Wednesday, July 5, 2017

FAQs about TMS - Transcranial Magnetic Stimulation

TMS Centers Houston, TXTranscranial Magnetic Stimulation – TMS is an alternative to anti-depressants. It is a mild therapy for those who cannot benefit from medicines or tablets to get freedom from anxiety or panic attack. It affects the most to the person who is sensitive to reactions. Here are the few queries which are being solved regarding TMS:

When can TRM therapy be used?
TMS therapy produces changes in neuronal activity in the prefrontal cortex that channelizes mood regulation. Each and every magnetic pulse will pass through the brain and will influence brain activity. The frequency of pulse delivery will show increased or decreased in the brain by a session of TMS.

What happens to TMS procedure?
Before any TMS therapy work, a person needs to remove any metallic object as magnetic pulse will pass through the brain and any metallic object near head could injure a person. Wear earplugs and seat comfortable during treatment for hearing protection as TMS produces a loud clicking sound with each pulse.

During the first TMS session, the custom measurements are made to ensure that the TMS coil will be properly positioned over the patient’s head. After this, the TMS coil is suspended over the patient’s scalp.

The motor threshold power is generated in the minimum amount of power necessary to make the patient’s thumb twitch. The measuring the motor threshold helps the physician personalize the treatment settings and determine the amount of energy required to stimulate brain cells.

Who will carry out the process?
TMS is always prescribed by a TMS physician. At Midtown psychiatry – a TMS Center in Huston, Texas, all TMS physicians are specifically TMS credentialed by the Hospital. The initial motor threshold is always determined by a TMS physician and treatment is being administered by an experienced TMS technician. The patient can stop a treatment at any time by asking the staff member present.

How long is the TMS therapy?
The TMS therapy involves a series of treatment sessions just like a physiotherapist. The length of one session depends on the TMS coil used and the number of pulses delivered. It generally lasts for around 30 – 40 minutes and 5 days a week. A typical course of TMS is 4 to 6 weeks. However, this is generalized units but it can vary depending on an individual’s response to treatment.

How can I get TMS treatment?
Before scheduling a treatment, you must be evaluated to determine TMS would be safe and appropriate for you.

These are the few queries solved by Midtown psychiatry TMS therapy Center. Do not fear the treatment because it will not harm you in any way and throw away your anxiety and depression permanently.

Friday, June 23, 2017

Same Sadness, So Why Different Types Of Depression?

If It’s The Same Sadness, Why Are There Different Types Of Depression?

And How Does This Affect Your Treatment?

It Is The Same Illness, So Why Different Medications?

I’m sure that some of you wonder that after seeing your psychiatrist that you received a different medication than your friend, coworker, or even family member. You have many of the same complaints of feeling sad, lacking interest and the energy to do much, isolating, crying at the drop of a hat and having ruminating bad thoughts that sometimes life is not worth living. You appear to have the same feelings, the same complaints, but are receiving different treatments and sometimes, a different diagnosis. This article describes why this might be the case.

From the beginning, it is worth noting that feeling sad, and crying when something bad and unexpected happens is perfectly normal, and oftentimes is expected. Feeling of sadness by themselves, does not result in a diagnosis of clinical depression, unless several conditions are met at the same time.

Different Types of Depression

Even if the criteria for clinical depression is met, there are different types of depression, and they need to be approached with different treatments to obtain a response and eventually remission.

Response, in clinical terms, means that the treatment provides some relief.

Remission means that the symptoms become absent.

What is The Commonality Within A Depression Diagnosis?

In all the different types of depression, sadness is the main complaint, usually associated with low self-esteem, sometimes irritability and difficulties enjoying life and increased tendency to cry very easily. However, there are differences in duration, intensity and severity as well as the way these episodes are triggered that make the diagnosis and therefore treatment, different.

According to the Mayo Clinic, to get a diagnosis of clinical depression, one must meet the symptom criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatric Association. The DSM is also used by mental health providers to provide a diagnosis of mental health conditions and by insurance companies to provide reimbursement for mental health treatment.

To get a diagnosis of clinical depression, you must have five or more of the following symptoms over a two-week period, most of the day, and nearly every day. At least one of the symptoms must be either a depressed mood or a loss of pleasure or interest. Signs and symptoms may include the following:
  • Depressed mood, such as feeling sad, empty or tearful (in children and teens, depressed mood can appear as constant irritability)
  • Feelings of worthlessness, or excessive or inappropriate guilt
  • Fatigue or loss of energy
  • Significantly reduced interest or feeling no pleasure in all or most activities
  • Insomnia or increased desire to sleep
  • Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected)
  • Either restlessness or slowed behavior that can be observed by others
  • Trouble making decisions, or trouble thinking or concentrating
  • Recurrent thoughts of death or suicide, or a suicide attempt
For a diagnosis of clinical depression, your symptoms must be severe enough to cause noticeable problems in relationships with others, or interfere with your day-to-day activities, such as school, work, or social activities. Symptoms may be based on your own feelings, or on the observations of someone else.

Clinical depression can affect people of all ages, including children. However, clinical depression symptoms, even if they are severe, can usually get better with counseling, antidepressant medications or a combination of the two.

Types of Depression Diagnoses

The following list of diagnoses that most mental health clinicians might choose from when determining a diagnosis. The diagnosis is important because proper treatment depends on an accurate diagnosis:
  • Persistent Depressive Disorder (or dysthymia):
  • Major Depressive Disorder, unipolar
  • Bipolar disorder, Depressed (bipolar disorder I, II and cyclothymia)
  • Postpartum Depression
  • Premenstrual Dysphoric Disorder
  • Adjustment Disorder with depressive symptoms
  • Bereavement
  • Depression secondary to medical conditions
  • Substance Induced Depression
As an example of the difference between two types of depression, a lot of times people who have bipolar disorder spend most of their sick time depressed and not hypomanic, or in a state of elation. However, the treatment for a depressed episode of a bipolar disorder is typically a mood stabilizer and not an antidepressant that might make symptoms worse. Having one episode of mania or hypomania, indicates a diagnosis of bipolar disorder and the treatment should focus on that, avoiding as much as possible an antidepressant without a mood stabilizer to start with.

How To Get The Most Out Of An Appointment With Your Care Provider

The best thing that a patient can do is to be as open as possible during the psychiatric evaluation and be willing to work with your doctor without leaving information out that might be essential not only in treating the symptoms but to avoid causing new ones.

Diagnoses Can Change Over Time

It is also worth remembering that your initial diagnosis is a working one that can evolve over time as more clinical information becomes available from the sessions. It is also important to see your psychiatrist often before the diagnosis is fully defined and until remission is achieved.

See Your Doctor And Psychiatrist Regularly, Even If You Are Feeling Better

Your primary health care and mental health care should be given in a coordinated manner. That is to say, your primary care doctor and mental health provider should be aware of the care the other is providing. If you haven’t already done so, and you are feeling sad or depressed, we recommend that you first speak with your primary care doctor and get a complete physical exam. The goal of the physical exam would be to try and rule out a physical cause for your depression. During the physical exam, the doctor typically will focus on the most likely causes of depression, the endocrine and neurological systems of your body. The doctor will look for any health concerns that may be contributing to clinical depression symptoms. For example, hypothyroidism is typically caused by an under-active thyroid gland. The under-active thyroid is the most common medical condition that is associated with symptoms of depression. Other endocrine disorders that are associated with depression include hyperthyroidism, caused by an overactive thyroid, and Cushing’s disease, which is a disorder of the adrenal gland. Oftentimes, treating these issues can alleviate symptoms of depression. Also, your doctor might look at other medications that you are taking to see if any of the side effects include depression.

Not seeing your treating physician and mental health care provider regularly can leave side effects unaddressed or allow symptoms to progress or worsen.

Monotherapy Vs. Combination Drug Therapy

There are multiple medications and therapies now available. In psychiatry for bringing mental illness to remission, and it is not uncommon to try several medications before finding one or more that are effective. Combination drug therapy is a type of treatment that many doctors and psychiatrists have been increasingly utilizing during the past decade, especially for Major Depressive Disorder, where there is some research to suggest that taking antidepressants from multiple classes may be the best way to treat Major Depression.

References:
Combination of Antidepressant Medications From Treatment Initiation for Major Depressive Disorder: A Double-Blind Randomized Study Pierre Blier, M.D., Ph.D., Herbert E. Ward, M.D., Philippe Tremblay, M.D., Louise Laberge, M.D., Chantal Hébert, R.N., and Richard Bergeron, M.D., Ph.D. March 1, 2010, American Journal of Psychiatry March 2010, Vol. 167, No. 3, pp. 281 – 288

http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/clinical-depression/faq-20057770

http://www.webmd.com/depression/guide/depression-tests – 1

Thursday, May 4, 2017

Tips For A Good Nights Sleep

Psychiatrist for Bipolar DisorderAre You Getting A Good Nights Sleep?

According to a study published by the Institute of Medicine, an estimated 50-70 million adults in the United States have a sleep or wakefulness disorder. Do you or your partner snore? If so, you should note that snoring is a major indicator of obstructive sleep apnea; however, not everyone who snores has sleep apnea.

How Much Sleep Is Enough?

The amount of sleep a person needs depends on many factors, including their age.

We did a search of the literature and found some recommended levels of sleep for each age group. These are approximately as follows:
  • Newborns/Neonates require 16-18 hours a day
  • Infants require 12-15 hours a day
  • Toddlers require 11-14 hours a day
  • Pre-school children require 11-12 hours a day
  • School-age children require 10-11 hours a day
  • Teenagers need 9-10 hours on average
It is recommended that most adults should get 7 to 8 hours a night for the best amount of sleep. Although there are individual differences in how much sleep people require. For example, some people may need as few as 6 hours, and some may need as many as 10 hours of sleep each night. And women in the first 3 months of pregnancy often need several more hours of sleep than they might usually require.

What If You Feel Drowsy During The Day?

For most people, it is normal to feel some daytime sleepiness. This occurs due to the natural rhythms of our bodies. However, you need to differentiate sleepiness from tiredness. When we are feeling sleepy, it can feel like a conscious struggle to remain awake. On the other hand, when we are tired, we may feel fatigued but will still remain relatively alert. It is therefore important that you know the difference. Some sleep experts say that if you feel drowsy during the day, even during boring activities, you may have not had enough sleep at night, or the quality of your sleep needs improvement.

Determine The Cause Of Your Sleep Problem

It is important that you let your primary care doctor know about your challenges with sleep so that they can rule out a medical cause. One rule of thumb, is that if your sleep difficulties last for a month or more then you should let your doctor know. Your doctor can check to see if you have a health condition such as asthma, arthritis, acid reflux, or depression. For some people, taking certain medications can be the cause of a sleep disorder, and the doctor can recommend medication changes that might make a big difference in your quality of sleep.

Why Is It Important To Deal With Your Sleeplessness?

Insufficient sleep has been linked to the development and management of a number of chronic diseases and conditions, including diabetes, cardiovascular disease, obesity, and depression.

Depression and Sleep Disorders: Is There A Connection?

Since we see a lot of people suffering from depression- we want you to know that the relationship between sleep and depression can be quite complex. While sleep disturbance has been known to be an important symptom of depression, there is recent research that has indicated that depressive symptoms may decrease once sleep apnea has been effectively treated and sufficient sleep restored. This relationship between depression and sleep suggests that it is essential to assess and monitor sleep disorders in people with depression.

What is Good Sleep Hygiene?

The promotion of normal sleep is known as sleep hygiene. The following is a list of 10 sleep hygiene tips which sleep experts recommend to improve sleep:
  • Make sure that the room you go to sleep in is the right temperature
  • Your bedroom should be conducive to sleep; quiet, dark, and generally relaxing
  • Go to bed at the same time each night and wake up at the same time each day
  • Make sure you have a comfortable bed that provide adequate support
  • Use your bed only for sleeping, and not for reading, watching television, or music listening
  • Do not have large meals before bed
  • Do not work out before bedtime
  • Write down your thoughts in a journal or notebook before going to bed. For many people, thinking about things that happened during the day keeps them up
  • Reduce or avoid alcohol, caffeine, and nicotine, especially near bedtime. Reducing alcohol will also reduce the time going to the bathroom at night, and improve your quality of sleep
  • Turn off TVs, computers, and other blue-light sources an hour before you go to bed. Cover any displays you can’t shut off. Then, read a book, take a bath, meditate, or listen to calming music
Is Taking A Nap Good For Sleep or Will It Affect Sleep?

We have seen mixed reviews on whether taking naps is recommended; with some experts saying if you take a nap after lunch, you see increased productivity throughout the rest of the day, and other experts saying not to take naps because it may affect your sleep at night. The consensus is that if you have to take a nap-you should keep it to 20 minutes or less, and try to take a nap in the earlier part of the day. Some people report that naps provide them with a short-term boost in alertness and performance. However, you should note that taking a nap doesn’t provide all the other benefits of sleeping during the night-time.

When To See A Doctor and What To Do Before You See One

As mentioned above, it is important that we practice good sleep hygiene. However, if your sleep problems persist despite your attempts, and if they interfere with how you feel or function during the day, you should seek evaluation and treatment by your primary care physician. If your primary care doctor does not resolve the issue, you may want to seek further evaluation and consultation from a medical provider who has experience with assessing and treating sleep disorders. Before visiting your physician, it may be helpful to keep a diary of your sleep habits for 7-10 days. This will help you to better understand and convey the issues you are having to the doctor so they can provide you with a better diagnosis. We have provided a couple examples of sleep diaries in the references below for you to choose the one you like best. However, we recommend that you include the following information in your sleep diary.

The times when you:
  • Go to the bedroom to sleep
  • Fall asleep
  • Wake up
  • Get out of bed
  • Take naps
  • Exercise
  • Consume alcohol
  • Drink caffeinated beverages
Need Help?

If you believe that you have a mental health concern that is affecting your ability to sleep- then seek help from a mental health professional. Call us at 713-426-3100 to learn more about our approach to psychiatric treatment, or to make an appointment.

References:
  1. Institute of Medicine. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington, DC: The National Academies Press; 2006.
  2. Schwartz DJ, Kohler WC, Karatinos G. Symptoms of depression in individuals with obstructive sleep apnea may be amenable to treatment with continuous positive airway pressure. Chest2005;128:1304–1306.
  3. Zimmerman M, McGlinchey JB, Young D, Chelminski I. Diagnosing major depressive disorder I: A psychometric evaluation of the DSM-IV symptom criteria. J Nerv Ment Dis2006;194:158–163.
  4. webmd.com/sleep-disorders/guide/sleep-requirements
  5. cdc.gov/sleep/about_sleep/sleep_hygiene.html
  6. sleepfoundation.org/sleep-diary/SleepDiaryv6.pdf
  7. cci.health.wa.gov.au/docs/ACF1946.pdf

Friday, April 7, 2017

Fairy Tales And Kids

Psychiatrist for Children HoustonThe Importance of Fairy Tales and Folk Stories in Fostering An Emotionally Healthy Child

A subject of interest for me is the role of fairytales and folk stories in bringing out and nourishing children’s spirituality.

There are many reasons why I think fairy tales are good for kids development. This article outlines just a few. Fairy Tales do the following:
  • Teach right from wrong
  • Help children deal with emotions
  • Foster imagination
  • Develop cultural literacy introducing them to different cultures
  • Develop critical thinking skills
  • They are fun!
Parents have a great opportunity when their kids are young to help them learn about people, the world, and themselves. Fairy tales provide kids the chance to put themselves in the shoes of the characters, which allow children and begin to develop essential decision-making skills. These are skills that will help children throughout their lives.

The Role Of Myths And Fairy Tales
Myths and fairy tales give children the opportunity to figured out how to apply the meaning of the stories in their own lives. The answers that are offered by fairytales are suggestive, not definite (Bruno Bettelheim). Which allows room for interpretation and questioning.

Sometimes children accept and internalize lessons more easily from fairy tales than from their parents. Fairy tales speak a language that is familiar and makes sense to children. Children tend to think animistically, everything has a soul, and both inanimate and the animate object freely interact. Since there is no clear distinction between the two worlds, kids may believe that death can be reversed, and things and people can come back to life. Fairytales and folkloric tales answers children’s fundamental questions such as: who am I, where do I come from, where am I going, and what is life all about?

From the adult’s point of view, the explanations given by the fairy tales are not realistic and in a rushed analysis, could be presented as ‘false,’ to a child’s mind that lacks certain abstract thinking. These realistic explanations are difficult to comprehend. Parents can serve as guides through the fairy tale world, helping their children to understand the underlying concepts in terms they can understand.

fairy tale castleThe story of Snow White and the Seven Dwarfs is a great fairy tale that has many lessons. Among the lessons are the following:
  • Be cautious with strangers
  • It’s great to have friends
  • Never give up hope
  • Bad deeds rarely go unpunished
  • Watch what you eat
  • Insecurities do not justify a mean attitude
  • Real beauty comes from within
Fairy tales are a great way to spend quality time with your kids, and help them learn about life.It is important that kids be exposed to fairy tales at the right stage of their development. Fairy tales are ideal bedtime stories, especially for 3 to 10-year-olds. Here are some websites that I like for book suggestions of various ages:

fairydustteaching.com/2010/11/age-appropriate-fairy-tales/
waldorflibrary.org/articles/977-choosing-fairy-tales-for-different-ages
parenting.blogs.nytimes.com/2009/01/12/are-fairytales-to-scary-for-children/?_r=0
To learn more about Psychiatry for Children, contact Daniela White, M.D. Psychiatrist for Children Houston at 713-426-3100.

Content Source Fairy Tales And Kids

Wednesday, March 8, 2017

Don’t Make it Permanent, Make it Temporary

Dr. Daniela White, MDDepression, feeling low, and lack of confidence: these are few synonyms that hit a person very hard in guts at one or the other point of life. Everybody has one or the other problem in life. Depression is the root of mental health disorder. Depression is fatal as it could also lead to suicide or brain paralysis.

According to National Institution of Mental Health, depression is one of the most common mental disorders in the USA. In 2014, around 15.7 million adults of age 18 or above experienced at least one major depressive episode, which represented 6.7% of all American adults. At any point in time, 3 to 5 percent of adults suffer from major depression; the lifetime risk is about 17%. As many as 2 out of 100 young children and 8 out of 100 teens may have serious depression.

When the feeling of depression lasts for more than two weeks interfering daily activities such as taking care of family, spending time with friends, or going to work or school, it's likely a major episode.

Do not let this depression make permanent house in your mind instead defeat this depression with Midtown Psychiatry and TMS center at TMS River Oaks, TX. Treatment for depression will make you love your life again and shows you how it was before depression episode.

Like depression is common in teenagers and young adults, ADHD is common in children. ADHD means Attention Deficit Hyperactivity Disorder where a child acts without thinking and focusing is their main trouble. ADHD hurts and damages a child's ability to function socially, academically, and at home.

Fifty percent of the kids apart from ADHD, also have learning, language, or motor skills disability. And approximately the same percentages of these children have a co-morbid disorder, such as anxiety, depression, oppositional defiant disorder, obsessive-compulsive disorder, conduct disorder, or a tic disorder.

Midtown has trained Child Psychiatrist for ADHD in Katy, Texas who has been curing these kids since many years.

Content Source Don’t Make it Permanent, Make it Temporary