Dr. K Psychiatry

06/01/2026

Some people describe themselves as fixers, others as people-pleasers, others as empaths. There are lots of words we use to describe ourselves, but we can be more than one way also. It's ok to have compassion for others without feeling like you need to fix them. Supporting people to fix their own problems might help the other person grow and become more effective and independent.
- Dr. K

05/29/2026

Save some surge capacity. This keeps coming up in therapy with various people. Some folks fear missing opportunities, or have difficulty with anxiety about disappointing others, so they say yes to things that result in them taking on too much. Life always delivers unexpected stuff, and that's normal. You can't anticipate everything, but you can anticipate that something will come. It's wise to save time and space for that. Painful experience eventually teaches that every foundation will crumble under too much weight. Instead, try working at 90% of your capacity and save 10% for the unexpected surprises. That way you will be less likely to exceed what you can sustainably deliver, and you will avoid a heck of a lot of stress. If that extra stress comes on top of the 100% you're already doing, the extra stress goes up exponentially, and contributes to deterioration of your mental health. This is a good mental hygiene practice.
- Dr. K

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05/28/2026

How do you distill a person's years of self-help work into a few sentences? One of my patients with a lot of trauma and even antisocial behaviour in the past has left all that in the dust. Sure, the right meds are part of it, and abstinence from substance abuse. But a big part of his formula for good mental health is self-awareness, recognizing that emotions come for reasons, self-compassion, listening to what his body is telling him and responding accordingly, recognizing what's within his control and what isn't, and asking for support when needed. Not overextending himself has also been important.
- Dr. K

05/27/2026

I was talking with one of my patients who wanted to improve her self-esteem, but she has been anxious about trying new things. I think self-esteem improves through experiences of success. But if you're worried too much about safety, you won't try enough new experiences to grow. A useful analogy is investing. If you want safety, you can choose a nice conservative T-bill and get a really low percentage of growth. Alternatively, if you want growth, from a mutual fund, you also have to accept a certain amount of risk. The more risk, the more potential for growth... or setbacks. At least in life, we can use our setbacks and learn from them without losing our entire net worth. But in life you will have to accept a certain amount of risk, letting go of some safety, to grow into the person you want to be.
- Dr. K

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05/27/2026

Sometimes when I prescribe a medication to help with sleep, people take it intermittently, but this way they might not get used to any hangover effect the next morning. If it's safe to take every night, it may be better to take it every night, and after a week or so, the hangover effect the next day is no longer noticeable.
- Dr. K

05/25/2026

Sometimes when a person is depressed, medication is needed. But other times, that's not enough, and what's needed is to solve a problem. Sometimes you may need to distract yourself from an issue that you can't solve, because ruminating doesn't fix it. Sometimes you just need to find a purpose. At different times in life, our purpose may change. Towards our later years, it's not all about making money and providing for your family. It's ok then for your purpose to shift more towards enjoying yourself. One thing that's always good to have is something that you like doing that also helps others. Are you missing that?
- Dr. K

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05/09/2026

Good advice for anyone, regardless of who really said it.

05/06/2026

Here is a thought record that one of my clients agreed I could post, for illustration purposes. He has bipolar disorder, taking lithium and feeling a bit flat emotionally.
Situation: Sitting at desk feeling uneasy. Emotions: Sad 50 → 20 fearful 60 hopeless 70 Bored 85. Automatic thoughts: I hate feeling this way. the walls are closing in on me. I can't cope. This feeling will never go away. I should stop taking lithium. This is no way to go through life. I don't feel like a normal person. I can't focus when I try to do an activity. Anxious about finances and future. What if my car breaks down. I've become a worry wart. I have Chicken Little Syndrome. Distortions: All or nothing. Jumping to conclusions. should statements, magnification personalizing, overgeneralizing, DQP, Labeling, Emotional reasoning. Rational responses: I felt worse in past. I survived worse. I have been coping SO I CAN cope. the rule of tens may take a bit longer. What evidence is there that it will never go away. Its normal to feel badly sometimes. the walls are static, not moving. Stopping meds seems like a short term solution to a long term problem. Perhaps med adjustment could be made. what Δ can I make to improve my day to day feelings? Walk. Meditate. Eat healthy. Normal people feel this way sometimes. I can't control the future but I can prepare, where possible. Otherwise stay in the present. Consider the Math of worrying. When you worry you suffer twice if it happens and once for nothing if it doesnt'. Bracing yourself is bu****it. Do a TR, I know it helps. Perception is not always reality. TR was worth the effort. Outcome emotions: Sad 20, fearful 30, bored 50.
- Dr. K

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05/05/2026

Here's a little snippet from today's Stoic Wisdoms email, about cultivating mindfulness:

Stay ten more seconds. When something briefly stops you today, a sound, a smell, a slant of light, do not move on right away. Stay where you are for ten more seconds. See what the moment offers when you do not immediately walk through it.

Eat one thing without doing anything else. Pick one bite of one meal today. No phone, no conversation, no planning the rest of the day. Just the food, in your mouth, fully attended to. Notice how much more there is in a single bite than you usually receive.

Find one ordinary thing you would have walked past. At some point today, name one small good thing you would normally not have noticed. The way a door closed. The particular feel of the air. A face that softened mid-conversation. You do not have to do anything with the noticing. Register that the thing happened and that you were there for it.

- Dr. K

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