Dr. Ahmad is well-regarded for his proficiency in treating patients with all types of psychiatric disorders, including extensive expertise in the following:

Bipolar Disorder

Epidemiology

The lifetime prevalence of bipolar disorder (“BD”) ranges from 0.4% to 1.6% of the population and is equal in both men and women. Manic episodes are more common in women while depressive episodes are more common in men. The age of onset is usually around age 30 with no difference in race or religion.

Types and Symptoms
Bipolar disorder, in simple terms, is a condition where the individual suffers from severe mood swings. The depressive state is characterized by hopelessness and a lack of energy—its clinical features are indistinguishable from major depressive disorder. In fact, depression is frequently the first symptom of bipolar disorder. The manic state may involve feelings of euphoria, excessive goal-driven activity, limitless energy and an inability to sleep. The time between mood shifts depends on the person. It is possible for individuals to experience mixed states with both manic and depressive features (i.e., sad but can’t sleep; hopeless, but going on gambling binges), and some even experience brief—minutes to a few hours—episodes of depression during manic episodes. It is well established that a stressful event may precede the first episode of this disorder and can cause permanent neuronal changes in the brain predisposing the person to subsequent episodes.

Bipolar disorder is subdivided into categories (I, II) depending on the type of mood state, and in severe states, may have associated psychotic symptoms. There are other subdivisions (rapid cycling, mixed state) of this disorder related to the frequency, severity and timing of the mood symptoms.

The Neurobiology of Bipolar Disorder
Like many other psychiatric disorders, genetics play a significant role in the etiology of bipolar disorder. The pathophysiology of BD involves a complex network of numerous neurotransmitters (serotonergic, cholinergic and catecholaminergic) in the brain, which not only are responsible for some of the behavioral symptoms but also lead to a variety of systemic manifestations in the body. These are mediated through a stress response system and contribute to numerous endocrine and other related medical conditions. It is this interconnection of brain and body that requires an integrative approach to the treatment of this disorder.

The Diagnosis
Psychiatric disorders tend to have similar presentations, but bipolar disorder is particularly enigmatic as a diagnosis. Dr. Ahmad compares the bipolar spectrum to a chameleon – like a reptile with the capacity to change its skin color. The rapidly shifting symptoms of bipolar patients often cause the disorder to blend in with other illnesses. The depressive state may also precede manic behavior by months or even years, causing a bipolar diagnosis to be overlooked in favor of depression. Detailed history, genetic and neurocognitive testing as well as collateral information from family and friends are all important factors in formulating a correct diagnosis.

The Plan
There is no one-size-fits-all treatment for bipolar disorder. The medication we choose will depend on the phase of the disorder, co-existing symptoms, and personal and family history. Moreover, as described above, the treatment requires a comprehensive, detailed approach including assessment of other systems in the body. Dr. Ahmad’s clinical and educational expertise provides a strong foundation for treatment, but he also encourages patient education, family integration and social support networks for their ability to dramatically improve a treatment’s effectiveness.

Like any chronic illness, BD requires a long-term approach to successful outcome, and therefore, the treatment plan is formulated based on clinical symptoms, co-morbid conditions, body composition and patient preference. Psychopharmacological treatments are initiated after full discussion of risk and benefits. There are numerous medications that are utilized in the treatment of BD, and Dr. Ahmad takes every opportunity to discuss in detail each aspect of this complex strategy and welcomes a free discussion and engagement in this process.

Click here to read more about bipolar disorder.

Depression

Epidemiology

Depression is the most common mood disorder in the world, and it takes a significant daily toll on our societies. Between 10 and 20% of the U.S. population experiences depression at some point. Independent of country or culture, depression is twice as common in females as it is in males. While recent data suggests the incidence of the disorder is on the rise among people less than 20 years old, the average age of onset is about 40 years.

Symptoms

When feelings of sadness, worthlessness, hopelessness and lack of motivation or interest begin to interfere with your life for weeks or months at a time, you may need to seek help for depression. Almost all patients complain about reduced energy, with a vast majority reporting irregular sleep patterns—either lying in bed unable to fall asleep or sleeping longer than usual. Other symptoms include decreased sex drive and fluctuating eating habits. Patients also tend to self-medicate with drugs and alcohol before seeking help.

The Neurobiology of Depression

Depression is first and foremost defined as a medical condition. It should by no means be thought of as a weakness in personality.

Genetics is likely to play a strong role in the development of depression. While scientists do not believe there is one “depression gene,” there is firm evidence that certain combinations of genes can predispose a person to depression. Medical research has shown that someone with a parent or sibling who has suffered from depression is two to three times more at risk for developing the disorder than the average person. There is also new evidence linking depression to an increased risk of cardiovascular disease.

A deficiency of norepinephrine, serotonin and dopamine are commonly associated with depression. Most antidepressants aim to stabilize the levels of these biogenic amines.

The Diagnosis

In addition to the biological influences above, Dr. Ahmad considers psychosocial factors when forming a diagnosis of depression. These include emotionally traumatic events (i.e., losing a parent, spouse or child) and environmental stressors (such as unemployment or natural disasters).

A depressive episode can often be the first symptom of bipolar disorder, and without proper evaluation, can be misdiagnosed as major depressive disorder.

The Plan

On average, an untreated depressive episode lasts 6 to 13 months; most treated episodes last only 3.
Studies show that upwards of 80% of people diagnosed with depression improve with a combination of psychopharmacology and psychotherapy(particularly cognitive and behavioral). These treatment options, along with genetic testing, are all available at the Center for Integrative Wellness and will be tailored specifically to your personal needs and preferences as a patient.

Click here to read more about depression.

Anxiety

Epidemiology

Anxiety disorders are the most common psychiatric illness in the world. One in four Americans suffer from at least one anxiety disorder. Medical research shows the rate of occurrence is slightly higher in women (30%) than it is in men (20%).

Symptoms

The core symptoms of anxiety disorders are nervousness, worry and fear persistent enough to cause some level of functional impairment. Anxiety produces feelings of shame and confusion that distort perception, which can interfere with learning by lowering concentration and reducing recall.

Specific symptoms vary depending on the type of anxiety disorder. Generalized Anxiety Disorder (GAD) is characterized by restlessness or edginess, becoming easily fatigued, difficulty concentrating, irritability and sleep disturbance. Physical symptoms include sweating, rapid heartbeat, dry mouth, frequent urination, lightheadedness and an upset stomach.

Panic Disorder is when similar symptoms culminate in a panic attack. Individuals may be engaged in a routine activity and taken completely by surprise. All of a sudden they will have difficulty breathing, feel lightheaded or dizzy, and start to sweat, tremble and shake. A common initial reaction is to believe they are experiencing a heart attack. Panic attacks usually last about ten minutes.

Posttraumatic Stress Disorder (PTSD) causes recurrent, intrusive and distressing flashbacks or dreams of a particular traumatic event. A person with PTSD can feel vulnerable, helpless, depressed or emotionally numb. Episodes will trigger both psychological distress and physical symptoms (e.g. sweating and rapid heartbeat).

Phobias are the most common anxiety disorder and include agoraphobia, social phobia and specific phobia. Agoraphobia is the fear of being separated from home and family; many psychiatrists believe it is the same illness as panic disorder. Social phobia is the fear of being judged or embarrassed when with others. Nerves before giving a speech for strangers are normal; nerves before a small social gathering with friends may be indicative of the disorder. Specific phobias are the fear of animals, objects, places or situations (e.g. constricted spaces or heights).

The Neurobiology of Anxiety

Studies show there is at least some genetic component to the development of anxiety disorders. Almost half of patients with panic disorder have at least one affected relative. The figures for other anxiety disorders are slightly lower but still significant.

The three major neurotransmitters associated with anxiety are norepinephrine, serotonin and GABA. The general theory regarding norepinephrine is that patients with an anxiety disorder often have a poorly regulated noradrenergic system, the cell bodies of which are primarily localized in the area of the brain stem that controls alertness (locus coeruleus). Serotonin and GABA are identified because medications altering their levels have been routinely successful in the treatment of anxiety disorders.

The Diagnosis

The Center offers in-house genetic and neurocognitive testing to determine the extent of the above biological influences. If the results show the brain and body are fertile for the anxiety disorder the symptoms are indicative of, Dr. Ahmad will make a diagnosis and the treatment process will progress from there.

The Plan

While specific medications and therapies are prescribed depending on the type of anxiety disorder, most treatment plans include a combination of psychopharmacology and psychotherapy (particularly behavior therapy). These options are all available at the Center for Integrative Wellness and will be tailored to your personal needs and preferences as a patient.

Click here to read more about anxiety.

ADHD

Epidemiology

ADHD is estimated to affect anywhere between 2 to 20% of the population, with most studies settling on a figure around 7%. The attention-deficit disorder afflicts both children and adults but is much more prevalent in males than in females, with the most conservative ratio set at 2:1. Symptoms of ADHD are usually present by the age of 3, but often not diagnosed until the structured setting of school or even adulthood.

Symptoms

The most common symptoms of ADHD are hyperactivity, inattention, impulsivity, emotional instability, restless fidgeting, interrupting others and a lack of organization. About 75% of patients suffering from ADHD frequently show behavioral symptoms of aggression and defiance. These symptoms tend to manifest themselves in academic difficulties—it is harder for a child with ADHD to acquire, retain and display knowledge on a consistent basis.

The Neurobiology of ADHD

The exact causes of ADHD are unknown, but like many other psychiatric disorders, genetics play a significant role in its etiology. Biological parents of children with ADHD are more frequently discovered to also have the disorder than adoptive parents. Siblings of hyperactive children are twice as likely to have the disorder as the general population.

While most patients with ADHD have little evidence of structural damage in the central nervous system, scientists have repeatedly linked a few neurotransmitters to the disorder. Noradrenergic neurons have been cited for their role in influencing attention, and adrenergic and dopaminergic neurons are mentioned because they are affected by the medicines that have the most success curbing the ill effects of the disorder.

The Diagnosis

Symptoms generally must persist over a six-month period to warrant a diagnosis. It is important to consider how the patient relates to people (parents, peers, teachers, etc.) and how his or her response differs to participation in structured and unstructured events.

The Plan

There has been a lot of coverage in the media about ADHD, its mis- or self-diagnosis, over-medication and prescription abuse. All of these are serious cause for concern. Dr. Ahmad has successfully and safely managed patients with ADHD by educating and partnering with them, thoroughly investigating, carefully diagnosing and ultimately providing treatment plans through a combination of neurocognitive testing, psychotherapy and psychopharmacology.

An educated decision on the best treatment plan can only be made by an informed patient in partnership with the treating physician.

Neurocognitive testing, which is offered at the Center, is a safe and effective method to identify frontal lobe deficits and executive dysfunction commonly associated with ADHD patients. It can also be helpful in distinguishing patients for whom psychopharmacology may alleviate ADHD symptoms.

Psychotherapy is also essential in the treatment of ADHD. Therapy is a collaborative approach that can help patients with ADHD increase self-esteem, improve social skills, and recognize that, while the symptoms of ADHD are not their fault, each patient can look forward to and take responsibility for meeting reasonable, agreed-upon expectations.

Click here to read more about ADHD.

Stuttering

Weight Management

Stuttering is a developmental disorder with a strong neurological component. In most cases, it begins to present itself in childhood, is made worse by anxiety, and occurs in males more frequently than in females.

There is no known medical “cure” for stuttering and the cause of the disorder is complex. However, in recent years researchers have found stutterers suffer from excessive dopamine levels in the striatal region of the brain – best known for its role in influencing motor skills – by as much as 300%. Various double-blind, placebo-controlled studies have found that medicines which help control dopamine levels can significantly reduce stuttering frequency and severity. Pairing a dopamine antagonist with an anti-anxiety medication can further increase treatment success rates.

The optimal treatment plan for stuttering will always include a prevalent aspect of the established, traditional speech therapies. But these new advancements in our understanding of the clinical root of stuttering suggest medication can augment traditional forms of treatment. Our hope at the Center for Integrative Wellness is that individualized treatment combining therapy and psychopharmacological management as appropriate will optimize relief of stuttering symptoms.

Click here to read more about stuttering.

Weight Management

Our bodies are a unique function of both our genetics and environment, and accordingly, treatment must be tailored to each patient. Dr. Ahmad’s Vital Balance program is an individualized approach to finding the best way for you to manage your weight.

Patients who can’t stomach the idea of giving up “real meals” will not only be taught which foods have the necessary nutrients for peak body energy and function, but also how to prepare them in the correct portion sizes with the healthiest cooking techniques. For patients without the time to cook their own meals, Optifast® meal replacement products help clients lose an average of 52 pounds and decrease cholesterol by 15%.

Our bodies are a unique function of both our genetics and environment, and accordingly, treatment must be tailored to each patient. Dr. Ahmad’s Vital Balance program is an individualized approach to finding the best way for you to manage your weight.

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Patients who can’t stomach the idea of giving up “real meals” will not only be taught which foods have the necessary nutrients for peak body energy and function, but also how to prepare them in the correct portion sizes with the healthiest cooking techniques. For patients without the time to cook their own meals, Optifast® meal replacement products help clients lose an average of 52 pounds and decrease cholesterol by 15%.

A Customized Solution

Your Vital Balance treatment plan will include a custom combination of:

  1. Body composition analysis
  2. Nutritional and anti-aging therapies
  3. Food preparation and portion control education
  4. Personal counseling for behavior modification

The program is designed to help you make healthy, lifelong changes to your daily eating and exercise patterns. Each patient is medically supervised and receives balanced medical, dietary, and psychological support.

Smoking Cessation

Why should I quit?

Tobacco dependence is the most common preventable cause of death in the world. About half of life-long smokers die of tobacco-related health issues. Cigarette smoke contains more than 7,000 chemicals; hundreds are toxic and 70 are known to cause cancer.

Yet those who successfully quit smoking can add up to eight years to their life. The positive health changes are apparent almost immediately. Within 24 hours, the risk of heart attack drops. In two weeks, lung function begins to improve. And within a year, the risk of heart disease decreases by 50%.

How should I quit?

Tobacco dependence is a chronic condition that requires diligent self-control and mental perseverance to conquer. Two-thirds of smokers say they want to quit; every year, more than half try. Those who go it alone succeed only 5% of the time. Those who seek the support of structured programs and medication succeed closer to 40% of the time.

The smoking cessation program at the Center for Integrative Wellness guides clients through the difficult process with reassuring expertise. Dr. Ahmad’s twenty-plus years of clinical experience in medicine and psychiatry provide the ideal platform to successfully quit smoking.

Throwing out your last pack of cigarettes is a cathartic act, but it is only the start. Dr. Ahmad utilizes his proficiency in behavioral therapy and his industry-revered knowledge of psychopharmocology to help manage cravings and withdrawal symptoms effectively for the long term.

The number of former smokers now exceeds the number of current smokers in the United States. Quitting isn’t a pipe dream. Choose your future. Schedule an appointment with Dr. Ahmad today and take back control of your health.

 

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