There are a number of web sites devoted to medicine, and it can be difficult to sort out the information that is accurate and unbiased from information that is placed more prominently after ‘donations’ to support the site. I try to ‘tell it like it is’ when it comes to mental health information, and if there are topics where I am expressing an opinion i try my best to point that fact– so that people know what is supported by data, what is supported by experience, and what is not ‘supported’ at all– but is conjecture based on background knowledge and opinion influenced by family issues and other personal life experiences.

Visit the growing medical database at Medpedia, and if you are an expert, add your knowledge as well.

I like the approach of Wikipedia and now Medpedia. The information is collected by the contributions of experts in the field, and if a person drifts into conjecture there are ways for others to step in and edit the information. That information is then edited by other readers. The result is a growing database of information that represents the best of human knowledge. Since contributors know that their comments are subject to edit, they are careful to get the facts right. And the very complex topics come together from the collective knowledge of the group.

I have contributed information about opiate dependence to Medpedia, and my two main blogs will be featured on their site. I invite readers to check out their information– which is growing daily. Please look for my blog while you are there, and say ‘hi’!

Here is another psychiatry radio show from the archive featuring myself, Jeffrey T Junig MD PhD, interviewed by Bob Hoffmaster of KFIZ radio.  I do tele-psychiatry by the way– if you are interested in a different type of psychiatry– the ‘old fashioned’ kind where you have time to talk. Check out my practice if you have the time; I am taking new patients, and I ‘see’ patients from across the country.  I avoid prescribing controlled substances, so if you require Xanax-type medications, I am not the right person.  But I can prescribe the typical psychiatric medications that are not controlled by the DEA– pretty much anything except for stimulants, ‘benzos’, or narcotics. Please read about my philosophy, which includes ‘seeing’ no more than 2 patients per hour. I don’t ‘belong’ to panels but I do submit insurance claims, and many people who have significant deductibles have no difference in payment for out of network docs– if the person never reaches the deductible, it doesn’t make any difference!

Another show from the archives.  I should mention that the other person on the show with me is Bob Hoffmaster, who does the morning show at KFIZ Fond du Lac every day.  As you can hear, he makes the show a breeze;  he has a curiosity about everything, and all I have to do is come in and chat with him.  It is always the high point of my week– too bad it has to happen on a Monday!!

Continuing my efforts to get all of the episodes on i-tunes, here is the show from 4.13.2009.  If you like it, send me a question and I’ll discuss it on the air next week!  Send it to radioshow@fdlpsychiatry.com.

Unpublished (until now) shows of  Shrink Zone Radio,  with Jeffrey T Junig MD PhD from Fond du Lac Psychiatry, and hosted by Bob Hoffmaster, KFIZ Radio, Fond du Lac Wisconsin.

Information about my psychiatric practice, click here;  for telepsychiatry offered across the entire country, click here.

I heard a report on the radio this morning about a study that was one of those ‘no brainers’—  results from a study about something that is already obvious, like ‘binge drinking associated with fighting,’ or ‘chronic illness linked to shorter life expectancy.’  But this report came over the radio just a I was driving past one of my community’s larger employers, a company that  is currently deciding whether to move operations to another state.

The study found that people who lose their jobs suffer as much emotionally as they do financially;  they have a high incidence of depression, anxiety, and sleep disorders.  This is no surprise when you think about the time we spend at work.  Many people find most of their friends through their work.  And after years of living a certain routine that includes going to a familiar place every day for the majority of our waking day, it is disorienting to suddenly drop out of the routine and spend the majority of the day at home.

If you find yourself in such a situation there are things that generally make a person feebetter and things that tend to make people worse.  In general, the person will favor the behaviors that ultimately make  them worse.  It feels good to ‘hole up’ at home, ignore the phone, and embrace isolation.  But such a course of action will surely cause one’s mood to suffer and reduce one’s self esteem.  All the the things that seem impossible are the ones that will likely make a person feel better;  spending some time with friends, opening the shades and windows, and getting some exercise.  The exercise in particularly will make a huge different on a persons’ mood.

I have a telepsychiatry practice that I use to ‘see’ patients from across the country.  As I have mentioned several times before I try to separate my practice from other practices by spending more time with people.  I see little value in the seven-minute follow-up appointment where you are tell how you are doing on the two-minute walk from the waiting room to the office, sit down for three minutes to describe your medication side effects, and then hear about the new drug on the 2-minute walk back out again.  I teach psychiatry residents about the practice options awaiting them, and my primary suggestion is to find a practice where they have TIME.  There is nothing more frustrating then seeing patients at a productivity based clinic (where you don’t have the option to slow down), and thinking ‘I could really help this person– if I had more time!’

What can we do for people who lose their jobs?  I’ve been considering holding group sessions once per week where people can get together and offer and receive support from each other.  Groups also help people realize that they are not alone, which can make a big difference in how people do after job loss.  If you are one of the many people who have lost a job, there are a couple things to consider that may help deal with the loss.  First, remember that it IS a loss;  people who lose jobs have many of the same feelings as those who lose a close family member to illness.  Many people have heard of the Kubler-Ross stages of grief:  anger, denial bargaining, depression, and acceptance.  You may go through each of these stages and additional stages– like feeling betrayed.  Remember that mourning does not occur in a straight line;  you will likely have good days and bad days.  If the general trend is not positive, you may want to consider seeing a psychiatrist to learn the medication options.  In general I will prescribe an SSRI, as that type of medication (like prozac, celexa, or zoloft) will often raise the floor under your mood, and will also help keep you from obsessive fear that you will never work again.  Sometimes a valium-type medications will be very helpful for a short period of time– a couple weeks– while waiting for the SSRI to start working.

How do you know if you should seek help?  Certainly if you are having thoughts of harming yourself.  In fact, in such cases you should seek help immediately from a crisis service or emergency department.  If you are not sleeping or if you have lost your appetite you should seek help, as both are signs of a serious depression.  Finally if you are feeling ‘numb’ al the time, or if you are feeling as if you are outside of your body and watching your actions from a distance,  you would likely benefit from psychotherapy and/or medication.  Keep in mind that many of the medications take time to start working and many offices have a delay before getting on the schedule, so try to be proactive;  avoid waiting until you have become desperate.

If you have lost a job, please leave a comment about what you would find helpful during this difficulty time.  As always, you are welcome to contact me for an appointment either in person or by telepsychiatry.  Take care, and I hope things turn around for you soon.

I am proud of the space I have created for my psychiatry practice.  I see patients across the country in telepsychiatry, but I prefer— and I think they prefer– coming for psychotherapy ‘in person.’ My office is at the South end of Main Street, within seconds of the highway 151 bypass and Highway 41.

The pictures below were taken with my i-phone so they aren’t the highest quality. The outdoor shots were taken directly out the window of my office.  Yesterday under one of the pine trees there were two fawns, still a bit wobbly on their feet.  A few days earlier a fox sat in the sunny area in front of the trees for 30 minutes, calmly giving himself  (herself?) a ‘tongue bath.’  Now and then a person will interrupt his/her own conversation to say ‘look-  a hawk!’

Some people have even set up a ‘blend’ arrangement, where they see me in person some days, and over the phone on days when the weather is bad or they just cannot fit the trip to my office into their busy schedules.  Whatever works for you– we can make it happen!

My Office:

The Reception Area

Patient Waiting Area

Conference Room

View out Side Windows

My Desk

View out Rear Windows

Patient Interview Area

Tele-Psychiatry

After checking out my web site at Fond du Lac Psychiatry, reading some of my articles, reviewing my treatment philosophy, if you think we would be a good fit, consider Tele-Psychiatry.  Psychiatry is uniquely amenable to the ‘tele’ approach, as the physical exam is not generally part of a psychiatric interview or psychiatric intervention.  In fact, during classic analysis the patient lies on a couch looking upward while the analyst sits in a chair behind the patient’s head– the patient does not see the analyst, allowing for the development of transference, where the work of analysis is performed (which maybe I’ll write about next time).  No, ‘Tele-Psychiatry’ is nothing like ‘analysis’– but my point is that any issue related to using a phone rather than a person-to-person visit becomes ‘grist for the mill’ for the psychiatrist-patient relationship.  For example if the patient, not seeing my face over the telephone, assumes I am mad about something he said, I would want to explore that further– as he may be assuming things with me because of how he sees the world, and he may also be making the same assumptions with others.  The assumptions made by the patient in that case would fall under the definition of ‘transference’, where the patient assigns characteristics to me according to how he generally sees his world, rather than according to my true statements or thoughts.

If you are considering treatment for depression, anxiety, or other issues please consider my practice.  I am able to prescribe medication if it is indicated even if you live in a different state, as during Tele-Psychiatry the location of the doctor is the issue in that regard–  I am practicing psychiatry in Wisconsin, even if the patient is in… Alaska.  I do submit insurance for Tele-Psychiatry patients, just as I do for ‘in person’ patients.

Thank you for considering me to be your psychiatrist,

JJ

Tele-Psychiatry