HomeProvider StoriesHelps reduce the number of variables Helps reduce the number of variables November 11, 2020 Josh Sizemore, RN, MN, PMHNP-BCOregon I’m known in Oregon for treating complex patient cases. Many of the patients I see aren’t presenting with just one condition – they have multiple illnesses, developmental disabilities, and other physical or mental conditions. For example, I may see a patient who is between 15 and 25 years of age and has a psychiatric break. But this may be completely atypical, and so I need to figure out what is really going on. There are always more people to treat than you could possibly have time for. Because I’m seeing patients with complex pictures, it is important for me to stabilize them as quickly as possible. I do a thorough assessment and use everything at my disposal to help my patients. One of the tools I use is the GeneSight test. Reducing the Number of Variables When you are looking at a complex patient picture, you want to limit the number of variables. Especially in the case of severe mental illness – you are trying to narrow down and pinpoint what’s really going on and what you need to do. You just don’t have a lot of time for errors. Families will stick with you for a while, but results matter. At the same time, conditions can be complex. For example, depression can be caused by 1,000 different things. My patient treatment philosophy is that we need to get to the root cause of depression, not just treat the diagnosis. I try to figure out the likeliest reason for depression: is it biological, genetic, conditional, or something else? The GeneSight test helps me reduce some of the variables in treatment decisions. After I order the GeneSight test, I will meet with the patient and their caregiver if appropriate to give them the results. I will NOT go through the GeneSight test results over the phone. It is much too complex. I take time to walk through the results report and share how to interpret the report. Further, I explain what’s important in the context of the entire medical assessment. When someone leaves my office, I share with them what they should hope to see, a timeline for medication response, and what they won’t want to see based on the medication. Part of My Tools to Help Patients I would say the GeneSight test helps me with my most vulnerable patients. For example, I had one highly ill patient who was on 13 different psychiatric meds when I first started seeing them, and still unstable even on that many medications. I was told by the locked, long-term facility where the patient was residing that the patient wouldn’t likely ever be stable enough to leave the facility. I ordered a GeneSight test, and using the genetic testing results, I created a detailed medication plan reducing the number of medications that showed a genetic conflict. My new medication regime for the patient reduced the number of medications down to seven. The new medication regime started to work for the patient. They began to stabilize and, most importantly, the patient was discharged from long-term facility within a year. If I were to talk to another clinician about the GeneSight test, I would tell them that if they want to increase their overall effectiveness and help patients get better, the GeneSight test may help them, as long as they can fully understand and interpret the report. Patient Barriers at Every Turn: How Systemic and Social Factors Block Men from Mental Health Care Taking the important step of seeking care for mental health isn’t always an easy decision. Uncertainty about the need for care, social stigmas associated wi... 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Patient Barriers at Every Turn: How Systemic and Social Factors Block Men from Mental Health Care Taking the important step of seeking care for mental health isn’t always an easy decision. Uncertainty about the need for care, social stigmas associated wi... Read more
Healthcare Provider Overcoming Side Effect Concerns: Leveraging Pharmacogenomic Insights to Inform Depression and Anxiety Medication Selection Whitnee Brown, a lifelong resident now practicing in Birmingham, Alabama has nearly an entire alphabet following her name, abbreviations for degrees and certifi... Read more
Patient Concerns about Mental Health Medication Side Effects Remain a Barrier to Getting Help for Those Diagnosed with Depression and Anxiety Lisa Roberts has raised a family, reached an impressively high level in her career, and was an anchor for her mother and other family members. When, within ... Read more
Patient Common Antidepressant Side Effects Taking an antidepressant can be an effective way to help treat a mental health condition like depression or anxiety. However, these medications can also cre... Read more
Patient MTHFR Mutations: Clinical Implications and Management Strategies MTHFR mutations—changes in the methylenetetrahydrofolate reductase (MTHFR) gene—have gained increased attention in the medical community due to their potent... Read more
Patient Can an App Help Me Manage My Anxiety? Health and wellness smartphone apps have become so common that if you can name a health goal, desire or condition, you can probably find an app for it. N... Read more
Patient Black Trailblazers of Psychiatry and Mental Health: A Legacy of Healing and Advocacy As we celebrate Black History Month, we want to recognize a few individuals who have made extraordinary contributions to the field of psychiatry and mental heal... Read more
Patient Mindful Moments: Tips for Anxiety If a well-meaning friend or family member has ever told you to “just breathe” when you’re feeling worked up or stressed out, you’d be forgiven if you felt l... Read more
Patient Hints To Help You Have A Better New Year The holidays have ended, and a new year has begun—a time when many embrace a fresh start by setting New Year’s resolutions. This year, why not consider s... Read more
Patient Movement as Medicine: Solutions for Anxiety Moving forward. It sounds like a nice idea, especially when you’re feeling stuck deep in the throes of an anxiety spiral. But it turns out that physically m... Read more