To people on the outside looking in, Donna* would appear to have a great life. She has a stable job doing what she loves, a nice home and a new car. She’s blessed with a healthy son, many friends and a close extended family. To any casual observer, she would seem to have everything she needs and wants.
On the inside, however, Donna is tormented by extreme mood swings. She shifts from periods of deep depression and fatigue to periods of heightened energy and agitation. There are times when she is nearly disabled by her condition, which was diagnosed by a psychiatrist as bipolar disorder.
Donna has not responded fully to her current doctor’s treatment plan, and her family has encouraged her to seek another psychiatrist’s opinion. But Donna is hesitant, mainly because she believes psychiatric offices are stark, cold and unfriendly. She dreads the thought of sitting in a sterile environment while being asked a multitude of probing questions. This image in her mind makes her anxious, which makes her feel worse.
“Our clinic is not like that at all,” assures Edward Zawadzki, DO, a board-certified forensic and adult psychiatrist at Lighthouse Health Group in Jupiter. “Ours is a spa-like setting that’s very calming and relaxing. Our office is decorated with bright, soothing colors, so it’s comfortable and welcoming for patients.
“And when we perform our evaluations, we don’t pepper patients with clinical questions, which can be awkward and unpleasant for them. Instead, our evaluations are very conversational, which puts patients at ease and makes them more comfortable with the treatment process. We find patients respond really well to that approach.”
Lighthouse Health Group is still a full-service psychiatric practice offering both traditional and leading-edge treatments for patients with mental health disorders. In addition to a board-certified psychiatrist, the staff includes a certified psychiatric nurse practitioner, doctoral level psychologists and master’s level therapists.
“At our clinic, we spend a good amount of time with our patients, longer than typical psychiatric practices, and we take an individualized approach to each person’s situation,” Dr. Zawadzki describes. “I see patients for an initial evaluation for about an hour, then follow-up visits with me are twenty minutes or longer.
“All of the counselors take time to listen and get to know their patients and what’s going on in their lives, then we use that information in the treatment process. Knowing all about our patients helps us gauge how they’re doing with their treatment and determine if any adjustments are necessary.”
The counselors at Lighthouse Health Group assist people with a broad range of mental health disorders. Many of their patients are diagnosed with depression and anxiety, but they address other conditions as well.
“We treat patients with many issues, including anxiety spectrum disorders such as post-traumatic stress disorder and obsessive-compulsive disorder,” Dr. Zawadzki observes. “We also treat people with trauma histories as well as major mood disorders such as bipolar disorder and schizophrenia.
“While we use medication to treat many of these conditions, not all patients are treated with medication,” Dr. Zawadzki stresses. “Patients often consult with a therapist or psychologist first, and they can recommend medication. But as the psychiatrist, I decide if patients need medication, psychotherapy or both. Treatment is specific to the individual.”
Dr. Zawadzki and his staff at Lighthouse Health Group use a mixture of science-based psychiatry and traditional psychotherapeutic methods to treat their patients. Traditional methods they employ include individual and family therapy. The staff also use leading-edge techniques such as transcranial magnetic stimulation, or TMS.
“During TMS, a high-strength magnet is placed on the head over an area of the brain called the dorsolateral prefrontal cortex,” Dr. Zawadzki describes. “This area of the brain is considered important in the development of depression. It has been shown on MRI studies to be under-functioning in people who have depression.
“Pulsing the magnet over that section of the brain induces a small electrical charge that forces the neurons in that area to fire. This essentially wakes up the dorsolateral prefrontal cortex so it functions normally again, which relieves depression symptoms.”
A course of TMS therapy is generally 36 sessions over approximately one month. The initial TMS session lasts 45 minutes to an hour. During that time,
Dr. Zawadzki maps the brain to determine the exact location for magnet placement. Subsequent sessions take about 30 minutes to complete.
“TMS is typically reserved for patients who struggle with medications, who’ve had only partial response to medications or can’t take medications due to side effects or another issue,” Dr. Zawadzki reports. “The nice thing about TMS is it bypasses the pill-taking process and focuses treatment directly on the area of the brain that we believe is involved in depression.
“Most patients start feeling better around the two-week mark after beginning TMS therapy. But for some patients, it takes a little longer to feel significant relief of their symptoms.”
Another leading-edge treatment offered at Lighthouse Health Group is esketamine, which is a new medication that helps people suffering from depressive disorders rapidly achieve symptom relief.
“Esketamine is an analog of ketamine, an anesthetic that’s been around for many years,” Dr. Zawadzki explains. “But esketamine has been reformulated as a treatment for depression. We use esketamine as a nasal spray, and we administer it in our office. It’s not something patients take home with them.
“Esketamine is an NMDA-receptor antagonist, which is a complicated way of saying it works on neurotransmitters in the brain that are involved with depression and other emotional states. By modulating those neurotransmitters with esketamine, we can help people feel dramatically better very quickly.
“The exact way esketamine works is complicated. But essentially, it operates through a variety of mechanisms primarily concerned with glutamate transmission. [Glutamate is a specific neurotransmitter]. With esketamine, patients enter a dissociative anesthetic state, during which symptoms of depression go away.”
Initially, esketamine is administered twice a week for one month, after which patients enter a maintenance phase. During maintenance, patients are treated once per week for a specific number of months determined by how each patient responds to the treatment.
Like TMS, esketamine therapy is typically considered after patients fail to achieve significant symptom relief using medications.
Patients with mental health disorders sometimes suffer physical pain as well. Lighthouse Health Group offers a service to support patients in that situation. To ease patients’ pain, a board-certified physiatrist is on site at the clinic to address their painful conditions.
“We’re not a pain clinic, but our physiatrist, Dr. Ellen Babinsky treats patients for many types of musculoskeletal complaints, including back pain and joint injuries,” Dr. Zawadzki states. “As a physiatrist, she can address any type of muscle or bone issue patients may experience.”
People don’t have to be mental health patients to make an appointment with the physiatrist at Lighthouse Health Group.
Hearing about Lighthouse Health Group was excellent news to Donna’s ears. She was thrilled to learn of a psychiatric clinic with a soothing atmosphere and concierge-like service. It took away the anxiety of seeking a second opinion on her bipolar disorder treatment plan. Donna was surprised to find out that Lighthouse Health Group is not brand-new.
“We’ve been around for close to five years,” Dr. Zawadzki shares. “And our patients are our priority. Our ultimate goal is to provide really good care to our patients at all times.”