Holistic Psychiatric Care

I was glad to read the Viewpoints article “Exercise, Nutrition Advice Crucial to Psychiatric Care” by Dr. Ashley B. Benjamin in the September 5 issue. I, too, discuss health issues with my patients.

Many patients lack interest in taking care of themselves because of their psychiatric condition. They gain weight for many reasons: the consumption of excess fatty foods and lack of exercise. Many live in group or family-care homes that provide high-calorie foods that cost less than nutritious foods. Also, most psychotropic medications are associated with weight gain.

I ask my patients what kind of health problems they have or think they will have by being overweight. Now many of them are able to repeat at least, “Diabetes, high blood pressure, heart problems. . . .” I encourage them to exercise—such as walking, jogging, and practicing yoga, depending on the status of their health and access to programs. If needed, I give them a calorie chart and ask them to keep a daily list of the food they eat.

Another common problem is that many patients smoke or smoke to excess to try to decrease their feelings of depression and anxiety. I ask my patients whether they know the consequences of smoking, and I encourage them to quit. If they don’t know the consequences of smoking or have only partial knowledge, I give them a list.

Let us not forget that we became physicians before we became psychiatrists. We should take the time to pass on general health and fitness advice to our patients—especially since some busy doctors may do only short medical checkups when they see a “mental” patient. Let us enjoy the satisfaction of work well done.