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Sunday, June 14, 2015

The Good, Bad and Ugly


When I see patients, I begin by using a biopsychosocial model.This kind of orientation allows me to organize treatment plans that are comprehensive and keeps the big picture in mind. It also prevents me from missing the details that are important to your healthcare.

The Good is in reference to biology. Is your health good? Is there a medical condition or history that is relevant now? Is there a drug use issue that is impacting you? Are there side effects from medications you use for other medical illnesses? Are you healthy without other undiagnosed illnesses causing problems? Are you nutritionally sound? Are there polypharmacy issues where drug interactions are causing changes in your mental status? Is there a history of mental disorders that could be genetically relevant? These are just some of the questions that I consider.

The Bad usually refers to the bad coping skills that are abnormal psychological processes involved in mental diseases. All people have experienced distress at sometime during their childhood. Most of us got through these trying times with successful resolution of  these conflicts. Some of the solutions we learned in response to conflict in the past, may not be sufficient now. In fact not only are they inadequate, they can be harmful. Understanding insufficient or harmful coping skills and learning better coping skills not only feels better but prevents future mental disease escalation and relapse. In fact, learning better coping skills can be curative.

The Ugly is usually the devastating social consequences of mental diseases in our lives. I typically see patients divorce, lose jobs, lose everything important in their lives. The ugly is usually the worse part of the diseases I treat. Families destroyed, individuals desolate. We are a social species, our survival individually and as a group depends on our social viability. A healthy person is socially engaged, fulfilled and happy.

As I continue with my postings, I will show how I use the good, bad and ugly (biopsychosocial approach) in the specific disorders that I treat.

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