Genetic Tests for Depression Reviewed

Peter Forster Best Practices, Major Depression, Psychobiology, Testing

Are genetic tests for depression treatment worthwhile? Or is this an expensive technology that is not ready for routine use? Peter Roy-Byrne, writing in NEJM Journal Watch seems to say no. Although some clinicians may argue that such testing “can’t hurt and might help,” current psychopharmacological practice is complex, usually including combinations of multiple medications, and patients can have multiple …

Mania and Depression Sequence

Peter Forster Best Practices, Bipolar Treatment

One of the key features of bipolar disorder that, in our experience, is most useful in predicting treatment response is the usual sequence of manic (or hypomanic) and depressive episodes. For years we have used the mnemonics MDI and DMI as ways of categorizing patients’ course. But we could not find the reference to that idea. We are indebted to …

Mindfulness for Depression – Research Update

Peter Forster Best Practices, Major Depression, Treatments of Depression

Mindfulness has received a lot of attention recently as an approach to improving mental health in a number of conditions. But is it really effective as part of a strategy for treating serious depression? And, if so, how can we best incorporate it into treatment, given the great difficulty that many people with depression have doing even a small amount …

“I am looking for a doctor who can treat me with Ketamine infusions for treatment resistant depression.”

Peter Forster About GPS, Best Practices, Bipolar Treatment, Costs of Treatment, Treatments of Depression

I was inspired to write this blog post by the third patient in three days to contact me about Ketamine infusions. She wanted to know if I could provide her with Ketamine infusions for her treatment resistant depression. Ketamine infusions are one of the treatments for depression that we provide access to for our patients. Among the other treatments are …

Common Over the Counter Medications Linked to Dementia

Peter Forster Best Practices, Insomnia Treatment

Common over-the-counter medications may increase your risk for dementia. That is the startling finding of a recently published journal article which used a number of approaches to examine the possible risk of using medications that have anticholinergic effects. This includes many psychiatric medications as well as many common over the counter antihistamine medications, medications for sleep, and for GI problems: …

Acceptance and Commitment Therapy Part 1: Acceptance and Willingness

Kelsey Schraufnagel Anxiety, Best Practices, Major Depression, Treatments of Depression

Acceptance and Commitment Therapy (or ACT, pronounced as the word, not A-C-T) is a comprehensive, empirically driven model developed by Steve Hayes, PhD and colleagues with nearly 200 randomized controlled trials (methodologically sound studies) supporting its efficacy for numerous problems and concerns. I recently attended the Anxiety and Depression Association of America conference in Philadelphia, where I offered a two-hour …

Early intervention for depression helps

Peter Forster Best Practices, Major Depression, Treatments of Depression

In a review of an article published in JAMA Psychiatry in early March 2016, Dr. Steven Dubovsky writes about encouraging findings about treatment efficacy of patients with major depression from a large study in Denmark. In the study, researchers reviewed 10 years worth of national data from the extensive population records capped in Denmark which provides nearly universal access to …

Depression Screening Recommended

Peter Forster Best Practices, Major Depression, Policy, Testing

Although it seems like nothing more than common sense, we were very pleased to see that the United States Preventive Services Task Force (USPSTF), which is the major organization responsible for guidelines for public health interventions in the United States, added depression screening for adults, in particular for pregnant women and women who recently given birth, to its short list of …

Mood Charting for Complicated Problems

Peter Forster Best Practices

I want to share a link to a blog post one the Moodsurfing site which talks about the value of mood charting when trying to understand complicated problems. The story is about Lucy, a patient at Gateway (name changed, of course) and our session yesterday. I think that the story neatly illustrates why keeping track of symptoms is so important when …

Cognitive Behavioral Analysis System of Psychotherapy

Peter Forster Best Practices, GPS Update, Major Depression, Treatments of Depression

I have just posted another page on the site devoted to orienting patients to types of psychotherapy that we may recommend for them. This most recent page talks about Cognitive Behavioral Analysis System of Psychotherapy, an approach to the treatment of patients with chronic depression that many people have benefitted from during the course of their treatment at Gateway Psychiatric. …