Anxiety, depression, insomnia, difficulties with alcohol or other substances: mental health is part of my work as a family doctor. I also see people going through grief, exhaustion or difficult changes, without there necessarily being a disorder.
Understanding before naming
What has changed, for how long, and how does it show up in sleep, work, relationships and the desire to do things? Your physical health and current medicines also need to be part of that conversation, because they can contribute to how you feel.
Naming a problem can help guide treatment. But a rushed conclusion can also miss the context of a loss, a difficult relationship or a routine that has become unsustainable. When there is uncertainty, I explain what needs following over time and agree on the next steps with you.
Building a workable plan
Care may include psychotherapy, changes to your routine and medicines. The choice depends on the condition, the intensity of distress and your preferences. A decision about medication needs to consider the expected benefit, possible side effects and when to assess the response.
At later appointments, it matters to understand how you are living: what has become easier, what is still difficult and which changes you have been able to maintain. Adjusting the plan is part of treatment. Involvement from a psychologist or psychiatrist can broaden that care, with a conversation between professionals when you give permission.
Alcohol, other substances and harm reduction
Harm reduction starts with understanding use and agreeing on ways to reduce its risks and consequences. Abstinence can be a goal, but you do not have to arrive ready to stop in order to begin care. That conversation requires trust and honesty on both sides.
I also help people who want to stop smoking. With physical dependence on alcohol, stopping abruptly may require specific care; I assess how to do this safely.
Shared care when needed
Care with a psychiatrist may be needed when there is greater severity, suspected bipolar disorder or psychosis, an insufficient response or a need for specialist management. I can remain your regular doctor, following your health and coordinating decisions. Immediate risks need emergency care.