My approach begins with an initial psychiatric evaluation that you can schedule by calling or texting 513-960-6526. Once we agree on a time for your initial appointment, I will send you an email with intake formss where you will fill out your demographic information and medical history. In this email, I will also send you instructions on how to get to my office and my telehealth link for telehealth appointments. Finally, I will also send you a link to use Spruce, which is the secure app I use to message my patients.
During the initial psychiatric evaluation, I will do a lot of listening as you explain to me what you would like to work on in terms of your mental health and wellbeing. I will also be asking you a lot of questions about your symptoms, your psychiatric and medical history, and your background and family history. Additionally, I will ask you about what has worked and what hasn't to improve your mental health. At the end of the evaluation, which can take up to 90 minutes, we'll talk about what we think is going on and what we should do about it. We may need to investigate your symptoms more through the use of validated assessments or we may need to get labs in order to rule out medical issues that are causing or contributing to your problems. We'll also talk about a preliminary treatment plan moving forward, which will include lifestyle and nutritional recommendations, psychotherapy, and, if needed, medications. An initial evaluation, though, does not necessarily mean it would be best for us to work together. If your needs exceed my ability to help you, I'll let you know and refer you to either a higher level of care or another provider who can better take care of you.
A vital part of our treatment plan includes lifestyle and nutritional recommendations. Although we can have a genetic predisposition towards mental illness, it is often the combination of environmental factors and hereditary factors that lead to a particular mental illness. This can apply to physical illnesses as well. We can't control our genetic coding, and we can't always control everything in our environment. However, I do want to help you change the aspects of your environment that are in your control so that you can weather whatever stressors come your way.
In terms of nutrition, I've noticed in my practice that those struggling the most with mental illness are very often struggling as well with metabolic dysfunction. Their fasting insulin and glucose are often too high and they are not able to effective utilize the calories they are taking in. I normally recommend focusing on whole foods such as meat, dairy, and fruit to help you get enough protein and healthy fat and to reduce the amount of omega 6 fatty acids in the diet. Too much omega 6 fatty acids can lead to inflammation. Minimizing omega 6 fatty acids can help some people reduce inflammation in their bodies. However, I don't recommend severe caloric restriction as this can cause too much stress and anxiety for people, and it is vital that patients eat enough calories and nutrients everyday. For some patients, I may recommend a ketogenic diet for a season which is a very high fat, moderate protein, and low carbohydrate diet. This sort of diet can help your body produce ketones which are easily used by the brain for fuel. If you are insulin resistant, your brain may be having a difficult time utilizing sugar which it prefers for energy. Therefore, your brain may not be getting enough energy even if you are eating enough calories. Brain cells can then become hypoactive or even overactive. This, in turn, leads to your brain not functioning as well as it could. I don't believe that people need to be on a ketogenic diet for the rest of their lives, though if they are able to heal the underlying insulin resistance. For more information about this, I recommend Dr. Chris Palmer's book, Brain Energy. In addition to nutrition, I believe human beings should be exposed to as much natural light and nature as possible. If that isn't feasible, I normally have recommendations for light therapy that you can implement at home. Finally, movement is also a vital part of being human, and I work with you to eventually find a movement that you truly enjoy and that you can do in community with others.
Psychotherapy, or talk therapy, can be an essential part of healing. All of us hold core beliefs about ourselves and the world around us that can either help or harm our mental health. These core beliefs may or may not be true, but in creating a therapeutic relationship, one can begin to explore those beliefs and gain insight about oneself, facilitating personal growth. This, in turn, can help one's relationships as well, changing the ways that one interacts with others. The majority of follow up appointments will consist of insight-oriented psychotherapy, and I often integrate aspects of third wave cognitive behavioral therapy based on your unique, individual needs. If you already have a therapist that you know and want to continue with, we will plan to space out your appointments then and focus on lifestyle and, if needed, medications.
As a psychiatrist, I can and do prescribe psychotropic medications if needed. Often times, these medications can alleviate symptoms and help to facilitate therapy. I do recognize that often people are over-prescribed medications, and many people I've seen are on extensive and confusing medication regimens. I often help people to have simple, effective medication regimens, and I try to minimize side effects as much as possible. I often help people as well come off of medications that no longer serve them. Along a similar vein, I recommend coming off of non-prescription drugs such as alcohol and tobacco as these not only negatively affect physical health but also mental well-being. Drugs like alcohol more often than not impede the healing process.
Dr. Eshleman Latimer, MD
3001 Highland Ave
Cincinnati, OH 45219
Ph: 513-960-6526