David Gersten, M.D. specializes in Integrative Psychiatry. He has utilized amino acid therapy for 30 years. Whether treating with medications or amino acids his decisions are based on comprehensive nutritional and metabolic lab work. His approach is holistic - integrating body, mind, and spirit. "I don't believe in splitting psychotherapy from physical treatments. I come from an era in which psychiatry residencies were half psychopharmacology and half psychotherapy. The psychotherapy I utilize (which starts with non-judgmental listening) involves mental fitness techniques (interactive guided imagery, use of the breath, and meditation). Guided imagery is similar to hypnosis."
Education and Training
University of Colorado Medical Shool MD 1975
UCSD Residency in Psychiatry 1978
American Board of Psychiatry and Neurology
Dr. David Gersten MD's Expert Contributions
Does mental illness cause a person to have "music hallucinations?" That is a great question, one that I've never heard. A conventional psychiatrist is going to diagnose you with a psychotic disorder and treat you with antipsychotic medication. I would need to know more. We're in the gray zone between mental illness and a spiritual/metaphysical experience. Is the music beautiful or frightening? If it's music you like, my guess is that you're having a paranormal experience. I'd want to ask a lot of questions to determine if you have a variety of symptoms or psychosis...or if this is the only unusual thing you experience. I wrote "Are You Getting Enlightened Or Losing Your Mind? - A Psychiatrist's Guide for Mastering Spiritual and Paranormal Experience" to help people sort out what is "craziness" and what is spiritual or metaphysical. READ MORE
Are there medications that can improve focus? Answer: Psychiatrists have been using Ritalin and Adderall (ADHD drugs) for decades, to improve focus. However, the long-term effects are not good and research shows that after 3 years use these drugs decrease focus. Norepinephrine is the neurotransmitter most involved in focus. The nutrient that makes norepinephrine is the amino acid L-tyrosine, which is converted into dopamine and norepinephrine in the brain. L-Tyrosine requires P5P, the active form of vitamin B6, to get converted into these neurotransmitters. This will boost norepinephrine, which usually improves mood, focus, and memory. READ MORE
RITALIN ADDI CTION Let me begin by describing research studies on Ritalin and Adderall. There have been thousands of studies about the effectiveness of Ritalin and Adderall. Perhaps the most respected study is the NIMH MTA study, which began in 1999. MTA is short for Multimodal treatment of attention deficit hyperactivity disorder. The MTA study showed that after 14 months on medications there were some benefits to ADHD target symptoms. But after 3 years treatment with Ritalin or Adderall there was deterioration caused by the medications. The MTA study showed that after 6 years on ADHD medication, including Ritalin and Adderall, ADHD symptoms were worse than before treatment had started. There was increased functional impairment, an increase in ADHD symptoms, and the development of oppositional behavior. These kids had a decreased curiosity in their environment, and decreased socializing. They were worse than kids who had not taken ADHD meds. Signs of Ritalin Addiction 1. Insomnia 2. Severe Fatigue 3. Nutritional deficiencies due to appetite suppresssion 4. Heart Damage Many people swear by these drugs and state that they feel better when taking Ritalin or Adderall. Why is that in contrast to what scientific research has found? 1) A research study involving thousands of subjects has much more science behind it that individual reports. 2) Research shows that Ritalin increases dopamine up to 3 years, but after that there is a permanent decrease in brain dopamine levels. If you are used to taking Ritalin, then stop, your brain will be operating with deficient dopamine. You will crave Ritalin, which is structurally similar to cocaine, in the same way an alcoholic will crave alcohol. Ritalin, which affects fight-or-flight biochemistry, may help you “feel” back to normal, but in the long run your brain on Ritalin is deficient in dopamine. My YouTube video "Natural Treatments for ADHD: A Complete Picture" goes further in answering your question. https://www.youtube.com/watch?v=WDjmY9Fhue8&index=1&t=12s&list=PL-yBN4nFUi5Ca_OkVomfPSdrKNO7F4XGv READ MORE
I'm glad that you're taking time to explore this issue. Benzodiazepines, like Xanax, do decrease anxiety...but it's easy to stay on these drugs and hard to get off them. These medications cannot be stopped suddenly. That will throw an individual into withdrawal. Tolerance develops with Xanax, which means that, "If the effect is 100% initially, in a few months that same dose may feel 70% effective...then 50%, etc.” What to do: 1) Consider natural treatments like the amino acid L-theanine and the herb kava kava, 2) Find a psychotherapist to help your daughter explore her feelings, thoughts, insecurities without focusing entirely on anxiety. 3) I practiced child and adolescent psychiatry for 8 or 9 years. One thing I learned was to be careful about jumping to diagnose a teenager. "Normal" adolescence includes: hormonal changes, identity changes and identity crises, and mood instability. That's Normal, so I want to know if this anxious teenager is experiencing normal teenage issues...or if she or he has a true mental disorder. 4) Increase exercise, 5) meditate, 6) learn breath techniques that can decrease anxiety significantly in less than 60 seconds. 7) Get your daughter grounded. I don't mean punishment! Prolonged barefoot contact with the Earth's bioelectrical field decreases inflammation and normalizes the stress response, which will decrease anxiety. 8) Identify what your daughter really likes to do. Sports, music? Foster those activities she loves and support her through the frequent chaos of adolescence. Avoid jumping to the quick psychiatric decision to medicate without first getting to know the person who has the problem. Best of Luck. READ MORE
Schizophrenia has a strong genetic component. There is a study called "The adopted away study," which has been observing identical twins who were adopted to different families at birth. The study has looked at many illnesses for decades. If one identical twin has schizophrenia, there is a 50% chance that the other identical twin, raised in a completely different family and environment, will develop schizophrenia. That tells us 2 things: 1) There is a strong genetic component to schizophrenia, and 2) If 50% are not developing schizophrenia, it means that there is something other than genetics that plays a big role. READ MORE
Very good question. Taking your son to a counselor could be quite helpful. But..."To make sure he does not get emotionally affected..." You son WILL be emotionally affected by a divorce. That's only natural. If your son establishes a relationship with a therapist/counselor, he can openly start to share his concerns...and if he gets overwhelmed by emotion, he will have that healing relationship established. You haven't said how old your son is, and that is important in terms of what kind of counseling and counselor is appropriate. I spent 9 years in child psychiatry. I believe that play therapy is the best modality for children. Somewhere between 9 and 12, interactive guided imagery (at least in my practice) becomes the modality I would use. Interactive guided imagery is essentially "inner play." READ MORE
A psychiatrist is a medical doctor like any other specialist (cardiologist, internist, neurologist, surgeon, etc), so they first go through college, then medical school, followed by a one-year internship. After internship each specialty has Residency training, including Psychiatry Residency. So psychiatrists do have training in all of medicine the same as other doctors. I, for one, worked as a GP for several years. Up until 25 years ago psychiatry residency training was half psychopharmacology and half psychotherapy. Now, psychiatry residencies are almost entirely lacking in psychotherapy training. Psychologists, like psychiatrists, finish college. They then get either doctorate degrees (PhD and PsyD) or masters degrees. Their training is heavily on the psychotherapy side. Many also have a great deal of training in complex Neuro-Psychological Testing. READ MORE
What I see in the question is a negative spiral. The question is: "Should I be worried about feeling negative?" Awareness without judgment is deeply healing. If a person can notice that they are feeling negative without reacting to that thought with another negative thought they will start to feel less negative. In terms of "worry" this is not a sign that a person has a major mental illness. Learning meditation or cognitive behavioral therapy will help tame the mind. READ MORE
Sit down to talk with your friend in a setting that the two of you are used to. Don't start talking about psychiatry. Tell him that you've noticed that he seems a bit out of balance since the divorce. Let him talk. Listen. Don't judge. He may start with denial, like, "I'm fine. There's no problem." So, you gently continue with, "You look great (if that is true), but you seem depressed, out of sorts, not the same old cheerful friend." Give him a chance to open up to you first. When the time is right, mention psychiatric help. READ MORE
Oh dear. At 32 you are not yet in your sexual prime. Many people desire sex once...or twice a day. Your husband may have a much lower libido than you do. Or...many men approach sex as a performance. His "job" is to help you reach orgasm. If that doesn't happen, he (men in general) may feel like a failure. He may be tired, stressed out from work. I have found that an open, creative conversation works wonders. The issue is about communication. From what you've written, there is nothing wrong with you. READ MORE
Madness or psychosis is a major break with reality, and may include hallucinations and delusions. Depression can be so severe that it reaches psychotic proportions, and should be treated as a psychiatric emergency. His depression is a reaction a response to an overwhelming stress. He may be traumatized and not know it. The biochemistry of trauma involves the freeze response, the third survival mechanism after fight and flight. A person who is still traumatized may feel emotionally numb, emotionally immobilized, and disconnected from self and others. READ MORE
Bipolar disorder is greatly overdiagnosed. True bipolar disorder has a genetic component. In the adopted-away studies, identical twins who were separated at birth and raised in different families go into a data base. In the case of bipolar disorder, if one twin has the disorder 50% of the time the other twin will have the disorder. For prevention, in my practice I do very extensive nutritional/metabolic testing. Two of the biggest issues that contribute to ALL illness are inflammation and toxicity. Chronic digestive problems wreak havoc with total body biochemistry. By addressing issues of a healthy life-style, you can make it much less likely that a bipolar gene will get expressed. READ MORE
There is nothing wrong with vivid daydreams...unless they are interfering with life. A person with a vivid imagination is usually a creative person. If this is a source of distraction or loss of focus, you may be deficient in norepinephrine in the brain. L-tyrosine is the amino acid that turns into dopamine and norepinephrine in the brain, but you have to take P5P (pyridoxal-5-phosphate) with it. Get an enteric form of P5P. READ MORE
If your father does suffer from schizophrenia, when did it first begin? Late onset schizophrenia is rare. Schizoaffective disorder, in my opinion, is a controversial diagnosis. But I'd need to know more about date of onset, symptoms, and medications he is taking. READ MORE
Kids with ADHD often end up on Adderall or Ritalin for life, but here is the most common cause-and-effect steps: 1) numerous childhood infections, especially middle ear, which are 2) treated with antibiotics over and over again. 3) the antibiotics kill of billions of friendly intestinal bacteria, which 4) allows the normal amount of intestinal yeast to explode. 5) This then can lead to all kinds of digestive problems and leaky gut syndrome with 6) systemic yeast and 7) delayed IgG food allergies. All of these steps can be corrected. Remember: the Gut-Brain connection is real, and powerful. READ MORE
Symptoms are almost always the tip of the iceberg. Thyroid or adrenal problems can cause this. I use plasma amino acid testing, urine organic acids (and sometimes plasma neurotransmitter testing) to find out what is going on with brain chemistry and total body chemistry. Your issue, "not able to put as much mental and emotional effort in tasks" sounds like norepinephrine deficiency, although it's guess work without having more info. Low norepinephrine is usually associated with impaired memory and concentration. The amino acid L-tyrosine is the nutrient that turns into dopamine and norepinephrine in the brain. It needs to be taken with P5P (pyridoxal-5-phosphate). I prefer Montiff brand P5P, which is called TriPhosB. I don't know your location, but New York will not allow 3 or 4 nutritional tests to be done. READ MORE
The nature of the mind is to churn out thoughts. The average person runs 5,000 random thoughts per day, 35,000 per week, 1,825,000 per year. The faster the mind moves the more anxious and stressed a person is. Very rarely is this a disease. Neurotransmitters can be involved (dopamine, norepinenephrine and/or serotonin), along with GABA (our most calming neurotransmitter). Low grade inflammation is often an issue. In situations like this I usually combine physical with mental treatments. (meditation, use of the breath, mental imagery). I've spent a career trying to figure out what the mind is. Oh, hmm I forgot something. I wrote a book for the POWs of Operation Desert Storm, and re-wrote it last year. It was part of military training for army and navy in Operation Desert Storm. The POW Survival Guide will be re-named and briefly re-written. The military is no longer interested in this information. It's on Amazon. It is high on technique, low on theory, and the most important thing it teaches is how to establish "Mental Home Base," a place you can return to internally over and over again, instead of constantly churning out thoughts. Most thoughts, by the way, are pretty neutral, even if a person is feeling negative. Affirmations are useful, but not as important as mantra meditation, and regular exercise is important. READ MORE
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Patient Experience with Dr. Gersten
- What Is Tachypnea?
Introduction Tachypnea is a medical term, which means rapid and shallow breathing. This condition is often confused with hyperventilation, which is another type of abnormal breathing that is characterized by rapid but deep breathing. Both conditions are caused by carbon dioxide buildup in the...
- Depression Leads to Non-Adherence of COPD Medication
Chronic obstructive pulmonary disease (COPD) is a progressive disease, which currently does not have a cure yet, as modern medicine has not found a way to reverse the damage done to the airways and lungs. For this reason, there is a slow and long-term development of debilitating symptoms. The...
- Recognizing Anxiety Disorders In Children
It’s sometimes difficult to understand your kids and their behavior. One moment they are happy and the next moment, they seem sad or irritated. Well, this kind of innocent behavior in children can be considered normal under certain conditions, but not always. For example, anxiety is useful and...
- What Is Flakka?
Flakka is now more popular than ever, with stories about its use spreading to national news channels. These stories range from hilarious to frightening, which makes flakka so interesting. There are stories of people running through the streets naked, which are a bit hilarious. However, there are...
- Psychologist vs. Psychiatrist
IntroductionFor individuals who suffer from certain mental health problems, there is always a question that comes to their mind. Whom should they approach for help? How would one know which type of doctor would be right and whom should they speak to? Do they need to go to a psychiatrist or a...
- Treatment Options for Depression and Anxiety
Anxiety and depression are similar conditions that develop when neurotransmitters, like serotonin, are not as effective. Low serotonin levels, as well as dopamine and epinephrine levels, play an important role in the development of both anxiety and depression. Since both conditions affect the same...
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