I have expertise in the treatment of psychiatric needs specific to women including premenstual mood changes, mental health and fertility, psychiatric disorders during pregnancy, and mental health in the postpartum period. I offer medication treatment and psychotherapy in an integrated approach that takes into account the biological, psychological, familial and social aspects of your life. If you are in treatment with another professional such as an obsetrician/gynecologist, family doctor or another specialist, I will coordinate my treatment plan with them.
Here are more specifics about my services and expertise.
Premenstrual mood changes occur on a spectrum, and may benefit from treatment. These changes, which are linked to hormonal fluctuations, are variously described as premenstrual syndrome (PMS), premenstrual mood disorder (PMDD), and premenstrual exacerbation (PME) which is the worsening of mood symptoms due to another psychiatric disorder preceding menstruation. Fertility and mental health are mutually related. Infertility can lead to psychological distress, and medical fertility treatments can directly cause mood changes. It is also widely thought that emotional stress can reduce fertility. I offer psychiatric treatment around the time of pregnancy planning, and help managing the interplay between psychological distress, infertility, and fertility treatments. I offer help for those coping with pregnancy loss.
Contrary to some idyllic notions, pregnancy is often accompanied by a worsening of preexisting psychiatric disorders. Furthermore, it is widely thought that psychological distress during pregnancy can worsen pregnancy outcomes, and this position has shifted the medical field in the direction of assertively treating psychiatric disorders in pregnant women. We are fortunate today to have extensive knowledge of pregnancy outcomes in the presence of fetal exposure to psychiatric medications. It may come as a welcome surprise to you that studies of thousands of pregnancies have demonstrated a favorable risk:benefit profile for many widely used psychotropic medications. For those considering the use of medication in pregnancy I current evidence-based counseling and a patient-centered approach that respects your values. I offer preconception risk assessment and planning for those who are at an elevated risk of psychiatric exacerbation during pregnancy. I also offer psychotherapy as an alternative or adjunct to medication use.
The postpartum period brings a new set of challenges. Along with the normal stress of raising a newborn, mood changes are expected, as well as changes to the parental relationship and family structure. Maternal psychological health is important for the welfare of everyone involved: the mother, the infant, and the mother’s relationships with her partner and other children. Beyond the normal mood changes (baby blues), more significant symptoms may occur such as postpartum depression, postpartum psychosis, or worsening of other psychiatric conditions. I offer guidance on choosing medications that are safe to use during breastfeeding, along with a comprehensive treatment approach that integrates the multifaceted changes of the postpartum period. I also offer treatment for other other family members: children and partners.
Last, I offer treatment for the perimenopausal period, for those coping with the consequences of gynecological illnesses or surgery, and I offer relationship and family counseling.
To make an appointment call (301) 750-2744.