Best Practices: Sujit Varma
The Edina, MN psychiatrist on the unique procedures he uses in his practice, the recent rise in American anxiety, and how mental health will change post-pandemic.
Dr. Sujit Varma believes in a holistic approach to mental health. In addition to psychiatric medication management, he leverages the power of cutting-edge research and new technology to offer his patients the most personalized and effective care possible. At a time when mental illness is on the rise, Dr. Varma believes there is bright light ahead when it comes to increasing patient access to mental health care. Read on to learn more about the unique procedures he uses in his practice and how he believes telehealth will improve the future of mental healthcare.
How did you get started in medicine and what inspired you to choose your specialty?
I was very interested in biology and human physiology as a kid. I also used to watch TV shows like Doogie Howser that made me realize how doctors really help and serve the people. Simply put, I gravitated toward a career in medicine early in life.
By the time I entered medical school, an initiative called the “Decade of the Brain” was underway in the United States. The movement inspired many advancements in neurology and brain research. Learning about this cutting-edge research was exciting, and I was fascinated by the tremendous progress that was being made in the fields of neurology and psychiatry. So I followed my fascination and entered the field at a time when it seemed as if the whole country was watching the space.
Today, I can confidently say that I picked the right career path. Mental health is always important, but now, we need psychiatrists more than ever.
What makes your approach to psychiatry and mental health different?
I don’t want to claim that I’m doing something different, but I will say that I keep an open mind — one of my favorite puns in psychology — about all kinds of treatments that have proven beneficial. I like to also introduce other forms of therapy that may or may not be FDA approved, but have been shown to help with conditions like anxiety.
Although I’m a psychopharmacologist, I don’t want to be perceived as a “pill pusher.” I’m happy if I can treat my patients with fewer medications, lower dosages, or alternate therapies. And, to me, that’s the beauty of psychiatry. Seeing a psychiatrist doesn’t mean that you always have to leave their office with a new medication.
In my practice, I always want to have a holistic approach with each patient. I don’t believe in a cookie-cutter style of care, especially when it comes to treatment and medication. People love to ask questions like: “What’s the number one medication for depression?” But the truth is, there isn’t one! There’s no one drug or one treatment that fits all. They have to be tailored to each person’s biology and history.
What’s more, I’m a strong proponent of lifestyle management, like eating right, exercising, and sleeping properly. Having a healthy lifestyle is just as important as taking a pill or doing therapy.
Can you tell us more about the unique procedures you use to treat depression, alcohol and opioid dependence, and obsessive-compulsive disorder?
My practice is called Psy-FI TMS. The Psy-Fi is a pun on sci-fi and a reflection of our jovial and lighthearted disposition. Though I’m a fan of science fiction, what we offer in the clinic is based on scientific fact.
The procedure we’re most known for is also included in our practice’s name: TMS. Transcranial magnetic stimulation, or TMS, is a non-pharmacological technique that is FDA approved for depression, OCD, and, more recently, nicotine addiction. It works by using a magnetic field to stimulate the specific region in the brain that controls mood. In addition to proving more successful in patients with treatment-resistant depression, it doesn’t carry the same side effects associated with antidepressants.
Another procedure we use is called Alpha-Stim, which is a device that you clip onto your earlobes that creates a stimulation similar to acupuncture or acupressure that can decrease some of the stress in your brain. Technically, it causes your brain to go into what’s called an alpha rhythm, which has been shown to improve anxiety, depression, and insomnia.
Recently, we’ve introduced a new assessment procedure called NEBA, which is a diagnostic tool for attention-deficit/hyperactivity disorder, or ADHD. In the process, we attach electroencephalograms to the patient’s scalp to monitor the patient’s brain. After about ten minutes of monitoring, we send the report to a lab to determine whether or not the patient has ADHD. Because ADHD can sometimes be hard to distinguish between anxiety, depression, and other conditions like bipolar disorder, having a diagnostic tool like NEBA ensures that we’re only prescribing ADHD medication to those who really need it.
Finally, I use pharmacogenetic testing to find out how a patient will metabolize medications before actually trying them. Instead of going to the pharmacy and trying every single antidepressant or antipsychotic, we perform this test to determine which medication a patient will metabolize best. I have patients who’ve tried so many different drugs before coming to us and are thrilled that this test can take the guesswork out of the prescription process.
2020 has been a difficult year for most, and studies show that anxiety and depression are on the rise. How have you seen this manifest in your patients, and how are you helping them cope with the uncertainty of this year?
Anxiety was the most common condition before Covid-19, but the present pandemic has definitely made things worse. People are losing their jobs, getting sick, and are continually faced with uncertainty — it’s no surprise that anxiety and depression are on the rise.
On the flip side, the pandemic has advanced our industry’s use of technology to ensure that patients are still able to receive adequate care. We’ve embraced telehealth at my practice, and all of my patients feel that it is a blessing in disguise. They no longer have to drive to the clinic and fight traffic or inclement weather to make it to their appointment. I truly believe this is the future of mental health. Now, I can reach out to more patients who are geographically displaced and provide them with the same care they would receive if they showed up at my clinic in-person.
Capsule has also helped me in this regard. I’m thrilled to be able to safely prescribe medications electronically and I trust Capsule to deliver them to my patients. I’ve also seen this reduce anxiety with my patients, who no longer have to worry about waiting in line at a pharmacy, especially with the pandemic on the rise.
It’s safe to say that the outbreak of Covid-19 has had a significant effect on the mental health of most Americans. How do you see this shared experience impacting our future public health?
I would like to say that it’s a mixed blessing. Though the pandemic has had a serious impact on our country — and our world — it has also led to the rise of telehealth, which I believe will only continue to improve patient access to care. With telehealth, we can serve a more diverse community of geographically displaced and differently abled people. Personally, I can treat someone who lives in a more rural county of Minnesota, and that excites me. Plus, companies like Capsule help reassure patients that they can still get their meds, no matter the current climate.
Vital Signs
Do you have a favorite book of the moment? The Tell-Tale Brain by V.S. Ramachandran.
Where is your favorite place to go for a walk in Edina, MN? I wish I had a more exciting answer for this one, but the truth is that I prefer to work out at my gym (especially once the colder weather hits). My go-to place for a walk or run is the treadmill at Life Time Fitness!
What tips can you offer people who live alone and feel particularly lonely at this time? Embrace technology! FaceTime with friends and family or watch some really great documentaries on Netflix of Amazon Prime, which can be a great way to improve your knowledge and keep your brain stimulated. I’ve also heard of people creating neighborhood therapy groups, where they keep in touch with regular phone or Zoom calls. My kids FaceTime with their grandmother every day. Even though most calls are only five to ten minutes, I know it’s the brightest spot in her day.
What real impacts (if any) will the recent increase in screen time have on our mental and brain health? Has Covid-19 and quarantine really made us dumber? Not at all. I believe technology is our ally and has greatly increased our access to knowledge. I like to draw the analogy to the invention of Gutenburg’s printing press back in 1450. Prior to the invention, only a few people had access to education or predated books. Thanks to the printing press, our ancestors were able to easily print books and spread knowledge that got us out of the dark ages. Similarly, I believe technology is one of the greatest innovations of our lifetime. Sure, we might be spending more time watching screens during the pandemic, but we choose what we watch. As long as you mix up the content you consume to include educational material, technology will continue to be our ally.
What’s one healthful habit you’d love to see patients adopt? Wear a mask! It’s easy, cost-efficient, and can save many lives (including your own).
You can learn more about Dr. Sujit Varma here.
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