Psychiatrists who don’t take insurance aren’t making decisions based on how much time your insurance company says you need with your doctor, or how often your insurance company thinks you need to be seen- we are determining that based on your needs and our medical judgment. In not taking insurance I get to spend adequate time with my patients and see them as often as necessary. Not taking insurance also allows me to be directly responsive to my patients, without a need for additional employees or “middlemen.” Many patients with limited mental health benefits through their insurance or high deductible plans may find their out of pocket costs to be similar to seeing an insurance-based psychiatrist. I am able to provide a superbill to facilitate out of network reimbursement if this is offered by your insurance.

Of course! I use medications conservatively as one potential tool to help women feel better; we are often simultaneously discussing other tools that may be helpful. I will always talk through with you potential risks and potential benefits of stopping medication and how to do so safely. I will be open and direct with you if I think coming off your medication at any particular time is inadvisable.

For most of my patients, the answer is “no.” Women I work with often benefit from medication for periods of time in which they are struggling, such as during the postpartum period. When we start medication we will discuss how and when we might look at tapering off. Based on your history and the kind of struggles you’ve had, taking medication long term may be important- we will discuss this together.

When women have high blood pressure in pregnancy we weigh the potential risks of blood pressure medication against the risk of mom’s blood pressure staying high, and then treat accordingly. When we think about using medicine in pregnancy for mental health challenges we are similarly always weighing what we know about potential risks of particular medications against what we know about the risks of mom struggling with mental health in pregnancy. We know that pregnancies in moms who are struggling with depression and anxiety in pregnancy carry a higher risk of complications and negative outcomes. We use medication judiciously and collaboratively to decrease overall risk to you and to your baby.

We know that women do best when they receive medications alongside therapy. Medication does not replace the need for therapy; rather, we see that when someone is really struggling often the work they are doing in therapy can’t be as effective as they need it to be until medication is started. I work collaboratively with therapists seeing my patients to better understand where medication may be helpful in the therapeutic process.

I see patients who are stable and not needing medication changes once every 3 months. I see patients who are really struggling, or who we are closely monitoring for side effects to medication, as often as weekly. Most patients who will be following with me see me within 1-2 weeks of their intake visit, again in 3-4 weeks, and if they’re doing well visits space further from there. I tend to follow women more closely during pregnancy or the postpartum period, as how women feel can change quite rapidly.