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Health Specializations
Medical services are currently only available for residents of California, New York, Massachusetts, and Florida. Coaching services are available in all states for those seeking educational information.
Menstrual-Related Mood Changes
Premenstrual Dysphoric Disorder (PMDD) is a complex menstrual disorder. Symptoms are a severe extension of premenstrual syndrome (PMS). It is not a hormonal imbalance, but instead it is understood to be a reaction to the normal changes in hormones across the menstrual cycle.
PMDD is often diagnosed through daily symptom logs across a minimum of 3 months. PMDD is often misdiagnosed as other psychological disorders. It is found that this disorder effects 3-9% of women, but researchers predict that rates would increase if there were more widespread knowledge of the disorder.
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Pre-menstrual mood changes can include physical changes (such as nausea, weight changes, insomnia, fatigue), as well as mental health changes (such as mood swings, irritability, anger, anxiety, depressed mood, easy crying, concentration issues, hopelessness, interpersonal difficulties, and lack of motivation).
Lifestyle Approaches:
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Nutrition
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Exercise
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Therapy
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Integrative Medicine Approaches
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Functional Medicine Approaches
Medication Options:
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FDA-approved treatments for PMDD
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Dosing & timing
Pre-Conception Counseling
Mental health treatment improves your physical wellbeing. Comprehensive, general wellness increases fertility odds and successful pregnancies. Some psychiatric medications may impact your ability to conceive, so a psychiatric consultation can allow for current or potential medications to be reviewed.
We can work on planning and conception in harmony with your mental health care. Additionally, we can discuss partner support and cooperative lifestyle adjustments. We continue to offer integrative approaches to fertility, including evidence-based approaches to lifestyle changes such as nutrition that can improve fertility.
Fertility Concerns and Pregnancy Loss
The experience of fertility issues, and its treatments, can be stressful and emotionally demanding.
Men and women undergoing IVF and similar treatments often experience increased anxiety and depression. Women tend to report more distress than men. However, less than 7% of individuals undergoing IVF treatments seek psychiatric care. Loss of a pregnancy can also contribute to a great deal of distress and grief, and require more specialized care. Psychotherapy and fertility counseling can help reduce the stress associated with fertility concerns and its treatment, and/or coping with loss.
Anger, sadness, and frustration are appropriate responses. Your partner/spouse may cope differently. It is important to communicate and understand each of your needs. It may also be helpful to connect with others who have similar experiences. Online or in-person support groups can provide great benefit in these circumstances.
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The mental health consequences of fertility concerns or pregnancy loss can be addressed through a focused psychiatric consultation. Both an integrative medicine approach, and a psychiatric/psychological approach, can be combined here to offer support through this time to strengthen coping skills during the process.
Pregnancy
The pregnancy period often brings significant emotional, psychological, and physical changes that can impact mental health. Pregnancy can increase the risk of mood disorders such as depression and anxiety, particularly when there may have been a history of mental health challenges. A psychiatrist can provide tailored support, helping to manage these issues in a way that ensures both the mother's and baby’s safety, especially when considering the risks and benefits of medication during pregnancy. Early intervention and guidance from a psychiatrist can promote emotional well-being, enhance coping mechanisms, and help prepare for the postpartum period,. Prioritizing mental health care during pregnancy supports a healthier journey for both the mother and the developing baby.
Breastfeeding (Lactation)
For breastfeeding mothers taking psychotropic medication, a psychiatrist can evaluate the safety of specific treatments and their potential effects on the infant, ensuring the benefits of mental health support outweigh risks to the mother and baby. For those not on medication, the postpartum period can still be emotionally challenging, with heightened risks of anxiety, depression, or mood swings due to hormonal changes, sleep deprivation, and the demands of caring for a newborn. A psychiatrist can provide a safe space to address these challenges, develop coping strategies, and monitor overall mental health. Proactively seeking psychiatric care ensures that a mother can nurture her child while maintaining her emotional and psychological health, fostering a positive breastfeeding and parenting experience.
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Postpartum Depression/Anxiety (PPD/A)
Postpartum depression and anxiety are understood to be a reaction to the severe changes in hormonal levels following pregnancy, similar to the reaction in Premenstrual Dysphoric Disorder. PPD/A can happen anytime in the first year after childbirth, though it often starts 1-3 weeks after.
PPD/A is different than the "baby blues," which effect 80% of women and lasts around 3-5 days. 1 in 7 women experience PPD/A.
Interpersonal and Identity Shifts
Meeting with a mental health provider after having a newborn can be very useful, as women often experience profound identity and interpersonal shifts during this life transition. Becoming a mother can bring feelings of joy and fulfillment but also challenge a woman’s sense of self, priorities, and relationships. Navigating changes in personal identity, shifting dynamics with a partner or family, and balancing the demands of motherhood can be overwhelming. Additionally, acclimating back to work or deciding on a new role within the family structure can evoke conflicting emotions, stress, or even guilt. A mental health provider can provide a supportive space to process these changes, develop strategies for work-life balance, and build confidence in new roles. Addressing these challenges with professional guidance promotes emotional well-being and helps women adapt to this significant life chapter.
Menopause
A shift in hormone levels can have an effect on mood and mental health during menopause. Mild symptoms of depression are common, and women with a history of anxiety and depression are more likely to experience severe symptoms.
Physical symptoms such as hot flashes can increase feelings of anxiety. Hormonal shifts can impact sleep quality and appetite, which may also increase feelings of anxiety and depression.
Increased symptoms during this period of time can be treated with psychotropic medications, and non-pharmaceutical interventions such as Cognitive Behavioral Therapy (CBT), exercise, mindfulness, supplements, and other integrative/functional medicine approaches.