Mental Health Services

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We offer mental health services including group therapy, one-on-one counseling, and mental health letters for gender-affirming surgery and electrolysis.  Our current group offerings include a gender process group and a late diagnosed neurodivergence group. 


Here are our current ongoing mental health offerings:

-One-on-one mental health services (not all insurances accepted at this time, call or text the office)

-Peer Support Trans Group (not facilitated) on the First Monday and Third Monday of the month at 6:00pm (free)

-Mental Health Medication if within the scope of our family nurse practitioners


We offer mental health medication that is within the scope of practice of our primary care nurse practitioners.  We do not treat bipolar disorder, schizophrenia, schizoaffective disorder, psychosis, mania, substance use disorder,  alcohol use disorder, and other conditions which cannot be safely managed in primary care. 


Additionally, you may require treatment by a specialized psychiatric nurse practitioner or psychiatrist if your other health conditions make it less safe to prescribe medications for you. We would refer you to a psychiatric prescriber in those cases. 

If your mental health symptoms are severe, we may recommend a higher level of care than what can be safely provided outpatient, such as an intensive outpatient program, partial hospitalization program, or residential treatment. 


We treat the following conditions:


ADHD

ADHD is a lifelong condition where there are mood, concentration, and attention differences. There are three main types of ADHD, with differing degrees of symptoms based on the type and the person. You can read more about ADHD on our neurodiversity care page. 

We do offer stimulant mental health medication for ADHD but require supporting documentation prior to starting medication such as notes from a past therapist, psychological evaluation, or notes from a past psychiatrist or primary care provider.  Common stimulant medications include Methylphenidate (Ritalin), Amphetamine-dextroamphetamine (Adderall), Lisdexamfetamine (Vyvanse), and others. 


Many people are not aware that there are both stimulant and non-stimulant mental health medications for ADHD available. Non-stimulant psychiatric medication options include Bupropion (Wellbutrin), Guanfacine (Intuniv), and Atomoxetine (Strattera). Your provider will work with you to find the best treatment option for you while working to minimize side effects. 


We also offer a late diagnosed neurodivergence group facilitated by a licensed mental health clinician.


Anxiety

Generalized Anxiety Disorder (GAD) is a condition in which a person experiences significant anxiety, worry, and difficulty relaxing around a variety of situations such as personal relationships, social situations, the workplace, and other environments. GAD is often best treated with a combination of anxiety medication and therapy or counseling. Lifestyle changes such as minimizing caffeine and alcohol, increasing physical activity, sleep hygiene, and relaxation exercises such as deep breathing, guided imagery, or meditation can be very helpful.  While GAD can be a lifelong condition, quality of life is usually significantly improved with a combination of anxiety medication, therapy, and lifestyle changes.

Social anxiety is a condition in which a person experiences anxiety, worry, and fear of judgment or negative evaluation in social situations specifically.  In extreme situations, it can progress to agoraphobia, a condition which makes it hard for an individual to leave the house. Depending on how severe the social anxiety is, some people take daily anxiety medication, others take only as needed anxiety medication, and other people can manage with only counseling and lifestyle changes. 

Panic disorder is a condition in which a person has panic attacks. Panic attacks look different in each person and may include sweating, chest pain, racing heart, shortness of breath, dizziness, tunnel vision, nausea, upset stomach, palpitations, and other symptoms. Some people with panic disorder take both daily anxiety medicine and as-needed anxiety medicine. Some people need only counseling. Most people do best with a combination of medication and counseling.

Many people also assume incorrectly that the only anxiety medications available are habit-forming medications like Alprazolam (Xanax) or selective serotonin reuptake inhibitors (SSRIs) like Fluoxetine (Prozac), Sertraline (Zoloft), Escitalopram (Lexapro), etc.  SSRIs are taken daily, and may come with side effects such as weight gain, decreased sex drive, and decreased range of emotions. There are many other anxiety medications available, which we are happy to explore with you! Buspar, gabapentin, and pregabalin (Lyrica) are good examples of anxiety medicines that are taken daily for anxiety. Other anxiety medicines include Clonidine, Hydroxyzine, Guanfacine, Propranolol, and others.  These medications may be taken daily or as needed.


Depression

Depression is a condition in which a person may experience feelings of worthlessness, hopelessness, sadness, grief, and guilt over a period of time that lasts longer than normal sadness. Other symptoms of depression include problems sleeping, appetite issues, attention and concentration problems, loss of pleasure in hobbies or other important daily activities, problems taking care of yourself or others, work difficulties, relationship problems, and thoughts of self-harm. Depression may come and go, be related to a specific situation, or be lifelong. Usually a combination of medicine, therapy, and lifestyle changes work better together than any one of these treatments works alone.

Similarly, there are many other options for depression. The most common class of psychiatric medications is selective serotonin reuptake inhibitors (SSRIs). These include escitalopram (Lexapro), sertraline (Zoloft), citalopram (Celexa), fluoxetine (Prozac), and others. These medications are generally well tolerated, but for some people can cause side effects such as decreased sex drive, weight gain, and some feelings of loss of emotional range. 


There are other classes of psychiatric medications that can also help that are not SSRIs. These include selective serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Duloxetine (Cymbalta), Desvenlafaxine (Pristiq).  Other options include tricyclic antidepressants such as amitriptyline and nortriptyline. There are also atypical antidepressants such as mirtazapine, trazodone, bupropion (Wellbutrin), and others which can be helpful if other medications have not worked or had negative side effects. Bupropion (Wellbutrin) is a good choice for people who wish to avoid decreased sex drive and weight gain.

Autism

Autism is a condition where there are differences in processing sensory information and in social interactions. You can read more about autism on our neurodiversity affirming services page. 

Though the only FDA approved medication for autism are antipsychotics, we have clinical experience with medications that may help reduce anxiety and improve quality of life.

We offer medication treatments to help improve some of the symptoms associated with autism such as irritability, anxiety, inattentiveness, executive dysfunction, insomnia, and sensory overstimulation. Beta blockers such as propranolol can help with sensory overstimulation, irritability, and meltdowns. Low dose naltrexone can help with sensory overstimulation and irritability. Guanfacine and clonidine can also help with anxiety and irritability, as well as inattentive symptoms.

We also offer a late diagnosed neurodivergence group facilitated by a licensed mental health clinician.

PTSD

Post-Traumatic Stress Disorder (PTSD) is a condition in which a person develops mental health symptoms in response to traumatic events. Many people think only military veterans can experience PTSD, but a variety of life experiences can create PTSD including single events and exposure to trauma over time. Single events that may cause PTSD include car accidents, sexual assault, witnessing violent events, and other events. Chronic exposure to trauma in the form of abusive relationships, childhood adversity, war, racism, and poverty may also result in PTSD. 


Symptoms of PTSD include nightmares, flashbacks, dissociation, irritability, rage, insomnia, sense of foreshortened future, memory problems, and addiction. There are treatments which may improve symptoms of PTSD including medication and counseling. 


Medications for PTSD include SSRIs, anxiety medicine, and medications which may specifically help nightmares such as prazosin, clonidine, or guanfacine. 


Counseling is also helpful for people with PTSD. There are now forms of therapy which do not require talking about the traumatic event directly, such as Eye Movement Desensitization and Reprocessing (EMDR) therapy, somatic therapy, and internal family systems therapy. 

Insomnia

Insomnia is a condition characterized by sleep problems. Some people with insomnia have difficulty falling asleep, while others have difficulty staying asleep, and yet others have challenges with both falling asleep and staying asleep.


Insomnia may be caused by traumatic events, stress, medical issues, medications, depression, anxiety, and other conditions. Some people only have short periods of insomnia during stressful periods, and other people have lifelong challenges with insomnia. 

Insomnia can be treated with medication, lifestyle changes, supplements, and counseling. Lifestyle changes include reducing caffeine and alcohol, reducing stress, increasing physical activity, reducing light exposure at night, avoiding eating too close to bed, and other changes. Thirty minutes of moderate to vigorous physical activity per day can be as effective as some prescription medications without side effects. 

Supplements for anxiety may include melatonin, valerian root, skullcap, kava kava, chamomile, and others. Many supplements interact with other medications and conditions, and we recommend discussing any supplements with your provider before starting them. 

Medications for insomnia include trazodone, clonidine, hydroxyzine, mirtazapine, and others. We do not recommend taking benzodiazepines such as alprazolam (xanax), clonazepam (klonopin), or others due to the risks of rapid tolerance and dependence. It is important to note that medications for insomnia may help you fall asleep, but may disrupt sleep quality or increase the risk of sleep disorders such as sleep apnea. 

Thoughts on Mental Health Treatments

It is important to acknowledge that everyone has a unique experience with mental health medications, and no single medication is going to work or be appropriate for everyone. We are happy to help personalize and individualize your treatment and work with you to choose the best medications for you!

Mental Health Navigation

We are happy to help you find mental health services in the community including  intensive outpatient programs, eating disorder treatment, substance use treatment, or residential treatment options. We also have local referrals for transcranial magnetic stimulation (TMS) and ketamine treatment for individuals with treatment-resistant depression.