Specialty Area: Psychiatry and Child Psychiatry

Description of Specialty: Psychiatry is the branch of medicine which deal with the diagnosis and treatment of mental and emotional illness. Patients with Internet access may wish to look at www.mentalhealth.com for further information on mental health issues. PubMed, the Internet site for the National Library of Medicine, is also a very useful resource.

1. Diagnosis: Anxiety/Phobia

Questions that should be asked:

1. What kind of anxiety do I have?
2. Doesn't everyone have anxiety some times?
3. What treatments are available? What non-medication treatments are available?
4. What kinds of medications are used?
5. Why would you want me to take medication?
6. What are the risks, side effects, and alternatives?
7. I understand some of the medications are addictive. Which ones are the least risky in this regard?
8. Why would you want to use a medication with addiction potential?
9. What is the risk of my children having this illness?
10. Can children get anxiety disorders?

2. Diagnosis: Depression

Questions that should be asked:

1. What type of depression do I have?
2. What types of depression are known?.
3. What treatments are available?
4. Do you recommend medication, talking therapy, or both?
5. Is medication really necessary? Why? What are the effects, side effects, and alternatives to the medication you recommend, if you recommend medication? Does it interact with any of the other medications I'm taking? Does it interact with any vitamins or herbal preparations?
6. What kinds of talking therapies are there? Which do you recommend for me? Why?
7. What is the risk of my children having this illness?

3. Diagnosis: Panic Disorder

Questions that should be asked:

1. I feel like I'm going to die. How can you be sure there is nothing medically wrong?
2. Why don't I have these feelings all the time?
3. What kinds of therapies are available to treat panic disorder?
4. What can I do to help myself when I begin to feel panicky?
5. What medications can help me? Which one(s) do you recommend for me? Why?
6. I have relatives with a similar problem. Are my children at greater risk?

4. Diagnosis: Alcoholism

Questions that should be asked:

1. I have a strong family history of alcohol problems. What is the risk of my having problems?
2. I drink (....) drinks a day. Does this mean I am an alcoholic?
3. I just had a ticket for driving under the influence. Does that mean I'm alcoholic?
4. My wife feels I have a problem, but I don't think so. Who's right?
5. What kinds of treatments are available for alcoholism?
6. Is medication helpful? Why?
7. What are the risks of not getting treatment now?
8. I think that my son/daughter is using alcohol excessively. What would you recommend that I do?
9. What non-medical therapies are available to treat alcoholism?
10. . Are there therapies which you feel uncomfortable with yourself? Why?
11. . Is alcoholism hereditary?

5. Diagnosis: Drug Abuse

Questions that should be asked:

1. What are the signs that a family member is abusing drugs?
2. My son tried marijuana. Does this mean he is an addict?
3. What are the most common drugs that are abused?
4. My child denies using drugs, but I don't believe that. How can be the certain that he is not using drugs?
5. My child now admits to having a drug problem. What should I do?
6. Does my child need inpatient drug treatment? Why or why not?
7. My child was just arrested for drug dealing. What should I do? I don't want him to go to jail.
8. My husband is using cocaine and heroin to handle stress. Is this reasonable?
9. My wife said she would stop using, but I keep finding evidence that she is using again. What should I do?

6. Diagnosis: Organic Brain Syndrome

Questions that should be asked:

1. My father is becoming increasingly forgetful and irritable. Is this a sign of Alzheimer's disease?
2. My mother seems to be spending her money unwisely. What should I do?
3. My mother remembers things from childhood, but can't recall what she did yesterday. Is this normal?
4. Dad has been a drinker for many years. He seems to be hearing voices and complains of things crawling on his skin. What is this about?
5. Dad is a drinker and was admitted to the hospital for surgery. He didn't tell them about his drinking. He became confused and combative. What is going on?
6. Mom lives alone and sometimes doesn't make adequate meals for herself. She seems to be confused more and more. I am worried she will start a fire. What should I do?
7. Are there any medications that can help with dealing memory?
8. What about ginko biloba?

7. Diagnosis: Schizophrenia

Questions that should be asked:

1. What is the Schizophrenia and what is the cause?
2. My teenager has begun to behave strangely. I am worried that they are using drugs. He seems paranoid and easily upset. What should I do?
3. Does schizophrenia mean "split personality"?
4. Is this the same thing as multiple personality disorder?
5. What medications are available to treat schizophrenia? What are the major side effects?
6. What is the best medication available for my child and why?
7. What is the future for my child with schizophrenia?
8. Can you recommend a good book to help the family adjust to the diagnosis?
9. Are there any organizations which can help us with the needs of our schizophrenic child?

8. Diagnosis: Autism /Asperger's Syndrome

Questions that should be asked:

1. What is the difference between Autism and Asperger's Syndrome?
2. My child has been seen regularly by pediatricians since birth. Why did it take so long to make a diagnosis?
3. Is there a cure?
4. Are there treatments?
5. What can I do to get more information on these disorders?
6. What resources can I expect from the school?
7. Can they ever be productive members of society?
8. Does psychotherapy help?

9. Diagnosis: Attention Deficit Hyperactivity Disorder (ADHD)

Questions that should be asked:

1. Is there really such a thing as Attention Deficit Disorder?
2. I think I have developed Attention Deficit Hyperactivity Disorder as an adult. Is this possible?
3. Everyone has trouble paying attention sometimes. What makes this a disorder?
4. Are there any problems associated with Attention Deficit Hyperactivity Disorder?
5. What are the non-medication treatments for Attention Deficit Hyperactivity Disorder?
6. What medications are used?
7. What are their effects and side effects?
8. How do they work?
9. Can my child outgrow having Attention Deficit Hyperactivity Disorder?
10. Does weekly counseling help for Attention Deficit Hyperactivity Disorder? Why or why not?
11. I have heard about (vitamins, EEG biofeedback, pycnogenol,) for Attention Deficit Hyperactivity Disorder. What is your opinion of these?
12. What tests can you do to diagnose Attention Deficit Hyperactivity Disorder?

10. Diagnosis: Tourette's Syndrome

Questions that should be asked:

1. What is this illness?
2. My child developed a tic. Does this mean he has Tourette's syndrome?
3. My child sometimes has severe tics and sometimes not..will it just go away?
4. I have heard that Tourette's is associated with use of foul language. Will my child develop this?
5. I keep telling my child to stop the tics...and he can, for a minute or so? Why can't he just stop it altogether?
6. What treatments are available?
7. What are the side effects of the medications?
8. Can my child ever lead a normal life with Tourette's Syndrome?

11. Diagnosis: Sleep Disorder

Questions that should be asked:

1. I haven't had a good nights sleep for months. Can you give me some medication for sleep?
2. I have heard about memory problems after taking sleeping pills. Can you tell me more about this?
3. I can fall asleep without problems, but I wake up many times during the night. What might be causing this?
4. My wife says I snore so loudly she has to sleep in another room. What should I do?
5. Do I need a sleep study?
6. What are the risks of taking sleeping pills every night?
7. Is there any reason I should not take medication for sleep bought over-the-counter at a local pharmacy?

12. Diagnosis: Personality Disorder

Questions that should be asked:

1. How is a personality disorder different from a disorder like depression? What types of personality disorders are there?
2. Is it harder to treat a personality disorder? Why?
3. Are medications helpful in personality disorders?
4. What medications and with what side effects?
5. How can I best cope with a family member with a personality disorder?

13. Diagnosis: Medication Side Effects

Questions that should be asked:

1. Does this medication have any side effects?
2. What are the common side effects of this medication?
3. How can I avoid having side effects, and if I get them, how can they be minimized?
4. I can't seem to sit still. Is this a side effect of my medication?
5. My muscles are sore. Is this the muscle cramping you were telling me about?
6. I don't seem as interested in sex as I used to be. Can this be a side effect of my medicine? I seem to be quite constipated. Is this a medication side effect?
7. My HMO won't allow the use of certain medications. Should I be concerned about this?
8. The last doctor I saw doesn't agree with what you are telling me. How do I know who is correct?

14. Diagnosis: Learning Disabilities

Questions that should be asked:

1. What are learning disabilities?
2. How do you get learning disabilities?
3. Does this means I am a slow learner?
4. What is dyslexia? Dysgraphia?
5. What is the relationship between Attention Deficit Hyperactivity Disorder and Learning Disabilities?
6. What help is available by law for people with Learning Disabilities? What is public law 94-142?
7. What state laws apply?
8. How does the Americans with Disabilities Act relate to Learning Disabilities?
9. My child is having problems in school. Does this mean that he/she has learning disabilities? What organizations are available to help me with problems with learning?
10. What is the National Library for the Blind?

15. Diagnosis: Alternative Medicine

Questions that should be asked:

1. So many of my friends are using St. Johns Wort. What is your recommendation about this?
2. Why are so many physicians against the use of herbs and vitamins to cure illness?
3. What things can I do that do not involve medication to improve my mental state?
4. What is the value of exercise in improving my mental health ?
5. I am under considerable stress at work.
6. What can you recommend to help me decrease my stress?

16. Diagnosis: Media Information

Questions that should be asked:

1. I heard that there are new treatments for many disorders. Just last night, I saw a doctor talking about new therapies on television. Why can't you offer these new treatments to me now?
2. I don't understand why you say this therapy I want is unproven. How do you prove that a treatment really works?

17. Diagnosis: Sexual Molest

Questions that should be asked:

1. My child came to me and said that someone had tried to molest him/her? Should I believe these stories?
2. I came to you in confidence to talk about my husband molesting our child. Do you have a legal obligation to report this to the authorities?
3. My daughter accused my husband of molestation and he denies touching our child sexually. What should I do next?
4. The child authorities have insisted that my husband leave the home. Should I send my child away instead?
5. My husband has admitted his molestation of our daughter. What should I do now? Does this mean our family is finished as a family?
6. Are there any support groups to help me with this problem?

Neil Alex, M.D. Department of Psychiatry Sub-Specialty Child Psychiatry Kaiser Permanante San Diego, CA