Psychiatric Mental Health House Calls
Medication and psychotherapy are combined to treat psychiatric and family issues for adolescents to seniors in their own home.
Family Psychiatry
At Metro Medical Direct, you'll receive mental health services that focus on reconnecting you to meaningful values, resolving childhood trauma, developing status and respect, and fostering a sense of hopefulness in a secure future. Medication includes long-acting injectables and is used only as a last resort. Dr. Raymond Zakhari’s treatment philosophy is a holistic one that aims to heal you in connection to the natural world you live in.
Psychiatric Conditions We Treat
Dr. Zakhari evaluates and treats a wide range of conditions, including mood disorders, behavioral problems, psychotic disorders, as well as dementia and addictions. Some of the most common psychiatric conditions he treats include:
Oppositional defiant disorder (ODD) and conduct disorder (CD) are serious conditions that are distressing for both you and your child. Unfortunately, these conditions are often diagnosed as bipolar disorder, and a child ends up receiving a lifelong diagnosis and medications that come with a host of adverse effects. Often, these disruptive behaviors are symptoms of anxiety or trauma. Kids may also start to use marijuana or other drugs in an attempt to reduce their distress, but the underlying issues must be addressed first.
One-fourth of the nation is suffering with anxiety or panic, especially in the wake of the COVID-19 pandemic – and some meet the criteria for an anxiety disorder. Compassionate mental health treatment in your home provides you comprehensive psychiatric care, including medication, therapy, and lifestyle modifications, to reduce your anxiety and enhance your overall wellness.
Attention deficit hyperactivity disorder (ADHD) is a prevalent mental health condition that affects children, adolescents, and adults. ADHD can disrupt your ability to concentrate, make decisions, and control your impulses. However, it is also one of the most over-diagnosed conditions, and patients often require higher and higher doses of stimulants. It is essential that depression, anxiety, and PTSD be treated before you settle for an ADHD diagnosis.
Bipolar disorder is a widely misunderstood mental health condition and among the most misdiagnosed conditions. Bipolar disorder involves intense mood swings over several days. Bipolar disorder is confusing and frightening, but the good news is that there are excellent treatments available to reduce symptoms. Psychopharmacology can help you develop the ability to regulate your emotions, so that you can feel the normal highs and lows of life without the distressing extremes that make it difficult to function.
Mood disorders such as depression are the most common type of widespread mental health condition, affecting more than 15 million Americans. A comprehensive psychiatric evaluation in the comfort of your home allows for a thorough assessment and treatment to reduce your depression symptoms and help you manage your thoughts, feelings, and behaviors.
Grief and bereavement are normal emotions to certain life events. While antidepressants can help reduce the intensity of your feelings, these medications will not replace the loss you’ve experienced. Effectively managing your emotions and making time for expressing your normal feelings can be very helpful in lowering your distress.
Almost everybody has a sleepless night now and then. However, if insomnia has you tossing, turning, and counting endless sheep more than three nights a week, you should seek professional treatment. Sleep disorders can occur with depression and anxiety. Often resolving the sleep problem improves psychological abilities and reduces symptoms of depression and anxiety.
Obsessive-compulsive disorder is not simply keeping rituals or routines or being overly precise. A patient with OCD often knows their behavior is a problem because it interferes with their life to the point where certain activities are avoided. OCD symptoms are often embarrassing for the person who suffers from it, because they realize how irrational the behavior is. If you’re driven to compulsive rituals by fear or negative thoughts, you could be one of the millions of Americans who live with obsessive-compulsive disorder (OCD).
Paranoia is an overpowering feeling or belief that others are out to get you. When you feel paranoid, you may believe others are conspiring against you, threatening you, or persecuting you. Paranoia is a facet of many different mental conditions, including borderline personality disorder, but it is most common in psychotic disorders such as schizophrenia, schizoaffective disorder, and delusional disorder.
Post-traumatic stress disorder (PTSD) is a mental health disorder that develops after you experience a horrifying or traumatic event, such as a terrorist attack, active shooter situation, car accident, or sexual assault. Patients can also experience trauma hearing about or witnessing someone else’s trauma. It is normal to experience anxiety and other symptoms after a traumatic event. However, in most cases, your symptoms subside with time. You may have PTSD if your symptoms persist or worsen and interfere with your life even months after the event.
In-Home Psychiatric Treatment We Offer
Dr. Zakhari’s goal-directed approach psychiatric care is ideal for individuals, couples, and families with relationship issues. Child and adolescent psychiatry is always conducted in conjunction with the parent or guardian. Eldercare includes both medical and psychiatric services, as needed. Telepsych services are available for established patients.
Psychiatric care often involves both talk therapy and medication. It may include one or more of the below therapeutic approaches:
Psychotherapy involves the management of mental health issues without the use of medication.
It includes traditional talk therapy as well as family therapy services, in which couples or family members are included in order to work through issues. Symptoms that respond best to talk therapy include personality disorders, relationship problems, poor life choices, poor insight, and skill development.
In addition, Dr. Zakhari is specially trained in sex therapy.
Some medications can be used to help make addiction recovery successful. This may include the use of either suboxone or naltrexone pills, or naltrexone (Vivitrol) injections. In certain patients, acamprosate (Campral) or disulfiram (Antabuse) can be used to help maintain sobriety from alcohol.
The Bridge is an FDA-approved electrical stimulation device that is worn by patients for 5 days. It can help patients get through the symptoms of an opioid detox. It can be used in conjunction with supportive medications instead of suboxone. It can also be used to help patients detox after prolonged suboxone use, which itself is an addictive substance.
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
- Overeating
- Lack of appetite
Psychopharmacology includes adjusting the dose of existing medications or stopping medications. In many cases, patients will not need to take medication for life.
Long-acting injectables: ARIPIPRAZOLE (ABILIFY MANTENNA AND ARISTADA), PALIPERIDONE (INVEGA SUSTENNA, INVEGA TRINZA), RISPERIDONE (RISPERDAL CONSTA), HALOPERIDOL DECANOATE (HAL-DEC), FOR ADDICTION NALTREXONE (VIVITROL)
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
Dr. Zakhari provides judgement-free, professional care. No subject is off limits.
Couples will learn to speak to each other effectively about sex and understand how the story you tell yourself (the script) is affecting your relationship.
Yes! Before couples sex therapy can begin, Dr. Zakhari will conduct an evaluation, which consists 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 in couples sex therapy, 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 significant problem before seeking help. Having said that, it’s never too late to seek professional help and try to mend a strained relationship.
Premarital counseling is for any couple who wants 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 – especially before they even occur – may be the key to staying together.