Women’s Reproductive & Integrative Psychiatry

"I'm overwhelmed," is the most common presenting concern we hear at Women's Wellness Psychiatry.

This anxiety could be part of general worries, heightened life stress, episodes of panic, ruminations, intrusive thoughts, and much more.

We work to first understand the contributors to that experience - perhaps it's hormonal changes; perhaps it's psychological factors; even dehydration can cause anxiety - and then use a comprehensive and individualized approach to address those contributors and help resolve the symptoms.

This could include conventional medications, sometimes at low doses for those more sensitive, repleting micronutrients, using anti-anxiety botanicals, exploring evidence-driven psychotherapy options for anxiety like cognitive-behavioral therapy to tackle catastrophic and intrusive thoughts, breathwork, and much more. 

Depression is not always feeling sad. It can be irritability, anger, or mood swings. And it's quite common, affecting 20% of postpartum women and many others throughout various life stages.

Bipolar disorder can also often present for the first time after hormonal shifts, like during postpartum windows. Our first step is always a comprehensive assessment to review potential risk factors like family or personal history, contributing factors, like hormonal issues, and perpetuating factors, like life stressors, in order to have a clear diagnosis.

From there, we will tailor a treatment plan that could include anti-depressant medication with a clear conversation about pros and cons, repleting micronutrients like low Vitamin D levels, which commonly leads to depression, trauma-informed psychotherapy, mindfulness approaches, adjusting hormones, and much more. 

OCD symptoms can really impact daily functioning - spiraling and intrusive thoughts leading to compulsive behaviors like checking or seeking reassurance. Most important is an accurate diagnosis, because intrusive thoughts can often be misdiagnosed as a condition other than OCD.

Treatment included evidence-informed treatments such as pharmacotherapy, OCD-targeted psychotherapies like CBT and ERP, and lifestyle interventions to improve the body's stress responses.

Trauma can be acute, such as a complex and traumatic birthing experience, and trauma can also be chronic, from a difficult and neglected childhood for example.

40% of women describe their delivery experience as traumatic, regardless of the medical outcomes. And a history of trauma in the past impacts the way an individual engages in their current relationships, functioning, and even medical treatment.

Our trauma-informed approach addresses both the symptoms of PTSD, such as an overactive sympathetic nervous system with frequent fight-flight-freeze episodes, and the root causes of the trauma with a combination of trauma-focused psychotherapy and approaches to balance the nervous system. 

ADHD can present differently in women and therefore be misdiagnosed or under-diagnosed. This can be particularly true for women in midlife whose symptoms may have been overlooked when they were younger. The added stressors in midlife and the hormonal shifts can often exacerbate symptoms.

Presentations can include overwhelm, anxiety, and low self-esteem because of difficulties with productivity and function leading to negative self-talk and stigma.

A thorough assessment includes questionnaires and conversations with each individual patient and their loved ones. Treatment can but doesn't have to include medication, as there are other tools and techniques that can improve organization, executive function, anxiety, and interpersonal sensitivity. 

Sleep issues are one of the most common complaints. These can include insomnia, but it's also important to rule out sleep conditions like sleep apnea, commonly under-diagnosed in women, mood and anxiety issues that can impact sleep, hormonal shifts like perimenopause, and more.

One of the gold standard treatments for insomnia is CBTi - cognitive behavioral therapy for insomnia - twice as effective as any prescribed sleep aid. Our team will also assess for any other contributing factors - micronutrient deficiencies, restless legs, and more.