​

We begin with a careful psychiatric evaluation. The purpose is not simply to match symptoms to a diagnosis, but to understand our patients well enough to make treatment decisions appropriate for them specifically.

 

That requires understanding the current problem in the context of the person as a whole. A comprehensive evaluation considers the individual’s characteristic patterns, strengths, and vulnerabilities. These features shape treatment. We also consider possible contributions from existing or past medical conditions. The diagnosis belongs within that picture, not apart.

 

Diagnosis and Treatment Planning

No diagnosis captures the complexity of an individual life, nor the ways a person interprets and responds to challenge. Two people may carry the same diagnosis but need very different treatment plans. Drawing on what we have learned from the evaluation, we discuss the options that seem best suited to the presenting concerns. This often includes medication. The solution, however, is rarely one-dimensional.

 

Treatment may therefore include medication, psychotherapy, coordination with other clinicians, and involvement of loved ones if the patient prefers. A higher level of care may also be part of the plan — including intensive outpatient programs, residential care, or inpatient hospitalization when needed.

​

Because ketamine and esketamine treatment are available within our practice, these options can be considered without separating them from the psychiatric evaluation. This allows a closer, more deliberate evaluation of whether ketamine or esketamine may be appropriate and effective. Sometimes another approach may make more sense. The decision depends on the same careful understanding that guides the rest of the plan.