Friday, January 30, 2015

New Year's resolutions have come and gone: getting 'unstuck' in 2015

The end of January has arrived, and for many, the enthusiasm for New Year's resolutions has waned. How does the song go? 'Back to life, Back to Reality'. This can be a discouraging time, especially if you're still feeling as 'stuck' as you did in 2014. A few weeks ago, just back from a European trip I came down with the flu. Stuck in bed, I decided to start watching the series Downton Abbey after enjoying London while abroad. I proceeded to watch 4 full seasons in 2 week's time. That's about 32 hours of Amazon instant stream binging. I'm actually not sharing this with you here to impress you with my television watching abilities (though they are now well honed) I want to pass on some wisdom from the character Violet Crawley, Dowager Countess of Grantham in Downton Abbey. A razor tongued, hilarious matriarch with brilliant one liners, she said something that struck me as impressively simple, yet an invaluable outlook to adopt in life. She said "All life is a series of problems which we must try and solve. The first one and the next and the next, until at last we die." This message was directed towards her discouraged granddaughter, who was feeling overwhelmed by the ongoing string of unfortunate events of her life. While some may take her advice as grimly pessimistic, it struck me as both calming and reassuring. We must try to take a step back from our current circumstances and keep in mind, we're always going to be facing a "thing" to overcome or achieve, big or small. No need to harbor shame in the process, or adopt a sense of personal defectiveness, it's the nature of life. Resolution will come and/or 'that thing' will pass, because change is inevitable. In the meantime, try to find a bit of joy. Reach out to friends, find humor in the process, remind yourself that you are not the only one. One of the many things I love about helping people when they feel 'stuck' in a bad place, is hearing from them down the road, long after we've worked through those darkest hours. Nothing brings me more joy than finding out they are now flourishing and past that difficult phase when they came to me for professional support and skill building. It's concrete evidence that even when things completely fall apart in someone's life, things will turn around in time. Resolution has a way of happening, one way or another. I am reminded that life goes on, and my confidence is renewed in helping others find their way too. The hardest moments pass, we find a way to work through those dark hours, and there are surely joyful times to come. Life is a series of highs and lows. We can't change that inevitably and in knowing that we can find some peace and comfort as we get though it. Dr. Christina Villarreal is a mental health expert and coach in the San Francisco Bay Area. For professional inquiries please visit

Monday, January 26, 2015

Prescription medicines: asking the right questions to keep you informed

Prescription medicines: asking the right questions to keep you informed This week is National Drug Facts Week (January 26th-February 1st), and in partnership with The American Recall Center, I’d like to highlight some key tips for better understanding the prescription medicine you’ve been prescribed. It’s not uncommon for people to leave their medical appointment without genuinely understanding why they’ve been given a prescription, and/or how it will work or feel if taken regularly. As a mental health provider I may help people explore the possibility of taking a medicine to help them better manage their mood, ability to sleep, etc. in conjunction with psychotherapy, coaching, and/or other health modifications like exercise, changes in work-life balance, or diet. I support them in taking an active role in managing their health, and understanding the risks and gains of the various decisions they may choose. Over the past 15 years in my work in healthcare, some of the most common concerns people have expressed to me about taking an antidepressant is the impact it may have on their sexual functioning, weight gain/loss, ability to experience ‘normal’ emotions, or fear of becoming ‘dependent’ on it over time. Others are concerned it could interfere with their active lifestyle or prevent them from enjoying alcohol or other recreational choices. It’s normal to have reservations about starting any new medication. If you don’t feel comfortable discussing your concerns with your prescribing provider you may miss out on the significant benefits it could provide you, by opting not to take it out of misunderstanding or fear. The following list is a helpful guideline to have with you during your health appointment, and/or when you pick up your prescription from the pharmacy. It can help to bring it to your appointment, and write down your provider’s responses as a way to make the most informed decision possible. Be proactive: gather as much information as you can before you leave your appointment What is the name of the medicine, and for what specific reasons should I take it? What is the name of the condition this medicine will treat? How long will it take to work? How should I store the medicine? Does it need to be refrigerated? Can the pharmacist substitute a cheaper, generic form of the medicine? Will the medicine create conflicts with other medicines, herbs or supplements or recreational substances I use? Find out how you are supposed to take it for optimal effect: When and how often should I take this medicine? As needed, or on a specific schedule? Do I take the medicine before, with, or between meals? How long will I have to take it? Know what to expect while taking this new medicine: How will I feel once I start taking this medicine? How will I know if this medicine is working in the way that it should? What side effects might I expect to experience? Will they go away? How long might it take for any side effects to subside, if at all? Ask how this new medicine fits in with any other other medicines or substances you take: Are there other medicines or activities I should avoid while taking this medicine? Will this medicine change how my other medicines work? (Ask about both prescription AND over-the-counter substances you take, even if it’s only occasionally or rarely) Will this medicine change how any of my herbal or dietary supplements work? Ask if your new medicine interferes with eating or drinking. Are there any foods or liquids that I shouldn’t drink or eat? Can I drink alcohol or other use recreational substances like marijuana while taking this medicine? How much is generally safe/unsafe? Is it OK to eat or drink food before or after I take the medicine? Other important questions to ask: If I forget to take it, what should I do? What should I do if I feel I want to stop taking this medicine? Is it safe to just stop or do I need to gradually stop taking it? Always call and check in with your doctor or pharmacist if: You have questions or you are confused/uncertain about the directions for taking your medicine. You are having side effects from the medicine. Do not stop taking the medicine without telling your doctor. You may need a different dose or a different medicine. Your medicine looks different than you expected. Your refill medicine is different than what you usually get. Dr. Christina Villarreal is a clinical psychologist practicing in the San Francisco Bay Area, CA. For more information about her practice, please visit her website at
References Your medicine: Be smart. Be safe. Patient Guide. AHRQ Publication No. 11–0049-A, April 2011. Agency for Healthcare Research and Quality, Rockville, MD, and the National Council on Patient Information and Education, Rockville, MD. Accessed May 10, 2014. NIH Senior Health. Taking medicines safely. January 2011. Accessed May 10, 2014. Update Date: 5/11/2014 Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.