Text messaging is becoming the dominant means of communication in today’s society and thus plays an important role in the dynamics of a romantic relationship. Texting is steadily eliminating traditional forms of communication such as the written word or a simple phone-call. While its convenience enables busy individuals to develop and maintain their relationships despite hectic lives , it is also lazy and emotionless which is detrimental to finding a lasting romance.

One problem is the absence of rules and guidelines for these interactions, especially in the beginning when even the slightest misinterpretation can wreak havoc. This absence of expectations ends up causing conflict or disappointment within the relationship. There is no established etiquette for acceptable message length, response time, or frequency of interaction. Interpreting, or rather misinterpreting continues to destroy relationships with every forgotten smiley emoticon.

Early in a relationship, benefits of texting include reducing uncertainty and lessening anxiety, allowing two people to be more open and honest. While this can be a good thing, it can also lead to overly honest and direct communication which without an established understanding of the person can be perceived as overly critical or obnoxious. Between the openness and speed of texting, it has become a lightning fast way of getting to know someone.  Unfortunately without knowing somebody’s true personality, and without the ability to read body language and facial expression, the information is often overanalyzed and misinterpreted.  .

Once a steady relationship is formed, texting does work well to express quick bits of information, arranging plans or simply saying good morning.  They key however is avoiding emotional conversations as the dehumanizing medium of text can lead to overly aggressive and hurtful attacks which permanently damage a relationship.

Ultimately it is those couples who invest the time to communicate face-to-face, on a much more personal level, who have successful relationships in this modern era of technology. Over reliance on texting also can jeopardize trust.  Trust is the foundation of a successful lasting relationship but reliance on texting unfortunately often leads to paranoia about your partners texting behaviors.  If you find yourself checking what your partner is texting behind their back, you might as well throw in the towel as that relationship will never last.

Finally, text messages are also not necessarily true reflections of your actual thoughts. Messages are often edited, re-read, and even written by other people.  These overly scripted thoughts add another layer of impersonal interaction.  Ultimately lasting relationships take time and energy.  It is easy to neglect the often time consuming phone-calls and or uncomfortable face-to-face emotional conversations but without these mediums of discussion a healthy long-term relationship will elude you.

Michael Yasinski MD

Vitamin D-are you getting enough?

Nobody in the valley of the Sun should have a reason for being low on Vitamin D, however it is actually quite common, even here in the valley.  What exactly makes vitamin D so important to our health? Quite simply, it directly and indirectly influences most of what happens in our bodies every second of every day.

First, Vitamin D isn’t actually a vitamin. Rather, it’s a hormone precursor that our biological ancestors made from being in the sun. When exposed to UV rays, a chemical reaction in the skin creates vitamin D, which travels to the liver and is changed to the active form of Vitamin D which then plays a key role in the activation of thousands of genes involved in keeping both the mind and body operating at peak health.

In addition to the well-known benefits on bone health, the evidence is particularly strong when it comes to vitamin D’s role in treating depression, strengthening immunity, and reducing cancer risks.

If you feel sluggish, struggle with concentration or feel depressed, consider spending 10-15 minutes in the sun, at least 3 days per week.  As summer nears, many of us avoid the sun at almost any cost; slathering on sunscreen or staying in the shade which can make you susceptible to low Vitamin D levels.

Vitamin D helps elevate your mood, both if you are severely depressed or mildly depressed. It also is crucial for cognitive function, memory and attention.  The effects have been comparable to anti-depressant drugs in some studies but without the unwanted side-effects they often have.

Another less known benefit of Vitamin D is its cancer-fighting properties.  Vitamin D can combat many types of cancer but especially in older women.  One study showed plentiful vitamin D reduced multiple types of cancer by 60 percent in older women.  However benefits for both men and women of all ages exist.

Do you struggle with constantly fighting a cold?  Vitamin D may be your answer as it strengthens the immune system and wards off colds and infections. Numerous immune compounds depend on vitamin D, including crucial components that activate immune cells. The vitamin D then turns on genes involved in immunity and boosts levels of powerful germ-fighting compounds, especially in the respiratory system

So does everyone need more Vitamin D? Not necessarily, however, it only takes 15 minutes in the sun without sunblock, 3-4 times per week to attain the majority of the benefits of Vitamin D.  I utilize this recommendation for almost all of my patients with great success in terms of mood improvement. Given the sun carries its own risks, especially if you are taking certain medications, talk to your doctor before spending more time outside this summer.

Are you ready for a new relationship?

As one relationship comes to an end, people often begin searching for a replacement immediately.  Fear of being alone often drives this phenomenon and it is a frequent scenario I see with my patients. “How do I know that I am ready to start a new relationship?”  Here is what I tell my patients:

Time-wise the answer varies widely from person to person as it depends on whether or not you can achieve personal growth and successfully implement necessary changes in yourself. Regardless of who was at fault or what went wrong in a past relationship, you can always learn valuable lessons which can be can be applied to future relationships to increase the odds of success.

Take time to grieve the loss of the relationship but begin to focus on constructive ways in which you can learn from the past and apply them to the future.  Feeling productive will keep you moving in a forward direction which is imperative to prevent falling back into a broken relationship or becoming consumed with debilitating grief.

The process begins by analyzing yourself and the role you played in the relationship’s demise.  Being open to admitting our faults allows us to begin to change negative patterns we have.  These patterns, if left unchanged will likely continue to negatively impact future relationships.  Success and personal growth in all facets of life come from making mistakes and learning from them.  If we focus on growth rather than grief, we can quite quickly emerge from the black-hole of a broken heart to the optimistic future of endless possibilities.

The goal of self-improvement is to repair any inner-emotional weaknesses.  These emotional deficits are typically what draw us to the wrong type of person in the first place in an unconscious attempt to heal our fractured ego.  Temporarily successful in the beginning with the excitement and euphoria which erupt in a new love affair, these relationships often quickly falter as the luster wears off.

How do you choose the right person? Only when you are able to be completely happy and fulfilled by yourself can you then compliment your life with the right partner.  Supplementing an already happy life where you have no feelings of emptiness or loneliness will lead to finding the right match rather than choosing someone to fill a gaping hole within our unconscious emotional-self.

Before you jump into a new relationship ask yourself these questions: Have I been honest with myself and identified my own faults? Have I addressed and repaired these flaws? Am I fulfilled as an individual by myself without feeling the need to be with someone?”

If you answered yes to all 3 than you have drastically increased your chance of future success.

Michael Yasinski MD

Alcohol detox in Scottsdale-A home-based approach

Alcohol detox in Scottsdale is typically carried out in an inpatient facility where you need to spend several nights in an uncomfortable bed, a loud roommate and a loud hospital setting.  There is a new option for alcohol detox in Scottsdale and I am now focusing on providing drug and alcohol detox in the comfort of your own home.

The way my program works is as follows-

1-A comprehensive initial evaluation will focus on your entire history, current use pattern and an emphasis on any prior problems while detoxing such as “DT’s” (delirium tremens) or seizures.  Also several medical problems such as difficulty with breathing or heart problems can make it unsafe to detox at home. By and large virtually all patients unless they have had previous life-threatening problems while detoxing are great candidates for Home-based Alcohol detox.

2-For the first 24 hours I have the patient take a dose of Ativan (a benzodiazepine that treats withdrawal) every 1-2 hours depending on their level of subjective discomfort as well as objective blood pressure and pulse thresholds. After 24 hours we take the total dose that was required and split the dose into a 3 or 4 times daily dose. If 12mg was needed than 4 doses of 3mg throughout the second day is used.

3-Blood pressure and pulse is monitored by the patient and reported back to me if it crosses above the set thresholds and I am available by cell phone or text always throughout the process. I require a family member or friend to stay with you as well to ensure safety.

4-Over the course of 5 days I taper down the dose in a very comfortable manner and detox is essentially complete by day 5.

This home-based alcohol detox in Scottsdale is an option that suits many people who are either too ashamed or too busy to take the time to go to a hospital facility.

One difference compared to other programs doing alcohol detox in Scottsdale is the fact I also provide follow-up and long-term treatment to provide relapse prevention, psychotherapy and treatment of any co-occurring psychiatric disorders such as depression or anxiety. I also facilitate getting placed in AA groups and other support resources to maximize the chance at maintained sobriety.

Having alcohol detox in Scottsdale with a psychiatrist available 24/7, the comfort of your own home and bed and in total privacy provides an unmatched experience.

Feel free to contact me with questions if you are struggling with addiction.

Michael Yasinski MD

Cold feet before wedding: Predictor of marriage success

Cold feet and anxiety have been part of the wedding experience forever and until recently these emotions were regarded as “normal” and nothing to worry about. With the divorce rate continuing to hover at a dismal 50 percent across the country, now, more than ever, people ask me about predictors of a successful marriage, hoping to avoid future emotional and financial demise.
Two studies in the past 1.5 out of UCLA and the University of Alberta, show consistent data and offer scientifically validated information which may offer some food for thought for those about to tie the knot.
UCLA researchers found that women who reported pre-wedding doubts were 2.5 times more likely to divorce than those who confidently walked down the aisle with no pre-wedding second thoughts.
Although men were more likely to report doubts about tying the knot (47 percent of husbands said they had been uncertain or hesitant about getting married), it was the women whose jitters were more indicative of later marital trouble. Nineteen percent of women who reported pre-wedding doubts were divorced four years later (It was 14 percent for husbands with previous cold-feet). Compare this to couples with no premarital doubts had a divorce rate of only 6 percent at the end of 4 years.
Knowing this creates an additional problem however, which is “How do I tell the difference between normal anxiety or legitimate doubt?
Both men and women with premarital anxiety involving the wedding itself or the challenges a marriage presents is more normal and less predictive of future failure compared with having doubts about the partner themselves. More indicative of predicting demise is whether one reminisces about a prior relationship and whether their previous love was really the right one.
How about predictors of a successful marriage? Making each other laugh, having a true interest in the other person, being affectionate outside the bedroom and being good at compromise are all traits of a long lasting marriage. Once thought to negatively impact marriage success, cohabitating prior to getting married is not predictive of future seperation and actually may improve success long-term given each partner can better evaluate their compatibility. Another factor with little predictive value which may surprise people is whether a couple shares common religious or cultural beliefs which proved to not predict future success.
So the quandary remains: I am having cold-feet, the wedding plans are made, guests are invited and all the money my family gave is spent; should I call it off?
No, not necessarily. Sure, it would be wonderful if the euphoria and elation were the only emotions felt but be practical and take a look at some of the objective aspects of relationship health. If problems exist and marriage doubt remains, it’s worth exploring the origin of doubt and ensure you enter into wedding bliss with a truly healthy relationship.

Michael Yasinski MD

With Valentine ’s Day near, exhilarating emotions and sexual attraction that accompanies a brand new relationship produce run rampant. However, what happens when these feelings subside over time?  Does that mean the relationship is unhealthy or ending?

One common concern of both men and women is whether or not their relationship involves enough sex.  With time and reduction of sex, people get concerned that their partner no longer attracted to them or loves them less.  In reality, it is normal for men and women to lose sexual attraction for their partner in a matter of months or less commonly, years.

Among many important factors that contribute to a successful relationship, expectations about sex need to re-evaluated. The tendency to use sex as a barometer to measure health or quality of a relationship needs to stop.  To make sense of why, let me offer a biological perspective.  Consider an evolutionary perspective where perpetuating one’s genes is the key to survival over time.  This “evolutionary fitness” is achieved by mating with as many women as possible, thereby increasing the likelihood that their genes are plentiful in future generations.  This is made possible by men quickly shifting their focus of sexual attention to new women on a regular basis because otherwise the drive to spread their genes would be limited.

How about women? Some women certainly lose attraction to their man equally as fast but more common is that women not only stay attracted but gain attraction as the relationship progresses.  Biologically, women seek out men who provide safety, love and stability from an evolutionary perspective because a man who provides these traits maximizes a women’s chance at having healthy offspring, which is paramount for their own fitness.  A man with these traits is in essence attractive and a desirable mate to produce offspring with.

Here lies the problem:  Men are hard-wired to lose attraction very quickly and women are wired to become more attracted over time.  How is this rectified?

First, both men and women should there are several stages within a healthy evolving relationship. The incredible attraction and infatuation with their partner is one of the most euphoric experiences in the world and should thoroughly be enjoyed and savored.  However it is a stage that will likely end in the healthiest of relationships. Accepting that sexual attraction is not a metric for the health of a relationship is key.  Discussion of this among partners will prevent feelings of hurt or inadequacy.

The next stage of a growing relationship involves feelings of trust, caring, unselfishness and adoration which replace sexual attraction over time.  While the wild sex was more exciting, this stage ultimately forms the basis for long lasting relationships and should be equally enjoyed and coveted, albeit for different reasons.

The most important thing is to openly discuss these concepts and feelings and continue open communication and honesty as the relationship grows.  Re-defining expectations will eliminate stress and build a lasting foundation for a lasting, loving relationship.

Michael Yasinski MD

Choosing the best Phoenix psychiatrist can be a difficult task because the quality of psychiatric care, and medical care in general, is difficult to objectify.  For example the absolutely best psychiatrist in Phoenix can have relatively quiet demeanor but may have the greatest depth of knowledge about utilizing psychiatric medications. Sometimes “unfriendly” translates into being a poor doctor, which often is not the case.

Not that you don’t expect most of the top psychiatrists in Scottsdale to be unfriendly because they are likely known as great doctors for a reason, especially in our field,  however here is a few tips on what to ask of a psychiatrist when seeking out treatment, especially for the first time.

1.Do they show an in-depth understanding of the medical-psychiatric interplay and relationship since many psychiatric disorders are caused by underlying organic medical disorders such as Lupus, Infections, tumors and many others. Top psychiatrists will always try to eliminate any “fixable” causes of psychiatric symptoms.

2.Top Phoenix psychiatrists should always offer both psychotherapy and medication expertise.  Without getting to know someone in a deep psychological way, it is really impossible to effectively know how to properly treat them with medications. For example, many causes of stress and depression are simply either situational or due to deep seated psychological trauma.  If you simply try to prescribe medication but do not understand the psychological issues than you essentially will be unlikely to get the patient better.

3.Your psychiatrist should know the mechanism of action, side-effects and their mechanism of action and alternatives to medications in great detail. Unfortunately the onus is often on the patient to ask these questions but if you do inquire and receive a poorly detailed response than consider seeking treatment elsewhere.

4.As recently voted the Best psychiatrist in Phoenix by the Arizona Foothills magazine I can attest to the benefit of having a doctor who is easily reachable after-hours, who spends lengthy appointments with his patients and someone who shows compassion for every patient seen.  These are less tangible but just as important.

So if looking for a new psychiatrist, take these tips into consideration before choosing to embark on long-term treatment with them.

Michael Yasinski MD

Choosing the best Scottsdale or Phoenix psychiatrist can be a difficult task because the quality of psychiatric care, and medical care in general, is difficult to objectify.  For example the absolutely best psychiatrist in Scottsdale can have relatively quiet demeanor but may have the greatest depth of knowledge about utilizing psychiatric medications. Sometimes “unfriendly” translates into being a poor doctor, which often is not the case.

Not that you don’t expect most of the top psychiatrists or doctors in Scottsdale to be unfriendly because they are likely known as great doctors for a reason, however here is a few tips on what to ask of a psychiatrist when seeking out treatment, especially for the first time.

1.Do they show an in-depth understanding of the medical-psychiatric interplay and relationship since many psychiatric disorders are caused by underlying organic medical disorders such as Lupus, Infections, tumors and many others. Top psychiatrists will always try to eliminate any “fixable” causes of psychiatric symptoms.

2.Top Scottsdale psychiatrists should always offer both psychotherapy and medication expertise.  Without getting to know someone in a deep psychological way, it is really impossible to effectively know how to properly treat them with medications. For example, many causes of stress and depression are simply either situational or due to deep seated psychological trauma.  If you simply try to prescribe medication but do not understand the psychological issues than you essentially will be unlikely to get the patient better.

3.Your psychiatrist should know the mechanism of action, side-effects and their mechanism of action and alternatives to medications in great detail. Unfortunately the onus is often on the patient to ask these questions but if you do inquire and receive a poorly detailed response than consider seeking treatment elsewhere.

4.As recently voted the Best psychiatrist in Scottsdale by the Arizona Foothills magazine I can attest to the benefit of having a doctor who is easily reachable after-hours, who spends lengthy appointments with his patients and someone who shows compassion for every patient seen.  These are less tangible but just as important.

So if looking for a new psychiatrist, take these tips into consideration before choosing to embark on long-term treatment with them.

Michael Yasinski MD

Scottsdale psychiatrists: Modernization of psychiatric care

The top Scottsdale psychiatrists all have varied types of practices and although each doctor is unique, the general approach is still a 9-5 office setting in a traditional sense.  If someone is looking among the best Scottsdale psychiatrists they will notice that flexibility, convenience and privacy is rarely a primary focus among the doctors.  This is where I do not fit the mold and I am trying to pave the way to a new, more modern delivery of the best psychiatric treatment.

Many of the top Scottsdale psychiatrists only prescribe medications and limit their visits to 20-30 minutes.  Historically psychiatrists were experts in both psychotherapy and medication treatment, however with changes in insurance payouts, training and peoples expectation and desire for a “quick fix” therapy with a psychiatrists if almost impossible to find.  Almost all of them refer their patients to social workers or psychologist for the counseling and therapy.

This is where I differentiate myself among the other Scottsdale psychiatrists. I feel it is paramount to offer psychotherapy in tandem with medications in order to maximize the chance for my patients to get better. I feel a complete arsenal of psychiatric “weapons” is needed to really deliver the absolutely best care.  It means I get to know my patients much better and by working with my patients during therapy, it allows me to much more adequately understand and fine-tune their medication needs.  Often when a separate therapist is used, the psychiatrists do not communicate with the therapists and it is a very frustrating experience for the patient.  I eliminate this and am one of the only Scottsdale psychiatrists do offer this.

The most unique aspect of my care is my house-call approach. My philosophy is simple: Use all of the best tools and approaches to get my patients better.  This includes their comfortable, home setting which allows them to better participate in deep emotional therapy and providing a level of privacy and convenience that is unmatched by any other Scottsdale psychiatrists.  I think outside the box and customize my approach with every patient who becomes very well known to me. Combined with both psychotherapy and medication, the extra flexibility of evening and weekend appointment, lengthy 75 minute appointments and the convenience really offers a totally different experience of care.

If you are struggling or sick of the detached care among providers, please call me anytime.  Having someone really take an interest in you and really develop a relationship with you, can make a world of difference in your mental healing.

Michael Yasinski MD

Dementia care in Phoenix:The complete family approach to care.

Dementia care in Phoenix is  unfortunately as “broken” as Dementia care in the rest of the country.  Residents here in Phoenix will be the first to have access to my model of complete “Family care” starting in January, 2013.  Unfortunately, the current options for Dementia care in Phoenix or anywhere in the country focuses on treating only the “patient” who has dementia.  The problem with this approach is that it neglects the several other “patients” that succumb to the disease including: spouses, children and close friends.  The reason dementia care in Phoenix lacks the approach to helping the family as a whole is sadly due to the financial limitations that insurance companies impose on people and their physicians.  There is simply not enough time for the modern medical system to devote to the entire family in this situation and thus care is limited to 15-20 minute appointments for the patient themselves with minimal family involvement and support.

Fortunately there is a much more effective way to approach these situations and dementia care in Phoenix will soon improve. As a house-call psychiatrist in Phoenix and Scottsdale, I already am involved intimately in the care of families suffering from dementia of a loved one.  This has allowed me to learn exactly what components are needed to best help families.  The fact is, the disease of dementia is often harder on the family members than it is on the patient.

Dementia care can be much better, and when I get involved in the care of a family, I evaluate, treat and support each family member including the spouse and the children.  I then customize my care to each person by providing supportive therapy, medication to help with depression, stress or insomnia if needed, provide education on coping with the situation and how to best support the family and I am involved from beginning to end-of-life care in which I am there to support the family every step of the way.

What makes this model the absolutely best Dementia  care in Phoenix is the addition of my care coordinator Tish Guzman, who is able to also support the family and be available 24/7 for questions or concerns. She also coordinates all of the care including appointments, placement in memory care centers if needed, coordinating home-care staff if needed and taking any other stress away from the family; she becomes the “quarterback” for care.

Dementia care in Phoenix will be more advanced and better than any other place in the country because this model takes a Psychiatrist who performs therapy/counseling and prescribes medication to each of the family members as needed. Also, all of this is done in the comfort of the family home or care-center.  Then a compassionate colleague with 30 years of experience working with dementia removes all of the stress from the family in terms of coordinating all of the needed ancillary care and doctor appointments.   In essence we give the entire family support from beginning to end, 24/7 and in the most comprehensive, personalized and convenient model unmatched by anyone else.

The greater goal remains to re-shape Dementia care in other areas of the country and to better educate physicians and care-takers about the concept of “family care” rather than “patient-centered care.”

If you have a loved one struggling with dementia and looking for the best dementia care in Phoenix, please contact us anytime.

Michael Yasinski MD

CEO Yasinski Psychiatry