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The U.S. National Survey on Drug Use and Health found that almost 8 million adults have both a mental illness and a co-occurring substance abuse problem. This “Dual Diagnosis” describes a complex relationship where those with mental health issues also have a problem with substance abuse, and likewise, those with a substance abuse problem who also have a psychiatric disorder. Dual diagnosis requires a mental health practitioner experienced in the complex and often complicated treatment strategy.

Confusing Symptoms with Dual or Co-Occurring Disorders

It can be difficult to diagnose a psychiatric illness in those who are substance abusers because it is common for drug abusers to exhibit psychiatric symptoms. The National Alliance of Mental Illness reports that psychiatric disorders induced by substance abuse can continue to impact a person’s life long after the drug or alcohol abuse has been curtailed.

Substance abuse can trigger panic attacks, depression, severe anxiety, delusional thoughts, personality disorder, and even psychotic behavior, all of which may continue to plague a person long after detoxification. Proper dual diagnosis is critical in establishing a successful treatment plan.

Dual Diagnosis Requires Specific Treatment Planning

Dual diagnosis needs a specially designed treatment plan, as dual disorders also come with an increased severity of medical, social and emotional issues. Dual disorders alone increases the chance of relapse as well as the psychiatric disorder becoming more pronounced in daily life functions. In addition, those with a dual diagnosis generally require a longer period of treatment with more gradual evidence of progress seen over time.

Complex Challenges of Dual Diagnosis

Dual diagnosis typically come with an increased rate of relapse, hospitalization, and homelessness, not to mention an increased chance of developing HIV or Hepatitis C infections due to risk-taking behaviors. The combinations of mental health disorders and forms of substance abuse that can be diagnosed show great variability, and thus each person with a co-occurring diagnosis does need their complex treatment plan uniquely constructed.

Severity of Disorders Change Over Time

Being followed and managed by a competent dual diagnosis psychiatrist is a priority for treatment plan success. Either diagnosis, whether of a mental illness disorder or substance abuse, may be evaluated as one or the other being severe or mild, or both severe — or by the degree of impairment they bring to daily life functions. The severity levels and impact change over time with the treatment plan modified to properly meet changing needs as they occur.

Atlanta Dual Diagnosis Psychiatrist

Dr. Darvin Hege is the Atlanta dual diagnosis psychiatrist of choice and expert in the field. Call the office for an appointment to start getting your life back under control.

It is a common complaint from women going through menopause that they find themselves facing a wide range of emotional and physiological symptoms. Menopausal symptoms typically reported include irritability, moodiness, and overwhelming sadness, not to mention feeling over-fatigued, experiencing memory lapses and poor ability to think clearly. For women already diagnosed with ADHD, they become acutely aware that ADHD symptoms become more pronounced over a period of 10 years, starting in peri-menopause and continuing non-stop into menopause. Hormonal fluctuations do result in intensified ADHD symptoms. For women with undiagnosed ADHD who enter menopause they may find the intensity of the symptoms so great that they seek mental health intervention.

Hormonal Effects of Menopause on ADHD

By the time of menopause, a woman’s estrogen level has dropped by 65% over the course of the prior 10 years. Psych Central reports that decreasing estrogen leads to decreased levels of the “feel good” serotonin and dopamine levels found in the brain chemistry. The drop in estrogen levels can exacerbate ADHD symptoms which can appear suddenly in women in their 30s and 40s as well as in women who have reached menopause. Decreased serotonin levels can lead to a depressed mood, while decreased availability of dopamine directly affects the appearance of increased ADHD symptoms.

Common Challenges of ADHD during Menopause

An insufficient amount of dopamine is a classic sign of ADHD. Additional declines of dopamine levels during the peri-menopause and menopause phases may result in more severe difficulties with concentration, attention and focus. In addition, women may discover that they are having trouble staying organized, managing their time, making thought-out decisions or finding that they become forgetful of even common routine activities and appointments. With peri-menopause starting about 10 years before menopause, it is important for women to know that there is help for their symptoms. Being diagnosed with ADHD opens the door to forming a complete mental health treatment plan that can provide relief.

Treatment Options for ADHD and Menopause

Attitude magazine reports it is important to find an ADHD menopause experienced psychiatrist who is able to set up a successful treatment strategy and make medication adjustments as needed to meet your changing needs through the decades long peri-menopause phase to the menopause stage. Women who experience intense PMS (pre-menstrual syndrome) may have undiagnosed ADHD. Receiving a correct comprehensive diagnosis can lighten the monthly depression, anxiety, irritability and “fuzzy headed” feelings that PMS and the pre-menstrual to menstrual phase bring.

Atlanta ADHD Menopause Psychiatrist

Dr. Darvin Hege is the expert when it comes to successful treatment of ADHD and menopause. Call the office for psychiatric treatment that will put your ADHD menopausal symptoms in check.

If times are tight, the search for ways to find discounts or save money is a common occurrence. Generic medications are often substituted when allowed, primarily due to insurance coverage policy or as a means to reduce co-pay cost out-of-pocket. Many prescribed physical health medications are used long term for chronic health issues or disorders, just as treatment for psychiatric and mental health conditions often involve long term pharmacological treatment. The monetary savings however may not be in the patient’s best interest who may discover generic is not the “right fit” for their needs.

Generic and Brand Name Psych Med Differences

The FDA’s definition of a generic drug is that it is pharmaceutically equivalent to its brand name drug, containing the same active ingredient, same strength, same dosage form as well as delivery of drug (i.e., swallowed, a patch worn, or injected). The generic version must perform approximately the same as the brand name drug. The key word approximately indicates that there will be a small or slight difference in the manufacture of the generic drug, whether it be inert ingredients added, coloring or dye used, as well as the shape or form.  In addition, the pharmacy uses a variety of manufacturers so that while the prescription itself may not change, the medication may appear different from month to month.

Generic Psychiatric Medication Concerns

While the majority who take generic psychiatric medications experience no problems, there are thousands who face increased side effects, exacerbation of their mental health symptoms, behavioral changes, development of allergies or a significant relapse that could require hospitalization. Generic psychiatric medications are supposed to deliver the same amount of active ingredient to receptors in the brain, however differences in the formulation of the product may cause more harm than help. An experienced and practiced psychiatrist is able to work with you on finding a generic medication that will work, as well as modification of the drug, dose or timing so that cost savings can be achieved without loss of mental health gain.

Top 10 Psychiatric Generic – Brand Name Medications

The top 10 prescribed U.S. psychiatric medications are ranked in a PsychCentral.com study. The medication with the highest ranking is Xanax or alprazolam used for anxiety at almost 48 million prescriptions per year. The psychiatric medication Seroquel or quetiapine, typically used for bipolar disorder or depression is ranked number 10 with over 14 million scripts per year.  The other psychiatric medications ranked in the top 10 of prescribed meds are Celexa/citalopram, Zoloft/sertraline, Ativan/lorazepam, Prozac/fluoxetine HCL, Lexapro/escitalopram, Desyrel/trazodone HCL, Cymbalta/duloxetine, and Valium/diazepam – in total, the top 10 ranking prescriptions exceed 270,000,000 a year. Working with an expert in both generic and brand name psychiatric medication is the best way to ensure you have a successful mental health treatment plan.

Atlanta Psychiatric Medication Doctor

Call Dr. Darvin Hege, the Atlanta psychiatrist of choice for successful medication management of your mental health needs using generic, brand name or a combination of psychiatric medications that work for you.

Spring is the time of year where spring cleaning and spring checkups are the norm. It can also be a great time to have a mental health checkup and address any concerns about changes in behavior or personality. Psych Central reports on the study by a United Kingdom neuroscientist indicate that one out of four adults suffer from a mental disorder at some point during the year. In addition, in the U.S., Canada, and the UK, mental disorders are the leading cause of disability with depression and anxiety diagnoses occurring most often.

Early Detection with Spring Mental Health Checkups

Psychological well-being is often taken for granted. When a mental illness or disorder begins to impact your work, social or home life, it is an important time to seek mental health evaluation and guidance. Early detection, discovered during a mental health checkup for example, provides for early treatment through a combination of a pharmacological plan and cognitive behavioral therapy. The idea of a spring mental health checkup along with increased education of the public may improve not only the ability to recognize early mental health problems, but may result in early detection and intervention.

10 Most Common Mental Health Disorders

Discovery.com reports spring mental health checkups given by qualified mental health disorder psychiatrists may provide early detection of a mental health illness. Early detection and treatment through an experienced practitioner can put your disruptive behaviors or fears into check and allow you to get back to enjoying life once again. The 10 most common mental health disorders in the U.S. are:

1. Mood Disorders
2. Personality Disorders
3. Eating Disorders
4. ADHD
5. Phobias/Fear
6. Anxiety Disorder
7. Panic Attacks
8. Bi-Polar
9. Schizophrenia
10. Autism Spectrum Disorders

Spring Mental Health Checkups in Atlanta

If new, old or changing behaviors, personality or mental health have started to concern you or your family, it may be time to have a spring mental health checkup.

Call Dr. Darvin Hege to schedule a checkup today.

Patients often want some treatment that will help their ADHD without using a stimulant such as Adderall, Ritalin, Vyvanse or Concerta. They may have different reasons. Some people have intolerable side effects from the stimulants or they may have insufficient help from them. Some people don’t want to be on stimulants for fear they may become physically or psychologically dependent on them. Others may be in recovery from substance abuse problems and don’t want to relapse from taking an abusable medicine. And some people just don’t want to take any medicine.

There are several non-stimulants, non-abusable, non-DEA controlled medications. Strattera is effective in 70% of ADHD patients. Wellbutrin is effective in 57%. The stimulants are effective in 80 to 90% of ADHD patients. Provigil is effective in a considerably lower percentage of patients. Clonidine and guanfacine tend to be less robust in reducing ADHD symptoms of inattention. Omega-3 fatty acids are helpful in a small group of patients. Effexor and Desipramine help some patients.

The major drawback to Strattera is that it takes 1-3 months to get a significant to maximal benefit, and the fact that it may cause a very rare liver toxic reaction has intimidated some patients from taking it. The advantages of Strattera over the psychostimulants includes its effective benefit 24 hours a day once it is working and it’s continuing to work for days to weeks if it is missed or forgotten.

Wellbutrin, like Strattera, has a lagging onset of benefit. So it can take 6 to 12 weeks to see the full benefit. Wellbutrin is an antidepressant as well as an ADHD medication. If the patient has depression as well as ADHD, Wellbutrin may be a parsimonious solution.

Provigil is usually well received by patients for whom it works. However, it is quite expensive and is seldom covered by insurance companies because it is not FDA approved for ADHD.

Clonidine and guanfacine are often used to augment stimulants. They also are beneficial to use in evenings or at bedtime because they tend to assist sleeping rather than disrupting sleep like the stimulants.

Omega-3 fatty acids have been more effective than placebo in studies where it was used along with a stimulant.

Effexor and Desipramine are older antidepressants that are frequently limited in their use for ADHD because of side effects.

Neurobiofeedback has now been classified as an effective treatment for ADHD by the American Psychological Association. It requires 30 to 60 sessions of computer guided and psychologist supervised sessions over 6 to 12 months which usually cost in the range of $4000-$7000. By the end of the therapy there is a group of patients who have a reduction in ADHD symptoms as much as a patient who is taking a stimulant. Long-term studies of several years have found some patients maintain this level of benefit.

Contact Atlanta psychiatrist Dr. Hege’s office for an appointment for an evaluation for the most helpful treatment for you.

There are three main advantages to psychiatric self-pay over health insurance coverage to pay for psychiatric evaluation, treatment and follow up. While many feel managed care reduces out of pocket expenses, this decision comes with a price. With so much variation between insurance companies including the types of policies they offer, it is not feasible to discuss all the differences between individual plans or work supplied group coverage. Today use of “networks,” “managed care,” or “HMO’s” may help cut costs for the patient as well as the insurance company; however, these types of policies typically place restrictions on who you can see, what you may pay “out of network,” as well as provide incentives to mental health providers to provide less treatment overall to their patients.

Insurance Plans Interfere with Process of Therapy

There is a growing trend among mental health professionals to provide services on a self-pay basis. The U.S. mental health system has serious coverage gaps, where psychiatric service is generally slated for limited payments and encounters. Very often group insurance plans require the patient to start with telephone-based counseling through an employee assistance program, or require first starting with a limited number of mental health practitioners including social workers or a family counselors, before authorizing an evaluation and treatment by a network or plan psychiatrist. Even if the plan allows partial payment for an out of network practitioner, the paperwork,  appeals for denied treatment, wait time for additional authorizations or restrictions to time or number of days, directly impact and interfere with the process of therapy and developing a therapeutic working bond.

Psychiatric Self Pay vs. Insurance Coverage

The Therapist Directory  categorizes the three main differences as  1.  Payment,   2.  Choice of Therapist,  3.  Choice of Length / Type of Treatment

Here are some of the other differences:

Privacy

• Self Payment: Info strictly confidential; therapists unable to share information about treatment without prior patient written consent, except in cases of danger to self or others.
• Insurance: Info required to justify treatment. Therapist must provide a diagnosis, treatment plan and progress notes. Info put in database where others may access it.

Choice

• Self Payment: Freedom to pick a therapist, get a second opinion, or change therapists.
• Insurance: Some plans limit choice of therapist, require treatment through a psychiatrist in their network, or provide no reimbursement for out-of-pocket care

Duration & Type of Treatment

• Self Payment: Patients active participants in their care. Treatment sessions continue as long as necessary without interference or restriction.
• Insurance: Plan determines session length, type of treatment, maximum dollar payout, or visit frequency

Atlanta Psychiatric Self Pay Treatment

Dr. Darvin Hege, a leading area self pay psychiatrist for over 30 years does not subscribe to insurance company restrictions or third party privacy invasions, but rather works with you to provide a successful mental health treatment plan that is unique to your needs. Call us today.

There are numerous reasons why a person taking psychiatric medication will decide to stop taking them. The decision to stop made without mental health consultation may because they feel better and believe they no longer need the medications. Additional influences include family or friend pressure to stop, feeling a stigma is attached to those who take psych meds, fear of personality change, discomfort from side effects, or other personal reasons.

Stopping Psych Meds Abruptly Release Many Symptoms

Psychiatry Online reports abruptly stopping psych medication can quickly cause a rebound or return of the symptoms that had previously been held under control for months or years. Depending on the medication being taken, the consequences of stopping their use include withdrawal symptoms, occurrence of new symptoms, or even the appearance of worse symptoms then were experienced prior to the start of psychiatric treatment.

Going “Cold Turkey” with Psych Meds Life Threatening

The decision to stop taking psych meds without benefit of mental health or psychiatric planned medication reduction or change can be dangerous, even life threatening. Withdrawal can bring distressing reactions including potentially fatal seizures with unmonitored stoppage of psych meds. It is critically important to have medical guidance when stopping any psych meds that affect the central nervous system; the biochemical balance of the brain needs to adapt and stabilize to changes over time to prevent a medical crisis.

Management of Time Course and Side Effects Important

Working with an experienced psychiatrist specializing in psych meds ensures a smoother transition during reduction of medications if that is the decision you have reached. Other options your Atlanta psych med psychiatrist may present include switching medications, slow reduction in dosage, cognitive behavioral therapy, reducing or eliminating some psych meds while keeping essential psych medication in place, adjunct therapy, as well other proven strategies.

Psych Med Psychiatrist Alerts you to Expected Symptoms

Working with your Atlanta psych med psychiatrist is crucial throughout changes or reductions in prescribed psychotropic medications. Side effects and possible problems are more tolerable when you know what to expect as well as being aware of certain symptoms or behavioral changes that need to be immediately reported to your psychiatrist. Changes or return to prior dosages are more easily managed when you are working closely with your Georgia psychiatric med psychiatrist.

Slow Dose Reduction of Psych Meds Most Successful

Psych Central.com reports some psychiatric medication studies have shown the slower the dose is reduced the chance of relapse is reduced by one-half or more. With many psychotropic drugs however, such as antipsychotics and mood stabilizers, studies have not been well established to determine percentage of success or relapse. The best recommendation is to work closely with your psychiatrist to gradually make changes and adjustments over time.

Dr. Darvin Hege, a highly regarded Atlanta psych meds psychiatrist, brings decades of successful experience to your evaluation, program strategy, medication regime, and in working with you to achieve optimum results. Contact us to schedule a consultation.

The Journal of Lifetime Learning in Psychiatry reports a growing number of pregnancies where psychiatric illness either predates or emerges during the course of the pregnancy. There are more than 500,000 pregnancies in the U.S. every year with a documented psychiatric illness and 33% of all pregnant women are prescribed a psychotropic medication at least once during the course of their pregnancy. While use of psychotropic medications may be a cause of concern of fetal safety during pregnancy, 30 years of research indicates many medications may be used safely. In some cases, discontinuing use of prescribed medications is not a safe option when reviewing the risks associated with psychiatric illness.

Psychiatric Illness Relapse up to 68% in those who Discontinue Medications

For many, pregnancy is a time of feeling both emotionally and physically well, however up to 20% of women develop a mood or anxiety disorder during pregnancy. Women with a history of psychiatric illness who choose to stop their psychotropic medications are found to be highly vulnerable to relapse. Women’s Mental Health online report studies show a 26% relapse rate for those who continue with psychopharmacology treatment as opposed to 68% that relapsed after discontinuing their prescribed psychiatric medication. Data indicates the risk of relapse was five times greater for those pregnant women who stopped their treatment medication for a mental illness or disorder. Relapse rates show similar findings for those women diagnosed with anxiety, panic, depression, mood disorder or bipolar disease.

Risks of Discontinuing Psychiatric Medications During Pregnancy 

It is critical to develop, pre-pregnancy if possible, a good working relationship with an expert not only in psychiatric treatment, but with a psychiatrist who combines a long standing history of successful individualized treatment strategizing, with the ability to tie in adjunct therapies or cognitive behavior intervention. Some of the risks involved in stopping psychiatric medications during pregnancy include:

• A decrease in the likelihood to receive adequate prenatal care
• A decrease in the ability to make good decisions
• An increase in use of alcohol, tobacco or illegal substances
• An increase in the potential to take part in dangerous behaviors
• Delivery of a child with low birth weight, or fetal growth retardation in depressed mothers
• Preterm delivery as a complication with mothers experiencing anxiety, panic or distress
• Increased risk for development of pre-eclampsia for mothers experiencing depression or anxiety/panic
• Increased risk of immediate treatment for infant respiratory distress, hypoglycemia or other health issues

Atlanta Mental Health Pregnancy Psychiatrist

Careful management of mental illness medications along with cognitive behavioral therapy during pregnancy can provide the optimal outcome for mother, family and baby. Dr. Darvin Hege is committed to providing individualized treatment planning that works for you.

Call to schedule a personal appointment with Dr. Hege today.

The diagnosis of ADHD or attention deficit hyperactivity disorder is a mental disorder that can include difficulty with paying attention, focusing on a task, displaying disruptive behaviors that can cause a problem at school, work or in one’s personal life. Other ADHD markers may also include exhibiting impulsive actions that could pose a safety risk and viewed as non-conforming behaviors that are not socially acceptable, or by reacting with episodes of hyper-activity which brings a feeling of chaos into an otherwise calm situation.

ADHD Diagnosis Broken Down into Subtypes for Clearer Understanding

Receiving the proper diagnosis is the first step toward finding the right treatment that works for you. HealthLine.com reports that ADD or attention deficit disorder is a term that was used years ago, it refers to those that have difficulty paying attention yet are not significantly impulsive or hyperactive in their behaviors and actions. When referring to ADD today, it is generally understood that it points to the inattentive sub-type of ADHD. Those with ADHD tend to exhibit difficulty with concentrating, paying attention, using organizational skills, as well as have problems with remembering details or directions, following instructions, or being able to focus in on their job trying to decipher the important meaning out from all the background noise and activity. In addition behaviors related to ADHD when left untreated include problematic confrontations with friends, family and co-workers.

ADD or ADHD: What’s the Difference?

The difference between ADD and ADHD is that today the terms are merged into one ADHD diagnosis with the sub-type of either inattention, impulsivity or hyperactivity as the prominent factor. An adult may display disruptive behaviors from one sub-type such as inattention, or have a combination of two or all three sub-types. A combination of sub-types may not all be exhibited equally at the same time, and their interfering factors may change from day to day, and situation to situation. Finding an experienced adult ADHD psychiatrist is critical in order to determine how each aspect or sub-type is interrelated, how it impacts your life, and how to adjust the right medication(s). Medicating for one problematic behavior without having a whole-person strategy in place will not provide an effective treatment plan.

Adult ADHD Psychiatrist Provides Comprehensive Treatment

Dr. Darvin Hege is the Atlanta area expert in adult ADHD to call. Dr. Hege will make the correct diagnosis and develop a personalized treatment plan which may incorporate cognitive behavioral therapy or an adjunct therapy in addition to medication.

Call the office to set up an appointment convenient for your life’s schedule.

Telepsychiatry saw its early beginnings decades ago when it was used primarily as a way to reach patients in supervised sites such as hospitals, health care facilities, prisons and rural clinics. The American Journal of Psychiatry reports technology has progressed over the years with live interactive video sessions, also coined Telepsychiatry, becoming a viable option for psychiatrists in today’s fast paced world.

Telepsychiatry Provides Open Access and Unique Point of Service Delivery

The American Psychological Association states that Telepsychiatry affords the option of meeting patient’s needs where they may be unable to easily travel for on-going treatment due to physical limitations, or where a mental health issue impacts their psychological ability to leave their home and travel to a set appointment.

In addition to meeting the need for patients who would otherwise “go without” regular psychiatric care, live interactive video conferencing also fits nicely with the busy patient who would like to have their session during a work break, while out of town on business, during vacation, or for any number of personal reasons. The normal office visit changes into a psychiatric session in the patient’s living or work environment.

Secure Private Live Video Treatment Sessions

Convenience may be a major factor in setting up live video conferencing with your Atlanta telepsychiatrist Dr. Hege. In addition, the security and privacy of your session is of the highest priority. The program and software utilized by Dr. Hege ensures privacy with a security rating that meets stringent HIPAA requirements for security and privacy.

Connecting to Live Video Conferencing Achieved from Wherever You Are

Once Dr. Hege, your Georgia telepsychiatrist, determines you would benefit from the option of live video conferencing, he would set up your session time, providing you with the information to log in at your scheduled time.

Telepsychiatry sessions with Dr. Darvin Hege can be accomplished from anywhere you have WiFi, cellular service or an internet connection. Your live video session can be accessed on your laptop or desktop computer, on an iPhone, Android, or Kindle Fire HD through use of an application that can be downloaded in just a few moments.

Georgia Telepsychiatry Expands the Boundaries of His Practice

Dr. Darvin Hege is well known among his colleagues not only for decades of successful treatment results for his patients, but also for expanding the boundaries of his Atlanta based practice to other areas of Georgia through the utilization of video technology to meet the changing needs and lifestyles of his patients.

Call the office to schedule an appointment today. Dr. Hege requires an initial in-office visit. When he feels the patient is stable, the visits may be via video conferencing.