Dr. Mortimer's Blog

Sample Summary of Successful Treatment of an Adult with ADHD

Physicians often attempt to diagnose and treat attention–deficit/hyperactivity disorder (ADHD) without adequate diagnostic information and without an objective measure of the patient's neurocognitive functioning or his/her subsequent response to treatment. This summary (with the identifying information changed to protect patient confidentiality) is one of many examples of Dr. Mortimer's psychiatric assessment and successful treatment of an adult patient with life–long, mostly inadequately treated ADHD.

Vancouver, Washington Psychiatrist Dale Mortimer, M.D. Recently Recognized as "Brilliant...Top Doctor...Top Psychiatrist" and More!

Dr. Dale Mortimer's Brief Guide to the Stimulants Used In Treating Attention–Deficit/Hyperactivity Disorder (ADHD)

This short, convenient, pithy Guide provides an overview of: the current stimulant medication options available for the treatment of attention–deficit/hyperactivity disorder (ADHD); along with their usual duration of benefit; and – when known – dose equivalences to the other stimulants. The dose equivalences and durations of action in this Guide have been surprisingly accurate in about 95% of Dr. Mortimer's patients. Following Dr. Mortimer's one–page "Stimulant Menu" is his one–page summary of ADHD medications and what to expect from them (– as well as who should be supervising the administration of these controlled substances).

So You Want Dr. Mortimer To Contract With Your Managed–Care, For–Profit Medical Insurance Company, Do You Now?

Every year, several of Dr. Mortimer's private practice patients notify him or Jill that they have switched to a managed care, for–profit medical insurance company. They will then ask Dr. Mortimer for the favor of contracting (i.e., signing a legally–binding contract) with their new, managed care, for–profit medical insurance company. Well...First of all, do be aware that Dr. Mortimer is unwilling to sign any contract with a for–profit managed care organization which puts the managed care company's profit ahead of what in his medical opinion is the most safe, appropriate and/or medically necessary medical care for his patient. Secondly, do be aware that Dr. Mortimer is unwilling to sign any contract with a for–profit managed care organization which results in his professional medical services being devalued – it is simply insulting. Lastly, do be aware that if Dr. Mortimer were to contract with a for–profit, managed care medical insurance plan without first negotiating the terms of its standard contract, Dr. Mortimer worries that he would then relive "the for–profit, managed care nightmare" – analogous to what prison inmates mean by “picking up the soap.” Want to learn more? Just click on the link below:

What Is Normal? – Dr. John Beahrs' "Common Sense Psychology"

Portland psychiatrist John O. Beahrs, M.D. is most likely the smartest psychiatrist Dr. Mortimer has ever met. During his general adult psychiatry training, Dr. Mortimer actively sought out Dr. Beahrs to be his supervisor as often as possible. Dr. Mortimer has read three of Dr. Beahrs' published books, and over a dozen of Dr. Beahrs' published journal articles. Among his many published clinical "jewels," Dr. Mortimer has found Dr. Beahrs' description of what he calls "Common Sense Psychology" so useful for his patients that Dr. Mortimer is publishing it here (with slight editing). This discussion by Dr. Beahrs is from his 1982 book: Unity and Multiplicity: Multilevel Consciousness of Self in Hypnosis, Psychiatric Disorder and Mental Health.

Just look at all the media articles featuring Vancouver, Washington psychiatrist Dr. Dale Mortimer! Wow!

Frequently Asked Questions About Dr. Mortimer's Private Practice in Child & Adolescent Psychiatry, and in General Adult Psychiatry

Welcome to Dr. Mortimer’s website! Some patients and their families are relatively new to Dr. Mortimer’s practice, and others might not yet be completely familiar with his office procedures or with relevant business aspects of his private practice. This document is intended to acquaint you with Dr. Mortimer’s private outpatient psychiatric practice. It will provide you with some of Dr. Mortimer’s professional qualifications. It will will also provide you with useful information about the politics, insurance economics and other complexities that can affect and/or potentially compromise your psychiatric treatment. This article is also intended to put in writing your agreement – or contract – with Dr. Mortimer regarding expectations of each other. It highlights areas that are frequent areas of contention so that there is less likelihood of misunderstandings. If you have any questions about what is discussed here, do be sure to ask!

Dual Agency and Wearing Two Hats: On the Incompatibility of Clinical Psychiatric Assessment and Forensic Psychiatric Evaluations

Distinguishing the ethical, legal, evidentiary and informational differences between fact and expert witnesses is an issue that continues to puzzle many psychiatrists, non–psychiatric physicians, attorneys and various governmental administrators. Dr. Mortimer composed this document as a response to the growing discomfort that he has felt as a treating psychiatrist when asked by various individuals or agencies to: send them copies of his patient’s confidential psychiatric records, render an expert forensic opinion on the cause of his patient’s alleged mental disability, determine a date regarding when his patient can return to work, and/ or give his professional guarantee that his former patient (– whom Dr. Mortimer last saw when the patient was an teenager) can safely and responsibly work around a submarine's nuclear weapons.

Brief information about Dr. Mortimer's professional qualifications and his private practice

Below is a very brief summary about Dr. Mortimer's independent, solo, outpatient, for–profit, patient–centered, pro–family values, pro–choice, pro–life, solutions–based, future–focused private psychiatric practice at: 10,000 NE 7th Ave, # 385, Vancouver, WA. Phone: 360-882-9058. A much longer and more detailed description of Dr. Mortimer's solo private practice and how things are done in his private practice can be found in his article/blog: "Frequently Asked Questions about Dr. Mortimer's Private Practice in Child & Adolescent Psychiatry and General Adult Psychiatry."

Off–label uses of Memantine (Namenda)

Memantine is a NMDA (N–methyl–D–aspartate) glutamate receptor antagonist which is, as one Portland psychiatrist summarized, “…good for any distressed neuron.” In this article, Dr. Mortimer discusses off–label uses of memantine in child, adolescent, and general adult psychiatry. Want to learn more? Click below!

Some Lessons I Learned in Prison – Dale Mortimer, M.D.

Here are a several clinical anecdotes illustrating a few of the many important life lessons which Dr. Mortimer learned from Lieutenant Don Mills while Dr. Mortimer served as Oregon Department of Corrections principle psychiatrist from 1990 to 1997. The lessons here are applicable far beyond the walls of Oregon State Penitentiary. Want to learn more? Click below!

Slow/Sluggish Cognitive Tempo Screening Questions – Dale Mortimer, M.D.

While not yet an official psychiatric diagnosis, Slow (or Sluggish) Cognitive Tempo appears to be a diagnostically valid and separate diagnosis from attention deficit/hyperactivity disorder. Want to learn more? Click below!

Mortimer's Tic Inventory – Dale Mortimer, M.D.

Many persons go through life with recurring, non–productive thoughts or repetitive quirky behaviors, never knowing that these thoughts or behaviors are, in fact, tics – and are treatable. Mortimer's Tic Inventory can help identify a wide range of bothersome motor, phonic, verbal tics and "thought" tics in children, adolescents and adults. Want to learn more? Click below!

Sleep Hygiene Recommendations to Improve Sleep – Dale Mortimer, M.D.

Based on a review of relevant literature – plus Dr. Mortimer's 31+ years of clinical experience treating children, adolescents and adults with sleep problems – below is Dr. Mortimer's summary of experts' recommendations for good sleep habits. Want to learn more? Click below!

Clinical Update on Marijuana/Cannabis/THC - Dale Mortimer, M.D.

This article is a synthesis of: (1) what Dr. Mortimer believes to be credible, non–biased, recently published studies on marijuana/cannabis/THC; (2) other articles on marijuana/ cannabis/THC; (3) Dr. Mortimer's clinical experience over the past 35+ years as: a child and adolescent psychiatrist, a general adult psychiatrist, an addiction psychiatrist, a prison psychiatrist (who “paroled” in 1997); combined with (4) Dr. Mortimer's experience as a parent who in June 2016 while on vacation in Canada was inadvertently poisoned by an innocent–looking but THC–laced peanut butter and jelly sandwich. Dr. Mortimer has excerpted liberally from the articles and books cited at the conclusion of this summary. Lastly, for an example of how chronic cannabis abuse can masquerade as chronic schizophrenia, see Dr. Mortimer's companion piece: “Clinical Lessons Learned About Cannabis Over the Past Thirty–Five Years – Starting with James.”

‍Clinical Lessons Learned About Cannabis Over the Past Thirty–Five Years: Starting with James – Dale Mortimer, M.D.

James was a Viet Nam combat veteran who, while on active service in the Army, was diagnosed with chronic paranoid schizophrenia. But James had a secret – and James provided Dr. Mortimer with an important lesson. Want to learn more? Click below!

Effect Size: Evaluating the efficacy of an intervention (e.g., medical treatment) or phenomenon – Dale Mortimer, M.D.

Effect size is an important measure of the efficacy – or strength – of a proposed intervention (i.e., medical treatment). While an intervention (i.e., a medical treatment) might be found to be statistically significant, it might still be clinically insignificant. Hence, the value of effect size. As one example of the usefulness of knowing effect size, just take a look at the feeble effect sizes aspirin or statins prescribed for the prevention of cardiovascular events (i.e., heart attacks or stroke). Then come to your own conclusions! Want to learn more? Click below!

What’s New About Attention Deficit/Hyperactivity Disorder? – Dale Mortimer, M.D.

Based on Dr. Mortimer's clinical experiences over the past 33+ years, plus his extensive review of the published literature on attention–deficit/hyperactivity disorder (ADHD), here is Dr. Mortimer's insights into the nature, causes, and effective treatments for ADHD. Want to learn more? Click below!

On the Safety and Efficacy of Buspirone (BuSpar) in the Management of Snoring, Sleep Apnea, and Bruxism (Teeth Grinding) – Dale Mortimer, M.D.

There have been a handful of case reports published on the efficacy of buspirone (BuSpar) in its off–label treatment of a number of sleep disorders. Here, Dr. Mortimer first summarizes the studies about which he is familiar. Dr. Mortimer then summarizes the efficacy of buspirone in some of his child, adolescent and adult patients (– both in and out of prison). Dr. Mortimer then offers his "recipe" for buspirone dosing. Want to learn more? Click here!

They Usually Don’t “Grow Out of It” – Dale Mortimer, M.D.

Is your child or grandchild not working up to his or her potential academic? Are teachers complaining that your child or grandchild is too social, too easily distracted, immature for his or her age? Developed by child psychiatrist and pediatrician Michael Jellinek, M.D., the Pediatric Symptom Checklist screening instrument can be used to improve the likelihood of identifying those children and adolescents between the ages of 4 and 16 years old who are having significant problems with school, friendships, family relationships, mood, and/or general medical conditions. Want to learn more? Click below!

Vyvanse (Lisdexamfetamine Dimesylate) – Dale Mortimer, M.D.

Since Vyvanse first became available for the treatment of attention–deficit/hyperactivity disorder (ADHD) in 2008, Dr. Mortimer has seen so many positive clinical responses to this medication that he decided to write this clinical report on Vyvanse. Many psychiatrists from around the United States have subsequently liked Dr. Mortimer's essay so much that they have asked Dr. Mortimer's permission to share this article with their patients. Want to learn more? Click below!