Many people suffer from depression
at some point in their lives.
We can help.

Treatment Options

At NPA, our recommended treatment plan is individualized to the patient’s needs. Treatment options

may include psychotherapy, psychiatric medication(s), and/or family involvement to achieve an optimal

outcome.

Psychotherapy

Some psychiatric problems may benefit from treatment with psychotherapy. Many patients achieve a

better outcome with a combination of medication management and psychotherapy than they would

with either treatment by itself. If psychotherapy is indicated the psychiatrist may either provide this

service or refer the patient to a psychotherapist. For those psychiatrists who do practice psychotherapy,

the decision as to whether to combine psychotherapy with medication management will be a collaborative and joint

decision between the patient and their psychiatrist.

For those patients who see an NPA psychiatrist for psychotherapy, psychiatrist and patient will assess if

the initial problems for which the patient sought help for are resolving. For some patients, there will be

underlying or persistent problems that require longer term or more intensive psychotherapy. The main

types of psychotherapy practices at NPA include problem-focused short term psychotherapy, cognitive-

behavioral psychotherapy (CBT), and psychodynamic psychotherapy.

Problem-focused short term psychotherapy involves looking at specific problems the patient is

confronting at the time and, with the psychiatrist’s help, exploring possible ways to resolve the

problems. Cognitive behavioral psychotherapy looks at the patient’s underlying beliefs about

themselves and their surroundings that are generating their thoughts, feelings, and behaviors, as well as

the responses these behaviors elicit, that usually reinforce the underlying beliefs. Alternative beliefs,

thoughts, and behaviors are explored and practiced to elicit different responses that will be more in line

with what the patient wants or needs. Psychodynamic psychotherapy focuses on patterns of relating

both with oneself and with others. Psychodynamic psychotherapy looks at how these patterns started

in the past, how they maybe repeating in some way in the present, and how they manifest themselves in

the context of the psychotherapeutic relationship. The overall goal is to change unhealthy or

destructive patterns to ones that are more satisfying and effective. This change often begins within the

psychotherapeutic relationship and gradually is applied to other relationships.

In psychotherapy for the child or adolescent, similar approaches as described above are utilized,

depending on the patient’s clinical presentation, as well as their cognitive and developmental level.

There are several types of psychotherapy that involve different approaches, techniques, and

interventions, all designed to help children and families resolve problems, modify behavior, and make

positive changes in their lives. At times, a combination of different psychotherapy approaches may be

helpful along with medication interventions. The child psychiatrist will work with you and your

child/adolescent to define the best therapeutic approach for treatment.

Psychiatric Medication Management

Exciting advances in the understanding of the brain and mental illness have led to the development of

many safe and effective psychoactive medication interventions. We now know that chronic, recurring

problems with anxiety, ADHD, depression, psychosis, and other debilitating mental symptoms are the

result of brain dysfunction. Many factors may contribute, including family genetics, stress, medical

illnesses, and drug or alcohol abuse. These are common illnesses, not signs of weakness, character

flaws, or moral failing. These common illnesses require complex treatments, and medication

management has become a safe and effective part of treatment for most patients with these conditions.

Treatment with medication begins with a thorough psychiatric evaluation which may require one or

more sessions. As part of the evaluation process, your psychiatrist may recommend medical evaluation

or laboratory testing if clinically indicated. The psychiatrist may wish to review records of previous

treatment or interview family members. At the conclusion of the evaluation process, your psychiatrist

will offer a diagnosis and discuss treatment options with you, including medication options appropriate

for your condition. With your input and informed consent, medication decisions can be made and

treatment started. You and your psychiatrist will then meet on a regular basis to monitor your

symptoms and any potential side effects making dosage adjustments and obtaining laboratory tests

when necessary. Medication trials and response may take several weeks, though in many instances you

may experience benefit within a much shorter period of time. If effective, medication will be continued;

if not, you and your psychiatrist will discuss other medication choices. Because treatment is often

complex, many patients require a combination of medications for adequate symptom control, and

arriving at this effective combination is a process you go through with your physician over the treatment

course.

Our ultimate treatment goal is ‘remission’ (complete control of symptoms and normal functioning) and

prevention of relapse in the future. The latter may necessitate remaining on your medication regimen

long term. During this ‘maintenance phase’ of treatment, meetings with your psychiatrist may be

infrequent (every 3-6 months) if you are doing well. In some patients, symptoms may return, despite

treatment, requiring medication adjustments and more frequent appointments. A combined treatment

approach, including medication management, usually provides the most effective outcome. Modern

medications are generally safe and effective, and may be essential to your recovery. Working with a

psychiatrist experienced in the use of these medications will maximize your potential benefit, with

minimum risk and side effects.

Common Psychiatric Disorders

Depression and Mood Disorders

Depression is a serious medical illness that is arguably one of the most debilitating illnesses in today’s

world. It is most commonly characterized by deep feelings of sadness or loss of interest and pleasure in

the activities of daily life. One may experience disruptions in sleep and appetite, loss of energy, feelings

of guilt and hopelessness, loss of concentration and even thoughts of death or suicide. Depression

affects the way one feels, thinks, and acts. There are other mood disturbances that are generally

referred to as cyclical mood disorders. Bipolar disorder, commonly known as manic depression, is one

such illness. It is characterized by shifts in a person’s mood, level or energy, and ability to function.

Bipolar disorder may include periods of depression, but also periods of intense elevation or irritability.

These symptoms may manifest as difficulty concentrating, experiencing racing thoughts, decreased need

for sleep, increased energy, and impulsive or reckless behavior. The causes of depression and other

mood disorders are varied and may involve chemistry of the brain, genetics, the particulars of

personality, and the stress of one’s environment. It is important to obtain experienced help.

 

Anxiety Disorders

Anxiety disorders are common and quite distressing emotional disorders. They affect millions of

Americans. Symptoms may include feelings of constant worry, panic, and fear. They can also include

very physical symptoms such as feeling sick to your stomach, muscle tension, difficulty sleeping, startling

easily, or heart pounding. Anxiety may result in social isolation and can escalate to the point of

difficulties in group settings or being unable to leave one’s home. There are multiple variants of anxiety

disorders including generalized anxiety, panic disorder, phobias, obsessive compulsive disorder, and

posttraumatic stress disorder. Individuals suffering from anxiety disorders are vulnerable to mood

disorders such as depression and substance abuse disorders, including alcohol dependence. Obtaining

experienced help is important.

 

ADHD

(Information coming soon)

Disruptive Behavior Disorders

(Information coming soon)

Substance Use, Abuse, and Dependency

Chemical dependency is a condition characterized by compulsive drug seeking and use despite harmful

consequences. Through decades of research, it is now accepted and understood that chemical

dependency is a brain disease. This revolutionary new understanding dispels the myth that individuals

with chemical dependency issues lack willpower or are morally flawed. Instead, these individuals should

and can seek treatment for their medical condition.

Many people first use drugs and alcohol for their perceived positive effects. These chemicals produce

and intense pleasure response in the brain by flooding it with dopamine (a neurotransmitter) up to 10

times more than natural rewards (such as food and sex). This experience makes a person want to repeat

the behavior. With increased chemical use, the brain becomes desensitized to the effect, and the ability

to experience any pleasure becomes reduced. Eventually, the person loses the ability to enjoy the

substance as well as natural rewards. The person only continues the use of the chemical to return to

some sense of normalcy.

Of the millions of substances that we ingest, only a few are capable of producing the characteristic brain

changes that make it essentially impossible for some to stop their use. Neurobiologists believe the

‘need’ to continue using the drug comes from dysregulation in the brain that causes the person to feel

that the drug is ‘correcting’ the brain’s problem. Genetic factors account for 40-60% of a person’s

vulnerability to addiction. The disease is, however, quite complex and affected by multiple psychosocial

and environmental factors.

By the time individuals enter treatment for chemical use and dependency, their disease has disrupted so

many aspects of their lives that treatment should include a number of rehabilitative services. Your

psychiatrist will provide treatment approaches appropriate for an outpatient environment and will

recommend other resources as needed for comprehensive recovery.

Important Links to National, State, and Local Organizations

American Psychiatric Association (APA)

American Academy of Child and Adolescent Psychiatry (AACAP)

National Alliance for the Mentally Ill (NAMI)

National Institute on Drug Abuse

Texas Society of Psychiatric Physicians (TSPP)

Texas Society of Child and Adolescent Psychiatry (TSCAP)

Austin Travis County Integral Care