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Continued from Dr Sangiacomo....
For example, a person who has had a deteriorating knee joint for years loses the ability to walk, climb stairs and stand normally as they have been compensating in an unnatural manner because of the painful, dysfunctional joint. Finally something definitive must be done and the person undergoes a total knee replacement. But the treatment does not end there. The true recovery process actually begins and often spans up to a year or more as they undergo extensive rehabilitation, "therapy" to relearn healthy ways of maneuvering within their environment. So is the process of fully recovering from progressively debilitating symptoms of depression, anxiety or other psychiatric disorders. These symptoms are so insidious, so unrelenting, and so intrusive and progressive that many aspects of a person's life has deteriorated. Even if medications are successful in reducing symptoms such as improving sleep, or reducing tearfulness, anger or anxiety, without learning to change how one approaches the stressors in their lives, (family, coworkers, medical illnesses) improvement will not be complete nor sustained. For too long, those suffering with psychiatric conditions often did so with shame and guilt, many times perpetuated either by their own beliefs, those of society, or even attitudes of other health care providers. Science is now validating that a vast majority of psychiatric disorders are biologically, chemically and/or genetically based. We get them from our families in many cases! Many such disorders may lie dormant on our genes until they are triggered by life adversities…stress! The more stress, the more expenditure of the chemicals that control mood, sleep, anxiety, pleasure, motivation etc. But understand, it is this genetic loading that determines who may display the disorder when exposed to the stressor. That is why two people exposed to similar stress may exhibit different emotional, biological, and even pathological (illness) responses. In addition, because of the monumental evidence linking accumulated stress with higher and higher demand for the very chemicals needed to reverse this trend in the body, unless the individual learns new coping skills to reduce their expenditure of these important health promoting neurochemicals, the disease process will continue unabated. Psychotherapy is an essential part of learning how to reduce this overuse and stop spending and wasting the very chemicals that are already in short supply and gravely needed for the central nervous system to heal and the person to become physically and emotionally well again. Just as a side note, the same neurochemicals that modulate mood and ability to be calm and relax and sleep in the brain, modulate pain impulses in the spinal cord and regulate digestion in the stomach and intestines. This is just one example of the huge dynamic connection between the mind and the body. In the past when someone was depressed or had anxiety they might have been told "It's all in your head". My answer to that has always been, "yes, it is, but so is a stroke or a brain tumor, we just can’t see this on an MRI, but this is very real too." With this knowledge, and armed with new pharmacologic therapies targeted at specific gene variants, newer medications can be employed to effectively reduce and eventually eliminate or control symptoms associated with disorders like Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder, Bipolar Disorder, Post Traumatic Stress Disorder, Attention Deficit Disorder and others . We address these and other conditions daily in our office. I firmly believe that when appropriate, treating these disorders with both the right medications while simultaneously improving coping mechanisms to reduce stressors by participating in psychotherapy with one of the staff Psychotherapists results in an aggressive and comprehensive approach to wellness. My goal is that while we may never "cure" these disorders, like we can't "cure" high blood pressure or diabetes, we can make it so that the most bothersome part of having them is taking a medicine once or twice a day or seeing a therapist to maintain productive, healthy and fulfilling life. If what you have been doing has not been working, we're here to help. Roxann Sangiacomo, MD Fellow - American Board of Psychiatry and Neurology |