Question: Can you refer me to a psychiatrist with experience working with patients on anabolic steroids?

I see a therapist for depression (and related issues) as well as a psychiatrist for medication management.

I've been in counseling and on meds for about 4 years now. I basically have a chronic, low-level depression and it's mostly biological (i.e. largely the result of unfavorable brain chemistry, and less the result of life circumstances). Because of that, I'll probably be on some kind of anti-depressant for many years - if indeed the rest of my life.

But I want to start using steroids because of the goals I have for my body. As you can guess, my psychiatrist advised me not to do this - he has the usual knee-jerk bias against Anabolic Steroids. And of course I'd expect any medical professional to advise me against using.

However, I am going to do it eventually. And since I'll probably be on anti-depressants for a very long time, I'm not going to wait until I'm off the meds - simply because that might never happen!

That said, I do want to use steroids in the most responsible way possible. But to do that, I really feel that I need a psychiatrist who (a) not only recognizes that I'm going to use steroids and so realizes he needs to work "with" me from a "harm-reduction" point of view, and (b) has the kind of experience in steroids using/users that will allow him to make educated assessments of what's going on. While my current psychiatrist is great, he simply doesn't have the knowledge that would enable him to objectively evaluate the use of gear in conjunction with anti-depressants.

I want to find a psychiatrist who can do medication management (of anti-depressants) effectively on an on-going basis with someone using steroids. I am "not" doing this to try to find a doc who will RX steroids for me - not at all.

So - can you refer me to anyone who fits the bill?

Answer: If you feel your current psychiatrist is great, stay with him and explore with your therapist why you are considering putting yourself in harm's way.

Explore why you can't be satisfied with the psychological and health benefits of exercise and bodybuilding, without feeling the need to take on all the risks associated with gear.

Question: My son (18) is an elite athlete (Div.l) basketball prospect who recently went on Zoloft. In your judgement will he lose some aggressiveness? He will be attending two critical live Div. l Scouting opportunities in July. Could you kindly respond and possibly reference some articles?

Answer: No hard research - just anecdotes.

World class athletes have personally told me that their aggressiveness was the same as it had been pre-illness, or actually beneficially increased, on Zoloft or other meds in this class. (Julie Krone, Pete Harnish)

If an athlete was over-aggressive and getting into flagrant foul trouble before Zoloft, then the mediation may reduce the aggression to more "normal" levels.

Your son will notice any significant reduction in aggressiveness. If it negatively effects his game, he should see a Sport Psychiatrist regarding possible titration of the medication.

Question: I am wondering how you advise parents on the sidelines to handle the issue of coaches yelling at their children? With so much recently publicized about parents and coaches going at it, the wrong behavior being modeled, what is a Mom to do to best equip her child for handling those incidents? Thanks for your advice. J

Answer: Dear J, Though the average youth sport coach spends over 80 hours a season with your child, most get little or no training in child psychology and child development. Sometimes it’s necessary for a coach to yell during an athletic contest - to move a player into proper position, for instance. When a coach does have to yell at a child athlete, however, it's essential that the proper tone be used. Too often, youth sport coaches yell at children as if they were adults, or like an NFL coach would yell at one of his players.

If you feel that the coach has crossed the line in the manner and tone in which he or she has addressed your child, follow these steps: 1. Talk to your child after the game and find out how they felt when they were yelled at. 2. Ask your child if the coach also yells like that during practice. 3. Call the coach on the phone and say something like the following:” Coach, I know you’re doing the best job you can, and I appreciate your volunteering to coach my son/daughter. However, at the game the other day I was uncomfortable when you yelled at my son/daughter. I talked to him/her afterwards and they said that they felt bad, too. I want sports to be a fun experience for Johnny/Susie and I know that you do too. Incidentally, are there things that you’d like me to work on with my son/daughter between practices and games?

A good coach will be receptive to your call, and will understand that you are giving them constructive feedback about their coaching behavior, and asking for feedback regarding your child as well.

If the coach starts to argue with you and does not seem to be listening, then tell he or she that you’re sorry that you’re both not seeing it the same way, but that you are going to mention the incident to the league commissioner.

The best leagues have hearing panels that deal with complaints about coach, athlete or parent behavior. These leagues have coaches sign a volunteer code of conduct before the season begins, where acceptable conduct is pretty much outlined and agreed to. End-of-the- season evaluation forms that parents and children fill out hold coaches accountable for their behavior during the year and help weed out verbally abusive coaches. (See examples of these forms on this web-site)

Your child should be told that such behavior by a coach is wrong, but that sometimes adults lose their temper and don’t talk to children like they should. If your child is going to continue in sports, they’ll unfortunately run into coaches like this from time to time. The important thing is for the child to realize it’s the coach who has the problem, and to try not to take the yelling personally.

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