Mirasol clinicians were recently featured at the University of Arizona College of Medicine Psychiatry Grand Rounds. Speakers included Medical Director Stephen Remolina, Executive Director Diane Ryan, Clinical Director Maeve Shaughnessy, Nutrition Director Anne Ganje and Trauma Therapist Ann Twilley Garcia.
The purpose of the Psychiatry Grand Rounds series is to provide mental health professionals with updates on psychiatric topics with the goal of increasing knowledge, competence and patient care. The full presentation is available on the Univeristy of Arizona's Biomedical Communications website at https://streaming.biocom.arizona.edu/event/?id=27374.
Dr. Remolina shares some of his experiences in working with eating disorders, and demonstrates how complicated they can be by presenting case histories for bulimia nervosa, anorexia nervosa and binge eating disorder. He emphasizes that there is a great deal of overlap between the three diagnoses, as well as a high degree of comorbidity with personality disorder, substance abuse and OCD. Dr. Remolina also notes the prevalence of trauma in eating disorders.
"I look at eating disorders as a way of protecting the brain from having to process trauma," says Remolina. Similarly, substance abuse can be used as a way of achieving an altered state and not thinking about the underlying trauma.
Remolina advocates for limited and cautious use of pharmacology to avoid numbing the client to the point where he or she is unable to move forward in recovery. He believes the best approach is working with a team including a psychiatrist, a medical practitioner, a dietitian and a therapist. He reviews the advantages, risks and recommended dosages of common medications for each of the three disorders, and stresses the importance of "complex treatment for a complicated diagnosis".