What we’ve said about Shared decision making

“Patients can make decisions, and I always think of our job as the lanes on a bowling. When you go bowling, they have those little kid lanes. That's our job. The patient decides where they go, but within certain parameters that we provide”

“I show my thinking and I say, what do you want to do? Obviously within certain parameters”

“So you really have to come to a shared agreement for what it is that you're targeting and the reasons that you're making these changes”

“you need to make sure to establish from the outset and to maintain that the patient is the primary agent in the treatment, even if they're conserved, okay? even if they're concerned, because ultimately we do want people to take medications voluntarily and knowingly”

“Sometimes some people are OK with having more hallucinations. if they're less sedated. And it doesn't mean that they're going to get hospitalized. You have to assess the patient”

“But everyone's a little different, and some people don't want to accept it. So if they don't want to accept it, you don't push the lithium. You move on to the next choice”

“I often document, I reviewed with patients why I think that there's, for this individual patient, an increased risk of some sort of bipolarity. However, the patient understood the alternatives and still wanted to pursue the major depressive treatment with an understanding that we're going to keep a very close eye and monitor”