Pre-Diabetes Weight Gain and Depression

Insulin Resistance, Pre-Diabetes, Central Obesity, Elevated Triglycerides and Depression

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Three different findings associated with insulin resistance and pre-diabetes are predictive of developing depression according to a study published online from the American Journal of Psychiatry. Study Summary MedPage Today (9/23/2021) writes that, “Three surrogate measures for insulin resistance all showed a significant link with developing a major depressive disorder [MDD] over a nine-year follow-up period,” researchers concluded. The 601-participant study …

Try Cognitive Behavioral Therapy for Insomnia First

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Although there is reason for optimism about some of the newer medications for insomnia (orexin antagonists) that are coming to market, it remains true that sleeping medications are not the right answer for many people with insomnia. Cognitive behavioral therapy for insomnia (CBTi) has several advantages as an initial treatment. Cognitive Behavioral Therapy for Insomnia First We have been writing …

Chronotherapy and Bipolar Disorder

Peter ForsterBest Practices, Bipolar Treatment, Insomnia, Insomnia Treatment Leave a Comment

Chronotherapy refers to treatments for depression, mania, or both, that focus on changing sleep and wakefulness patterns. This blog post provides an update of this important area. Background The International Society of Bipolar Disorders (ISBD) task force on chronobiology and chronotherapy published a comprehensive review of chronotherapy techniques and their effectiveness in bipolar disorder in 2019. This article summarizes the …


CBASP Advanced Training and Certification for Gateway Therapists – Update

Peter ForsterAbout GPS, Best Practices, Major Depression, Treatments of Depression Leave a Comment

Gateway Psychiatric was established with the belief that in order to give our patients the best care possible, it is necessary to invest heavily in training for the clinical staff. We particularly focus on evidence based practices that have been shown to address significant problems facing our patients. Since chronic depression is one of the most common problems seen in …

specialty care for bipolar matters according to bob post

Specialty Care for Bipolar Matters

Peter ForsterBest Practices, Bipolar Treatment Leave a Comment

Bob Post (one of the most eminent psychiatrists of our time) published a passionate article in the March 2018 edition of the Journal of the American Medical Association in support of the importance of specialty care for bipolar disorder. Of course, we couldn’t agree more. That is one of the reasons we founded the clinic. We saw that specialty care …

Invisible Work for New Patient Consultations

Peter ForsterAbout GPS, Best Practices, Costs of Treatment Leave a Comment

New patient consultations at Gateway are expensive, in large part because of the hidden or invisible work that takes place as part of the consultation process. The table below contrasts the visible work, which is contained in the two sessions with clinicians, to the hidden work done by clinical and nonclinical staff in order to make those two in person …

Integrated Care

Peter ForsterAbout GPS, Best Practices

We have a passion for providing the most effective treatment at Gateway and that passion is illustrated by the efforts that we make to ensure that we deliver integrated care. Integrated care is a very simple idea. In fact it is probably something that you expect your treatment providers are already delivering. It means that the different providers who are …

Measurement Based Care Controversies

Peter ForsterBest Practices

Measurement based care often evokes controversies. A brilliant colleague, Carol Heckler, who is something of a local expert in psychopharmacology, interrupted a conversation I was having with another psychiatrist to say that she thought that standardized rating scales were useless. Echoing comments that I’ve heard from many of my patients, she said “how can you reduce human experience to a number?” This …