When people begin the journey of addressing their mental health, they often find themselves standing in front of multiple doors, each labeled with a different approach. Some are familiar: medication, therapy. Others, like integrative or functional psychiatry, are less well understood. In moments of distress, it can feel overwhelming to know which one to open first.

Psychiatric care is not a single, linear path. The best treatment for one person might be entirely different for another, even if their symptoms appear similar on the surface. Each person’s mental health is shaped by a unique combination of biology, environment, life experience, and resilience factors. As an integrative psychiatric nurse practitioner in Richmond, VA, I see daily how important it is to explain the range of options in a way that helps people feel informed and empowered to make decisions for themselves.

Conventional Psychiatry – The Traditional Model

Conventional psychiatry is the most widely recognized form of psychiatric care. It is based on the medical model, which focuses on diagnosing a condition and treatment with medication. This model has provided relief for countless people living with depression, anxiety disorders, bipolar disorder, ADHD, and more. The process usually starts with a thorough psychiatric evaluation. This may include reviewing personal and family medical history, current symptoms, and sometimes ordering basic lab work to rule out medical conditions that could be contributing to psychiatric symptoms.

Once a diagnosis is established, the psychiatrist works with the patient to select a medication that aligns with the symptoms, history, and treatment goals. Psychotherapy may be recommended, but it is often delivered by a different clinician, such as a therapist or counselor. Conventional psychiatry is effective for many, especially when symptoms are acute and need to be stabilized quickly. However, because it often focuses on symptom reduction, it may not address the cause of those symptoms. For someone looking for relief beyond what medication can offer, other modalities could be life changing.

Psychotherapy – A Space to Understand and Transform

Psychotherapy — often called “talk therapy” — has been a cornerstone of mental health care for generations. While psychiatrists do not always provide therapy themselves, its role in psychiatric treatment cannot be overstated. Therapy creates a safe, consistent space to explore thoughts, feelings, and patterns of behavior. It helps people understand how past experiences shape present reactions and equips them with tools for managing life’s challenges. There are many different therapeutic approaches. Some are highly structured and skills‑based, like Cognitive Behavioral Therapy (CBT), while others are insight‑oriented, like psychodynamic therapy.

Trauma‑focused approaches, somatic therapies, and relationship‑based interventions can also be important for those whose mental health concerns are rooted in specific life events or patterns. Therapy can stand on its own as a primary treatment. But it is often most powerful when combined with other psychiatric care. Medication may help calm intense symptoms so therapy can work more effectively. Lifestyle changes can reinforce the skills and insights gained in sessions. Together, they create a more comprehensive, durable path to mental health stability.

Integrative Psychiatry – Blending Conventional and Holistic Approaches

Integrative psychiatry expands the view beyond medication and therapy. It blends the best of conventional psychiatric care with complementary, evidence‑informed practices aimed at supporting the whole person — mind, body, and lifestyle. This approach might incorporate mindfulness training, nutritional guidance, sleep hygiene, physical activity, or relaxation techniques. It might include herbal or nutritional supplements when appropriate, or a referral to practitioners who provide acupuncture or other complementary care.

The philosophy behind integrative psychiatry is that mental health cannot be separated from the rest of the body’s systems. Improving physical well‑being, building stress resilience, and making intentional lifestyle shifts can significantly improve emotional health. Integrative psychiatry can be a good fit for people who want to take a more active role in their care without diving into the deeper investigative process of functional psychiatry. It allows for a blend of approaches that are both familiar and holistic.

Functional Psychiatry – Treating the Root Causes

Functional psychiatry takes the integrative approach further, making root‑cause treatment a central part of care. In using functional psychiatry in Richmond, VA, I look beyond standard lab tests and dive deeper into the body’s systems to understand the biological and environmental influences on mental health. This often involves advanced testing to evaluate hormone balance and metabolism, gut microbiome, nutrient status, inflammation, and detoxification pathways.

These areas are deeply interconnected with brain function. An imbalance in thyroid function can contribute to depression. Disruption in the gut microbiome can alter serotonin and GABA production and lead to anxiety. Chronic exposure to toxins can interfere with concentration and mood regulation.

By Identifying These Imbalances, Treatment Can Target Them Directly

That might mean identifying sources of inflammation that have been driving up cortisol and reducing adrenal resilience, addressing dysbiosis in the gut to allow for optimal nutrient absorption and improve the function of hormones and neurotransmitters, or improving detoxification to restore mitochondrial function and improve energy. This approach is often paired with lifestyle changes that support long‑term recovery, such as optimizing diet, improving sleep, and managing stress.

Functional psychiatry can still include medication when needed, but it uses it as part of a larger plan rather than the primary solution. For those who have tried conventional or integrative approaches without lasting improvement, it can open a new pathway toward healing.

Other Modalities in Psychiatric Treatment

While the primary modalities are conventional, integrative, and functional psychiatry, other approaches can also play a vital role. Neuromodulation techniques like Transcranial Magnetic Stimulation (TMS) offer non‑invasive brain stimulation that can be life‑changing for treatment‑resistant depression. In more severe cases, Electroconvulsive Therapy (ECT) remains a valuable, evidence‑based option.

Ketamine and psychedelic treatments are emerging as promising options in the field of psychiatry. Ketamine, traditionally used as an anesthetic, has shown rapid antidepressant effects, particularly in treatment-resistant depression. Administered in controlled, low doses, it can provide relief within hours, unlike traditional antidepressants that may take weeks. Psychedelics like psilocybin and MDMA are also gaining attention for their potential therapeutic benefits. Psilocybin, the active compound in magic mushrooms, has been studied for its efficacy in treating depression and anxiety, while MDMA is being explored for its potential in treating PTSD. These treatments are thought to work by promoting neuroplasticity and enhancing emotional processing, offering new hope for patients who have not responded to conventional therapies. However, it's important to note that these treatments are still under investigation with limited legal access and should only be administered under professional supervision.

Choosing the Right Approach for You

Deciding which modality is right for you depends on many factors: the urgency of your symptoms, your treatment history, your willingness to make lifestyle changes, and how deeply you want to investigate underlying causes. For some, starting with conventional care offers the fastest path to relief. For others, integrative or functional psychiatry better matches their goals and values.

Many people find the most benefit from a blend of these approaches, adjusting their plan over time as their needs change. The most important factor is finding a psychiatrist or psychiatric provider who can guide you through these options and adjust your care as you progress. A flexible, individualized approach increases the likelihood of meaningful, lasting improvement.

Finding Your Path Forward

If you are searching for a psychiatrist in Richmond, VA who will take the time to truly understand your story and your goals, know that you do not have to sort through the options on your own. At Mountain Psychiatry, I partner closely with each person, listening deeply. Together, we weave a plan that could draw from conventional tools, integrative supports, and the deeper work of functional psychiatry in Richmond, VA and virtually in Colorado, California, and throughout Virginia.

Your mental health journey is far too important to be confined to a single, rigid path. With the right collaboration, we can shape a thoughtful approach that helps you feel better now while also building the foundation for long‑term emotional and physical well‑being.

Could a Root-Cause Approach Transform Your Mental Health in Richmond, VA?

If you’ve been feeling weighed down by symptoms and aren’t sure which direction to take, know that there is a way forward. At Mountain Psychiatry, I thoughtfully combine conventional, integrative, and functional methods to create care that addresses your needs as a whole person—mind and body. Reach out today to explore a compassionate, evidence‑driven approach to psychiatry in Richmond, VA. Follow these three simple steps to begin:

Review fees and clinic policies
Schedule a phone consultation to explore whether psychiatric treatment is the right fit for you.
Begin meeting with NP Collins for your psychiatric evaluation
Start your healing journey with a personalized, root‑cause approach designed for lasting well‑being.

Additional Services Offered at Mountain Psychiatry

In addition to offering comprehensive psychiatric care, Mountain Psychiatry provides specialized support for those navigating complex concerns such as trauma and PTSD, treatment-resistant depression, ADHD, sleep-related challenges, substance use recovery, benzodiazepine tapering, and gender-affirming care. While my home base is in Richmond, Virginia, I also offer secure telehealth sessions to clients throughout Virginia, Colorado, and California—ensuring that skilled, compassionate care is accessible no matter where you live.

What Are the Modalities of Psychiatric Treatment?