I'm Thomas Sargent, a board-certified psychiatrist seeing adults in New York and Texas by telehealth. I treat anxiety, depression, ADHD, PTSD, OCD, and bipolar disorder, and every visit includes both medication management and therapy. I have a master's in pharmacology alongside my MD, so my prescribing is careful and specific, and I'd rather get one medication right than stack several. I'm direct, I say what I'm thinking, and I welcome pushback when something doesn't fit.
I ask a lot of questions before I recommend anything. What you've already tried and how it went usually tells me more than the diagnosis does. I keep up with the research and I'm willing to say when the evidence for something is weak, including medications people are already on. We check symptoms with short questionnaires at most visits so neither of us is guessing about whether things are improving. If you see a therapist, I'll coordinate with them.
Most of the first visit is you talking. I'll ask about what's going on now, your history, and what treatment has looked like so far, and I'll want to know what "better" would mean for you specifically. Near the end I'll tell you what I think is happening and what I'd suggest, including if I don't think medication is the answer. We decide on the plan together.
