Psychiatric Mental Health

Dr. Zakhari provides psychiatric mental health house calls for the family.  He evaluates and treats mood disorders, behavioral problems,  and psychotic disorders, as well as dementia  and addictions. His goal-directed approach is ideal for individuals, couples, and families with relationship issues. His psychiatry services are available to adults, children, and adolescents. Child and Adolescent Psychiatry is always conducted in conjunction with the parent or guardian.

At Metro Medical Direct, you'll receive mental health care that focuses on reconnecting you to meaningful values, resolving childhood trauma, developing status and respect, and fostering a sense of hopefulness in a secure future. Medication is used only as a last resort. Dr. Zakhari's treatment philosophy is a holistic one that aims to heal you in connection to the natural world you live in.

Mental health conditions Dr. Zakhari addresses include:

Psychiatric Care often involves both talk therapy and medication, but sometimes it can be just be just one of the following treatments.

• Psychotherapy. This involves the management of mental health issues without the use of medication. It includes traditional talk therapy and family therapy services in which couples or family members are included in order to work through issues. In addition, Dr. Zakhari is specially trained in sex therapy. Symptoms that respond best to talk therapy include personality disorders, relationship problems, poor life choices, poor insight, and skill development.
  • Addiction can take many forms (Drug addiction, alcoholism, pain medication addiction). People will commonly self-medicate with chemically addictive substances, but they will also engage in behaviors such as gaming, gabling, and sex addiction (more accurately called compulsive sexual behaviors) to help themself feel better if only for a short time. Some medications can be used to help make addiction recovery successful. Addiction takes a toll on the whole family. Many clients will benefit from a family system approach to addiction therapy. The comprehensive approach requires a team of experts to collaborate and get you the best possible care.
  • Family Addiction Specialists: provide the one stop shop for high net-worth individuals and families to deal with addiction from crisis intervention to maintenance
  • Alliance Home Care: a concierge nursing agency who can provide the needed Registered Nurse level of care needed for alcohol or benzodiazepine detox in the home for 7-10 days. During an alcohol detox or benzo detox the Registered Nurse will monitor your vital signs and CIWA score to evaluate your stability to complete your detox at home. They work in conjunction with me to adjust your medications during the alcohol detox or benzo detox phase. This is a good alternative to inpatient detox.
    • Clinical Indications of Withdrawal Alcohol Scale (CIWA Scale)  this helps quantify how likely you are to have severe adverse effects from alcohol withdrawal or benzo withdrawal which if not treated sufficiently and in a timely manner can be fatal. It is for this reason direct supervision by an RN is essential in order to have a safe alcohol detox at home.
    • Clinical Opioid Withdrawal Scale (COW Scale)  this scale is used to quantify your symptoms of opioid withdrawal so that you can time your suboxone dose or bridge device for the most comfortable results. If you take the suboxone before you are not in sufficient withdrawal you can precipitate your symptoms (intense withdrawal symptoms).
• Psychopharmacology. A wide variety of medications are available to treat mental health symptoms. Symptoms that respond well to medication include: inattention, impaired concentration,  sleeping problems, irritability,  impulsivity, grandiosity, cravings, compulsiveness, over eating, and lack of appetite. Often times psychopharmacology involves adjusting the dose of existing medications or stopping medications. Often patients do not have to take medication for life.
  • Medication Assisted Therapy for addiction treatment includes the use of either suboxone, naltrexone, or Vivitrol injection. In certain patients Campral (acamprosate), or Antabuse (disulfiram) can be used to help maintain sobriety from alcohol.
    • Non Medication (Suboxone) Opioid Detox: the Bridge is an FDA approved electrical stimulation device that can be worn to get through the symptoms of opioid detox. It can be used in conjunction with supportive medications instead of suboxone.  It can also be used to detox from suboxone after prolonged use. The device will need to be worn for 5 days.
  • Dual diagnosis: many patients with addiction also have an underlying mental illness such as depression, anxiety, or PTSD. It is best to treat both conditions at the same time to help achieve and maintain sobriety.

A combination of psychotherapy and medication is often called for, especially as a part of addiction treatment or crisis intervention. Treatment of drug or alcohol dependence or addiction centers on at-home detox followed by maintenance care to prevent relapse.

Couples Sex Therapy

Sex therapy is a behavioral intervention to help couples enhance or perform better in the bedroom. Therapy is intended for both partners and everyone keeps their clothes on during therapy sessions.

Sex therapy is specifically designed to address problems such as:

• Erectile dysfunction (ED)
• Inability to orgasm
• Low or absent sexual desire
• Mixed orientation marriages
• Painful intercourse
• Premature or delayed ejaculation

No subject is off limits.

Couples will learn to speak to each other effectively about sex and understand how the story you tell yourself (Script) is affecting your relationship

 What to Expect

Before therapy can begin, an evaluation is conducted, consisting of four discrete sessions:

• Session 1 (with both of you in your home): We discuss how each of you view the problem and what effect is it having.
• Session 2 (webcam with one person): We discuss your individual sexual history, your take on the problem, and how your partner is aggravating, perpetuating, or alleviating the problem.
• Session 3 (webcam with the other person): We discuss your individual sexual history, your take on the problem, and how your partner is aggravating, perpetuating, or alleviating the problem.
• Session 4 (with both of you in your home): If sex therapy is right for your situation, Dr. Zakhari will offer a diagnosis and a treatment plan. Subsequent sessions will include both parties.

If you are interested, request an appointment now and indicate that you would like a sex therapy evaluation. Please include your partner’s email address as well. You will receive an email containing assessment forms that you should complete individually and not discuss with each other. You will each email the forms back separately; do not include identifying information on your forms such as your name, address, phone number, etc.

Premarital Counseling

Life – and relationships – are more unpredictable and complicated than ever before. Smart couples who want to stay together don't wait until there's a problem. Premarital counseling is for any couple who want to discover their strengths, weaknesses, and how to get better at dealing with conflict.

Because problems are inevitable, premarital counseling can help a couple discover the tools they need to stay connected and keep their relationship vibrant and mutually rewarding. Addressing issues early – before they even occur – may be the key to staying together.

House Call Mental Health Psychiatrist in NYC

Discreet and convenient psychiatric care in the comfort of your Manhattan, New York, home is just a phone call away. Call (917) 484-2709 or request a confidential consultation today.