A Guide to Pregnancy and Psychiatric Medication

Shruti nadkarni , MD

Neha Naqvi, MD

Monique Santone, LCSW

Danielle Ruchaevsky, LCSW

Trauma-focused therapies have proven to be effective PTSD treatments. These sessions typically last between 8 to 16 visits, depending on the patient’s status and progress. The therapies involve exploring trauma in a safe space and developing coping strategies. Some of these include:- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): This approach helps in identifying and modifying unhelpful thought patterns.

– Eye Movement Desensitization and Reprocessing (EMDR): EMDR uses eye movements to assist patients in processing and making sense of traumatic memories.

– Prolonged Exposure Therapy: This therapy involves gradual, repeated exposure to thoughts, feelings, and situations related to the trauma to reduce fear and anxiety.

– Cognitive Restructuring: Helps patients make sense of the bad memories by reframing negative thoughts.

These treatments offer a ray of hope for individuals battling PTSD, aiding them on their recovery journey and enhancing their life quality.

One of the common treatment methods recommended by our psychiatrists includes the use of antidepressants. Some types of antidepressants successfully used in managing PTSD symptoms include Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) and Selective Serotonin Reuptake Inhibitors (SSRIs). Antidepressants can provide relief from specific symptoms and enhance feelings of well-being.

Diagnosis:

Key symptoms they search for include at least one recurring distressing memory or dream related to the traumatic event, as well as symptoms of avoidance, arousal, reactivity, cognition, and mood. Specifically, the diagnosis requires at least:- One recurring symptom, which could be distressing memories or dreams related to the trauma

• One symptom of avoidance of the memories, thoughts or feelings related to the event
• Two arousal and reactivity symptoms
• Two negative changes in cognition and mood that are associated with the event

These symptoms must be prevalent for a minimum of one month and severe enough to interfere with significant aspects of life, such as relationships or work.

In making a firm PTSD diagnosis, the role of a trained mental health professional is crucial.

Women’s Behavioral Health Treatment

We provide clinical consultations and evaluations regarding psychotropic medications in pregnancy and lactation, medication management for postpartum depression and anxiety, and mood disorders specific to the menstrual cycle and menopausal transition. 

These evaluations can function as a one-time comprehensive consultation only, or as an ongoing resource for patients during a difficult period. Our in-depth psychiatric evaluations can determine the most appropriate course of treatment including non-medication options such as therapy. When appropriate, we also work closely with referring physicians to design the best treatment plan for each individual.

Cognitive-Behavioral Therapy (CBT) is a commonly employed evidence-based approach that helps individuals identify and change negative thought patterns and behaviors associated with PPD. Interpersonal Therapy (IPT) focuses on improving relationships and communication skills, addressing issues in social support networks.

Supportive psychotherapy offers emotional support and a safe space for individuals to express their feelings. Mindfulness-Based Cognitive Therapy (MBCT) combines mindfulness meditation with cognitive-behavioral techniques.

Group therapy and family therapy are also available, providing peer support and addressing family dynamics, respectively. Online therapy and telehealth options have made accessing help more convenient. In some cases, medication may be prescribed alongside therapy.

Personalized treatment plans are key, emphasizing early intervention and ongoing support for PPD’s effective management and recovery. Seeking assistance from mental health professionals or support groups is crucial for new mothers experiencing PPD.

The healthcare provider determines the initial dosage of the prescribed antidepressant, taking into account the patient’s individual needs. Dosage adjustments may be necessary over time to optimize the treatment’s effectiveness and minimize side effects.

Diagnosis:

Psychiatrists diagnose postpartum depression (PPD) by first conducting a comprehensive clinical evaluation with the patient. This includes a detailed interview to discuss the individual’s mental health history, current symptoms, and changes in behavior or mood since childbirth.

Particular attention is paid to signs of PPD, such as persistent sadness, excessive crying, feelings of hopelessness, severe mood swings, loss of energy, sleeping difficulties, changes in appetite or weight, difficulty bonding with the baby, withdrawal from family and friends, and reduced interest in activities that were previously enjoyed.

Diagnosis:

Our qualified psychiatrists make an anxiety diagnosis based on careful observation, understanding the person’s medical history, and suggesting psychological tests. We adhere to the criteria set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to ensure our diagnosis is accurate and appropriate.

Child ADHD/ADD Evaluation

Similarly, physical health conditions such as sleep problems, gastrointestinal issues, metabolic issues or vitamin deficiencies, immune problems (asthma or allergies) can also complicate ADHD symptoms. We can liaise with relevant specialists if needed.

If ADHD is diagnosed, as well as any other potential disorders or conditions, we will develop a personalized treatment plan specifically for your child. We will develop this with your input, based on your child’s needs and unique circumstances.

We offer a wide range of medication and non-medication treatments for ADHD. If medications are chosen, we will typically recommend therapeutic support to work on optimizing the effects of those medications by learning executive functioning skills to help manage ADHD symptoms. The treatment will include an integrated approach so that your child can achieve their full potential, both academically and socially.

Teen Therapy

We collaborate closely with families and teens to craft tailored solutions and instill positive habits. We empower teens with the necessary skills to handle the overwhelming pressures they face today, enabling them to manage peer pressure, academic issues, and more successfully.

Why Choose Kolli Psychiatric and Associates?

– We provide a supportive and non-judgmental environment.

– We offer personalized strategies and solutions.

– We believe in the potential of every adolescent to overcome their challenges.

If your adolescent is struggling, don’t hesitate to reach out. Let’s work together to help them navigate this challenging phase and emerge stronger and more resilient. For more information about adolescent treatment or to book an appointment, contact our office today.

Our dedicated team is here to support you and your teen in every step of the journey towards a happier, healthier future.

Diagnosis:

– Priorities shift – Neglecting home, work, or school responsibilities because of the substance use.

– Compulsive usage/feeling helpless – Multiple unsuccessful attempts to quit the substance.

– Relationship impacts – Persisting with substance use despite it causing relationship strife.

– Health issues – Continued use even when it leads to or worsens mental or physical health problems.

– Social sacrifices – Reducing social or recreational activities because of substance use.

– Risky usage – Utilizing the substance in situations that could be dangerous.

SIREESHA KOLLI, MD, MPH

School Fit-to-Return Evaluations

This process can be very stressful for parents. While it’s not uncommon for children to say things they don’t really mean or fully understand to get negative attention from peers and adults, more serious comments tend to reflect a child’s internal desire for help or severe distress. 

Dr. Naqvi’s goal is to quickly and effectively determine if the child is safe to return to school and how best to proceed in terms of individual or family treatments or additional evaluations.

Medication Management

Our providers have strict rules regarding the prescription of controlled medications. We follow all state and federal regulations. There should never be an expectation that a provider will write a patient for a controlled medication, even if the patient has previously taken a specific medication, or previously been given a diagnosis (like ADHD, anxiety or insomnia) by another provider.

If a patient feels that they “need” a controlled medication urgently prescribed, we are not the right practice for them to schedule with.

Adult ADD/ ADHD Evaluation

Adults with ADHD are likely to have one or more comorbid disorders, such as anxiety or depression, which may contribute to additional emotional distress and difficulty meeting the demands of everyday life. During an ADHD evaluation, our psychiatrist will ask about your mood, thoughts, and behavior patterns to determine if your symptoms may be caused by one of these conditions.

If ADHD is diagnosed, as well as any other potential disorders or conditions, we will develop a tailored treatment plan for you. Treatment can consist of therapy, psychiatric medication management and/or behavioral modification

Child and Teen Psychiatric Evaluation

During the initial evaluation they will explore child developmental history, medical history, family history, social and environmental influences, academic/school concerns, peer relationships, social media influences, emotional and behavior issues, and observations of a child’s behaviors and affect.  

After information is gathered from both the child and parent, the psychiatrist will arrive at a diagnosis and provide treatment recommendations. The family will be educated about the treatment options and together with the psychiatrist, will come up with a treatment plan.

Therapy:

Behavioral counseling has proven to be effective for addiction treatment. This allows individuals to identify triggers, change harmful behaviors, manage stress, and improve relationships with friends and family.

Support groups and twelve-step programs such as Alcoholics Anonymous also aid recovery. They offer needed peer support, personal growth opportunities, and strategies for maintaining sobriety.

Furthermore, residential treatment provides a structured environment which can be beneficial for severe addictions.

Medication Management

Medication management plays a pivotal role in managing withdrawal symptoms and reducing cravings, particularly in cases involving substances like alcohol.

For substance abuse treatment, medication is tailored to individual needs to assure the best possible outcome and is regularly adjusted and monitored for effectiveness and side effects.

Medication-assisted treatment is an evidence-based approach that combines medication with counseling and behavioral therapies.

Therapy:

Exposure and Response Prevention (ERP), a form of cognitive-behavioral therapy (CBT), is a highly effective treatment for OCD. In an ERP session, patients face their fears directly via situations or images related to their obsessions.

The treatment typically starts with scenarios that spark mild to moderate anxieties. Patients may experience heightened anxiety initially. Patients are guided to refrain from their compulsive behaviors, which is the “response prevention” part of ERP.

Over time, as patients remain in their feared circumstances without any harmful occurrence, they learn to understand that their fears are merely thoughts. This realization can greatly assist in their journey towards overcoming OCD.

Medication Management:

Medication management is one of the ways to manage OCD symptoms. A specific group of medicines, known as selective serotonin reuptake inhibitors (SSRIs), are usually employed to treat depression but can also effectively treat OCD.

SSRIs are often administered in higher dosages for OCD than for depression. Some patients, who don’t see improvement with one SSRI, may respond well to another.

It is important to remember that the maximum benefits from this treatment usually become evident between six to twelve weeks.

Diagnosis:

To diagnose Obsessive-compulsive disorder, our mental health professionals conduct an in-depth interview with the patient. They ask about any symptoms, worries, or repetitive behaviors. This helps understand the patient’s thought patterns.

An important part of the process is ruling out other causes for the symptoms. These could be physical health issues or other mental health disorders. Psychiatrists will often administer psychological questionnaires or tests for help in diagnosis.

The primary indicators for an OCD diagnosis are having obsessions, compulsions, or both.

Treatment:

Eating disorders, such as anorexia, bulimia, and binge eating, can be challenging. Thankfully, a variety of treatments can help individuals on their path to recovery. Medical care is essential for those facing immediate health concerns related to their disorder. Meanwhile, therapy sessions can address underlying emotional triggers and thought patterns.

Nutritional counseling offers guidance towards a balanced relationship with food. For some, medication management might be recommended to handle certain symptoms or coexisting mental health conditions. 

Moreover, joining support groups can provide a platform to share experiences and feelings. Remember, treatment should be individualized, as everyone’s journey with an eating disorder is unique.

Causes:

Eating disorders come from a combination of factors. Some are biological, like genes that might make someone more likely to develop these conditions. Chemicals in the brain, which control our feelings about food and emotions, can also play a role. Personal traits, such as a drive for perfection or fear of change, might add to the risk.

Our environment plays a part too. Society often values a thin appearance, leading some to feel insecure about their bodies.

Peer pressure or teasing, especially during the sensitive teenage years, can be triggers. Additionally, stressful or traumatic events might push someone toward an eating disorder. So, it’s often a mix of inner and outer factors that lead someone down this path.

Do I have an eating disorder?

Diagnosing eating disorders involves a thorough evaluation of a person’s behaviors, thoughts, and physical health. The diagnosis typically includes a clinical interview, a physical exam, and various diagnostic tests.

Psychiatrists start the process by conducting an in depth interview with the patient and collecting important information. They delve into the patient’s eating habits, their body image perceptions and their attempts to control weight. In these discussions, they commonly involve family members for additional insight.

Therapy:

We explore non-medication options like mindfulness-based practices, exercise regimens, and dietary adjustments.

Our goal is to provide you with comprehensive care that addresses the root causes of your depression and helps you on your path to recovery.

If you’re seeking effective depression treatment, we are here to support you every step of the way, ensuring that you receive the care and attention you deserve

Treatment:

Treatment for bipolar disorder can involve a combination of medication management, therapy, and lifestyle changes.

Finding the right treatment for bipolar disorder may require patience and persistence. Different medications affect individuals in unique ways, so what works best may vary from person to person. Sometimes, a treatment plan takes a little while to provide full relief from symptoms – it could be a month or more.

Treatment:

Effective treatment for depression is essential for regaining mental well-being and improving the quality of life. At Kolli Psychiatric and Associates, our experienced team offers a range of evidence-based treatment options tailored to your specific needs.

These treatments may include psychotherapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT), medication management with antidepressants or mood stabilizers, lifestyle modifications, and support from our compassionate mental health professionals.

Diagnosis:

It may encompass the use of questionnaires, direct observation, and discussions to assess the type, severity, and duration of your depression. Our psychiatric assessments adhere to the guidelines outlined in the Diagnostic and Statistical Manual, ensuring accurate diagnoses and facilitating targeted treatment.

Medication Management:

One commonly used treatment type for bipolar disorder is mood stabilizers, like, lithium. They can be very effective in managing the condition.

Sometimes, other types of medications complement the treatment plan. This might include anticonvulsants, atypical antipsychotics, or antidepressants. Each has a role in controlling different aspects of bipolar disorder.

Identifying the most effective treatment can take time and might involve some trial and error. Finding the right medication balance is important for managing bipolar disorder. We can assist you with this at Kolli Psychiatric and Associates.

Diagnosis:

Bipolar disorder is diagnosed based on certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It includes specific requirements for manic and depressive episodes.

Diagnosing bipolar disorder is a collaborative process between the patient and the mental health professional. Remember, a correct diagnosis is crucial for treating and managing bipolar disorder effectively.

Therapy:

To enhance the effectiveness of medication management, we also suggest Cognitive Behavioral Therapy (CBT). This integral part of therapy helps patients identify and change harmful thought patterns that induce distressing emotions and behaviors. 

CBT empowers patients to recognize and shift detrimental thought patterns, thereby reducing distressing emotions and behaviors. With our holistic approach, which fuses focused psychiatric care and tailored medication management, we aim to arm patients with the tools they need for sustained mental well-being.

Medication Management:

Seeking help for an anxiety disorder is crucial. With the right support and treatment, it is possible to regain control of your life and find relief from the constant worry. Therapy, medication, and self-care techniques can all play a role in managing anxiety and reducing its impact on your daily life.

While medications do not cure anxiety disorders, they can provide substantial relief from symptoms. In combination with CBT, this dual approach helps foster resilience, and self-confidence, and improve mental health. 

We use focused psychiatric care and medication management and we aim to equip patients with the necessary tools to manage their symptoms effectively and promote lasting well-being.

Our commitment to monitoring each patient’s progress means we can adapt, in real time, to adjust medications to guarantee the best therapeutic outcomes.

Talk Therapy

To learn more about specific types of therapy we offer such as cognitive behavior therapy, dialectical behavioral therapy, solution focused therapy and supportive therapy, please visit our blog. Our therapists are here to guide you on your path towards mental wellness— set up a consultation today to begin your healing journey.

Therapy:

Behavioral therapy plays a vital role in treating ADHD, especially in children and teens. This approach involves working with a therapist to develop coping strategies and skills to handle challenging situations and decrease disruptive behaviors.

For young children, parent training in behavior management, often referred to as Parent-Child Interaction Therapy (PCIT), can be especially effective. In school-aged children, classroom interventions and strategies that provide more structure and consistent daily routines can be beneficial.

Additionally, adults with ADHD can gain a lot from cognitive-behavioral therapy, which helps in addressing time management skills, and organizational challenges, and improving overall self-esteem. In combination, medication, and therapy can significantly improve daily functioning and quality of life for those with ADHD.

Medication Management:

One of the primary treatments is medication, specifically stimulant and non-stimulant medications.

Stimulant medications, like Ritalin or Adderall, are commonly prescribed and work by increasing the levels of certain neurotransmitters in the brain, enhancing focus and reducing impulsive behaviors.

Non-stimulant medications, on the other hand, might be chosen for those who don’t respond well to stimulants or if there’s a concern about potential side effects.

They act differently in the brain but also help reduce ADHD symptoms.

Diagnosis:

It offers insights into how a person’s brain processes information and can pinpoint specific areas of strength and challenge. Such an evaluation can help differentiate ADHD from other conditions that might have overlapping symptoms. Additionally, it can highlight coexisting issues that might be affecting an individual’s ability to focus or control impulses.

When combining the insights from these assessments with details about school performance, work challenges, and personal relationships, professionals can make an informed diagnosis and devise an effective treatment plan tailored to the individual’s needs.

Second-Opinion Consultation

When individuals are already working with a provider and are looking to get a second opinion on diagnosis or treatment recommendations, this form of consultation is recommended. 

Our psychiatrist will obtain a thorough history of current and past symptoms, review past medical records and coordinate with the individual’s other treatment providers in order to help clarify any diagnosis or treatment questions.

The individual can then decide to continue to work with their previous provider or switch to the consulting psychiatrist for follow-up appointments. We also work closely with referring physicians to design the best treatment plan for each individual.

Adult Psychiatric Evaluation

A psychiatric evaluation is designed to diagnose emotional and behavioral disorders. The initial evaluation will explore many aspects including developmental history, medical history, family history, social and environmental influences, work concerns, relationship factors, and emotional and cognitive issues. 

Each psychiatrist has his or her own system for the initial evaluation. After information is gathered, the psychiatrist will arrive at a diagnosis and provide treatment recommendations. The individual will be educated about the treatment options and together with the psychiatrist, will come up with a treatment plan.

Telehealth Appointments

We understand that life is busy, and adding a commute to the mix is not always ideal. TeleMedicine can help you enjoy a more convenient approach to your mental health. 

Our psychiatrists and therapists can perform either initial evaluations or follow-up appointments online, allowing you to engage in treatments from the comfort of your own home. Ask our staff about setting up your next TeleMedicine appointment today. Please note that all ADHD/ ADD evaluations need to be conducted in-person if a stimulant medication needs to be prescribed.

Genetic Testing for Psychiatric Medications

Your genes play a key role in the effectiveness of your medication— a treatment that works well for one person may not for another. Genetic testing helps our doctors take a personalized approach to prescribing. Using DNA gathered with a simple cheek swab, a genetic test will analyze your genes and provide individualized information to help select medications that better match your genes.