One of the first things people ask me when they are thinking about getting help for PTSD or trauma is, how long will this take?

Anxiety and ADHD are two of the most common conditions I treat, and they are also often mistaken for each other. This confusion happens not only with patients, but also with providers who have not gathered a complete history.

At some point, most people who take antidepressants ask the same question: can I stop? Maybe you are feeling significantly better and wondering whether you still need the medication. Maybe the side effects have been bothering you. Maybe you ran out and did not refill in time, and now you are noticing strange symptoms you cannot quite explain.

If you have decided to seek help from a psychiatric provider but are unsure where to begin, you are not alone. The mental health system can appear confusing because it includes several different provider types, such as psychiatrists, psychiatric nurse practitioners, psychologists, and therapists, each offering varying services. This variety, combined with multiple platforms for care delivery and conflicting information about insurance coverage, can make it challenging to know how to start the process.

Therapy is one of the best things a person can do for their mental health. A good therapist gives you tools, perspective, and a space to process the things that are hard to say out loud. Millions of people have turned their lives around through consistent, quality therapy alone.

When people decide to seek psychiatric care for the first time, one of the first questions they ask is who, exactly, they should see. Therapist? Psychologist? Psychiatrist? There's another option that many people haven't heard of — and for a lot of patients, it turns out to be exactly what they were looking for.

If you've been dealing with anxiety for a while, you've probably tried things. Deep breathing. Cutting out caffeine. Exercise. Journaling. Avoiding the situations that trigger it. Maybe therapy. Maybe a lot of therapy.

Something interesting is happening in psychiatric waiting rooms right now. Mixed in with the college students and new parents are people in their 30s, 40s, and 50s — people who have held careers and raised children and managed lives — who are only now finding out they have ADHD.

Somewhere in the last few years, burnout became a word for nearly everything. Tired of your job? Burnout. Overwhelmed by responsibilities? Burnout. Struggling to find motivation? Burnout. The word is everywhere, which means it's become easy to reach for it when something more serious might actually be going on.

I've noticed that a lot of people who need psychiatric care don't seek it — not because they don't want help, but because they're not sure what seeking help actually looks like. They picture something clinical and intimidating, or they're afraid of being judged, or they don't know if their problems are 'serious enough.'

If you've been treated for depression for years and you still don't feel right — if antidepressants have helped some but never quite delivered what they promised, or if they've made things worse in ways you can't fully articulate — there's a possibility worth considering.

When the pandemic forced mental health care online, a lot of people — patients and providers alike — assumed it was a temporary workaround. A stop-gap until things went back to normal.

When most people think of trauma, they think of a single catastrophic event — a car accident, an assault, a natural disaster. And they think of the classic picture of PTSD: flashbacks, nightmares, hypervigilance, avoidance.

There's a debate that comes up regularly in mental health care — though it's one I think is mostly a false choice. The question is whether medication or therapy is the right treatment for anxiety, depression, PTSD, ADHD, or bipolar disorder.