​While all of us suffer from anxiety from time to time, for those with an anxiety disorder, these troubling thoughts and feelings greatly interfere with daily life and reduce the quality of life. The good news is that anxiety can be treated, and an anxiety psychiatrist can help. Here are a few important facts about anxiety and your treatment options.
 
1. Anxiety Disorders Are Common
According to the National Alliance on Mental Illness about 20% of all adults in the United States and about 7% of children suffer from some type of anxiety disorder, and this is the most common mental health issue in our country. Millions of Americans suffer from anxiety, and many never seek treatment, which is a shame, because there are treatment options that can greatly reduce the symptoms of anxiety and help a person live a happier, healthier life.
 
2. Chronic Anxiety Is A Cause For Concern
We’ve all been a bit nervous before a big event or perhaps a school exam or perhaps the first time flying in an airplane. Sometimes anxiety is a normal response to a perilous situation, alerting us to danger. Sometimes we even feel a bit of anxiety when going through a positive change, such as taking on a new job position or moving into a new home.
 
For people with an anxiety disorder, however, these anxious feelings can be far more severe and not necessarily connected with a specific event. Some people with anxiety, feel anxious and worried throughout any given day, even if there is no specific event or reason behind the anxiety. Many people with an anxiety disorder might dread an event, but the anxiety doesn’t simply disappear once that event is over or they might avoid the event entirely because of the fear and anxiety.
 
People with an anxiety disorder often feel anxious for no particular reason, not associated with any upcoming event or task. Even if the anxiety is associated with a specific event, it tends to be a much higher level of anxiety than a person without an anxiety disorder would experience. Worries and fears are constant, or chronic, and affect daily life, interfering with work, school and personal relationships.
 
As an anxiety psychiatrist, I find that many people don’t realize that chronic anxiety is not just a normal way of life. However, if worries and fears are keeping you from enjoying life, an anxiety disorder could be the culprit, and there are resources available to help you manage this anxiety.
 
3. Symptoms Can Be Emotional & Physical
Anxiety disorders can cause a wide range of symptoms. For instance, you might find that you have difficulty breathing, a faster heartbeat and even hyperventilate. These are common symptoms of an anxiety disorder. Some people feel nervous or tense or have difficulty focusing or concentrating on daily tasks due to worry and anxiety.
 
Physical responses include sweating or having an upset stomach or even severe gastrointestinal distress. Most people with an anxiety disorder often feel tired and weak and have trouble sleeping. In many cases, people with anxiety will avoid circumstances that tend to trigger an anxious response, such as social events, flying, going to a medical doctor, etc.
 
4. There Are Several Types of Anxiety Disorders
The American Psychiatric Association recognizes several different types of anxiety disorders. Some individuals will be diagnosed with one of these disorders or perhaps more than one anxiety disorder, depending on their symptoms.
 
Generalized Anxiety Disorder – With this disorder, a person tends to suffer from consistent feelings of worry and anxiety that interfere with daily life. They may suffer from both physical and emotional symptoms and often tire easily and have difficulty concentrating and sleeping. These worries typically aren’t focused on one specific event, but rather worries and anxiety about many things, big and small.
 
Social Anxiety Disorder – Individuals with this type of anxiety disorder tend to focus most of their fears and worries on social situations. Those with social anxiety might avoid meeting new people, attending social and family events or even interacting with salespeople and cashiers. They might fear going to school or going to work, and even when they still manage to handle social interactions, they do so with a tremendous amount of anxiety. 
 
Panic Disorder – People with a panic disorder will experience extreme feelings of fear and physical symptoms that include shortness of breath, chest pain, rapid heartbeat, dizziness, trembling, feelings of numbness and often gastrointestinal pain or distress. These are intense episodes where a person feels an almost complete lack of control, and sometimes they literally occur completely unexpectedly and not necessarily related to a specific event. If you have experienced recurrent “panic attacks,” this may indicate that you have panic disorder.
 
Agoraphobia – When we think about agoraphobia, it’s not uncommon that you might think about a person that is afraid to leave their home. While this can be one manifestation of agoraphobia, in some cases, a person can leave their home, but they have very intense fear when leaving this perceived “safe” space.
 
People with agoraphobia typically are afraid of crowded places and often a person will develop agoraphobia after suffering from panic attacks in a public setting. Staying in their home, therefore, often seems like the safest option, but, of course, this severely limits their ability to live a fulfilling life.
 
Specific Phobias – When a person develops an intense fear about an object, animal or situation, this could be classified as a phobia. With agoraphobia, which is considered separately from specific phobias, the fear is usually very broad with intense fears surrounding public areas or crowded areas.
 
With a specific phobia, the fear is focused on one specific issue or object, such as an intense fear of heights or perhaps of dogs or spiders or even a fear of flowers or trees or choking. In general, the person is irrationally fearful about something with very little real danger.
 
For instance, of course, a person could choke on a piece of food, but a person with a true phobia of choking might only eat a liquid diet or avoid many types of foods. Often, a person with a phobia will become preoccupied with feelings of fear about this object, even when they are not presently confronted with the object.
 
Separation Anxiety – This tends to be more common in children but can occur in adults. This is a type of anxiety where a person feels an irrational level of fear when separated from a specific person or persons.
 
While it’s common for a person, especially a child, to experience some anxiety about separating from a parent, especially the first few times this occurs, a person with separation anxiety will experience extreme distress and fear. The person might feel consumed with worry about losing this person or even suffer from nightmares about becoming separated from the person.
 
5. OCD & PTSD Are In Their Own Category
While people with Obsessive-Compulsive Disorder and Post-Traumatic Stress Disorder do suffer from a great deal of worry, fear and anxiety, these two disorders are no longer classified in the Diagnostic and Statistical Manual of Mental Disorders as anxiety disorders.
 
Of course, just because these aren’t listed as anxiety disorders doesn’t mean that they don’t cause anxiety or that an anxiety psychiatrist cannot help. As a psychiatrist, we are trained to diagnose and provide treatment for a wide range of mental health disorders, including all types of anxiety disorders as well as OCD and PTSD.
 
6. Many People Have Co-Occurring Disorders
In many cases, a person will have an anxiety disorder as well as another type of mental health disorder. A person could suffer from a panic disorder and PTSD, for example, or perhaps an anxiety disorder and an eating disorder. It isn’t uncommon for people with anxiety disorders to also suffer from depression.
 
As an anxiety psychiatrist, my job is to take a deep dive and discover all of the issues a patient is facing and why. In some cases, an anxiety disorder could be exacerbated or caused by a physical condition or even a medication that a person is taking. In other cases, a past trauma might be a contributing factor.
 
A person also might develop an anxiety disorder because they also have a substance use disorder, such as drug addiction. Genetics often play a part, so if your parent or grandparent suffered from anxiety, you might be more likely to have an anxiety disorder.
 
Your psychiatrist should look at all factors that could cause an anxiety disorder including co-occurring disorders. Once we determine the correct diagnosis for a patient, we can design a treatment plan that addresses all of the issues the patient faces and not just the anxiety.
 
7. There Are Many Treatment Options
As an anxiety psychiatrist, my focus is on diagnosis and providing treatment options. In some cases, this might include medication, which I can prescribe. However, medication is not the only option we would consider.
 
Often, cognitive behavioral therapy is the best way to manage an anxiety disorder. This type of therapy helps you build strategies and skills to help you alleviate and deal with symptoms. Often learning these skills boosts a person’s confidence and allows them to handle fearful situations with greater ease.
 
In some cases, a combination of medication and therapy is recommended. There are several anti-anxiety medications and even some antidepressants that can help relieve feelings of anxiety and improve one’s quality of life. Typically, we do recommend that you also undergo psychotherapy, as well, so that you also have strategies to help you through stressful situations.
 
Often, if a person has co-occurring disorders, we will work with a variety of therapy types and possibly a combination of medications. Alternative treatments such as ketamine treatments, transcranial magnetic stimulation (TMS) or eye movement desensitization and reprocessing (EMDR) might be options, especially for patients with treatment-resistant depression or PTSD in addition to an anxiety disorder.
 
No matter what type of mental health disorder you have, a quality psychiatrist should be able to help. Whether you find someone advertised as a depression psychiatrist or bipolar psychiatrist or ADHD psychiatrist, they should have the skills to help you with anxiety disorders as well as any other co-occurring disorders you may have.
 
Do You Need An “Anxiety Psychiatrist Near Me?”
So often, when we search the internet, we add the words “near me” to the search, such as “anxiety psychiatrist near me.” Obviously, everyone wants a psychiatric provider conveniently close to their home but opting for a telepsychiatry service can be the best option.
 
Not only does this allow you the freedom to find the best doctor match for your needs and personality, but you also have the freedom of being able to meet with your doctor from just about anywhere on the planet as long as you have an internet connection.
 
Whether you want a local psychiatrist or a virtual psychiatrist, I can help. As a psychiatrist in Thousand Oaks, I can serve patients in Newbury Park, Westlake Village, Calabasas, Simi Valley, Agoura Hills and Camarillo, but if you live outside of these areas, I am always happy to meet virtually to help you find solutions for any mental health issues.
 
If you need an anxiety psychiatrist or need treatment for depression, bipolar disorder, ADHD, substance use disorders or perhaps co-occurring disorders, please contact us today. I will provide you with a thorough evaluation and design a treatment plan that can greatly improve the quality of your life. Psychiatric disorders are not a weakness, they are biological diseases that we can treat, so get in contact with us as soon as possible to set up an appointment.

Living with a psychiatric disorder isn’t easy, and some medications can help successfully treat many mental health conditions. As a virtual psychiatrist, I know that patients are often wary of taking medications so let’s take a look at some facts and myths about medical intervention for mental illness.
 
Myth: Psychiatric Drugs Are Always Addictive
Let’s be honest, drug addiction is an enormous problem in the United States, and many patients are understandably worried about taking a new medication, especially if they have heard rumors that these types of drugs are dangerous and addictive. However, when taken as directed, medications can alleviate symptoms of mental illness without becoming addictive. Taking a prescribed medication is absolutely not the same as recreational drug use.
 
After all, your psychiatrist is providing you with a controlled dose of medication. If you take the medication, following the doctor’s instructions, addiction shouldn’t be an issue. However, many people who opt to not seek the help of a virtual psychiatrist and decide against taking prescribed medications end up self-medicating with alcohol and drugs, which is far more dangerous and ineffective than simply taking the prescribed dose of a medication that has been well-studied for the treatment of your particular mental health issue.
 
Myth: Psychiatric Medications Change My Personality & Health
Many people worry that these drugs will alter their personality or perhaps lower their energy levels to the point where they feel like a “zombie.” In general, this is a myth. Psychiatric medications are meant to help alleviate the symptoms of a mental health disorder and while you may no longer experience mania, anxiety or depression, you are still you and the medication won’t change that.
 
However, it is important to note that the medications can have side effects. For instance, some medications might suppress the appetite, so you will need to make sure, if this occurs, that you still eat a healthy, balanced diet. Additionally, if you do find that your medications make you feel exceptionally tired or that you have “brain fog” or other issues, please talk with your virtual psychiatrist as you may need to adjust the dosage of your medication or perhaps try a different medication.
 
Some common side effects, such as nausea, dizziness or fatigue, do tend to subside as your body gets used to the medication. Your psychiatrist should go over, in detail, the common side effects of these medications and how to manage these side effects in general. Usually, the side effects are far less difficult to deal with than the symptoms you deal with from depression, anxiety, bipolar disorder or any other mental health issue.
 
Myth: Medications Aren’t Really Necessary
As an experienced virtual psychiatrist, I don’t always reach for the prescription pad for every patient. In some cases, I might recommend a different type of treatment, such as EMDR treatments or a ketamine treatment rather than prescribing medication. Sometimes cognitive behavioral therapy or even meditation can be used to lessen symptoms. However, it’s important to keep in mind that mental health disorders are biological problems, and, in many cases, medications are the best treatment for these issues.
 
Many patients feel weak for using medications to help with their symptoms, but would you think that someone with asthma was weak for using an inhaler? Would you think someone with high blood pressure was weak for using medication? Of course not. There’s no reason to feel shame for using medication to help you alleviate symptoms of depression, anxiety, bipolar disorder, ADHD or any other mental health disorder. If these medications help you live a happier, healthier life, that’s all that matters.
 
While medications do help people manage the symptoms of mental illness, I also typically recommend concurrent therapies, such as behavioral therapy and talk therapy as it’s smart to use as many tools as possible to help you achieve long-term success. I also recommend that my patients schedule regular exercise, eat healthy meals and try to get a good night’s sleep whenever possible as a combination of all of these strategies can yield the best results.
 
As a virtual psychiatrist, I am a mental health professional as well as a medical doctor. This means, during the diagnostic process, I will consider your physical health as well as your mental health issues. Often, we need to address physical issues, such as chronic pain, in addition to your anxiety or depression or bipolar disorder. It is important to treat the whole person and all of their co-occurring disorders.
 
Types of Psychiatric Medications
In the chart below, there are five basic categories of psychiatric medications, take a quick look and then we will dive into some facts about the most commonly prescribed drugs for specific mental health issues.

Post-Traumatic Stress Disorder, or PTSD, is estimated to affect more than 3.5% of the U.S. population, and this disorder can happen to anyone. If you think you have PTSD, a PTSD psychiatrist can help you reach a diagnosis and there are many treatments available including EMDR, which is a type of psychotherapy that many people are unaware exists. Let’s take a look at PTSD, EDMR and other treatment options.
 
What Is PTSD & What Causes It?
PTSD is a mental health disorder that affects people who have either experienced a traumatic event or witnessed a traumatic event. Soldiers often will suffer from PTSD because of their combat experiences. In fact, PTSD was sometimes called combat fatigue or shell shock, and while it is common for soldiers to experience PTSD, many other traumatic events can trigger this disorder.
 
For instance, if you have been the victim of violent crime, such as rape or assault or witnessed a violent crime, this can cause PTSD. Victims of abuse (physical, sexual or mental abuse) can suffer from PTSD. A car accident or another type of accident or a near-death experience can cause PTSD, even if it was a loved one who was near death or in an accident. A person who lost a loved one to suicide or a long-term illness also can experience PTSD.
 
Additionally, others might experience PTSD. For instance, police officers or firefighters that repeatedly are exposed to violent crimes or severe trauma, such as car accidents, might experience PTSD.
 
In general, the American Psychiatric Association defines PTSD as a disorder caused by either experiencing or witnessing a traumatic event or series of traumatic events. In addition to witnessing or experiencing trauma, the person must be experiencing intrusion-related symptoms, such as suffering from flashbacks, experiencing recurrent dreams related to the trauma or perhaps experiencing frequent involuntary memories of the event. For children, they may engage in repetitive play that mimics various aspects of trauma.
 
Additionally, the criterion for PTSD includes avoidance. This means the person might avoid any places or people that remind them of the event or perhaps try to block out the memories or their feelings regarding the trauma.
 
People with PTSD also experience altered moods and reactivity. For instance, they might have difficulty expressing any positive feelings and instead focus on feelings of negativity. They might even have trouble remembering details about the trauma itself, which is known as dissociative amnesia, which is an amnesia that is not caused by factors such as a head injury or drug use.
 
We also find that PTSD sufferers experience heightened reactivity. For instance, they might be hypervigilant, constantly checking doors and windows. They might have outbursts of anger or physical violence that seem out of proportion. They often experience difficulty with sleep and general concentration or even engage in reckless behavior.
 
In order to reach a diagnosis, these issues must last for at least one month and cause a significant disruption in your daily functioning and relationships. This could be problems at home or at work that can not be attributed to another physical condition or substances such as medication or alcohol. Your PTSD psychiatrist should conduct a thorough evaluation to ensure a proper diagnosis and once we’ve reached a diagnosis of PTSD, psychiatrists will start looking at treatment options.  
 
What Is EMDR & How Can It Help?
While there are many treatments for PTSD, one that I find particularly interesting is known as Eye Movement Desensitization and Reprocessing (EMDR). This treatment was designed to help those with traumatic memories, and it requires no medication nor extensive treatment to be effective.
 
There are several steps or phases in the process of EMDR, including:
 
Phase 1: History, Evaluation & Planning
During the first session, your PTSD psychiatrist or psychologist will take a detailed history and identify the traumatic memories associated with your PTSD as well as taking a look at what current situations trigger a negative response. Once we’ve evaluated the source or sources of your trauma, we can begin to focus on planning effective treatment.
 
Keep in mind, if you don’t meet the full criteria for PTSD, EMDR may still be a successful treatment option for your anxiety and stress. Some studies show anxiety and depression may be reduced using EMDR techniques.
 
Phase 2: Preparation
In this phase, your PTSD psychiatrist, psychologist or therapist, will provide you with some tools to help you handle emotional distress. These tools will be useful during your actual EMDR sessions, but also can help you handle stress and anxiety in general, especially during the times in between an EMDR session.
 
Phases 3-6: The Desensitization Phases
In Phase 3, we identify a specific trigger memory that we want to address. For those with single traumas, that experience (car accident, rape, death of a loved one, etc.) will be the memory we target. For people with multiple traumas, we might select a specific incident, such as a particular moment of abuse that was especially traumatic or typical of the general type of trauma you experienced.
 
In Phases 4-6, we undergo the desensitization process. The patient will focus on the memory, and we use special eye movements where your therapist moves their fingers in your line of sight, and you follow the movement with just your eyes. Your therapist then will introduce more pleasant thoughts as you continue to move your eyes and follow hand movements, although a therapist often uses a different rhythm or type of hand movement when introducing positive thoughts.
 
 
 
Phase 7: Closure
After we’ve completed a session, we evaluate whether or not the specific target memory was processed during the desensitization phases. If not, the therapist will provide the patient with some techniques to help them handle anxiety and stress between the sessions. The goal of the closure section of the session is also to help the patient feel more peaceful, less anxious and more optimistic about the next session and the future in general. Often the sessions are spaced very closely together, so that the patient can work through the issues as quickly as possible.
 
Phase 8: Re-Evaluation
This actually will be the first component of your next session as your therapist evaluates the success of the previous treatment or treatments. If you have completed all of your sessions, this re-evaluation appointment might be a follow-up appointment scheduled several weeks after finishing your desensitization treatments.
 
The advantages of EMDR include the success rate, ranging from 70% up to more than 95% in some studies. Typically, patients with a single trauma experience faster and more permanent success. If you have experienced multiple traumas, it can take a few more sessions to achieve successful remission of PTSD symptoms. Additionally, no medication is needed, and the entire process can be handled very quickly, providing you with quick relief from your PTSD symptoms. EMDR also seems to yield permanent results for most patients.
 
Of course, in some cases, especially for those who experienced multiple traumas, such as years of abuse or perhaps just several traumatic episodes, it can be helpful to use additional therapies, and there are several options to consider.
 
What Other Types Of Treatments Can A PTSD Psychiatrist Provide?
There are several additional options to help reduce or eliminate symptoms of PTSD. Cognitive Processing Therapy (CPT) can be an option. With this type of therapy, you address negative thoughts about the trauma or about yourself, and this includes talk therapy as well as writing about your trauma.
 
Typically, CPT begins with a person writing a detailed account of the trauma and reading it aloud to their therapist. The therapist’s office serves as a safe space so that the patient can face their emotions and also perhaps identify issues associated with their interpretations of the events. For instance, an abuse victim might write out several examples about why they, the victim, are to blame, and the therapist can begin to redirect these thoughts and help them look at the trauma from a more detached perspective.
 
With CPT, the therapist also provides their patients with an assortment of strategies to help them deal with issues related to PTSD. People with PTSD often struggle with issues related to self-esteem, safety, power/control, intimacy and trust. Finding ways to redirect negative thoughts about these issues can be very helpful.
 
Prolonged Exposure (PE) therapy also has shown some success, and, again, this targets those negative feelings and thoughts. With PE, you undergo talk therapy where you discuss traumatic events in detail and process your emotions regarding these events and use different breathing techniques to help you manage your anxiety.
 
Additionally, with PE, the therapist will give you some homework to help you begin to expose yourself to situations or people that might generate fear and anxiety. This homework begins with smaller, less stressful assignments and is known as in vivo exposure.
 
For example, with PTSD from a car accident, a person might be fearful of allowing another person to drive while they are a passenger, as this can feel like a lack of control. With in vivo exposure, you might begin by just sitting in the passenger seat with someone in the driver’s seat. Then, you might allow that person to drive around the block. Gradually, you could increase the time as you begin to feel more comfortable, utilizing the breathing techniques and other tools you learned in therapy.
 
Finding A Psychiatrist for PTSD
A PTSD psychiatrist is a professional that provides you with a solid diagnosis. My goal as a psychiatrist is to identify all of the issues troubling a patient, which might include identifying PTSD as well as any co-occurring mental health disorders. Additionally, as a medical doctor, I also consider any medical conditions that might need to be addressed to achieve a happier, healthier life.
 
Typically, a PTSD psychiatrist can provide you with a diagnosis and any medications that you might need, and some might provide EMDR treatments. In some cases, your PTSD psychiatrist might refer you to a therapist or psychologist for EMDR or other types of therapy.
 
In my practice, I offer comprehensive telepsychiatry services, so we can meet virtually from wherever you might live. My offices are in Thousand Oaks, but as a virtual psychiatrist, I can provide services to patients throughout Southern California and beyond.
 
If you are suffering from PTSD or severe anxiety related to a single trauma or multiple traumas, don’t hesitate to get in touch with me or another PTSD psychiatrist as soon as possible. PTSD is a treatable disease, and we can provide you with options that will help you live a happier, successful life.

Millions of Americans suffer from some level of depression and while some depressive episodes are brief, for those that suffer from long-term depression, the effects can be devastating on one’s day-to-day life. Fortunately, an experienced depression psychiatrist can help, even with treatment-resistant depression. Let’s take a look at types of depression, symptoms and the many treatment options available.
 
It’s not uncommon for anyone to feel low or blue once in a while, even for a few days or a week or more. This is quite common after the loss of a loved one or perhaps in the aftermath of a divorce or another traumatic event, such as losing your job. Of course, many physical factors can contribute to depression, such as suffering from chronic pain, managing life with a disease such as cancer or even having a baby.
 
Reaching out to a trusted friend, a therapist or even a religious adviser can help during these times. However, when depression is constant and chronic and lasts for an extended period of time, it’s time to think about contacting a depression psychiatrist and finding treatment options that help you alleviate symptoms of depression or eliminate them altogether.
 
It is often hard for people to seek help for depression, but just like with physical pain, mental pain is a sign that something is wrong. As a depression psychiatrist, my philosophy is that psychiatric disorders are not a weakness, they are simply a biological disease that is often treatable.
 
Symptoms Of Depression
Again, most people have moments of sadness, loneliness and depression, but when depression lasts for several weeks or months, it is time to seek help. Here are a few symptoms you might notice that indicate you are clinically depressed:

• Fatigue
• Insomnia
• Irritability
• Feelings of hopelessness & pessimism
• Loss of interest in hobbies, work, relationships, etc.
• Chronic aches and pains (often headaches, as well)
• Persistent feelings of sadness and anxiety
• Feelings of guilt and helplessness
• Feelings of worthlessness
• Trouble concentrating & forgetfulness
• Suicidal thoughts (or attempting suicide)

 
If you are having suicidal thoughts, please call the National Suicide Prevention Lifeline at (800) 273-8255. While not everyone with depression will attempt suicide or have suicidal thoughts, please know that if you are feeling suicidal, help is available at any time of day or night.
 
What Causes Depression?
Many factors can cause depression, and in some cases, a combination of factors occurs. For instance, there is thought to be a genetic component with depression, so if your parent, grandparent or other relatives are prone to depression, this could be one of the causes of your depression.
 
For others, issues with brain chemistry might be an issue, such as lowered serotonin activity. Medical issues also can cause depression, and this can include conditions that cause chronic pain as well as diseases such as cancer, diabetes, Alzheimer’s disease, Parkinson’s disease and others. Of course, many women experience postpartum depression after giving birth. 
 
In some cases, drug or alcohol abuse can cause depression, but there are also some types of prescribed medications that can cause depression. A life-altering event also can trigger depression, and this can be anything from a death in the family to a car accident or some other type of traumatic event or just simply suffering from loneliness and feelings of isolation can cause depression.
 
Types Of Depression
There are several types of depression, and a depression psychiatrist will do a thorough evaluation to determine which type of depression is occurring, as treatment plans can vary based upon the type of depression.
 
Major Depressive Disorder (MDD) – With MDD, a person will experience a combination of the depression symptoms listed above for at least two weeks that mark a change from the person’s previous or usual mood.
 
The DSM-V, which is the classification system for mental disorders designed by the American Psychiatric Association, also states that for this diagnosis, these symptoms must be causing a significant amount of stress or reducing your ability to function. Perhaps your work suffers, or you have difficulty keeping your house clean or taking care of daily hygiene tasks.
 
These symptoms also must be independent of other disorders, such as schizophrenia or bipolar disorder. Additionally, the depression symptoms cannot be attributed to a medical condition or to drug or alcohol use.
 
Persistent Depressive Disorder (PDD) – While MDD is a type of depression lasting at least two weeks (or more), those with PDD have chronic depression lasting at least two years for adults and one year for children and teens. The symptoms of PDD often are milder than MDD, but the chronic nature of this depression obviously lessens one’s quality of life substantially. Again, the depression symptoms must be independent of disorders such as schizophrenia, bipolar disorder, medical conditions, etc.  
 
Postpartum Depression – While having a baby can be a wonderful event, a woman’s body goes through immense changes during pregnancy not to mention the huge changes that parenthood brings. Children are a blessing, but life does change signifcantly once they arrive, and it’s very common for women to experience depression and anxiety.
 
In fact, most women (as many as 70%) will experience what is known as the “baby blues.” This is a short-term issue that often causes women to feel anxious, irritable and perhaps very emotional, including bouts of crying for no specific reason. The good news is that the baby blues typically doesn’t interfere with daily life tasks and tends to resolve fairly quickly.
 
However, postpartum depression, also known as peripartum depression, is in a class by itself, so to speak. If you notice persistent feelings of depression, extreme sadness, anxiety or even feelings of indifference that last more than two weeks and prevent you from handling any normal activities, it’s important to seek help.
 
It’s also important to note that fathers also can suffer from this form of depression. While they don’t go through the same physical changes as mothers, the extreme changes and financial obligations of fatherhood can be daunting.
 
Premenstrual Dysphoric Disorder (PMDD) – While it’s not uncommon for women to experience mood changes as well as issues such as cramping, bloating, acne, headaches, etc. While this is certainly frustrating and uncomfortable, these issues rarely interfere with normal functioning at home, work or school.
 
For those with PMDD, the changes tend to occur about a week prior to menstruation and can last the duration of your period and the symptoms are severe enough to disrupt daily functioning. Symptoms of PMDD include severe fatigue and depression, anxiety, confusion, anger, crying spells, severe moodiness and sometimes even paranoia.
 
Many women with PMDD will experience headaches, dizziness, muscle spasms and heart palpitations.  Nausea and vomiting are other common symptoms as well as swelling of the ankles, feet and hands. In some cases, those with PMDD might experience vision changes and frequent eye infections. These are just a few of the severe symptoms a person with PMDD might encounter.
 
Seasonal Affective Disorder (SAD) – If you’ve ever had the winter blues for a few days, you are not alone. Many people tend to feel a bit down now and then during the winter, as there is less sunshine in our hemisphere. However, if you notice feelings of sadness, loss of energy, difficulty concentrating, oversleeping and the loss of interest in activities you previously enjoyed for a period of several weeks, this could be SAD, especially if these symptoms interfere with daily functioning.
 
With SAD, we might use some of the medications that are listed in the section below, but also light therapy and talk therapy, such as cognitive-behavioral therapy, have been shown to help lessen symptoms. With light therapy, the patient sits in front of a special light therapy box for about 20-30 minutes each day throughout the winter months.
 
Co-Occurring Disorders
As a depression psychiatrist, my job is not to simply diagnose depression, but also to look at the whole patient and determine all of the issues that you might be facing. For instance, it is not uncommon for people with depression to also suffer from anxiety. You might also suffer from addiction, OCD, PTSD or another mental health issue. Additionally, your depression could be caused by bipolar disorder or another mood disorder.
 
A depression psychiatrist must consider all of the possible diagnoses before setting on a course of treatment. We also must consider your general physical health. Is your body vitamin-deficient? Do you have diabetes? Are you suffering from chronic pain? Simply treating depression is often not enough, we need to treat all of the issues you are facing to improve your quality of life.
 
Depression Treatment Options
Many people with depression are hesitant to ask for help, but this is simply a biological disease, and it can be treated. Seeking help for depression is no different than seeking medical help for any other condition such as asthma or a broken bone.  It can, however, take some time to find the best treatment plan to fit your needs. Medications and therapy take time to work, so it’s important to have patience and keep taking medications and attending therapy as directed by your physician.
 
There are many treatment options to consider, including:
 
Selective Serotonin Reuptake Inhibitors (SSRIs) – This is often the first line of treatment for many types of depression, including MDD, PDD, postpartum depression, etc. These drugs tend to have fewer side effects and work for many people to lessen or eliminate symptoms of depression by boosting serotonin in your brain.
 
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) – These are similar to SSRIs, but they increase norepinephrine in the brain as well as serotonin. If you don’t respond well to SSRIs, your depression psychiatrist might try an SNRI instead.
 
Ketamine – Some patients will suffer from what is known as treatment-resistant depression. While this obviously can be frustrating and discouraging, ketamine is a medication that has shown some success with treatment-resistant depression as well as anxiety and PTSD.
 
Ketamine initially was used as an anesthetic, but interestingly, many EMTs and ER doctors would use it to calm agitated patients, especially those who had attempted suicide. While it did calm them initially, many of these patients would come back months later and state that they hadn’t felt suicidal or depressed since the ketamine treatment. Eventually, after much study, the FDA approved two types of ketamine as a treatment for depression, anxiety and PTSD.
 
Ketamine can be given either intravenously or as a nasal spray. After receiving the treatment, you need to wait at least two hours before heading home, and you will need to have someone drive you home as you might be drowsy.
 
Transcranial Magnetic Stimulation (TMS) – This is a non-invasive treatment that typically is used for people with treatment-resistant depression. For TMS, we place an electromagnetic coil by your forehead, and a magnetic pulse is delivered to nerve cells in your brain. This process is entirely painless for the patient and has been shown to stimulate the areas of the brain that control our mood. Often if TMS is unsuccessful, we will consider ketamine as our next approach.
 
Therapy – While medications certainly can be helpful, it is also wise to add some type of therapy to your treatment plan. Talking with a therapist or psychologist can help you work through problems and learn some tools to help you manage depression and anxiety. Some type of cognitive-behavioral therapy is usually always recommended in addition to medication.
 
Keep in mind, that if you have a co-occurring disorder, we may need to consider additional medications and treatments for those specific disorders. For instance, if your depression is caused by bipolar disorder, we might need to try more than one medication or perhaps other types of medications than those discussed above.
 
If you have depression caused by a physical medical condition, treating that condition can alleviate depression symptoms, so we might approach your depression treatment differently than for someone with MDD or PDD.
 
In addition, it is always recommended that you eat a healthy diet, and you consider daily exercise as these steps can help lessen symptoms and improve your overall health. Some patients, such as those with low levels of vitamin B12, iron and other vitamins or minerals also might need to consider taking vitamin supplements.
 
Contact A Depression Psychiatrist Today
As a depression psychiatrist, I can provide you with a thorough diagnosis as well as helping you find a medication or treatment plan that helps alleviate your symptoms. This thorough diagnosis is a crucial first step and it can take more than one session to determine the diagnosis and create a treatment plan, but it’s best to find ways to address all of the issues you are facing to achieve long-term success.
 
In addition to treating depression (including treatment-resistant depression), I also work as a bipolar disorder psychiatrist, ADHD psychiatrist, anxiety psychiatrist and can provide treatment for drug and alcohol addiction. While I have offices in Thousand Oaks, I also offer telepsychiatry services. Whether you live near my office or elsewhere in Southern California and beyond, I can provide you with quality virtual psychiatrist services.
 
If you need a depression psychiatrist, don’t wait another day to give me a call. No one should have to suffer from depression and there is hope. We have many treatment options that can help you live a healthier, happier life and you deserve to live your life to the fullest.

​Every day, hundreds of people search the internet for a “psychologist near me” or a “psychiatrist near me,” but which type of doctor do you really need? There are some important differences between these two professionals that are important to understand.
 
The Role Of A Psychiatrist
A psychiatrist is a medical doctor with an emphasis on treating mental health disorders. Psychiatrists treat mood disorders, such as depression and bipolar disorder as well as behavior disorders or neurodevelopmental such as ADHD. Other issues a psychiatrist can treat include anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, eating disorders, schizophrenia and even addiction.
 
Because a psychiatrist is a medical doctor, they are able to prescribe medications, so much of their focus is on diagnosis and medication management, although they certainly might recommend a therapy such as Cognitive Behavioral Therapy (CBT) or alternative treatments for some conditions such as Transcranial Magnetic Stimulation (TMS) or Eye Movement Desensitization and Reprocessing (EMDR). In many cases, you might end up with a treatment plan that includes medication and several types of therapy.
 
While that “psychiatrist near me” can provide patients with diagnosis and medication, as well as recommending therapies such as cognitive behavioral therapy, the psychiatrist is not typically the person that will be sitting across from you every week or a few times each month for talk therapy or CBT sessions. Psychiatrists tend to focus on finding the proper treatment, rather than focusing on providing one-on-one therapy.
 
The Role Of A Psychologist
Though a psychologist is not a medical doctor, these professionals do have extensive training to help those with mental health disorders. They cannot prescribe medication, but they often can help with the diagnosis of issues such as anxiety, depression, bipolar disorder and much more. Your psychologist might refer you to a psychiatrist if they believe that medication would be helpful, but they also will be able to provide many types of psychotherapy.
 
Which Doctor Do You Need?
I often am asked which professional is best – a psychiatrist or a psychologist? However, there’s rarely an “either/or” answer. In many cases, it is recommended that you seek out the services of both professionals. You might begin the journey with a psychiatrist and then branch out to use a psychologist to help you with cognitive behavior therapy, talk therapy or another type of therapy.
 
Even if you don’t end up using any type of medication, it can be smart to talk with a psychiatrist at first because of their medical perspective. A psychiatrist will be interested in gaining a complete picture of health, and not just mental health. Medical conditions can make an impact on our mental health, so it is important to look at the whole patient and every condition that might be affecting them.
 
Once we determine the best course of action, a psychologist or therapist can provide you with psychotherapy and your psychiatrist can help you with the medication management. In some cases, we might need to adjust the dosage or try another type of medication or medications before we find the best combination to suit your unique needs. This can take time, but the result should be a happier life where the symptoms of your mental health disorders are as well-managed as possible.
 
Types of Psychotherapy
Many types of therapy may be beneficial, and these often are utilized in conjunction with medication or in lieu of medication, depending on the patient’s needs. Here’s a quick look at a few psychotherapy options that can be helpful tools.
 
Cognitive Behavioral Therapy (CBT) – This is a type of talk therapy that helps you redirect negative thinking to help you generate more positive results when faced with challenges. This is considered short-term therapy because it’s meant to provide patients with tools that they can use to help them manage difficult situations.
 
For instance, for someone with a panic disorder or perhaps PTSD, this type of therapy helps identify triggers and also provides you with some self-calming techniques to help manage anxiety and panic. CBT also can provide you with tools to help overcome loss or even to cope with a chronic medical illness.
 
CBT often is used for patients with depression, anxiety, PTSD, eating disorders, obsessive-compulsive disorder, substance use disorders, phobias, schizophrenia and bipolar disorder. Again, sometimes medication also is used in conjunction with CBT. You would use a psychiatrist for the medication management, and a therapist or psychologist for the CBT.
 
Dialectical Behavior Therapy (DBT) – DBT is actually a type of CBT, and it is very effective for patients with borderline personality disorder as well as those with people who self-harm, such as cutting, and those with chronic suicidal thoughts. It also can be used for people with substance abuse issues and even PTSD.
 
With DBT, the goal is to help those with very intense and uncontrollable emotions. Using DBT techniques, patients help regulate their thinking and also learn better ways to communicate with family, friends and others, as this is often a difficult issue, especially for those with borderline personality disorder.
 
Psychodynamic Therapy – Back in the 60s and 70s, we often just called this analysis or psychoanalytic therapy. The goal here is to help change behavior by diving into a patient’s history to learn how past experiences (including traumas) may be affecting current behavior or thoughts.
 
This can be helpful for some patients with depression and anxiety or those with a trauma in their past, but it is still wise to consider using tools that one gains through cognitive behavioral therapy as these help us get through challenging situations as they occur. Still, sometimes it can be a good idea to identify how our childhood events or traumatic events impact our current behavior and thoughts.
 
Humanistic Therapy – This is a talk-based type of therapy and the goal with the humanistic approach is on the individual in the present. Rather than focusing on what caused a certain type of behavior, we focus more on how we can help a patient improve their sense of self. This can be used as a treatment for anxiety, depression, addiction and personality disorders, but, again, as with psychodynamic therapy, it can be smart to consider some type of CBT to provide you with concrete tools that can help you deal with fears, anxiety and interpersonal relationships in the moment.
 
Eye Movement Desensitization and Reprocessing (EMDR) – This is a body-oriented type of therapy that has proved very effective for the treatment of PTSD or any type of past trauma. EMDR also has been found to help with depression, anxiety and phobias. With EMDR, the theory is that some specific eye movements can reduce negative emotions associated with trauma, anxiety or depression.
 
EMDR has eight phases as part of the treatment plan. The first phases include documenting a thorough history of the patient, providing the patient with self-control and self-soothing techniques and identifying the specific memories that trigger those negative emotions. This could be any past trauma including a traumatic accident, sexual assault, a death in the family, domestic violence, etc.
 
During the next phases, patients will help desensitize the patient to these traumatic events using specific types of eye movements. The therapist also will help you replace negative thoughts with positive thoughts. While this won’t erase the memory of the traumatic event, it helps you redirect your emotions into a more positive way of thinking so that those traumatic events no longer trigger exponential emotional responses, such as panic attacks or anxiety.
 
Transcranial Magnetic Stimulation (TMS) – TMS can be an excellent option for treatment-resistant depression. If you’ve tried various medications and therapies with little success, TMS might be something to consider. It is FDA-approved, painless and noninvasive. It also can be beneficial for some patients with anxiety and PTSD.
 
For this treatment, we place an electromagnetic coil near your forehead, and this delivers a magnetic pulse to nerve cells in the prefrontal cortex, which is the area of the brain that controls mood. By stimulating those nerves, this can help improve mood and ease some of the symptoms associated with depression.  
 
Medication & Mental Health
Of course, in some cases, medication is an excellent treatment option. Typically, I would recommend combining medication with another type of therapy, such as cognitive-behavioral therapy. While medication can help reduce symptoms and greatly improve life for many patients, learning how to respond to stressful situations and how to deal with unpleasant memories and emotions are valuable tools for all of us.
 
Finding A Psychologist or Psychiatrist “Near Me”
In many cases, you don’t really need to find a psychologist or psychiatrist “near me,” because we can provide many of these treatments using telepsychiatry. Throughout the pandemic, telepsychiatry has been our tool of choice, allowing both doctor and patient to remain socially distant while still receiving treatment.
 
Visiting a virtual psychiatrist or online psychiatrist not only provides you with the same level of service as an in-person appointment, it also can be less stressful for patients. Additionally, it makes it far less necessary to find a “psychiatrist near me,” and allows you to broaden your scope and find the best possible doctor-patient match.  
 
If you do want that psychiatrist near me, I have offices in Thousand Oaks so if you’ve been looking for a psychiatrist in Thousand Oaks, a psychiatrist in Simi Valley or a psychiatrist in Westlake Village or perhaps Woodland Hills, but I also can provide telepsychiatry for patients throughout Southern California. I treat a wide range of mental health disorders including ADHD, depression, anxiety and bipolar disorder, as well as helping those with substance use disorders.

​As an experienced bipolar disorder psychiatrist, I am often asked how often does ADHD co-occur with bipolar disorder? While this is quite common, many disorders can co-occur with each other, and all of these issues need to be addressed in order for any treatment plan to be successful.
 
According to the National Institutes of Health, nearly 3% of all adults in the United States have some type of bipolar disorder so this mood disorder is much more prevalent than you might think. ADHD (Attention Deficit Hyperactivity Disorder) is even more common, and it is estimated that about 5% of adults have this disorder and perhaps as many as 9% to 10% of children may have ADHD.
 
But, how often does ADHD co-occur with bipolar disorder? This question is difficult to answer definitively, but one thing I’ve found is that many of the symptoms of each disorder are quite similar. As a psychiatrist, my goal is to discover if a patient has bipolar disorder or ADHD or a combination of the two, which certainly could be the case.
 
Both ADHD and bipolar disorder often include symptoms such as irritability, restlessness, hyperactivity, increased energy and impulsivity, but there are some key differences. For instance, with bipolar disorder, a person will experience severe mood swings, ranging from elation to extreme depression and these mood swings can last for days or weeks.
 
People with ADHD may be quick to anger, but these mood changes tend to be more appropriate to the situation and they have less difficulty calming themselves than a person with bipolar disorder. People with bipolar disorder also might actively seek out problems and dangerous situations that might cause them to act out in anger or express rage. With ADHD, these are isolated moments of strong emotion usually reacting to a specific situation rather than episodes of mania or depression that last for a long time and have no identifiable trigger.
 
Additionally, with both ADHD and bipolar disorder, you might see symptoms such as distractibility or inattention. With ADHD, these are symptoms that tend to always be present, while a person with bipolar disorder might only experience these issues during a manic phase.
 
Likewise, both disorders can cause sleep-related issues. With ADHD, a person might be experience discomfort and fatigue due to sleep deprivation. With bipolar disorder, there also might be a lack of sleep during a manic phase, but without fatigue or a lack of energy accompanying this sleep deprivation.
 
While these conditions have many similarities and differences, it is not uncommon for a person to experience both disorders concurrently. Some studies have shown that more than 60% of people with bipolar disorder also have ADHD. Because of this comorbidity, it’s not uncommon for a doctor to miss one of these diagnoses.
 
A proper complete diagnosis is crucial for treatment to be effective. With bipolar disorder, medication is a common treatment option and while many people with ADHD often take medication, as well, we tend to use different medications to treat ADHD than we would for bipolar disorder. Additionally, both patients benefit from other types of therapy, such as cognitive-behavioral therapy and other strategies.
 
Additional Co-Occurring Disorders
When we talk about how often ADHD co-occurs with bipolar disorder, we often forget that many other disorders also can be present. For instance, many people with ADHD or bipolar disorder also have an anxiety disorder or depression. A substance use disorder also can be a common co-occurring disorder with either ADHD or bipolar disorder.
 
Additional co-occurring disorders might include obsessive-compulsive disorder, borderline personality disorder or even an eating disorder or body dysmorphia. It also is important to take into consideration other possible physical diseases that may have an impact on treatment for mental health disorders. For instance, if a person has diabetes, stabilizing insulin levels could have a positive effect on lessening some of the symptoms of a mood disorder.
 
Psychiatrists should, and must, in my opinion, take the time to truly assess each patient’s physical and mental issues. As an example, if a patient came to you with bipolar disorder, a substance use disorder and suffered from chronic pain, you need to address all three, including the chronic pain, as this can be a reason why people turn to alcohol and drugs and chronic pain has a distinct impact on our mental health.
 
Finding A Diagnosis
The first step to finding a diagnosis is a thorough evaluation and for this, you will need to start with a bipolar disorder psychiatrist or ADHD psychiatrist, although most will treat both conditions. A psychiatrist is a medical doctor that specializes in mental health disorders. Not only is a psychiatrist the only mental health professional able to prescribe medication, but they also have the medical expertise necessary to look at all physical and mental issues and arrive at a complete diagnosis.
 
Once we’ve arrived at the diagnosis, the next step is to create a treatment plan, and this often includes medication, but it also typically includes different types of therapy. Psychiatrists don’t typically provide this therapy and you will need to find a therapist or psychologist to help you with this portion of your treatment.  
 
Achieving Long-Term Success
In addition to working with a psychiatrist and therapist/psychologist, I do have some additional advice for those seeking treatment for bipolar disorder, ADHD and other co-occurring disorders. These include:
 
1. Have Patience
It takes time to identify the treatment options and the best medications as well as the ideal dosage. It takes time for medications to work in general, but we often start with a low dose and alter the dose after a few weeks or months. There’s no magic cure that will delete all of your symptoms overnight, so you need to be committed to taking your medication and attending therapy sessions and understand that it takes time to find the best fit for your needs.
 
In some cases, such as with substance-use disorders, we might need to address that issue first and then work toward a solution for the co-occurring mental health disorders. While it takes time, in the end, you can live a much happier, healthier and more fulfilling life, which is always our goal.
 
2. Avoid Online “Experts”
While it can be very helpful to learn all you can about bipolar disorder and ADHD, the internet is full of misinformation. There are hundreds of so-called psychiatric “experts” on social media sites such as YouTube, Reddit, Tik Tok and other sites that will tell you all about bipolar disorder or ADHD and how to “diagnose yourself” or promise all-natural cures. While there is helpful information out there, too often, these postings are filled with half-truths and not with the information that you need.
 
It’s also important to keep in mind that what works for one person might not work for another. Head to any message board about a specific drug and you’ll find 100 people who it helped and another 100 who it did not help. Every human is unique and needs an individualized treatment plan to ensure the best results.
 
When you look for information on the internet, search for sources that include people with degrees in psychiatry and psychology and scientists that have studied ADHD and bipolar disorder in-depth as well as pharmacology. Look for long-standing publications with solid reputations for accuracy.
 
3. Take Care Of Yourself
Medication and therapy are helpful, but they aren’t the only steps that you can take to alleviate the symptoms of bipolar disorder or ADHD. With both of these issues, some studies show that sticking with a healthy diet and a daily exercise routine can be very helpful. Some people often find that activities such as meditation can be beneficial.
 
It can be smart to create a manageable daily schedule for yourself that includes planning healthy meals, time for exercise and maybe some time spent outdoors in the fresh air and sunshine. Create a nightly routine to help yourself relax and more easily transition into sleep. A structured daily plan can make it easier to achieve stability and lower stress levels.
 
For those who need psychiatric help, I specialize in the treatment of bipolar disorder, ADHD and other co-occurring disorders. While I have offices in Thousand Oaks, I also offer telepsychiatry services throughout Southern California, so we can meet securely and virtually from just about anywhere. In fact, many people prefer using the services of an online psychiatrist because you can relax in the privacy of your own home.
 
If you have been wondering how often does ADHD co-occur with bipolar disorder or another psychiatric disorder, I hope this blog has helped you understand a bit about co-occurring disorders and treatment options. If you are suffering from any psychiatric disorder, please give me a call and let’s find a treatment plan that works for you.