Here I’m going to show you that you can make an appointment with me, Dr. Forster, in a minute using the online office tools. This example applies only to appointments made in April 2020. During April, because of coronavirus, all of our appointments will be telehealth and you can make a telehealth appointment in any available time slot. First go …
Stimulus Control Therapy for Insomnia
Disrupted sleep rhythms may drive mood instability and sleep and insomnia are some of the most frequently cited problems of people seeking help for mood disorders. Research has shown that most frequently prescribed medications are not very helpful – they may lengthen sleep times by only 15 – 45 minutes per night. Cognitive Behavioral Therapy for Insomnia Cognitive Behavior Therapy …
Can a Change in Diet Affect Psychiatric Disorders?
Can a change in diet affect mood and anxiety? What dietary changes or interventions may be effective in treatment or management of mental or mood disorders? Diet is more than weight loss, and has been invoked, modified and studied for a wide variety of physical and mental ills and conditions. We have written a summary of what we know about …
Insurance Coverage of TMS for Bipolar Depression
A patient represented by an attorney obtained AETNA health insurance coverage for rTMS treatment of bipolar depression. The patient satisfied the insurer’s policy guidelines for rTMS treatment of major depression by demonstrating failed trials of 4 different medications. Reimbursement was based on the plan’s allowed percentage of the “covered amount”. The AETNA Appeals Decision stated – “TMS treatment is being …
Recognizing Depression – Nancy
Seems like everybody ought to be able to recognize depression, and that it’s so widespread that it can hardly be hidden, but the reality is that many people with major clinical depression are not diagnosed, or are given insufficient treatment to address the realities of their situation. Major depression is defined as an episode in which for at least two …
Ketamine Short Term Treatment Strategies
What are the best strategies for using ketamine to treat major depression in the short term? Although we know that ketamine (and, now, esketamine) can be helpful we really don’t know that much about what strategy works best. The most commonly used ketamine infusion protocol is adapted from studies using ketamine to treat chronic pain. An article in the March …
Gateway Welcomes New Therapist: Alana Kivowitz, LCSW
We are highly enthusiastic about our new therapist and case manager, Alana Kivowitz, LCSW joining Gateway’s team just before the new year. Alana is a San Francisco native who is returning after completing her master’s degree in social work at the University of Michigan, Ann Arbor, where she remained for a number of years working with adults and adolescents in …
Welcome New Staff Member Chris Restivo
I am so excited to welcome new staff member Chris Restivo, who starts full time work next week as a therapist and case manager. Chris joins us from the Felton Institute’s award winning Prevention and Recovery in Early Psychosis program and the Bipolar Early Assessment and Management program, where he quickly established himself as an especially gifted therapist working with young …
Intranasal Esketamine is Effective for Depression
Intranasal esketamine is effective for treating severe depression and suicidality when added to comprehensive standard of care treatment in patients who were felt to be at imminent risk of suicide. 68 patients seen in an emergency department were randomized to receive esketamine or placebo as well as comprehensive treatment including inpatient care and antidepressant medications. Patients receiving esketamine had a …
Rising Estrogen Levels Trigger Premenstrual Dysphoria
New research suggests that rising estrogen and progesterone levels trigger premenstrual dysphoria symptoms. “Although the mechanisms underlying the mood-destabilizing effects of ovarian steroids in PMDD remain to be better characterized, as does the source of susceptibility to this trigger, our findings provide a new target for interventions,” Peter Schmidt, M.D., chief of the Section on Behavioral Endocrinology at the National …