The Eastern Shore of Maryland is a beautiful place! I have been fortunate enough to visit a lot of it by boat as a former Chesapeake Bay Sailor. However, it is also very secluded when compared to Baltimore, Towson, or D.C. Even the larger towns offer few health care amenities. For women living on the Eastern Shore, this can present an added burden on top of all the things women do. That is why we have prepared this psychiatric medication guide for women on the Eastern Shore of Maryland. Below you will learn how to identify conditions that will benefit from psychiatric medication, different types of medicine, and how to access care.
Who Can Benefit from Psychiatric Medication?
Almost any woman with moderate to severe depression and/or anxiety symptoms! Additionally, some women may carry forward symptoms of ADHD into adulthood. Lastly, women with Bipolar should stay on medications even when feeling well.
Are you feeling any of the following?
Everything feels “Meh”
That may seem like an odd statement, but often depression does not feel sad. It feels like a lot of indifference. It’s a slow burn, not particularly noticeable in day to day life. However, if you stop to think about it, absolutely nothing brings any pleasure. I’m not talking about the big capital letter “J” joy. I mean looking forward to a good cup of coffee or a juicy book. The technical term is called anhedonia.
Persistent Sadness or Hopelessness.
Some women will feel actual sadness, hopelessness, or helplessness. FWIW, people experiencing this aren’t necessarily “more depressed” than those with anhedonia, it’s just a different presentation. Some women will be more tearful during this time.
Unable to Relax
Do you always feel on edge or keyed up? Do you have a lot of thoughts about a lot of different things? Often, these thoughts center around what can go wrong? It can feel like being proactive, thinking about all the next steps but in reality it causes distress. Moreso, most of your friends and family are not as concerned about these issues as you are? Does your spouse often tell you you need to relax?
Physical Symptoms
Have you noticed any changes in sleep, appetite, or energy? Perhaps you are having trouble falling asleep or staying asleep. It is not uncommon for women who are depressed or anxious to wake too early and not be able to fall asleep or to wake in the middle of the night for no reason. Conversely, sometimes you wake because your mind is racing.
Women with depression or anxiety may eat less than normal. Sometimes this is due to anhedonia, lack of interest or pleasure in things. In other cases, they may eat more than normal.
Fatigue is a common symptom of both anxiety and depression. However, it is important to have a thorough physical evaluation to rule out physical causes of fatigue like vitamin D deficiency, anemia or hypothyroidism.
Cognitive Symptoms
Did you know there were cognitive symptoms related to depression and anxiety? Many women think they have adult ADHD but in reality, it’s their mood or anxiety. Indecision, decreased concentration and getting overwhelmed easily are all common symptoms of depression and anxiety.
When to Get Help
If you are reading this, you probably are ready to get help. If you have had the above symptoms for more than two weeks, its time to call for help. Additionally, if your symptoms are interfering with your ability to work, take care of yourself or home, or interact with others how you normally do, it’s time for help.
Thoughts of Self-Harm or Suicide
This requires immediate assistance, especially if you have a plan. You can call a national hotline like 988 or go to a local crisis center. Sante Eastern Shore offers mobile crisis services. If you are experiencing postpartum depression, call 1-833-TLC-MAMA. Make sure your baby is in a safe place. There is no shame in any of this. You matter and deserve help.
Impairment in Work or House keeping
You should seek help if your work or ability to maintain your home is suffering. Perhaps it is only noticeable to you but it’s a sign that you need help. In some cases, your co-workers or employer may notice a shift in the quality of your work. Similarly, you may find it harder to care for yourself. Perhaps you stopped exercising or putting effort into how you dress.
Of course, getting a good psychiatric evaluation for psychiatric medication can occur whenever you feel you need it.
Finding Psychiatric Care on The Eastern Shore of Maryland
Accessing expert psychiatric care on the Eastern Shore may feel overwhelming. However, it is essential for your well being. Finding the right psychiatric nurse practitioner or psychiatrist involves knowing where and how to look, gaining an understanding of what is important to you in your provider, and preparing for the visit.
Selecting the Right Psychiatric Nurse Practitioner or Psychiatrist
The right provider can make all the difference. This is a very personal process. Therefore, not every provider is a good fit for you. Many people treat this process like dating. You may need to try a few providers to get to the best one for you. Below are some factors to help guide you.
Credentials and Experience
Look for a provider licensed to practice on the Eastern Shore of Maryland. A psychiatric nurse practitioner is an advanced practice nurse. This is a nurse with a masters or doctorate degree. Nurse practitioners can diagnose and prescribe medications, order labs, and sometimes provide therapy. They use the nursing model which is client centered and wellness based.
Psychiatrists are medical doctors. They go to medical school and then complete a residency in psychiatry. They use the medical model which is illness based. They also prescribe medicine, order lans, and offer therapy.
The right psychiatric nurse practitioner or psychiatrist should also have specialized training in what is bothering you.
Treatment Approach
Emily, a SAHM in Rock Hall, MD, has been trying to manage her depression with herbal supplements and Reikie. She has tried therapy without much success. Her husband gently suggests she needs to do something. She is short tempered with her sons, age 6 and 4. This makes her feel really guilty. She is also interested in potentially trying for a third child.
Someone like Emily needs a provider who is open to holistic approaches. Furthermore, she needs someone well versed in medicating during pregnancy and lactation if she does indeed try to have a third child. Conversely, some people benefit from someone who can provide therapy and medication or someone who is very well versed in genetic testing.
Communication and Rapport
Similarly, the more comfortable you are with your provider, the more progress you will make. It’s natural to feel nervous when you first meet a new provider, but by the end of he visit you should feel heard and a lot more comfortable.
Location and Accessibility
Consider the location of the practice and accessibility, like office hours, telehealth availability, and insurance coverage.
Tele-health is critical when you live on the Eastern Shore. Fortunately, there are many psychiatrists and psychiatric nurse practitioners in Maryland who can serve the Eastern Shoe by tele-health in addition to providers located locally.
Referrals and Reviews
Ask for referrals from your family and friends. Your primary Care Provider or Obstetrician are also good sources of referrals. They usually keep a list of mental health providers they like.
You can also look at reviews online as well. However, reputable mental health providers will never ask clients directly to do a Google Review. Therefore, you may see reviews from colleagues or simply a lot less than for other services like hair dressers, etc.
Making the Most of Your Psychiatric Appointment
Proper preparation for your appointments can make them more productive. The following items will help your provider get you the best treatment.
Medical History: Compile your past and present medical conditions, medications, and allergies. Additionally, your provider will want to know any supplements you take. The more detailed, the better. For example, knowing the doses of medications you have taken as well as how long you took them.
List Your Symptoms
Write down a list of your symptoms. This is FAR more valuable than telling your provider what diagnosis you think you have. It’s not that your opinion is irrelevant, it’s that it can distract from what might actually be occurring. Remember, part of your provider’s job is to diagnose you correctly. Of course, if a prior mental health provider diagnosed you with something, that is valuable information.
Prepare Questions
Prepare a list of questions to ask your psychiatric nurse practitioner or psychiatrist about your condition, treatment options, and potential side effects. Common questions include treatment options, side effects, and how medication may interact with supplements or medications you are already taking.
Bring a Support Person: Some women like bringing a friend or family member to provide support and take notes. Sometimes they provide an objective opinion. Of course, many people prefer more privacy.
Be Open and Honest
You certainly don’t need to tell your provider your “deepest darkest secrets”, however the more your provider knows the more they can help. For example, it’s important to be honest about how much alcohol, caffeine, and cannabis you use. They affect mood and anxiety and we can’t medicate around them.
Understanding Psychiatric Medication
Psychiatric medications, when prescribed correctly by a psychiatric nurse practitioner or psychiatrist, can be life changing. Psychiatric medications work by affecting neurotransmitters in the brain. They can have side effects, as well. You can work with your provider to manage the side effects or find one that does not cause them. SOmetimes, genetic testing can be helpful in determining which medications are more prone to cause side effects for you.
Types of Psychiatric Medications
There are different types of psychiatric medication. A psychiatrist or psychiatric nurse practitioner will help decide which medication is right for you, considering your specific situation and needs. SSRIs and SNRIs can treat both depression and anxiety.
SSRis/SNRis
Selective Serotonin Reuptake Inhibitors and Serotonin Norepinephrin Reuptake inhibitors both work by increasing the amount of these neurotransmitters in your system. They do not contain serotonin or norepinephrine in them. There is no way to package those chemicals in a way that can actually get into the brain. Or, at least one has not been found yet.
Common side effects include weight gain, sexual dysfunction, and either insomnia or fatigue. It is important to understand that not everyone will have these side effects. If they do occur, the weight gain may only be a few pounds. Furthermore, as mentioned above, often people eat less when depressed or anxious so the medicine may not be causing weight gain, returnign to a good mood may be.
Anxiolytics:
There are some specific medications for anxiety alone. They include Buspar, Benzodiazepines (Ativan, Xanax) and Hydroxyzine.
Buspar and Hydroxyzine are safe to take long term but the benzodiazepines are addictive and should only be used short term.
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Resources on The Eastern Shore of Maryland for Psychiatric Medication
The Eastern Shore of Maryland can help you access psychiatric medication. Understanding where to find these resources makes the process easier. The following offers a detailed look at the places that provide assistance and care in Towson.
- Local Hospitals: Hospitals like the University of Maryland have inpatient care in Easton, MD. Eastern Shore Hospital Center is another option for in-patient care.
- Mental Health Clinics: Numerous clinics throughout Eastern Shore offer psychiatric medication services. These clinics usually have psychiatrists, psychiatric nurse practitioners, and other mental health professionals who can assess your needs and provide treatment. Mental health clinics will assess your needs and provide medication management, therapy, and other helpful resources.
- Community Mental Health Centers: These offer a full range of mental health services from individual visits with a therapist or psychiatric mental health nurse practitioner or psychiatrist as well as groups and even day programs for people requiring a higher level of care.
- Prescription Assistance Programs: Prescription medication can cost a lot! Fortunately many pharmaceutical companies offer financial assistance. Sometimes they offer free medication or reduced prices. Additionally Good RX offers lower prices.
Final Thoughts
It takes a lot of courage to manage your mental health with psychiatric medications. The process can feel overwhelming. We hope this guide helps you identify when to get help, how to access it, and what to expect. There are multiple types of medication. A good psychiatric nurse practitioner or psychiatrist can help you find the right medication for you.
About the Author: Sharon P. Fisher, PMHNP, PMH-C is a psychiatric nurse practitioner and founder of Nurtured Well, a boutique women’s mental health practice in Towson, MD. She serves all of Maryland including the Eastern Shore with tele-health. Schedule now to get the help you need.