Frequently Asked Questions

Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders.

A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems.

Psychiatrists are trained physicians who specialize in mental health. They evaluate, diagnose, and treat psychiatric disorders according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. The treatments they offer include medication, therapy, and behavioral interventions.

To become a psychiatrist, you must go to medical school, complete residency training in psychiatry, fulfill state licensing requirements, and—optionally—get certified by the American Board of Psychiatry and Neurology.

A Psychiatrist is a medical doctor, either M.D. or D.O., who specializes in mental health diagnosis and treatment.

Child & Adolescent Psychiatrists are psychiatrists who diagnose and treat mental health disorders in children and adolescents as opposed to adults.

A psychiatrist is a medical doctor (completed medical school and residency) with special training in psychiatry. A psychiatrist is able to conduct psychotherapy and prescribe medications and other medical treatments.

Psychologists treat mental disorders with psychotherapy and some specialize in psychological testing and evaluation.

During your first appointment with a Child & Adolescent Psychiatrist, they are looking to find out what you’re struggling with and why you’re at the appointment in the first place. So, during an initial assessment, expect a lot of questions. The goal of a psychiatric consultation is to find out how you are feeling, discuss your symptoms and diagnosis. Your psychiatrist will likely ask general questions about your mental and physical health, your family, social, developmental history. Your Psychiatrist may order medical laboratory, genetic and psychological tests which help provide a picture of a patient's physical and mental state. Their education and clinical training equip them to understand the complex relationship between emotional and other medical illnesses and the relationships with genetics and family history, to evaluate medical and psychological data, to make a diagnosis, and to work with patients to develop treatment plans.

You may or may not receive medications at your first appointment.

It depends, usually your first appointment will be longer because of the amount of information that your psychiatrist obtains from you. This may range from 45-120 minutes depending on the complexity of your problems. After this, your follow up appointment may be shorter and can range from 20-60 minutes.

There are a few things you can do to help you prepare for your first session with a Child Psychiatrist. To start, prepare your medical history, including: Diagnosis (if you have one), Current and past medications (and dosages), Past treatment for mental health, Medical history (physical and mental health conditions). If you have access to your medical and mental health records, share them with your psychiatrist.

Writing down some notes will keep you on track so you can share what you need to get the most out of the session. You can also prepare for the session by handling payment and preparing any administrative information you need beforehand.

Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses can be associated with distress and/or problems functioning in social, school/work or family activities. Mental illness is nothing to be ashamed of. It is a medical problem, just like heart disease or diabetes.

Mental illness is common. According to the CDC, in a given year:

• Nearly one in five (19%) U.S. adults experience some form of mental illness.

• One in 24 (4.1%) has a serious mental illness*.

• One in 12 (8.5%) has a diagnosable substance use disorder.

Mental illness is treatable. The vast majority of individuals with mental illness continue to function in their daily lives.

There are several types of mental illnesses like Anxiety disorders, Mood disorders like Depression, Bipolar Disorder, Behavior Disorders, Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder, Post Traumatic Stress Disorder (PTSD), Schizophrenia, Obsessive Compulsive Disorder (OCD), Substance Use Disorder, Eating Disorders.

According to the Centers for Disease Control (CDC), ADHD, anxiety problems, behavior problems, and depression are the most commonly diagnosed mental disorders in children. Estimates for ever having a diagnosis among children aged 3-17 years, in 2016-19, are given below.

a. ADHD 9.8% (approximately 6.0 million)

b. Anxiety 9.4% (approximately 5.8 million)

c. Behavior problems 8.9% (approximately 5.5 million)

d. Depression 4.4% (approximately 2.7 million)

Some of these conditions commonly occur together.

Learning about developing symptoms, or early warning signs, and taking action can help to ensure prompt treatment. Early intervention CAN help reduce the severity of an illness and interruptions in quality of life and functions. It may even be possible to delay or prevent a major mental illness altogether. If several of the following are occurring, it may be useful to follow up with a mental health professional.

• Sleep or appetite changes — Dramatic sleep and appetite changes or decline in personal care.

• Mood changes — Rapid or dramatic shifts in emotions or depressed feelings, greater irritability.

• Withdrawal — Recent social withdrawal and loss of interest in activities previously enjoyed.

• Drop in functioning — An unusual drop in functioning, at school, work or social activities, such as quitting sports, failing in school or difficulty performing familiar tasks.

• Problems thinking — Problems with concentration, memory or logical thought and speech that are hard to explain.

• Increased sensitivity — Heightened sensitivity to sights, sounds, smells or touch; avoidance of over-stimulating situations.

• Apathy — Loss of initiative or desire to participate in any activity.

• Feeling disconnected — A vague feeling of being disconnected from oneself or one’s surroundings; a sense of unreality.

• Illogical thinking — Unusual or exaggerated beliefs about personal powers to understand meanings or influence events; illogical or “magical” thinking typical of childhood in an adult.

• Nervousness — Fear or suspiciousness of others or a strong nervous feeling.

• Unusual behavior — Odd, uncharacteristic, peculiar behavior.

• Changes in school or work — Increased absenteeism, worsening performance, difficulties in relationships with peers and co-workers.

One or two of these symptoms alone can’t predict a mental illness but may indicate a need for further evaluation. If a person is experiencing several at one time and the symptoms are causing serious problems in the ability to study, work or relate to others, he/she should be seen by a physician or mental health professional. People with suicidal thoughts or intent, or thoughts of harming others, need immediate attention.

Certain mental disorders tend to run in families, and having a close relative with a mental disorder could mean you are at a higher risk. If a family member has a mental disorder, it does not necessarily mean you will develop one. Many other factors also play a role.

Attention Deficit Hyperactivity Disorder or ADHD is a common childhood illness that can be treated. Studies show that ADHD may affect certain areas of the brain that allow us to solve problems, plan ahead, understand others’ actions, and control our impulses. The primary symptoms of ADHD are hyperactivity, impulsivity, and inattention.

Many children have times when they are sad or down. Occasional sadness is a normal part of growing up. However, if children are sad, irritable, or no longer enjoy things, and this occurs day after day, it may be a sign that they are suffering from major depressive disorder, commonly known as depression. Some people think that only adults become depressed. In fact, children and adolescents can experience depression, and studies show that it is on the rise. More than one in seven teens experience depression each year.

Anxiety is the fearful anticipation of danger or problems accompanied by an intense unpleasant feeling or physical symptoms. Anxiety is not uncommon in children and adolescents.

All children experience anxiety. Anxiety in children is expected and normal at specific times in development. For example, from approximately age 8 months through the preschool years, healthy youngsters may show intense distress (anxiety) at times of separation from their parents or other caregivers with whom they are close. Young children may have short-lived fears, (such as fear of the dark, storms, animals, or strangers).

Anxious children are often overly tense. Some may seek a lot of reassurance, and their worries may interfere with activities. Parents should not discount a child's fears. Because anxious children may also be quiet, compliant and eager to please, their difficulties may be missed. Parents should be alert to the signs of severe anxiety so they can intervene early to prevent complications.

Autism is a neurodevelopmental condition which is usually diagnosed in the first 3 years of life. Generally parents become concerned when their child has delays in speech development, limited social relatedness, and restricted interests and activities. Although the cause of autism is unknown, it is generally believed that etiology may be due to multiple factors. Many genetic, environmental, metabolic and neurological conditions that affect the normal functioning of the brain are being researched.

The most common disruptive behavior disorders are oppositional defiant disorder (ODD), conduct disorder (CD)

Oppositional Defiant Disorder (ODD) refers to an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster's day to day functioning. All children are oppositional from time to time, particularly when tired, hungry, stressed or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is often a normal part of development for two to three year olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child's social, family, and academic life.

Conduct disorder refers to a group of repetitive and persistent behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules, respecting the rights of others, showing empathy, and behaving in a socially acceptable way. They are often viewed by other children, adults and social agencies as "bad" or delinquent, rather than mentally ill.

Most health insurance companies cover mental health and substance use treatment. However, you should verify with your insurance company if Serene or Dr Lionel Pereira is in network. If you do not have insurance, Serene will work with you at a cost that is affordable to you. Just ask.

Serene accepts Medicare, Medicaid and most commercial insurances like Blue Cross Blue Shield-Anthem, United-Optum, Harvard Pilgrim, Tufts, Aetna, Cigna and many more.

It depends on your condition, your treatment plan and the medications you take. Some patients may need to see their psychiatrist up to 1-2 times a week whereas some patients may see their psychiatrist once in 1-2 months.

Not every child needs medications, some need only psychotherapy while some need medications. Talk to your Child & Adolescent Psychiatrist about your preferences and they will work with you to provide the best treatment for your child.

It is recommended to not stop medications without discussing with your psychiatrist. Some medications may have severe side effects if stopped suddenly.

It depends on your insurance carrier. Families seek Child Psychiatrists when they are concerned about the mental health of their child or adolescent. Others may present to a primary care physician, pediatrician, family physician, general psychiatrist or non-physician practitioner.

There are approximately 8,300 practicing child and adolescent psychiatrists in the US and over 15 million children and adolescents in need of the special expertise of a child and adolescent psychiatrist. Despite the availability of effective treatment, there are average delays of 8-10 years between the onset of symptoms and intervention--critical developmental years in the life of a child.