The short version: SSRIs are a class of medications that affect emotions, used for depression, anxiety, anger, etc. My usual regimen is to start Lexapro 5 mg, go up to 10 mg after one week, and potentially go up to 20 mg later if that isn’t enough. The most common side effects are loss…| Lorien Psychiatry
The short version: People can go to psychiatric inpatient units voluntarily, or be involuntarily committed if someone thinks they could potentially harm themselves or others. Usually this involves a ~12-hour emergency room stay, followed by ~3-5 days in a hospital ward. Once doctors believe the patient is safe, they will discharge them, possibly but not…| Lorien Psychiatry
The short version: L-theanine is a chemical found in tea. It probably decreases some of the actions of glutamate, the main activating neurotransmitter in the brain. Some people take l-theanine along with caffeine in a 1:1 ratio to make the caffeine work better, with less jitters and anxiety. Other times people take it on its…| Lorien Psychiatry
The short version: Borderline personality is a condition where people's emotions, assessments, and self-image swing around wildly. Its most destructive feature is sudden extremes of negative emotions with high associated suicide risk. The best treatment for borderline personality is dialectical behavioral therapy, which you should get at a reputable Dialectical Behavioral Therapy Center that combines…| Lorien Psychiatry
The short version: If you can't sleep, start by ruling out drugs (eg coffee, alcohol), other psychiatric disorders, circadian rhythm issues, or trouble getting to bed on time for psychosocial reasons. Once those are cleared up, practice good sleep hygiene, eg making sure your bedroom is cool, dark, and quiet (and maybe try a weighted…| Lorien Psychiatry
The short version: Melatonin can help you get to sleep, and/or help correct circadian rhythm disorders (ie you feel sleepy when you want to be awake, and wide awake at bedtime). To help sleep, take 0.3 mg just before bedtime. To help with circadian rhythm disorders, take 0.3 - 1 mg at a time depending…| Lorien Psychiatry
Scott Siskind, MD| Lorien Psychiatry
The short version: Ketamine is a new and exciting depression treatment, which probably works by activating AMPA receptors and strengthening synaptic connections. It takes effect within hours and works about 2-3x as well as traditional antidepressants. Most people get it through heavily-regulated and expensive esketamine prescriptions, or through even-more-expensive IV ketamine clinics, but evidence suggests…| Lorien Psychiatry
The short version: Each extra drink you have per day probably takes an extra year off your life. This may or may not be true for the first 1-2 drinks per day, but it definitely is after that. If you feel like you're drinking too much, you may want to quit; although some people…| Lorien Psychiatry
I. Most psychiatric disorders are at least partly genetic. Some, like schizophrenia and ADHD, are very genetic, probably 80% plus. This is strange, because having psychiatric disorders seems bad, so you would expect evolution to have eliminated those genes. Researchers looking into this question argue between two hypotheses. First, failures. Evolution is imperfect, so some…| Lorien Psychiatry
The short version: Depression has many possible causes, including stressful life events and biological problems like inflammation and hormone imbalances. Any given case of depression might be due to some of these causes and not others. Some people have long-standing mild depression (dysthymia), but more often depression comes in episodes; these usually go away on…| Lorien Psychiatry