•A Sure Way to Fight Stress
A Sure Way to Fight Stress by Michael G. Rayel, MDI usually put my children to sleep. Routinely, each one takes turn saying prayers before dozing off.“Dear heavenly Father, thank you for my family and relatives and for all the blessings. Thank you for giving me only good dreams and good thoughts.”As this prayer echoes around the room, it somehow exudes a faint acapella amidst evening tranquility. Since this is about thankfulness for family, blessings, good dreams, and good thoughts, I...
•Are All Dementias Alzheimer’s?
Are All Dementias Alzheimer’s?
by: Michael G. Rayel, MD
I’m surprised when some patients and caregivers confuse dementia and Alzheimer’s as one and the same. Each time a family member is suffering from memory loss, the conclusion is always Alzheimer’s. Is it reasonable to label all dementias as Alzheimer’s?
As a clinician, my answer to queries is that Alzheimer’s dementia is only one type of dementia and that not all dementias are Alzheimer’s. Aside from Alzheimer’s disease, other...
•Behavioral Manifestations of Alzheimer’s Dementia
Behavioral Manifestations of Alzheimer’s Dementia
by: Michael G. Rayel, MD
Alzheimer’s Dementia has a combination of cognitive and behavioral manifestations. Cognitive impairment is the core problem which includes memory deficits and at least one of the following: aphasia or language problem, agnosia or problems with recognition, apraxia or motor activity problem, and impairment in executive functioning (e.g. planning, abstract reasoning, and organizing).
As the disease advances, the...
•Can You Make a “Torpedo” Out of Personal Junk? How to Optimize What You Have
Can You Make a “Torpedo” Out of Personal Junk? How to Optimize What You Have
by: Michael G. Rayel, MD
“Junkyard Wars,” a TV series showed two teams of experts contending for a title. The aim of the competition was for teams to construct a torpedo that can hit a target. But the challenge was more than just the process of construction. The challenge was creating a torpedo out of a junk.
Each team had crafted a unique design and members wasted no time looking for junks — hoses, batteries,...
•Depression Series (Part 2): My Antidepressant Doesn’t Work. What Can My Psychiatrist Do?
Depression Series (Part 2): My Antidepressant Doesn’t Work. What Can My Psychiatrist Do?
by: Michael G. Rayel, MD
Maria has been increasingly depressed for the past few years. She has tried at least four newer antidepressants but so far, she doesn’t seem to respond. Unable to work, she’s now feeling helpless and hopeless. Likewise, her family is discouraged. Frustrated and baffled by Maria’s lack of progress, the family doctor refers her to a psychiatrist.
What can the psychiatrist do to...
•Depression Series (Part 3): What to Do with Those Antidepressant Side Effects?
Depression Series (Part 3): What to Do with Those Antidepressant Side Effects? by Michael G. Rayel, MDMaria’s depression was difficult to treat. As you can recall, various medications had been tried to no avail. But after several months of treatment, Maria has eventually become stable on a combination of two antidepressants. She’s now able to do her usual activities and is motivated to go back to work — something she has struggled to do for a while. Despite her improvement, antidepressant...
•Depression Series: Why Don’t I Respond to Medications? (Part 1)
Depression Series: Why Don’t I Respond to Medications? (Part 1)
by: Michael G. Rayel, MD
Maria has been feeling depressed for at least two and a half years. About three years ago, her husband of 20 years left her for another woman. Devastated, she became despondent and tearful almost daily.
Eventually, her depression got worse associated with inability to function. Her appetite, energy, concentration, and sleep became impaired. She also felt hopeless and suicidal. Her psychiatrist put her...
•How Distressing is Social Phobia?
How Distressing is Social Phobia? by Michael G. Rayel, MDI remember a friend in college who would blush, sweat, and tremble when required by a teacher to speak in class. A few weeks before the presentation, he’d be anxious, agitated, and couldn’t sleep. Because I was still a student then, I didn’t have any clue what he was going through. But I knew that something was terribly wrong.A few years ago while in the airport, I noticed a man who’d wait for everyone to leave the washroom before he’d...
•How Do You Know if You Have Manic-Depression
How Do You Know if You Have Manic-Depression
by: Michael G. Rayel, MD
Nancy was doing very well until about two years ago when Phil, her boyfriend of 9 years, broke-up with her. It was a difficult moment for her especially after she learned that Phil eventually married her cousin. Since then, Nancy had deteriorated. One evening, she was involved in a motor vehicular accident because she was driving fast and recklessly in a quiet suburban neighborhood.
During interrogation, the cops noted...
•How to Prevent Suicide
How to Prevent Suicide
by: Michael G. Rayel, MD
A British weapon’s inspector was found dead in the woods after he slashed his wrist. For the past few weeks, he was entangled with a controversy about the war in Iraq.
On Monday, a Hyundai executive leaped to his death from the 12th floor. He was on trial for allegedly paying off North Korea $100 million to agree to a 2000 summit between North and South Korea.
In both urban and rural areas, many more suicide cases do not go unnoticed....
•Is Dysthymic Disorder a Second-Rate Depression?
Is Dysthymic Disorder a Second-Rate Depression? by Michael G. Rayel, MDDysthymic Disorder, used to be called Dysthymia, is a low-grade and yet chronic depression characterized by feelings of sadness or depression associated with lack of interest to do things and some physical symptoms such as lack of energy, sleep, and concentration.Psychological symptoms such as feelings of hopelessness, helplessness, and worthlessness can also occur. In addition, some patients harbor thoughts of death and...
•Major Depression and Manic-Depression — Any difference?
Major Depression and Manic-Depression — Any difference?
by: Michael G. Rayel, MD
Countless number of patients and their family members have asked me about manic–depression and major depression. “Is there any difference?” “Are they one and the same?” “Is the treatment the same?” And so on. Each time I encounter a chorus of questions like these, I am enthused to provide answers.
You know why? Because the difference between these two disorders is enormous. The difference does not lie on...
•Make Role Modeling a Hobby
Make Role Modeling a Hobby by Michael G. Rayel, MDLike in most families, children are around you everyday. Whatever you show to your children is what you teach and impart to them regardless of your intentions. In the eyes of your children, you are a teacher. Everyday you are teaching “live” — whether you like it or not. You’re like a walking lecture in your child’s life.What are you willing to show to your child? What are you going to teach your child through you? Do you want to be...
•Panic Attacks: Effective Ways to Cope
Panic Attacks: Effective Ways to Cope by Michael G. Rayel, MDJill is a 21 y/o college student who used to do well until about a few months ago when she started to experience “weird” attacks almost daily. She described her experience as “horrible.” When she has the attack, she feels that she’s about to die or develop a stroke.One day while she was in a mall, she suddenly developed an “overwhelming” sensation all over her body. She was sweaty and tremulous and felt that her heart was pumping...
•What is the Treatment for Bipolar Disorder?
What is the Treatment for Bipolar Disorder?
by: Michael G. Rayel, MD
How do we treat bipolar disorder? Specifically, how do we treat mania or depression associated with bipolar disorder? The treatment of these two clinical states is not the same.
The treatment of mania is dependent upon its severity and acuity. For mild to moderate mania, mood stabilizers such as lithium and valproic acid (Valproate) are still the standard of treatment and may be sufficient to contain the symptoms. Lithium...
•Who Needs a Rear-view Mirror? Successful Living by Mastering Our Past
Who Needs a Rear-view Mirror? Successful Living by Mastering Our Past
by: Michael G. Rayel, MD
When driving, we need to check our rear-view mirror every few minutes to perceive dangers lurking behind — tailgaters, hecklers, over speeding cars, and drivers under the influence. Aside from anticipating threats, it helps us contemplate our next move, giving us enough time to be cautious before overtaking or stopping or . . . slowing down.
So for safety reasons, the rear-view mirror is...
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