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Inside a Psychiatrist’s Head
Gloria Williams

A group of us from Foster Care Youth United interviewed Dr. Leon Hoffman, a psychiatrist who treats people of all ages, in his Manhattan office. On our way there, I felt intimidated because I'd had so many bad experiences with therapists, but I found out he was a pretty cool guy. He was up front about the pros and cons of medication and therapy. He even said that therapists make mistakes. He said they're not mind readers, and that they rely on their patients being as honest as possible. I was impressed with his honesty. Here's what he had to say.

Dr. Hoffman was also interviewed by Jackie Knight, Shawn Fred and Kareem Banks.

Q: When should medication be prescribed and when shouldn't it be?

A: There are some situations when medication is absolutely necessary, and other situations when it's overused.

If someone is in a severe emotional state, they aren't going to be able to address their real problems. Then the goal of prescribing medication is to help that person be more in control of their feelings. If you take medication and the depression gets a little better, maybe you can find a better way of dealing with the depressing situation. That's where therapy can help.

But some doctors do over-prescribe medication. Sometimes it's easier to give a child a pill than talk to that child.

image by Yvonne Chen, image by Linda Rodriguez

My philosophy is that with most cases, it's important not just to be on a pill. It's important to talk to someone about your problems.

Q: All of us act strangely sometimes, but that doesn't mean everyone should be on medication. How do you judge if someone should be?

A: What you evaluate is a person's relationships and how they're coping with life in general. Does that person have friends? How do they function in school? How are they getting along with their family? If your depression becomes so severe that it's interfering with your interactions, or if you become suicidal, for instance, then medication is needed.

Q: Some of us take medication but don't like how it feels. What should our doctors do?

A: Sometimes you can change the dosage. Sometimes you have to switch the medication. It's very important to be followed by a doctor for any unforeseen things that happen.

Q: When I was on medication, I would get zoned out, and it still happens sometimes now that I'm not on medication. Why is that?

image by YC-Art Dept

A: It's very important to realize that people get zoned out for all kinds of reasons. People may get zoned out from medication. But they can also get zoned out from unpleasant feelings. So it's important not to automatically blame everything you're feeling on the medication.

Q: What should you do if you're upset about your medication, but your doctor doesn't seem to be listening to you?

A: I think the best thing to do is to try to speak to a different doctor in the same clinic or the same institution. [See also "Your Rights In Foster Care," page 13.]

Q: What do you do if your patients are having a problem with you?

A: I try to help them understand. I try to understand if it's something that I'm doing. I encourage my patients to be as open as possible with their thoughts, even if they think I'm going to feel criticized. We're not mind readers. We rely on the patient trying to be as honest as possible. Still, sometimes people say, "I'm not going to see you anymore."

Q: A lot of us in care are forced to go to therapy and take medication, so we don't trust the doctors. What can be done about that?

A: How do you get help from a system when you don't fully trust the system? That's a very good question. I think somehow you have to begin talking within the system about addressing the problem of not trusting.

Are you a caring adult looking for more stories to help your youth? Go to, a resource for the front-line staff in schools and community based programs to help teens who are struggling with difficult emotions.

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