Douglas Berger psychiatrist Tokyo is an American board certified psychiatrist and is the Director of the Tokyo Meguro Counseling Center. He’s also fully bilingual in Japanese and English. Dr. Berger received his M.D. and psychiatry training from New York Medical College, and his Ph.D. from the Department of Psychosomatic Medicine at the Tokyo University School of Medicine. He speaks native-level Japanese. Dr. Berger utilizes a variety of approaches to psychiatry, which you can find here, and on the Tokyo Meguro Counseling Center’s home page.

Dr. Berger can be contacted by phone: 03-3716-6624 (+81-3-3716-6624 from outside of Japan). Please use this form if you wish to contact Dr. Douglas Berger psychiatrist in Tokyo.

 

> Dr. Berger’s credentials & publications can be found on this page.
> Click here for more information about his practice
> To read reviews from some of Dr. Berger’s patients.

What is “Baby Rage”? It's when mom-in-law gets livid about daughter-in-law’s way of caring for a new baby. What to do? Try to make grandma think she is giving great advice and do it your way later. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G

Why would anyone want to date their best friend’s girlfriend?: she’s beautiful & men are lonely and horny causing a “natural addiction” to women. The problem is that dating your friend’s GF is likely to blow-up in your face. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

Even suicidal people vacillate on getting medications for help, even when depression is chronic and there are no stressors. Anchored beliefs often run against logic. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

When deciding what caused a drug response we would need to control one's lifestyle, dosing regimen, stress, and other factors. Until this is studied in a blinded fashion we are left with a subjective rating.

Many persons with a long up & down history of mild symptoms just can't see that they are really ill, yes "mildly ill, but still ill" is harder to accept than really ill. Why? No one wants to be ill. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

“Do you feel ill or not ill?”, “Do you want the full treatment or not?” We try to see clearly what people need and go from there. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

What’s the answer to finding the right therapist? The one who tells you, “We have to find out what will work by some trial and error”. Not the one who says “This is what to do”. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg

Many persons with a history of depression, even suicidality, continue to have lingering symptoms many years later. The problem is that they don’t want to believe it’s them, they want to blame their environment. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg #depression

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What is CNS medication "hesitancy"? "It will change my personality", "it's addictive", "It's only for crazy people", etc. While many of these persons drink, smoke, do some drugs, etc., the "brain drug" fear is a tough nut to crack.

Can you give elderly medications? Often yes, but be careful of the dose and monitor closely. Many doctors will just avoid it for "responsibility" reasons not clinical reasons.

Can we use pk and pd in the office with patients? Yes, sometimes, but in psychiatry, at the end of the day it's the subjective way the patient responds that drives dosing and/or drug-type regimen.

Risks of drugs during pregnancy? Look at the stages: fertility effects, malformations, newborn toxicity & withdrawal, lactation. There is no way to study these well & Drs not easily willing to take risk & say ok to take them. Us: https://t.co/VOm63Hc41r, https://t.co/uaoP3ZvxU7

Loss of memory due to meds or underlying illness? Try changing doses, get a history. You may find an even different problem, a "hidden one", like Sleep Apnea!

If one is used to taking certain meds they may not want to make any changes. People get attached to a certain make, certain doses, immediate vs. delayed release, etc. Sometimes there is an actual reason to keep the regimen, sometimes changing is just a "nocebo" effect.

Is polypharmacy ok or not? Fewer drugs are better of course, but while polypharm regimen A may cause troubles, polypharm regimen B may work well.

Patient, "Is this drug effective?", Dr, "Clinical trials show efficacy in persons with problems similar to yours, but THERE IS NO DATA ABOUT YOU, so we need to carefully look at this as treatment progresses". #clinicaltrials #Psychiatry

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Why don’t people look things up and figure out what to do in life? They are stuck in a hole and don’t think there is anything else to see. Us: https://t.co/xJKjtzIjZq, https://t.co/bggAMvY10t

Is it possible to lose weight on SSRIs? Supposedly not, but MAYBE. Psychiatry is a fuzzy and irregular science. It takes time to have a full appreciation of this. Us: https://t.co/xJKjtzIjZq, https://t.co/bggAMvY10t

"Hotheads" can result from a number of problems: irritable depression, manic depression, ADHD, personality issues. There should only be rare occasions to get worked-up!. Us: https://t.co/xJKjtzqJ7S, https://t.co/bggAMvGq8V

A recurring problem in Japan is the pharmacist trying to give advice in a 3-min meeting to a patient in front of the whole waiting room…often leading to the patient not wanting to talk. Us: https://t.co/xJKjtzIjZq, https://t.co/bggAMvY10t

The problem with ADHD is often with a significant other who's upset the person doesn’t seem to “do things”. Advising that the person “cant do” rather than “doesn’t do” is a very effective way to decrease frustration all-around. Us: https://t.co/xJKjtzIjZq, https://t.co/bggAMvY10t

Your spouse was difficult before marriage, now w/child & things worse. If therapy or living close-by but separately doesn't fly, then choices are bleak: bad-outcome divorce court or risky escape w/kids to your home country. Us: https://t.co/xJKjtzqJ7S, https://t.co/bggAMvGq8V

Inconsistencies: look for them in your environment, the TV, what others say, etc., and decide on your own if they make sense with reality or not. Always think, “maybe I’m wrong”. Us: https://t.co/xJKjtzqJ7S, https://t.co/bggAMvGq8V

Concerns about side effects reasonable? Meds can be adjusted, changed, stopped etc. so usually very safe. Surgery, certain injections, radiation, and others are irreversible, unremovable, and often with little antidote. Think carefully about the former, deeply about the latter!

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