Melanie provides answers to commonly asked questions

"If I have a therapist, how do you work with them to ensure consistency and quality of care?"
We understand that you may have a long standing, trusted, and therapeutic relationship with a therapist. I am happy to collaborate with them to achieve the best care outcomes possible. We can coordinate care by communicating on progress and clinical observations (i.e. specific symptoms). Also, since your therapist typically spends more time with you than I, and they come to know intimate details about you, therapists can help provide invaluable insight into your situation and overall mental health status. The therapist may also observe things that you have not been aware of, and can help facilitate communication between us as well, which can help in making more informed decisions regarding medications and other interventions.
"What do clients often say after starting a new medication?"
I have heard all of the following statements over the course of my practice: "I feel like my old self again." "I'm now able to be present." "I no longer wake up with that pit in my stomach." "I'm now able to enjoy spending time with friends and family without avoiding gatherings" "My fuse is longer" "I no longer carry that heavy weight I felt before" "I no longer spiral when I feel anxious" "That dark cloud hanging over me is gone" "I am able to be patient with my children" "I haven't had a panic attack since starting medication"
"Will I become addicted to new medications?"
No, I have a conservative approach to medications that avoids potential dependencies. I will not start you on medication unless I believe it is necessary and going to help you. I will typically only start one medication at a time, and I always try to avoid medications that carry any risk of dependency and addiction. I will always inform you of the expected benefits of the medication, as well as potential risks and side effects so that you can make an informed decision. It will always be up to you to decide to take a recommended medication or not.
"Will this medication change who I am as a person?"
No, medications will not change your personality or who you are. For many people, the goal is to actually help you to feel like your "old self" again.
"Do I have to stay on medication for my entire life?"
No. Throughout your life, there will be difficult seasons and stressful situations that occur and contribute to or cause depression and anxiety. Medication can be a temporary fix to help you cope and allow your body to heal from those difficult situations and seasons of life. We will work together when appropriate to successfully get you off medications for the best outcome.
"What can medication do for my ADHD?"
The goal for treatment of ADHD with medication is to decrease symptoms based on your individual circumstance. Medication for ADHD can improve and/or eliminate symptoms including but not limited to: poor concentration, lack of focus, distractibility, forgetfulness, making careless mistakes, overlooking details, decreased attention span, struggles with listening when others are talking, mind wandering, failure to finish tasks or duties, difficulty organizing tasks and activities, avoiding or disliking tasks that require sustained mental effort, frequently losing things necessary for tasks, fidgety behavior, difficulty or inability to stay in place, restlessness, talking excessively, and frequently interrupting others.
"What can medication do for my depression?"
The goal for treatment for depression is symptom relief, and ultimately recovery from depressive symptoms. I choose specific medications to target each individuals' symptoms. Medication for depression can improve and/or eliminate symptoms including but not limited to depressed mood, prolonged sadness, feeling hopeless, empty, worthless or helpless, feelings of excessive or inappropriate guilt, feeling like a burden to others, irritability, frequent crying spells, loss of motivation, loss of interest, fatigue, low energy, decreased sex drive, poor energy, changes in appetite, weight changes, poor sleep, feeling slowed down, poor concentration, indeciveness, and thoughts of death or suicidal ideation.
"What can medication do for my anxiety?"
Using medication for treatment of anxiety focuses on symptom relief, and ultimately recovery from anxiety symptoms. As in all scenarios, I'll consult with you on your specific symptoms. Medication for anxiety can improve and/or eliminate symptoms including but not limited to frequent and excessive worrying, compulsive thoughts, behaviors, or rituals, racing thoughts, rumination, catastrophic thinking, feeling nervous and tense, feeling unable to relax and be present, poor concentration and focus, irrational fears, feeling uncomfortable in social situations, talking to others or presenting, restlessness, irritability, fatigue, poor sleep, physical symptoms such as frequent upset stomach, muscle tension, heart racing, or feeling like chest is tight and/or its hard to breathe with no medical cause.
"What benefits does medication offer?"
The ultimate goal of medication is to help improve your quality of life and reach your maximum potential, regardless of what your diagnosis may be. Patients who see me for medication are likely to have experienced mental health symptoms which have caused significant impairment in their daily life. Our goal is to help restore as much of that normal daily functions as possible. For example, we would seek to use medication for a person with depression to target their specific symptoms, including, but not limited to insomnia, low energy, poor motivation, sadness, poor concentration, and loss of interest / pleasure in daily activities. Another example would be for people with anxiety disorders, where our goal would include to help manage the symptoms of anxiety including reducing excessive worry, racing thoughts, restlessness, social fears, other irrational fears, and ultimately helping the individual to be present and comfortable in their daily life.
"What should I expect during my initial appointment (assessment)?"
For your initial appointment, we will spend some time getting to know one another to establish a solid foundation for our therapeutic partnership. We will review your medical history, social history, and psychiatric history, including past / current diagnoses, as well as any current or past treatment. Once we have reviewed all pertinent information, we will initiate a treatment plan, including discussing options for medications to manage mental health symptoms. Additionally, any recommended therapy / non-pharmacologic treatments will be discussed. The initial evaluation / workup may also include recommending or ordering of laboratory studies / testing that are pertinent to your treatment. These appointments are generally scheduled for one hour.
"Why do you do med checks and what do those appointments normally look like?"
Med checks are much more brief than initial assessment ( usually 20 minutes) depending on the situation. The primary objective of these appointments is to review any prescribed medications for how well they are tolerated, how beneficial they are, and to discuss any potential side effects or concerns you may have. This is also an opportunity to discuss any potential changes to medications, including discussing options that are not currently being used, making adjustments to existing medications, or even potentially eventually stopping medications. We will occasionally order lab studies or review vital signs at these visits as well in order to evaluate how your body is responding to the medications.
"What happens if we try a medication and it doesn't work?"
If a medication doesn't work, there can many reasons to explore. Some of these include the dose being incorrect or too low, not having the proper combination of medications, or you may not be tolerating the prescribed medication (i.e. side effects). If any of these scenarios occur, we always recommend making a follow-up appointment to discuss treatment options. If there are intolerable side effects or an adverse reaction, you should contact Charis. It is important that I meet with you to discuss specific concerns so that we can appropriately decide if it is best to stop the medication, change the dose, or potentially add another medication to the treatment plan.
"If I'm nervous about seeking help with medication, what would you want me to know?"
I would want to assure you that there is no obligation to take any medications. If you are apprehensive about psychotropic meds, I'm happy to provide more information, answer questions, and to give all the time you need to make a decision. Even if I meet with you and recommend / prescribe a medication, it is ultimately up to you whether you'll try it. I provide a client-centered approach to care, and will not prescribe any medications if you and / or your family are not in full agreement with the treatment plan.