About CSULB articles:
I arrived at Cal State University, Long Beach (CSULB) in 2017 to become the only psychiatrist there for 39,000 students. I work two days a week at the counseling center (CAPS) backing up the psychologists there and two days a week at the student health center (SHS) backing up the doctors, nurses, health educators, and other staff there. In both settings the vast majority of students I see have never seen a psychiatrist before. That’s largely by design. If they already have some perspective on what’s going on with them and how to use medications to help or are already seeing a psychiatrist, don’t come overwhelm me. There are plenty of students who don’t know where to start. I only see people once for a consultation to put together a picture with them (“pulling out the strands of their story from their tangled lives”) and to see if medications might be useful to them, or a few times to get them started on medications, work through the early side effects, and find the best dosage, before I send them out to the community to find another provider. I don’t keep anyone as an ongoing patient, since I’d get overwhelmed and look just like the providers in the community if I did, prescribing as fast as I could to as many people as I could.
I know that we live in a time when we talk about psychiatric illnesses and DSM 5 diagnoses and chemical imbalances and medication management and genetics and stabilizing brain functions, but I take a more developmental point of view: We’re all born with whatever our strengths and weaknesses and our tendencies are, and even a blueprint for our growth and development comes with the factory packaging. And then we’re born, and life happens. Sometimes we’re nurtured and supported, and we blossom and grow. Sometimes we’re traumatized, and become injured and scarred. Sometimes we’re repressed or depleted. Sometimes we get stuck. I think what we call mental illnesses is usually getting stuck in our growth and development. Maybe something in life needs to be changed to get unstuck, or maybe you need to think about things differently or work through emotions or learn some new skills and habits, or maybe medications can help get unstuck. Hopefully then you can grow and develop again to become the person you were meant to be, and even outgrow needing the medications, because you’re not stuck anymore. Sometimes the reason you’re stuck is the biology of your brain, but most of the time it’s a clash between who you are and what’s going on in your life. Most students do get unstuck.
As I keep working with students, I sometimes stop to write down what I’ve learned with them. I’m posting what I write on this website as well as sharing some of it with the students I’m seeing it and the staff I’m working alongside, hopefully to help explain things I’ve figured out.