I rolled my eyes when I first heard a rehab show was about to air on television. “Oh, that’s great — a producer-driven inpatient rehab show. Healing on television. Good luck with that.”
I had no doubt it would be “faux” treatment riddled with inherent conflicts including: sensationalistic production tactics trumping what’s right for the client, a total lack of confidentiality, no private time for the clients and also exposure to stressors that are absolutely unnecessary in the process of healing from drugs/alcohol and/or mental health issues. My other immediate concern was, “What happens when the cameras shut down and the lights turn off? What do those people do then? And are you doing more harm than good?”
I thought the problem was primarily ethical with a potential for medical consequences. And although I didn’t expect great results, I never expected the recently-reported five deaths of participants from just one television rehab show.
Respect the disease!
As a double board-certifie… Read More

Body art, body bling, self-graffiti, walking billboards, fashionable ink accessories… Each of these expressions depict the physical nature of the tattoo. What’s often NOT discussed, however, is the emotional side of tattoos.
I vividly remember the first time I saw a “tramp stamp.” A woman was reaching for something in the front row of a large auditorium and a few rows of men and women witnessed her walking artistry. Everyone had a reaction. And once she left the room, we all talked about it. It was like group therapy.
The responses ranged from “She’s definitely a party girl, probably drinks a lot, has a lot of sex and a rough childhood,” to “She’s probably really creative, edgy, a leader and an independent thinker.” Some liked her more, some liked her less and many guys were more interested in her because of the tattoo. Whatever the response, we were all intrigued, and each of us conjured up our own personal version of her story — all from the sight of a well-placed tattoo.
In those days, tatto… Read More

In the world of psychiatric medicine, we often have to play the role of emotional detective.
As a psychiatrist, my job is to understand the intricacies of the human mind.
The purpose may be to help strengthen a relationship, assess why someone is self-destructive, diagnose a mental health problem or understand how someone could be dysfunctional enough to commit a mass murder. I’ve worked with individuals who are neurotic, emotional, impulsive, psychotic, self-destructive, suicidal, homicidal and even serial killer mass murderers.
At this very moment, everyone is asking the same question of James Holmes. WHY?
In the world of psychiatric medicine, we often have to play the role of emotional detective.
So let’s go through what kind of questions need to be asked to gain a better understanding of who we’re dealing with and why they may have committed such a tragic and terrible act.
Background Questions:
1) Do they have a history of violence?
2) Do they have a history of mental health impairment? Seen a professional? On medications? Received a… Read More

Have you twittered today? Is your Facebook page repeatedly bugging you about updates awaiting your attention? Can’t stop texting and driving?
Just reading information from social media sites can send some people’s stress levels soaring, says Reef Karim M.D., board-certified psychiatrist, assistant clinical professor at the UCLA Semel Institute for Neuroscience and the director of The Control Center outpatient rehab in Beverly Hills.
As a medical specialist in addiction and menta I health, Dr. Reef normally sees patients with chemical and behavioral problems, mood and anxiety difficulties, relationship problems and self-destructive habits.
Lately, however, he’s encountering more and more patients desperate to get the social media monkey off their back. They seek his help at the center, 9777 Wilshire Blvd., because that social media monkey has now turned into an obsessive, all consuming 800-pound gorilla.
“His problems began when he broke up with his girlfriend, became totally stressed out, got
hooked on Facebook an… Read More

What price do you pay to be a professional football player?
Initially we thought it was the price of creaky, lingering musculoskeletal injuries suffered during old age.
But it’s so much more.
We are witnessing one former player after another committing suicide. The reports about Junior Seau are just the latest. Players are suffering from dementia, neurodegenerative disorders, post-concussive syndrome, mental health disorders and substance abuse disorders. Many current players and former players are suffering from head and body trauma from their playing days in the NFL. And many also suffer from the mental health symptoms associated with those blows in addition to the emotional stressors of not being prepared to deal with life after giving up the game.
Many people aren’t aware that concussions and head trauma make you more vulnerable to dementia, brain disorders and mental health disorders during and after the blow to the head.
The professional icons we put on a pedestal during their playing days are paying the price later.
I have worked wit… Read More

What do Elvis, Heath Ledger and Michael Jackson all have in common?
Yes, they are celebrities, super talented and died before their time. That’s true.
But they also, per reports, had doctors “involved” in prescribing or over-prescribing medications that were found in their system during their fatal overdose. These were legal medications given to a patient by a physician or various physicians.
Which leads us to the introduction of … Dr. Feelgood.
Most physicians are smart, ethical and actually care about their patients. And the process of pre-med, medical school, internship, residency and fellowship is long, painful and costly with large amounts of stress and sleep deprivation. It’s not fun. But, many doctors get through it because they love the cutting edge science, healing, stability and helping people.
But, to be a good physician, you have to be street smart as well as book smart. You have to know when you’re being conned. You have to be strong enough to “just say no” to a medication seeking patient who… Read More

I don’t know Amy Winehouse, but I do know addiction.
There’s been a lot of talk about how she died and what circumstances led to her death. We’ve all heard the reports of multiple rehab admissions, on and off recovery, public “altered” appearances where it was obvious she was taking something, etc.
Winehouse’s death is obviously a terrible tragedy, and her celebrity status made her recovery that much harder. Why? Because there’s no privacy, and there’s a great deal of pressure to start working again before you are mentally and physically ready because so many incomes depend on you (managers, agents, publicists, musicians, etc.). You receive “special” care that is not good care, and the public enjoys watching or hearing “drama” — and sober people just aren’t that dramatic compared to when they’re using.
I was treating a rock star once who told me something that I’ll never forget: He said, “When I’m loaded, I’m a better news story, p… Read More

Many Californians with mental health and addiction concerns are unable to afford the treatment they need because mental health and substance use disorder treatment is not covered by insurance like other physical disorders.
As such, countless individuals report not initiating treatment or dropping out of treatment and are left struggling with their life threatening condition without medical support.
The insurance industry consistently argues California simply can’t provide humane treatment to the mentally ill and people with substance use disorders. It’s too expensive, they say.
Research, however, consistently shows otherwise: Creating parity – providing coverage for mental health and substance use disorder treatment equivalent to physical health care – will save money for consumers and taxpayers.
The public understands this, and surveys show there is popular support for parity. But Assembly Bill 1600, legislation requiring health care insurers to cover mental illnesses and substance abuse disorders just as they do for physical… Read More

Dr. Reef Karim, a physician, psychiatrist and addiction specialist, reveals five things you may not know about drug dependency. Plus, why heroin and prescription drug addictions are so dangerous.
1) People need to recognize that they are consumers and their doctors are their expert advisers. But just like you research a product that you want to buy at the store, you also have to research your physicians and the medications that you are putting in your body. You need to be your own consumer advocate. It’s ultimately your job to know what medications you are taking and why. If you have a vulnerability to an addiction, it is your job to tell the doctor this information.
2) Doctors are overprescribing medications. Prescription medications are a good thing and are necessary … but only in limited amounts, unless you have a chronic medical illness. Doctors need to be reminded that certain medications narcotic analgesics (Vicodin, OxyContin, etc.), stimulants (Adderall, Dexedrine, etc.) and sedative hypnotics (Xanax, Ativan, etc.) have addictive po… Read More

No one wants to go into a marriage thinking it’s destined to fail. But these days, it’s hard to not be scared by the statistics. So, we’re offering you some therapy … free of charge. Check out these tips for making marriage work from Dr. Reef Karim.
Young love … there’s no better. It’s exciting, intoxicating euphoric. When in love, we feel “chemistry” literally – our brain’s reward and pleasure circuitry lights up like a Christmas tree. And what’s the ultimate prize for being in love? Getting married. So with all that build up, why are so many young couples getting divorced? As a relationship therapist, I get asked this question all the time.
Are people taking marriage seriously? Are people preparing for marriage? Is marriage a dying concept? Let’s look at the numbers. 50-60% of marriages end in divorce. There are too many divorces. And there too many marriages. It’s so important to get married for the right reasons, because couples have a higher probability of staying… Read More