Psychiatric Treatment in Richmond, VA
Psychiatric Services, Treatment Modalities, & Conditions Provided in Virginia, Colorado, & California
Mountain Psychiatry offers high-touch, holistic, integrative psychiatric care with functional psychiatry options. We are located in The Fan neighborhood of Richmond, Virginia, and offer telemedicine 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, my goal is not 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.
Psychiatric 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 will 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.
When treating minor patients, parents will be part of the assessment process. If you are electing to use functional psychiatry, specialty labs typically include the adrenal and sex 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.
Psychiatric 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 lifestyle 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.
My focus as a psychiatrist is to help you achieve your goals and reduce symptoms in the most efficient way to provide durable and lasting changes, with the least amount of medications. We have a lot of options on how we get there. I will be here to guide you, and ultimately, the path we follow will be your choice. Here are some of the treatment interventions I offer:
Psychiatric Treatment Modalities
There is a world of different ways to support mental health. I believe in meeting individuals where they are and finding interventions that will work for them to help address their symptoms and goals.
Psychiatric Assessments
All clients receive a thorough psychiatric assessment to fully understand both the symptoms that are present and to rule out other conditions. It is an opportunity to be seen and also to receive a second opinion if there are concerns that something has been missed in the past.
Occasionally, a client or family wants a thorough assessment and diagnosis and is not interested in treatment or medications. The psychiatric assessment can provide answers and clarity as to the nature of a mental health concern. We will review recommendations for treatment, but any treatment offered will be done only with the client’s consent.
Conventional Psychiatric Treatment
Traditional psychopharmacotherapy treatment is available. If a client would prefer alternatives, these will be discussed and recommended when alternatives to conventional care are appropriate.
I offer thoughtful medication management for nearly all psychiatric conditions and prescribe most psychiatric medications that are appropriate for outpatient settings. Common psychiatric medications used to treat depression and anxiety disorders include selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine), Zoloft (sertraline), Lexapro (escitalopram), Celexa (citalopram), Paxil (paroxetine); serotonin-norepinephrine reuptake inhibitors (SNRIs) like Cymbalta (duloxetine), Effexor XR (venlafaxine), Pristiq (desvenlafaxine), and Fetzima (Levomilnacipran); tricyclic antidepressants ( amitriptyline, amoxapine, clonidine, desipramine, doxepin, imipramine, maprotiline, nortriptyline, protriptyline, trimipramine); and others such as, mirtazapine (Remeron), bupropion (Wellbutrin), Vortioxetine (Trintellix), and the monoamine oxidase inhibitors (MAOIs).
For mood stabilization, lithium and anticonvulsants such as Depakote (valproate) and Lamictal (lamotrigine) are common. Other medications used to treat both bipolar disorders and psychosis are categorized as modern neuroleptics or second-generation antipsychotics, including Abilify (aripiprazole), Seroquel (quetiapine), Risperdal (risperidone), Zyprexa (olanzapine), Geodon (ziprasidone), Invega (paliperidone), Latuda (lurasidone), Saphris (asenapine), Fanapt (iloperidone), Rexulti (brexpiprazole), Vraylar (cariprazine), and Clozaril (clozapine). First-generation antipsychotics, also known as typical antipsychotics, include Haloperidol (Haldol), Chlorpromazine (Thorazine), Fluphenazine (Prolixin), Perphenazine (Trilafon), Thioridazine (Mellaril), Thiothixene (Navane), Loxapine (Loxitane), and Trifluoperazine (Stelazine). These medications are primarily used to manage symptoms of schizophrenia and other psychotic disorders by blocking dopamine receptors in the brain.
Some of these medications are available as multi-week or multi-month injectables, which can help clients who struggle with remembering to take a medication every day. Currently, these are risperidone (Risperdal Consta), paliperidone palmitate (Invega Sustenna, Invega Trinza), aripiprazole (Abilify Maintena, Aristada), olanzapine pamoate (Zyprexa Relprevv), haloperidol decanoate (Haldol Decanoate), and fluphenazine decanoate (Prolixin Decanoate).
There are a number of other medications used to treat anxiety, attention disorders, and substance use disorders that I also prescribe. If you are interested in discussing whether I prescribe a specific medication, please reach out to our clinic or schedule a phone consultation.
Nutritional Psychiatry
Most of us feel better when we eat nutrient-dense foods. Many, not all, psychiatric conditions can be improved or treated with improved nutrition. Several randomized controlled trials have demonstrated that nutritional interventions, such as the Mediterranean diet, are associated with reduced depressive symptoms and enhanced mood regulation. One in particular, the MIND trial, demonstrated significant improvements in depression, anxiety, and cognitive function among participants. Specifically, depression decreased by an average of 35% over 12 weeks, and anxiety symptoms showed a 30% reduction in severity scores. Cognitive outcomes were also notable, with participants exhibiting a 20% improvement in executive function and memory tasks, as measured by standardized neuropsychological assessments.
These results highlight the benefits nutrition can provide across multiple domains of mental health. Nutritional psychiatry is a durable and effective way to improve someone’s mental health, and I find it very rewarding to help clients get started on this path.
Integrative Psychiatry & Functional Psychiatry
Many clients rightly would like to avoid psychiatric medications and are hopeful for alternative options rooted in science. Integrative and functional psychiatry can offer a different path for treatment for those interested.
Integrative psychiatry uses evidence-based treatments to reduce symptoms and help the body heal. Clients learn ways to reduce stress, improve sleep, find healing foods, and supplements to address concerns. It will often prioritize natural and less invasive treatments whenever possible but is agnostic about whether the best treatment is conventional or alternative. Typical integrative approaches include:
Animal therapy
Aromatherapy
Eco therapy and forest bathing
Meditation and mindfulness training
Movement and exercise
Supplements and nutraceuticals
Acupuncture
Massage
Circadian rhythm support
Herbal and plant medicine
Art and creative practices
Humor and laughter
While integrative psychiatry is a healing modality, it takes approaches that often work for a cluster of symptoms or a diagnosis. The interventions may not be targeted or based on specific testing results, while functional psychiatry is based entirely on testing results, evaluating the client’s hormones, gastrointestinal microbiome, and organic acids. I offer functional and integrative psychiatry to my clients to provide highly specific and holistic treatment plans.
Deprescribing of Medication
After a period of stability, or when a prescription is poorly tolerated, many clients would like to get off a medication. In other cases, clients would like to stop a medication but want to ensure that the process will be successful and that all of the hard work they have been doing in their life and in therapy is working. Stopping medications like citalopram, venlafaxine, escitalopram, and others, abruptly or even as prescribed by an uninformed provider, can result in discontinuation syndrome. Lasting weeks, or occasionally months, discontinuation syndrome is a type of withdrawal that can manifest as flu-like symptoms, poor sleep, dizziness, and electric shock sensations in the head or body. Benzodiazepines like alprazolam, diazepam, and clonazepam also warrant special care in helping clients stop and are discussed below.
Unfortunately, sometimes a prescriber will start a psychiatric medication and later not know how to help someone get off the medication without problems. In all of these cases, you should have an informed and experienced provider to assist you in the careful, gentle, and comfortable cessation of prescriptions. Helping clients gently discontinue medications while preventing withdrawal and relapse into mental illness is something I have been helping clients with for years. This is a specialty that I offer, and I would be honored to support you in your process of getting off of medications successfully and the right way.
Whole Person Wellness
Ideally, we want to feel well as a whole person. Often, what helps us feel good physically supports our mental health, but sometimes there are injuries or chronic conditions that need care and attention. Together we will look at your goals and discuss a variety of treatment options from talk therapy, eco therapy, mindfulness or meditation, exercise, sleep hygiene, nutritional psychiatry, and as well as other modalities or specialty care referrals when needed. You will be the decider of what feels like the right fit for you and what the priorities are.
Benzodiazepine Dependence Treatment
Benzodiazepines are often prescribed with the intention to help a client manage an acute stressor, cope with a form of anxiety, sleep through the night, or treat seizures. They are popular for their calming and sedative effect, regularly used for non-medicinal purposes, and have household name status. While US pharmacies are dispensing enough benzodiazepines for one out of three Americans to receive a prescription, many individuals obtain benzodiazepines from other sources.
After decades of research showing harm and advocacy work from injured clients and their loved ones, the FDA has determined that patients are not adequately warned and providers are not sufficiently aware of the risks of this class of medications. Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), Librium (chlordiazepoxide), Ativan (lorazepam), Restoril (temazepam), and Halcion (triazolam) all may cause fatigue, sedation, impair cognition, interfere with memory consolidation (part of how we benefit from psychotherapy), worsen anxiety and depression, cause suicidal ideation, benzodiazepine-induced neurological dysfunction (BIND), abuse, dependence, death, and more. These risks are present to clients even when taking the medications as prescribed, without a history of substance use, and after only weeks of adherence.
As a prescriber, I will prescribe benzodiazepines to clients seeking my assistance, helping them gently taper off benzodiazepines. To do this work well is often a lengthy process, typically appropriate for outpatient care, and can be more comfortable and successful than detox medical clinics. I am passionate about benzodiazepine dependency treatment and welcome clients in Virginia, Colorado, and California. Find more information here.
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 of perinatal psychiatry and athletes.
Mood Disorders
Major Depressive Disorder (MDD) and Treatment-Resistant Depression (MDD-TR)
Persistent Depressive Disorder (PDD)
Premenstrual Dysphoric Disorder (PMDD)
Bipolar Disorders
Seasonal Affective Disorder
Anxiety Disorders
Generalized Anxiety Disorder (GAD)
Social Anxiety Disorder
Panic Disorder
Specific Phobias
Obsessive-Compulsive Disorders (OCD)
Post-Traumatic Stress Disorder (PTSD)
Psychotic Disorders
Schizophrenia
Schizoaffective disorder
Substance/medication-induced psychotic disorder
Attention Deficit Hyperactive Disorder (ADHD)
Inattentive Type
Hyperactive Type
Combined Type
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
Frequently Asked Questions
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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.
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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, and poor sleep. Standard laboratory testing may also be a part of both conventional and 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 that, if present, will limit the body from building hormones, neurotransmitters, and maintaining homeostasis, 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 practitioner’s ability to assess and treat problems in the digestive tract. 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 healthy, so that the mind can be healthy.
Additional testing may include food intolerances, amino acid testing, toxins (heavy metals, environmental, mycotoxins), and gluten sensitivity.
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In providing holistic care, psychiatrists and psychiatric nurse practitioners are asking about and listening to the client’s full experience in their lives and working to elevate the individual’s health from all angles. I want to know about your relationship with exercise, do you feel satisfied with your relationships, how often do you wake in the middle of the night, where is your energy compared to where you want it to be, what percent of what you think and feel are you talking about in therapy?
As holistic providers, we focus on treating mental health by considering the whole person—mind, body, and environment—rather than just symptoms. We integrate traditional psychiatric methods, such as medication management and psychotherapy, with complementary approaches like nutrition, exercise, mindfulness, and stress reduction techniques. My goal is to promote overall wellness and balance, addressing underlying factors that affect mental health, including lifestyle, physical health, and social dynamics. This comprehensive approach aims to support long-term mental and emotional well-being for children, adolescents, and adults.
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Each individual who goes through depression will often share certain symptoms, but will also have their own very personal and painful experience. These differences and similarities warrant care and attention to help a client feel understood and also to help the clinician provide meaningful and effective treatment decisions. In determining how to treat an individual with depression, integrative psychiatry providers will start with a comprehensive evaluation to understand the client’s medical, social, academic, and psychiatric histories. They will ask about family mental health history and may ask to speak to a family member or spouse to gain additional information on the client’s symptoms. They will order relevant lab studies for evaluating depression, including:
Complete Blood Count (CBC): To check for anemia or infection that might contribute to mood symptoms.
Thyroid Function Tests (TSH, Free T4): Hypothyroidism or hyperthyroidism can mimic or worsen depression.
Basic Metabolic Panel (BMP): To assess electrolytes, kidney function, and glucose levels, which can affect mood.
Liver Function Tests (LFTs): Important if considering medication metabolism and to rule out hepatic causes.
Vitamin B12 and Folate Levels: Deficiencies can present with depressive symptoms.
Vitamin D Levels: Low levels have been associated with depression.
Inflammatory Markers (e.g., ESR, CRP): Sometimes assessed if systemic inflammation is suspected.
Screening for Lyme Disease or other infections: In endemic areas or if clinically indicated.
These labs will help differentiate primary depression from medical causes or contributing factors to mood symptoms.
Once the assessment is complete, the provider will discuss the diagnosis, prognosis, treatment options, risks and benefits, and recommendations for care. Depending on the severity of symptoms, a medication may be recommended. Often, the client will receive referrals for psychotherapy, recommendations for lifestyle interventions that we have discussed, including exercise, nutrition, social engagement, creative endeavors, spiritual practices or meditation, time in nature, and other interventions depending on the provider’s specialty and what the client is amenable to.
Begin Healing with Psychiatric Treatment in Richmond, VA
If you’re seeking compassionate, personalized psychiatric treatment in Richmond, VA, Mountain Psychiatry is here to guide you on your journey to mental wellness. Our holistic and integrative approach focuses on healing beyond symptoms, helping you regain balance and joy with careful medication management and alternative therapies. Contact Mountain Psychiatry today to schedule your assessment and take the first step toward lasting mental health. Follow these three simple steps to get started:
Schedule a phone consultation to see if psychiatric treatment is right for you.
Begin meeting with compassionate psychiatrist Lis.
Start your healing journey!
Additional Services Offered at Mountain Psychiatry
In addition to comprehensive psychiatric treatment, Mountain Psychiatry offers specialized care for trauma and PTSD, treatment-resistant depression, gender diversity support, ADHD management, benzodiazepine dependence and substance abuse treatment, and sleep hygiene concerns. While my office is based in Richmond, Virginia, I also provide secure telehealth services to clients across Virginia, Colorado, and California, ensuring you can access expert, compassionate care wherever you are.