Psychiatric Services, Treatment Modalities, & Conditions

Mountain Psychiatry offers high-touch psychiatric care in-person in The Fan neighborhood of Richmond, Virginia, and virtually throughout the state of Virginia, as well as Colorado, and California. From our website and communication with our office, through the phone consultation and assessment process, to careful monitoring of your condition, I want you to feel like you are in excellent and caring hands. Together we will be working to reduce your symptoms, address your goals, and build up your mental health to steadily put me out of a job - at least with you. And that’s one of the differences about how I work, I don’t want to keep you on a medication for years. I want to help you stabilize, heal, and find joy, with less or -ultimately - no reliance on medications. Let’s look at how we do this.

Assessments

Treatment will start with a thorough psychiatric evaluation, also known as an assessment. The assessment will be held during multiple appointments (see the FAQs page for additional details) and allow time for us to discuss your concerns, symptom history, and additional medically relevant information. Medical records, laboratory studies, and a conversation with your current therapist are standard sources of information for this process. Often, it can be helpful for me to hear from parents of adult children, spouses, or loved ones, to help enrich the psychiatric evaluation process. This would only happen with your permission and is not required. If you are electing to use functional psychiatry, specialty labs typically include adrenal and hormones, the gut microbiome, and organic acid testing (see Specialty Testing page for more information) Once we have completed the assessment, we will discuss the diagnoses and treatment recommendations.

Treatment

To achieve mental wellness, and not just a reduction of symptoms, we will be working to improve energy, sleep quality, focus, resilience and stress tolerance, social connections, confidence, and joy - to name a few. Fortunately, there are a myriad of different ways to help promote these classic features of mental wellness. Treatment is the part of the process that enlists different interventions such as medication, therapies, and life-style factors to move the needle on helping you feel better. Some clients will benefit from specific interventions and some will be drawn to other methods. I will be here to make recommendations but ultimately the choice is yours. Here are some of the treatment interventions I offer:

Treatment Modalities

There is a world of different ways to support mental health. I believe in meeting an individual where they are and finding interventions that will work for them to help address their symptoms and goals.

Psychiatric Conditions

I offer psychiatric services to children, adolescents, and adults suffering from a wide variety of mental health challenges as well as the specialty populations perinatal psychiatry and athletes.

Anxiety Disorders

• Generalized Anxiety Disorder (GAD)

• Social Anxiety Disorder

• Panic Disorder

• Specific Phobias

• Obsessive-Compulsive Disorders (OCD)

• Post-Traumatic Stress Disorder (PTSD)

Substance Use Disorders

• Alcohol Use Disorder

• Benzodiazepine Dependence

• Opioid Use Disorder

• Nicotine Use Disorder

• Cannabis Use Disorder

• Methamphetamine Use Disorder

• Cocaine Use Disorder

• Stimulant Use Disorder

• Anxiolytic and Sedative Use Disorder

What is functional medicine in psychiatry?

Functional medicine works to identify and address the underlying causes of mental health conditions rather than just treating symptoms. It involves a comprehensive evaluation of biological, environmental, and lifestyle factors that influence brain function and emotional well-being. Specialized testing is used to identify nutrient deficiencies, inflammation, infection, toxins, issues with organic acids, hormone imbalances and problems with hormone metabolism. By focusing on root causes and holistic care, functional medicine aims to treat mental health symptoms while reducing the reliance on pharmaceuticals.

What is the difference between functional psychiatry and integrative psychiatry?

Integrative psychiatry blends conventional, or standard, psychiatry - ie medications and therapy - with complementary interventions such as mindfulness, acupuncture, yoga, nutrition, and other modalities. Often supplements or nutrients are used to help alleviate symptoms of anxiety, depression, irritability, poor sleep. Standard laboratory testing may also be a part of both conventional or integrative psychiatry. Typically practitioners will recommend evidence-based interventions, occasionally there may be options or referrals for less studied or science-based practices that have proven beneficial.

Functional psychiatry prioritizes evaluating and treating biochemical and physiological imbalances found on testing of various systems in the body that help regulate biological processes. Typically, these would include evaluation of:

• Hormones, including the Hypothalamic-Pituitary-Adrenal axis but also sex steroids such as estrogens, testosterone and other androgens, and how they are metabolized by the body. Limitations in these areas can manifest in hormonal symptoms (PMS, PMDD, acne, hair growth, bloating, constipation), anxiety, poor sleep, depression, irritability, and low stress tolerance.

• Gut Microbiome Testing the gut-brain axis is proving to hold a critical role in mental health. Neurotransmitters like serotonin and dopamine are produced in the gut. The microorganisms that hold court in the gastrointestinal system influence cognition, mood, and your ability to respond to stress. Diagnosing and treating infections, inflammation, and digestive challenges can improve moods, sleep, immune health, metabolic health, and the absorption of nutrients.

• Organic Acid Testing (OAT) can reveal nutrient deficiencies which if present will limit the body from building hormones, neurotransmitters, and maintaining homoeostasis which is necessary for mental wellness. OAT will show imbalances in neurotransmitters like serotonin, dopamine, and norepinephrine, which are crucial for mood regulation, focus, and managing anxiety. It provides another view of gut dysbiosis and gut health which can increase the practitioners ability to assess and treat problems in the digestive track. It also provides information on how effective the body is with detoxification on a cellular level which is necessary to protect all those important cells and keep the body health so that the mind can be healthy.

Additional testing may include food intolerances, amino acid testing, toxins (heavy metals, environmental, mycotoxins), and gluten sensitivity.