Dr. Rachael J. Murphy - RiverStep Functional Psychiatry

07/10/2026

Support animals come in different forms, each with an important purpose 🐾 💜

Thank you for respecting their roles and the people who rely on them

Service Animal vs. Therapy Animal vs. Emotional Support Animal (ESA): What’s the Difference?

These terms are often used interchangeably, but they have very different roles and legal protections.

Key points to know:

• Service animals (currently dogs under the ADA) are individually trained to perform specific tasks for a person with a disability and are generally permitted in public places.

• Therapy animals provide comfort to others in settings like hospitals, schools, and nursing homes. They visit by invitation and do not have special public access rights.

• Emotional Support Animals (ESAs) provide comfort related to a person’s disability but are not service animals under the ADA. Their primary federal legal protection is in certain housing situations under the Fair Housing Act (FHA) when a disability-related need is appropriately documented.

A few common misconceptions:

✔️ ESAs do not have the same public access rights as service animals.
✔️ Airlines are generally not required to accommodate ESAs under current federal law.
✔️ There is no federally recognized registry or certification for service animals or ESAs.
✔️ Businesses may ask only two questions when a service animal’s role is not obvious: (1) Is the dog required because of a disability? and (2) What work or task has the dog been trained to perform?

A mental health professional’s role is to evaluate whether a patient has a qualifying disability and whether an emotional support animal is an appropriate disability-related accommodation (not simply whether someone would enjoy having a pet).

*This post is for educational purposes only and is not legal advice. Federal, state, and local laws may vary and change over time.

06/30/2026

Tapering isn’t a straight line.

Stopping an antidepressant safely for some people takes more than willpower; it takes a plan. Slow, individualized tapers give your nervous system time to adjust and make potential withdrawal symptoms far less likely.

06/13/2026

People want to come off stimulants for all kinds of reasons. The side effects start to outweigh the benefit - poor sleep, anxiety, headaches, feeling flat or not like yourself. It stops working the way it used to.

Or maybe life shifts, and the circumstances that led to the prescription aren’t there anymore. Maybe you simply don’t like taking a controlled substance indefinitely. Maybe you simply want to know if you need it or not.

Here’s the part that surprises people: stimulants don’t cause the kind of physical dependence we worry about with benzodiazepines, or the withdrawal effects we may even see with other drug classes like antidepressants.

There’s no acute danger in stopping. So you’re often told you can just quit any day you like.

But then the “crash” hits - the flat, foggy stretch as the brain recalibrates.

For those interested in lowering their stimulant dose or eventually discontinuing it: it doesn’t mean white-knuckling through to meet your goals. It’s telling your experiences apart, and that’s exactly what a thoughtful, gradual taper makes possible.

New on the blog: why people stop, what tapering actually means, and how to come off thoughtfully instead of abruptly.

🔗 Link to the blog:

https://www.riverstephealth.com/blog/coming-off-stimulants-what-tapering-actually-means

06/12/2026

www.riverstephealth.com/blog/the-last-milligram-is-the-hardest-what-hyperbolic-tapering-teaches-us-about-stopping-antidepressants

New Blog Post:

Why The Last Milligram is The Hardest

Most people — patients and prescribers alike — assume that the hard part of coming off an antidepressant is the beginning. Cut the big dose, and the small dose left at the end should be a formality. The pharmacology says the opposite. The closer you get to zero, the more carefully you often have...

04/16/2026

The dangers of using antipsychotics like Seroquel and Zyprexa for insomnia. Why off-label prescribing for sleep leads to dependence and tapering issues.