Stress, Anxiety & disturbed rhythms

I diagnose and treat hormonally induced conditions which cause anxiety and mood disturbance including:  premenstrual syndrome, premenstrual dysphoria disorder,  perimenopause, menopause, premature ovarian failure and medication side effects including those arising from the birth control pill.   These are phrases  which women often reveal to me during an initial consultation:

• "I am on edge for no reason"
• " My mood swings are out of control"
• " I have a lot to be grateful for, but inside I feel like Im falling apart"
• "I am beginning to feel all alone even with my friends and family"
• "Social events make me self-conscious and I need to medicate before I go out"

Women in their thirties, forties, fifties & sixties work with me to deconstruct the biochemical gestalt of changes which have begun to thwart their happiness, confidence, autonomy and  purpose.   Helping women gracefully navigate this nuanced transition is by far the most meaningful and inspiring area of my work.  I also work with teens and young women to provide a second opinion regarding  cognitive and emotional health concerns.   Using a collaborative model, I accept referrals from primary care providers, specialists and mental health professionals  in order to support the biochemical aspects of anxiety, depression and life stress such as divorce and career change. 

Many of my female patients have been told that they are suffering from an 'anxiety disorder', and have often been prescribed anxiolytic and antidepressant medications as the primary treatment option.  These women seek out alternatives or adjunctive care, not because they are looking for 'alternative' medicine, but because these medications have not worked sufficiently, or because they prefer a medical paradigm which inquires into complex factors which may be contributing to their present state.  There is so much more to understanding and treating  female anxiety than merely assigning  a label to a constellation of physiological, mental, emotional, sociological and spiritual unrest.  Women with a history of anxiety experience a higher surge of mood changes and anxiety in perimenopause.  If an anxious woman is hormonally imbalanced, she may be incapable of resilience and transforming her life, even in spite of superb counseling and support.    

Depression in mid-life is a strong independent risk factor for developing Alzheimer's disease and other chronic diseases.  Coming full circle, chronic diseases such as metabolic disorders can also cause mood disturbances and fatigue.   The symptom of fatigue can merit an in-depth assessment.  If you find yourself asking 'why am I always tired and have no energy', exhaustion, depression and even relationship stress may be aggravated by  hard-to-detect hormonal depletion.  In many cases, simple treatment can result in  profound improvement in mental and emotional well-being.  

The neurobiology of menopausal hormonal change is complex. Regions of the female brain are densely comprised of estrogen and progesterone metabolite receptors, and several neurotransmitters  are impacted by hormonal decline. The phenomenon of menopausal depression is profound for some women, impacting the self-care, cognitive function and social relationships.   The use of estrogen has been shown to improve responses to certain antidepressants, and some women may not require these mediations if their hormones are moderately restored.  

Being physiologically supported during menopause can offer a well-spring of new life opportunities.  The personalization of one's care within my integrative medicine affords women many options for treatment.  My patients & I collaborate to create a comprehensive program that addresses their concerns, budget and health.    Both holistic and medication-inclusive programs are available to restore my patients' capacity for emotional poise and vitality.   There are cases when medications make a world of difference, and I am happy to prescribe them when deemed appropriate. I  also support tapering of some medications as part of an integrative care team, and refer patients back to their prescribing doctors for the management of controlled substances, as I do not manage tapering of narcotics.   On a case by case basis, I employ hormone balancing,  counseling and lifestyle support, as well as prescriptive care and referrals to psychotherapists, counselors and other sources of inspiration.  Prescriptions for low-dose naltrexone and oxytocin are provided for specific conditions.   I also prescribe Nature, social service and time with animals as transformational aspects of healing.