Effective Treatment for Mood, Anxiety, Sleep & Chronic Pain Disorders
Treating Patients in Jacksonville, Florida

FAQ

I am a psychiatrist who specializes in treating people who suffer from chronic physical pain and the emotional suffering that always develops, due not only to the physical suffering, but also due to frustration with physical limitations that accompany chronic pain conditions. 

Chronic pain is by definition a treatment resistant condition. It takes a combination of therapies and treatments. I am here to help you get on the right track, to get back to the best part of your old self.  

I emphasize the use of non-addictive medications and healthy physical activity that reduces your  pain. And we will use stress management as well as lifestyle adjustment to improve your ability to function in those areas of your life that are most important to you. Stress is the great amplifier of chronic pain so learning to reduce the negative impact of stress on your mind and body is important. 

This combination results in a personalized treatment plan that is both safe and effective. The goals of your treatment plan include reducing physical pain, reducing the negative impact of stress on your mind and body, and improving your ability to do the things you want or need to do.

I speak to patients, physicians, and communities about the need to treat a whole person.  My experience is that we can reduce your suffering and improve your functioning both  physically and emotionally. We work together to make sure that current treatments are doing no harm.  We also work together to learn from the past – discussing prior treatments that have not worked or caused side effects.  

 

There are several categories of medications that are effective for chronic pain when carefully chosen, monitored, and prescribed at effective dosages. Non-addictive analgesics, non-addictive muscle relaxants, nerve cell “membrane stabilizers,” and “SNRI’s” (Seotonin-Norepenephrine reuptake inhibitors) have all been shown to be effective both individually and in combinations. Careful selection, monitoring for side effects, and learning from results of past treatment trials are important in developing a safe and effective treatment plan. When medication changes are made “one step at a time”  we can carefully monitor for benefits and for any adverse effects for each medication. 

Most prescribers believe that narcotic pain medication (opiates) can be safe and effective for short-term severe pain, in most individuals. But taking narcotic pain medication for chronic pain long-term often results in decreasing benefits and increasing side effects. If you have have a personal history of emotional trauma, a personal history of addiction, or a family history of addiction, then there is an increased rish that one of the “side effects” will be addiction. You may have a genetic predispostion and increased risk for developing very rapid tolerance to habit-forming medication (eg. opiates), alcohol, and /or other addictive substances.

Stress-related physical disorders” are “real” physical conditions made worse by stress. These disorders include headaches, non-cardiac chest pain, most gastrointestinal (“GI”) problems, and pelvic pain from any cause (PMS, endometriosis, interstitial cystitis). Maximum benefits result from carefully selected and monitored treatments for the “physical,” mood, anxiety, and sleep disorder aspects of the condition. Stress is a great amplifier of chronic pain so learning to reduce the negative impact of stress on your mind and on your body is important. 

I define “healthy physical activity” as activity that helps you feel better and function better, without doing any harm. Conversely, “unhealthy physical activity” I define as any physical activity that results in you feeling progressively worse or anything that can potentially damage your body. The challenge for you is to gradually adjust your lifestyle to incorporate more “healthy” physical activity and less “unhealthy” physical activity. 

You will also understand what “lifestyle adjustment” can do to help you function in roles that are important to you, for example in your role as a parent, or spouse, or at work, and/or other roles.  When you learn how to function in these roles without damaging your body, you get a very important part of your life back. 

In my experience, The 7 Habits of Highly Effective People can help you adjust your thoughts and behaviors to better accomplish what’s most important to you. 

Originally published in 1989, the book is based on Stephen Covey’s extensive research reviewing  the common elements of “self-help” books (dating back to and including the Bible). He explains how habits are based on “laws” of human behavior – meaning that they impact your life whether you recognize them or not. For example, one law explains how “being proactive” produces better outcomes than “being reactive.” 

Covey emphasizes that you should first examine and focus on your “core values,” values like health, honesty, loyalty, etc. Then you should examine and focus on life roles that are important to you, like taking care of yourself or being a good parent or spouse. Then recognize that you experience healthy pleasure and fulfillment when you make it a priority to do things that serve those core values and roles. At first glance this is just common sense. But the book can challenge you to identify and change certain habits, in a way that produces a better result – from your definition of what a better result is for you.   

It is hard for patients to understand that healthy core values, like the importance of being a good parent, can sometimes be the motivation for unhealthy physical activity. The challenge is to find new ways to fulfill these healthy core values without doing unhealthy, or painful physical activity. Many patients have said to me “If you could help me figure out how to be a good parent without making my pain worse, that would be great. Right now, if I take care of myself physically, then I am not being a good parent.

Here is the good news. Working with a counselor and therapist, you may find that small adjustments can often reduce pain and significantly improve your ability to perform important life roles. It’s also important to bring in family and friends to help you identify activities that can be adjusted, so you can feel better as you perform your role as a parent with much less pain.