Notes from Practice

Fall officially started last week, and if you live anywhere in the northern half of the country, you've probably already noticed it's getting dark earlier. Right now we're losing a couple of minutes of daylight every day. On November 1 the clocks fall back, and suddenly it's dark by 5. This is the time of year I start bringing up seasonal depression with patients who've had it before. Not in December, when they're already sleeping ten hours and can't get off the couch. Now, w

Stimulants that help your focus can also leave you wired, but that feeling is usually one of four different problems: adrenergic activation, end-of-dose rebound, sleep loss, or anxiety the ADHD was covering up. Sorting out which one you have is most of the work, and the dose is usually the first thing to look at.

Sexual side effects are one of the most common reasons people stop antidepressants, and one of the least discussed. Here's why they happen, which antidepressants tend to be easier on sexual function, and what your options are if you're already dealing with them.