1. Trusting Your Patient (and Vice Versa)

Psychiatric diagnosis is different from other medical specialities in that many conditions lack true objective measures that are independent of patient self-report.

As a result, the ability of a psychiatrist to be able to discern a patient’s symptoms will rely on their ability to obtain reliable information about their symptoms, either directly from the patient themselves and/or from obtaining additional information from family members and past treaters.

If a patient does not trust their psychiatrist, the reliability of the information they will receive from the patient will suffer. Patients may not feel comfortable sharing with their psychiatrist if they are experiencing negative side effects or may not feel comfortable sharing their ongoing psychiatric symptoms if they feel like their psychiatrist does not want to listen to them.

In my experience, being intentional about trusting a patient often results in a similar improvement in the patient trusting you as their psychiatrist.

2. Realistic Expectations with Medications | Medications Should Not Be The Only Aspect Of Psychiatric Treatment

While there are a certain percentage patients who report a marked improvement in symptom improvement after starting one medication, this may not be the case for some others.

Being mindful and informing patients of the often varied response to medications is something I try to emphasize in treatment.

The potential issue of underemphasizing realistic expectations are situations where patients may end up on higher doses of medications that may cause side effects that end up additionally harming them unintentionally.

3. When Symptoms Are Complicated, Lean Towards Simplifying Medications Rather Than Complicating Things Further

The reality of current psychiatric treatment is that the tools available as medications to psychiatrists today are broad instruments that do not work in precise ways that can specifically target areas of the brain to improve psychiatric symptoms.

While a multiple medication regimen (also known as polypharmacy) may be needed to optimize an individual’s mental health, I believe it is always worth carefully monitoring these regimens regularly, re-evaluating co-morbid psychiatric diagnoses, and ensuring safe practices when deploying these medication regimens.

4. We Need Time Together

It is very rare for me to reach a definitive diagnosis for an individual in one single session. Because of the inherent complexity of many individuals’ symptoms, valuable information is needed from observing an individual’s symptoms and medication response with repeated observations and assessments.