play, such as childhood trauma, that feed into that behavior and it's not simply caused entirely by bipolar disorder. Additionally, these issues tend to manifest far more in patients with untreated bipolar disorder. When treated, people with bipolar disorder are no more violent than anyone else in the general population.
It's also important to understand that people with bipolar disorder are not always experiencing either mania or depression. When well-controlled, a person may not experience any severe symptoms at all. That’s perhaps the most important fact about bipolar disorder to understand – treatment can be successful and people with bipolar disorder can enjoy a successful, fulfilling life. But, there’s no one size fits all treatment, so it can take time to create a plan that truly helps reduce your symptoms and allows you to live a better life.
What Is Bipolar Disorder
There are several types of bipolar disorder, which is classified as a mood disorder. Symptoms of bipolar disorder vary based on the type of bipolar disorder you have, but people often will experience these symptoms differently.
In general, mood and energy levels are affected to some extent with any type of this disease, often severely. Mood stabilizers and other medications often are prescribed to reduce these symptoms; however, bipolar disorder treatment also should include additional types of therapy.
Bipolar I Disorder
With a diagnosis of Bipolar I Disorder, the patient will experience both severe episodes of mania and depression. The manic episodes will last at least a week, while the depressive episodes will last at least two weeks. A diagnosis of Bipolar I also can be made if these episodes were shorter in length but required hospitalization.
There also may be episodes of hypomania, which is a milder type of mania. In some cases, a patient with Bipolar I also will experience symptoms of psychosis, such as confusion, delusions and even hallucinations.
Bipolar II Disorder
With this type of bipolar disorder, a patient will experience the same long periods of depression, but without the manic episodes, although they do typically experience some hypomanic episodes. In general, most people with Bipolar II will not experience psychosis or extreme mania as this is generally milder than Bipolar I.
This is the mildest form of this mood disorder, but it still can cause brief episodes of hypomania and mild depression that can be quite upsetting. If you experience mood swings that seem more severe than others, cyclothymic disorder is a possible diagnosis, especially if these mood swings continue for at least two years. Typically, people with this disorder will only have brief periods where they experience normal moods.
5 Tips For People With Bipolar Disorder
1. Find A Specialist
Ok, easier said than done, right? Most of my patients with bipolar disorder have seen a myriad of psychiatrists specializing in bipolar disorder, not to mention psychologists, therapists and other health professionals. It can be tough to find a psychiatrist with whom you feel comfortable and to find a doctor that truly meets your needs.
However, these days, with telepsychiatry, you do have more options than ever before. In the past, we were often limited to finding that elusive “psychiatrist near me,” but an online psychiatrist can provide you with comprehensive treatment and the best part is that you can meet with your doctor anywhere you have an internet connection.
With bipolar disorder, you do need to find a psychiatrist and not just a psychologist or therapist. Psychiatrists are medical doctors, and they can assess all of your health issues and determine if any physical health conditions are impacting your mental health. They are also the only mental health professionals that can prescribe medication, which can be a highly successful treatment option for people with bipolar disorder.
That said, I highly recommend that you also find a psychologist or therapist that specializes in bipolar disorder. Talk therapy, cognitive behavioral therapy and other therapies can greatly reduce symptoms and help you better manage your life. A combination of medication and therapy tends to yield the best long-term results for any mental health condition.
2. Be Honest With Your Provider
Trust me, your bipolar disorder psychiatrist has heard it all so there is no reason not to share all of the symptoms you are experiencing. It’s also crucial that you share everything with your doctor so that they can provide you with the most accurate diagnosis. After all, many people with bipolar disorder have co-occurring disorders and we need to treat everything, not just bipolar disorder.
For instance, if you have an anxiety disorder or ADHD and bipolar disorder, both of which are quite common, we need to be careful about any medications that are used. There are ways to treat all of these disorders concurrently, but we need to diagnose them properly to find the best treatment.
I am often asked how often does ADHD co-occur with bipolar disorder? Some studies suggest that as many as 1 in 6 people diagnosed with bipolar disorder also have ADHD. ADHD symptoms can be similar to some bipolar symptoms, so we need to be very careful during the diagnostic phase to ensure that we know precisely which disorders a patient is experiencing.
When it comes to anxiety disorders, some studies suggest more than 40% of people with bipolar disorder also suffer from an anxiety disorder. I also find that many people with bipolar disorder suffer from addiction disorders, often as a result of trying to sort of self-medicate and reduce their symptoms. All of this needs to be addressed during treatment.
3. Stay Active & Eat Healthy
Regular physical activity and a balanced diet can help manage the symptoms of bipolar disorder. Exercise has been shown to reduce depression and anxiety and improve mood. Similarly, a healthy diet can support overall well-being and energy levels. Avoiding alcohol and drugs also are crucial as these can interact dangerously with your medications or trigger and exacerbate mood episodes.
While a consistent daily routine will not cure bipolar disorder, it can be helpful to create a workable, easy daily schedule. Don’t try to pile too much on your plate, so to speak and create a restful nighttime routine that allows you the best chance of enjoying a good night’s sleep. It’s also smart to keep a daily mood journal. Track your sleep patterns, as well, as sleep disruptions can lead to a manic or depressive episode.
4. Join A Support Group
You are not alone! Many people have bipolar disorder, and it can be great to talk to others with this disorder. Not only will you feel less isolated, you will likely find it beneficial to share your experiences and will probably find some good strategies to help you cope with bipolar disorder.
If you are the loved one of someone with bipolar disorder, I recommend educating yourself about this disorder and also perhaps seeking support as a caregiver. Both people with this disease and those that love and care for them need support!
5. Take Your Medications & As Prescribed
Medications can greatly reduce or even eliminate symptoms of bipolar disorder. Unfortunately, once those symptoms abate, many patients decide now that they feel better, they don’t need to take their medication.
Bipolar disorder is a chronic disease, and that means it’s always there, it’s simply being controlled by medication. Let’s compare it to asthma for a minute. This is also a chronic disease but when controlled by medication, the symptoms often go away. However, this doesn’t mean a person should stop treatment. Once you quit using your daily asthma meds, the symptoms will simply reappear.
It's just the same with bipolar disorder except that while it can be relatively easy to get your asthma back under control, it’s not nearly as easy to get bipolar disorder back under control. Additionally, with some bipolar medications, you cannot simply just stop using them, you must gradually taper off these medications.
Taking your daily medications and taking them exactly as prescribed is always the best option. If you do have concerns about your medications, contact your psychiatrist and discuss these concerns with them. They may be able to adjust the dosage or try a different medication, but it is never a good idea to simply stop taking your meds or alter the amount of your meds without professional medical advice.
Call Dr. Jesalva Today
If you need a psychiatrist specializing in bipolar disorder, I am always here to help and I offer telepsychiatry services. I also work as an anxiety psychiatrist, depression psychiatrist, addiction psychiatrist and can treat PTSD and other co-occurring disorders you may be facing. Don’t suffer another day with bipolar disorder, help is out there, and treatment can be successful. We will work together to come up with a treatment plan that truly transforms and improves your life.
Everyone suffers from anxiety from time to time, it’s simply a part of the human condition. However, if constant feelings of anxiety are impacting your life and making it difficult for you to complete daily tasks and enjoy relationships, it’s probably time to seek the services of a psychiatrist for anxiety.
Why Seek Treatment?
Some people mistakenly believe that chronic feelings of anxiety are “normal,” and while we all do feel nervous or anxious once in a while, millions of Americans suffer from daily feelings of anxiety, and this is a serious mental health issue that affects your ability to function and live your life to the fullest.
For many people, chronic anxiety makes it difficult for them to work or handle school or even complete daily tasks. Anxiety can impact your social life and have a negative impact on your relationships. The good news is that there are many treatment options available, and while it can take time to find a treatment plan that fully meets your needs, anxiety can be lessened, and you can live a happier, healthier and much easier life.
Too often, people with anxiety disorders feel ashamed about seeking treatment for anxiety, mistakenly believing they are weak or should just be able to handle their problems. The truth is millions of people suffer from chronic anxiety. In fact, it’s estimated that about 30% of adults suffer from an anxiety disorder at some point in their life.
An anxiety disorder is nothing to be ashamed of, it is simply a medical disorder just like diabetes or high blood pressure or asthma. Just like the latter three diseases, there are many ways to successfully treat anxiety. If you seek medical help for your high blood pressure, seeking medical help for anxiety is truly no different.
Why A Psychiatrist?
People with anxiety have the option of working with therapists and psychologists, and while this is always an excellent option, you may also need to contact and work with a psychiatrist for anxiety and there are several reasons why.
1. Psychiatrists Can Evaluate Your Medical Health
Unlike therapists or psychologists, psychiatrists are medical doctors, which gives them a unique perspective. Unlike a psychologist or even a primary care physician, we can diagnose and treat both mental health issues as well as other types of health conditions that may be affecting your mental health.
There are many physical health conditions and medications that can cause anxiety disorder symptoms. If we can work to improve your physical health, this often can help reduce your anxiety, as well.
2. Psychiatrists Can Provide Medication
While psychologists can diagnose mental health conditions, they cannot prescribe medication, which is why you likely will need the support of a psychiatrist. Several different types of medications have been shown to reduce or eliminate symptoms of anxiety disorders and this can be an approach to consider.
Keep in mind, treatment for anxiety disorders should include more than medication. Medication can be hugely beneficial, but it is even more beneficial when we also provide patients with cognitive behavioral therapy and talk therapy. Behavioral therapy can provide you with helpful tools to help you manage stressful situations and reduce anxiety and talk therapy can help you work through problems.
It’s also important to note that medication takes time to work, and it can take time to find the right dosage for each individual. Some medications also have side effects, such as nausea, dizziness and fatigue. While this may resolve after a few weeks of taking the medication, it’s important for patients to have realistic expectations about medication.
3. Psychiatrists Can Help With Co-Occurring Disorders
Many patients with anxiety disorders also suffer from other mental illnesses, such as depression or PTSD or OCD or perhaps bipolar disorder. My focus is always on getting to the root of all of the issues and illnesses is facing to create the best possible treatment plan.
We can treat your anxiety, but if you also have an eating disorder or perhaps ADHD or bipolar disorder, we need to treat those as well to ensure that all of your health needs are met.
While mental health professionals such as psychologists and therapists can provide many types of behavioral and talk therapy for people with co-occurring disorders, a psychiatrist also can help with medication management for co-occurring disorders. This can be tricky as certain medications can interact and we must find the best possible combinations of medications and therapies for each patient.
In addition to my services as an anxiety psychiatrist, I also offer services as a depression psychiatrist and PTSD psychiatrist. I also treat bipolar disorder, ADHD, addiction and any other co-occurring disorders you may have along with an anxiety disorder.
Types of Anxiety Disorders
Treatment for anxiety disorders often varies based on the type of anxiety disorder a patient might have, and there are several disorders recognized by the American Psychiatric Association and listed in that organization’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), including:
Generalized Anxiety Disorder (GAD): Persistent and excessive worry about various aspects of life, such as work, health, family, or finances.
Panic Disorder: Recurrent and unexpected panic attacks, which are sudden periods of intense fear or discomfort, accompanied by physical and cognitive symptoms.
Agoraphobia: Fear and avoidance of situations where escape might be difficult, or help might not be available in the event of a panic attack or other incapacitating symptoms.
Social Anxiety Disorder (Social Phobia): Intense fear of social situations in which the individual may be scrutinized, judged, or embarrassed.
Specific Phobia: Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving injections, or seeing blood). Exposure therapy often can be a helpful treatment for some phobias.
Separation Anxiety Disorder: Excessive fear or anxiety about being separated from attachment figures, typically in children but can also occur in adults.
Selective Mutism: Consistent failure to speak in specific social situations despite the ability to speak in other situations, usually affecting children.
Post-Traumatic Stress Disorder (PTSD): In the DSM-5, PTSD is classified as a trauma- and stressor-related disorder, but it often is associated with anxiety disorders. We have many new treatments for PTSD that can be quite helpful including Eye Movement Desensitization and Reprocessing (EMDR) and possibly ketamine treatments.
Telepsychiatry For Anxiety
During the pandemic, telepsychiatry became one of the easiest and safest ways for psychiatrists and other mental health professionals to treat patients. While we are back to meeting face-to-face, many patients have come to prefer using a virtual psychiatrist over in-person meetings.
Many people feel comfortable meeting virtually and it can be more convenient. After all, meeting online allows us to meet from anywhere you have an internet connection. You also don’t have to fight your way through traffic, which can be very stressful, and you save time because no commute is necessary. Telepsychiatry also allows you to choose a psychiatrist that truly meets your needs rather than simply settling for that “psychiatrist near me.”
Contact Dr. Jesalva Today
If you are suffering symptoms of anxiety, don’t wait another day before contacting a psychiatrist for anxiety. I can meet with patients virtually or in person and have been successfully treating patients with anxiety, depression, PTSD and other mental health conditions for many years. There is always hope, and we can find a treatment plan that truly reduces your anxiety and improves your life.
Psychiatrists can treat a wide range of psychological conditions, and while you might think more of psychiatric disorders such as ADHD, bipolar disorder, anxiety or depression, many psychiatrists also can treat addiction. An addiction psychiatrist is a medical doctor that specializes in helping patients with substance use disorders.
Is Addiction A Disease
There’s a lot of debate about this, and I think it’s important to truly dive in and understand why most medical organizations, including the American Medical Association and the American Psychiatric Association, classify substance use disorders as a disease.
Let’s compare substance use disorders with another medical disorder – diabetes. While lifestyle choices can be reasons why a person develops diabetes, there are other factors that come into play including genetics, biology, psychology and even environmental factors.
We can look at two people with virtually identical lifestyles and body types and see one develop diabetes and another person never develop this disease so it’s not all about diet and exercise, although those certainly can be an issue. Additionally, while dietary choices might contribute to diabetes, those choices don’t take away the fact that diabetes is a disease.
When it comes to substance use, many people are able to drink alcohol or use drugs such as marijuana without ever becoming addicted to these substances. In many cases, a person’s biology, genetics and psychology all contribute to both using drugs or alcohol and becoming addicted to these substances.
It’s also important to keep in mind that substance use actually changes our brains. While we might make that initial choice to use a drug, if we continue using drugs or alcohol, this can alter the brain and once that occurs, a person has far less control of their ability to stop drinking or using drugs.
For those suffering from addiction, it’s important to understand that addiction is a disease and a chronic disease just like diabetes or asthma. And just as with those medical conditions, we can treat the disease and help a person live a healthier life. As an addiction psychiatrist, I have seen firsthand that substance use disorders can be treated and recovery can be successful.
How An Addiction Psychiatrist Can Help
While there are many therapists, counselors and psychologists in the field of addiction counseling, an addiction psychiatrist is uniquely qualified to help with addiction treatment, especially during the initial phases of treatment.
Psychiatrists are medical doctors as well as mental health professionals, and while they typically don’t provide talk therapy or behavioral therapy, they can provide you with a thorough diagnosis and treatment plan as well as diving into your medical history and psychological history to determine all of the issues you might be facing. It is important to identify any and all mental health disorders and medical issues before creating a treatment plan.
While a general psychiatrist certainly can be helpful, if you are suffering from substance abuse, it can be wise to select a psychiatrist that specializes in addiction psychiatry. Addiction psychiatrists treat more than substance use disorders, but they have additional training and keep up with the latest developments in addiction treatment.
Of course, many of their patients will have co-occurring disorders and an addiction psychiatrist can help with other mental health issues. For instance, a patient might have a dual diagnosis of depression as well as substance abuse or perhaps bipolar disorder or chronic pain.
In order for addiction treatment to be successful, we must address all of the issues and not just substance abuse. This is why I spend so much time on reaching a thorough diagnosis because it’s not just about helping someone to stop using drugs and alcohol. It’s getting to the root of all of the problems and finding ways to address each issue.
As a patient, it is also highly recommended that you also seek the services of a therapist or psychologist. A psychiatrist can provide you with a diagnosis and prescribe medications for medication-assisted addiction treatment, but it’s also crucial to utilize the power of talk therapy and cognitive behavioral therapy. This combination approach tends to yield the greatest rates of success.
What Is Medication-Assisted Treatment
For some types of substances, there are medications that can help people maintain long-term sobriety. These medications do not cure addiction, but they can reduce the severity of withdrawal symptoms and reduce the craving for drugs or alcohol.
It might seem counterintuitive to use medications to prevent drug and alcohol abuse, but it’s important to remember that medications are used to treat many common diseases and the medications used to treat addiction have seen very high rates of success.
For instance, medications such as naltrexone and methadone have been shown to help alleviate cravings for people addicted to opioids. Naltrexone, acamprosate and disulfiram all have been used to help patients addicted to alcohol. Again, these aren’t cures, but they reduce the need for substance use and allow people to live better, more successful lives.
What About Telepsychiatry?
As a psychiatrist in Thousand Oaks, I see patients throughout the Los Angeles area, as well as in southern Ventura County. If you live outside that area, I can provide you with the services of a virtual psychiatrist.
Telepsychiatry allows you the freedom to select an addiction psychiatrist that truly fits your needs, rather than simply trying to find a local psychiatrist, which might put limits on your search. Additionally, many people prefer meeting with a doctor from the comfort of their homes and you can save time and avoid the hassle of dealing with traffic.
Call Me Today!
Even if you’ve tried multiple times to stop using drugs or alcohol, there truly is hope for a long-term recovery. Addiction is treatable, and I can help. If you need an experienced addiction psychiatrist, please contact my office today and let’s get you on a path toward sobriety and a happier, healthier life.
If you have a child struggling with ADHD, seeking the services of an ADHD psychiatrist can be beneficial. We can provide a clear, documented diagnosis and help find options to reduce symptoms and make life easier for your child. As a parent, however, you also have the opportunity to advocate for your child through the school system, and the following information may be of help.
What Is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is a neurological disorder that can affect children and adults in many ways. People with ADHD can experience a wide range of symptoms including difficulty with attention, focus and organization. Hyperactivity and impulsivity and moodiness also are among the symptoms.
ADHD often presents more obviously in boys than in girls, but that doesn’t mean that girls don’t need just as much support. If your child is struggling in school with focus or completing homework or perhaps they seem forgetful, anxious or constantly daydreaming, ADHD could be the cause.
The best step that parents can take is to have their child evaluated by a psychiatrist or psychologist. Be sure to find a psychiatrist or psychologist that focuses on providing a thorough diagnosis that gives you a clear picture of all of the issues your child might be facing. It is very common for a person with ADHD also to have a co-occurring disorder such as anxiety, depression, OCD or Autism Spectrum Disorder and we must uncover all of these issues to provide the best possible support.
Is ADHD a Disability?
We often think about disabilities as something physical or perhaps we think of a student with an intellectual disability such as Down’s Syndrome. However, neurological disorders also are disabilities.
The Americans With Disabilities Act (ADA) defines an individual with a disability as a “person who has a physical or mental impairment that substantially limits one or more major life activities.” These activities would include attending school, and, as anyone with ADHD can attest, school can be tough when you have ADHD.
Children with disabilities are entitled, by law, to have an education equal to that of their peers. To ensure that level of equality, accommodations may be needed and the school site will need to create a plan to facilitate a learning environment that supports a child with ADHD or with any type of disability.
As a parent, you are well within your rights to contact the school and ask to meet with the teacher and administrators to talk about what types of plans can be put into place for your child. This can be easier to do once you have a diagnosis in writing either from a psychiatrist or psychologist, but you definitely don't have to wait in order to seek support from your school.
IEP Vs. 504 Plans Vs. SSTs
The educational system throws plenty of acronyms and abbreviations at parents, and you may hear a teacher or special education provider talk about terms such as an IEP, an SST or a 504 plan. Let’s take a look at each of these plans and how they can benefit a student with ADHD.
Individualized Education Plans (IEPs) – These are binding legal documents that create a plan for a child struggling with one or more disabilities. The IEP might include special education instruction, outside support services and classroom accommodations that are deemed necessary to ensure student success.
With an IEP, parents also can request an Independent Educational Evaluation (IEE). If the school approves the request, the district will pay to have an outside expert evaluate the student. Keep in mind, the district might not agree to your request for an IEE. If you still want an IEE, this will mean you must pay for it out of pocket.
Additionally, the IEP can only be used to help students that fit within one of the 13 disability categories listed in the Individuals with Disabilities Education Act (IDEA), which is an act that requires all public schools to provide special education services to any student that is eligible. The 13 categories include:
504 Plans – These are known as 504 Plans because they are derived from section 504 of the U.S. Rehabilitation Act of 1973. This act prohibits any organization that receives federal money from discriminating against people with disabilities. Because ADHD is considered a learning disability, this means that students diagnosed with ADHD are protected under section 504. As with an IEP, a 504 Plan is a binding legal document.
504 plans provide specific accommodations for students with ADHD, such as allowing a student to have extra time to complete an exam or assignment. For older students, this also might entail being allowed to record a classroom lecture. For younger students, this might include allowing them to take a break and walk around or perhaps placing them in a seat that helps to limit distractions. Every student's needs and accommodations are unique, so teachers and administrators need to be flexible to create plans that meet the needs of a specific student.
The main differences between the 504 Plan and an IEP are that the 504 includes a broader range of disabilities, but you cannot request the IEE. A 504 Plan also doesn’t typically include special education services and instead focuses on creating goals and classroom accommodations to help a student.
Student Study Team (SST) – This is often the first step you will take as a parent toward acquiring support for your child. Sometimes a teacher will suggest the formation of an SST, but parents also can request it. This team typically consists of the child’s parents and teacher and at least one other school staff member. This could be a special education teacher, a student’s former teacher, the school principal or the school counselor.
During a Student Study Team meeting, the team will address issues and create some goals and perhaps identify some accommodations or support that could be helpful to a student. SSTs aren’t as binding as a 504 plan or IEP, but they can be an excellent first step to take while you are setting up therapy and meeting with an ADHD psychiatrist. In some cases, a child with mild ADHD might only need a few minor accommodations and an SST might be all that is warranted.
ADHD Medication: Is This A Good Option?
Parents are often hesitant about having their children use medication for ADHD, and as a pediatric psychiatrist, I understand the hesitation, but as a medical professional, I also feel that medication can be very beneficial for some patients.
The most common medications used to treat ADHD include methylphenidate (brand names Ritalin and Concerta) and dextroamphetamine with amphetamine (Adderall). Another stimulant medication is lisdexamfetamine (Vyvanse),
These are in a class of drugs known as stimulants, and they help to boost the levels of norepinephrine and dopamine in your brain. These are brain chemicals that help us focus and pay attention to tasks.
Because these drugs are stimulants and because some people (without ADHD) abuse them recreationally, they have a dubious reputation. However, both of these medications have a long history of use to treat ADHD and other disorders and the majority of children taking these drugs, or about 80%, report a significant reduction of ADHD symptoms when using these medications.
Ritalin was developed in the 1940s and has been used for more than 50 years to treat symptoms of ADHD. Concerta, which is essentially an extended-release type of Ritalin, was approved for use more than 20 years ago. Adderall has been used for nearly 30 years, and Vyvanse, is essentially the extended-release version of Adderall. Unlike some medications, a few of these ADHD medications can be taken as needed, such as just on school days.
While these medications can be effective, there are a few side effects that some children experience. One of the most significant side effects is a reduced appetite, so parents must pay close attention to their child’s eating habits to ensure they are continuing to get proper nutrition. In some cases, these drugs can upset sleep schedules and cycles, and we can adjust the dosage or adjust the type of drug to help with this issue. It is also important to note that if your child has another condition, such as bipolar disorder, some ADHD drugs aren’t going to be an appropriate treatment option.
Non-stimulant drugs for ADHD include atomoxetine, which is in a class of drugs known as selective norepinephrine reuptake inhibitors (SNRIs). Guanfacine is yet another option, in a class of drugs known as centrally-acting alpha2A-adrenergic receptor agonists. This drug is meant to affect the portions of the brain responsible for attention and impulsivity.
Therapy Is Crucial
Your ADHD psychiatrist can prescribe medication and will provide you with information about all of these drugs and recommend options that seem to be the best fit for your child. However, we usually also recommend some behavioral therapy. Medications prescribed by a child psychiatrist can help with focus, but patients experience the highest level of success with a combination of therapy and medication. These therapies teach essential coping mechanisms and strategies to help a patient deal with their ADHD long-term.
Adult With ADHD? Contact Me Today
While I don't offer services as a pediatric psychiatrist or child psychiatrist, I can help young adults and older adults struggling with ADHD, including providing a diagnosis that covers all of the issues you may be facing. I can meet with patients in person and offer telepsychiatry services if you prefer to meet with an online psychiatrist or live too far from my offices in Thousand Oaks.
As a psychiatrist in Thousand Oaks, I meet, in person, with patients throughout Los Angeles and Ventura County. However, if you need to find a psychiatrist, you don’t necessarily have to opt for that “psychiatrist near me.” Telepsychiatry can be another option to consider.
What Is Telepsychiatry?
With telepsychiatry, you simply meet using your phone, tablet or computer using a secure connection. A virtual psychiatrist will have the same training as an in-person psychiatrist. Both types of psychiatrists are medical doctors as well as mental health professionals, which means they can prescribe medications as well as diagnose many mental health conditions and create a treatment plan.
Advantages Of Telepsychiatry
These days, more and more medical visits are being handled either by phone or video visits. This, of course, became more common during the pandemic, but it’s likely to continue for several reasons, including:
1. Convenience & Flexibility
With telepsychiatry, you can meet with your doctor in the comfort of your own home or anywhere you have an internet connection. Even if you are on vacation or away for business or another reason, you can still receive quality care from your psychiatrist.
2. Easier Access To Care
For patients with disabilities or mobility issues, telepsychiatry can be a much easier option than in-person visits. There’s no need to arrange transportation or deal with the typical hassles of finding parking spaces, navigating through medical buildings, etc.
Additionally, for patients with anxiety, being able to receive care at home can reduce the stress related to driving in traffic. For patients with depression that might have a tough time getting out of the house to receive care, meeting with an online psychiatrist can be a great option to consider.
4. Reduced Costs
Let’s face it, these days, gasoline prices are exorbitant and if you can avoid driving back and forth from the psychiatrist’s office, you can save a decent amount of money. Likewise, telepsychiatry may eliminate the need to pay for childcare expenses. However, it can be wise to have someone watch your children during a session so that you can focus entirely on the doctor's visit. Still, without having to drive, you can reduce child-care expenses, which is always a positive.
5. Save Time
Our time is precious, and spending it driving to and from appointments can be difficult. You could save an hour or more of your time by simply meeting with your psychiatrist virtually. Additionally, wait times are reduced, as well, because no one is ever late to an appointment due to traffic or other issues. Telepsychiatry can streamline the entire doctor visit process, saving both you and your psychiatrist some much-needed time.
6. Reduce The Stigma
Too often people avoid getting mental health care because they are ashamed of asking for help or ashamed of their condition. Let’s be clear – mental illness is not a weakness, it’s simply a medical condition that usually can be treated. Still, I know that many people are reluctant to seek help or feel as though asking for psychiatric services makes them “weak.”
While this isn’t true at all, that’s the stigma and while we are beginning to break through that stigma, it is still there for some patients. Being able to meet in the privacy of your home can feel like an easier, safer option. You won’t risk being seen by friends or co-workers leaving the doctor’s office, etc. If this level of privacy pushes you toward seeking help, then by all means, opt for telepsychiatry and telepsychology services. We can help you reduce your symptoms and live a happier, healthier life.
Advantages of Using A Psychiatrist “Near Me”
Of course, not everyone prefers to meet online with their psychiatrist or therapist, and that’s perfectly fine. I am always happy to meet in person with my patients, and some people truly need that one-on-one, face-to-face connection rather than a video visit.
In some cases, such as with severe disorders such as schizophrenia, it can be better to meet in person as these individuals can be at higher risk of self-harm and suicide. Of course, there are certain types of therapy, such as EMDR and ketamine treatments that must be handled in person.
We also can opt for a hybrid approach, where we meet in person initially and eventually move toward virtual visits once a treatment plan is in place. With my practice, I try to be as flexible as possible to meet the needs of a diverse group of patients. Every person is unique, so it’s important to curate a situation that is best for the individual.
How To Find A Psychiatrist
With virtual psychiatry, you can move beyond your immediate locality and search for professionals that seem to be a good match for your personality and your mental health needs. In some cases, you might need to find doctors that fit within your insurance plan, but, if possible, it can be good to extend your search to private practices as well, to find a good fit for your unique needs.
I recommend looking at everything from the doctor’s philosophy to searching for reviews and asking for recommendations from other physicians that you trust. Additionally, you will want to select a psychiatrist who specializes in helping patients with your specific mental health issues.
In my practice, I offer services as a bipolar disorder psychiatrist, an ADHD psychiatrist, and a psychiatrist for anxiety and depression. Additionally, I can help treat patients with substance use disorders as well as treat people with co-occurring disorders, which is extremely common.
My goal is to spend time truly getting to know a patient and understanding their issues and symptoms. This helps me create a thorough diagnosis that addresses all of the issues a patient is facing. As both a medical doctor and mental health professional, I can assess whether or not any physical conditions are impacting your mental health and I can help with medication management.
Of course, it is also important to seek the services of a psychologist or therapist. These professionals cannot prescribe medications, but they do provide talk therapy, cognitive behavioral therapy and other types of therapy that can improve your life significantly. Medication can be extremely helpful, but we achieve the best, long-term results with an approach that also includes therapy.
Call Dr. Jesalva Today
Whether you want to find a psychiatrist “near me” or you would like to try telepsychiatry, I am always here to help. Don’t suffer another day with mental health conditions. Treatment can be effective, and you deserve to live a happier, healthier life. It might take us some time to achieve these goals, but we will get there together.
Dr Jesalva is a psychiatrist. He is in private practice in Thousand Oaks, CA since 1989. He successfully treats very challenging patients with varying co-occurring disorders with medications.