Dr. Robert A. Dahmes, M.D.

We have seen a loss of efficacy with drugs that affect serotonin after 6-8 months. That doesn't mean the medication won't work, but your prescriber may want to increase the dosage some.

No matter what you do, your son will have reactions to the divorce. How he reacts is dependent on many things, such as age, previous functioning, nature of the breakup, ability of parents to communicate in best interest of the kids, external supports for your son such as friends, and a bunch more. If he is below age 6 or 7, counseling is probably a good idea, as younger children generally have the most difficult time with the death of a family (which is how they perceive divorce). But another factor that affects outcome is whether you and his father can learn to communicate about your son's needs in a rational, effective manner and NOT use the child to get back at each other.

A great question. Shift work definitely affects sleep which, in turn, can affect work productivity. The problem lies within the limbic system of the brain where controls exist for setting a sleep cycle. This sleep cycle is tied to sunlight and darkness cycles and can be influenced by all kinds of internal and external factors including emotional state, exercise, diet, smoking, alcohol, etc. So, to compensate for shift work changes, you must make sure that you follow good sleep habits such as not eating right before going to bed, not exercising within 3-4 hours of bedtime, no alcohol or cigarettes before bedtime, use room darkening window coverings in your bedroom, make sure the bedroom is as quiet as can be (or get a white noise machine) and to help "set" a new sleep cycle (i.e. going from a graveyard shift to a daytime shift), you may try a sleep aid for the first couple of bedtimes, such as Benadryl, Melatonin or Valerian.

Rob Dahmes, MD

There are many reasons for increased appetite and subsequent weight gain. Anxiety, depression, binge eating disorder are certainly possibilities, but physical illnesses can also cause increased appetite and weight gain. Diabetes, thyroid disease and others can cause this behavior. It is best to have a complete physical done by the pediatrician or primary care provider and then a psychiatric consultation if no physicall illnesses are detected.

In fact there are several medications approved by the FDA to treat OCD including fluvoxamine, sertraline and others. All are serotonin reuptake inhibitors. In severe cases, medications such as aripiprazole and Risperdal are used adjunctively. Despite these meds, there is no "cure" for OCD, but with medication and therapy, there can be a significant lessening of troublesome obsessions and compulsions.

The old adage is "everything in moderation." If there are no other symptoms, such as addictive sexual behaviors, compulsive masturbation, inability to complete activities of daily living or physical symptoms, then seeking a medical opinion is not a necessity. Women's sexual desire peaks in the 20s to 30s, and if it doesn't interfere with necessary daily tasks, then you shouldn't be worried. However, if the behavior is causing problems with work, relationships, or there are other physical symptoms, then it would be appropriate to see a physician such as an endocrinologist.

It may be Binge-Eating Disorder, but could be other things as well, such as depression or even anxiety. Best route to follow would be to schedule an appointment with a mental health professional with expertise in eating disorders and, depending on the assessment, develop appropriate treatment plans.

Rob Dahmes MD

There is a genetic component to depression, but depression is not 100% hereditary. Other internal and external factors also play a role, such as life experiences, family interactions, etc. With all of that said, you should be aware of depressive symptoms and seek professional help if any arise.

Rob Dahmes, MD