Psychiatry is not one size fits all.
Two people with the same diagnosis rarely need the same treatment. We take the time to find out what's actually driving your symptoms — then build a plan around you, not around a checklist.
The same diagnosis, two very different people
Modern psychiatry often works like a sorting exercise: match a set of symptoms to a label, match the label to a medication, adjust the dose, repeat. It's fast, it's what insurance rewards, and for some people it works.
But symptoms are the end of a story, not the beginning. Fatigue, low mood, brain fog, anxiety, and poor sleep have dozens of possible causes — and several of them have nothing to do with psychiatry at all. When nobody looks, the plan gets built on an incomplete picture.
We'd rather spend the first visit understanding why — because the right explanation changes the entire treatment plan.
What we actually look for
An unhurried evaluation that goes past the symptom checklist — and, where it's clinically useful, objective data instead of guesswork.
Medical conditions that mimic psychiatric illness
Thyroid disease, anemia, vitamin B12 and D deficiency, sleep apnea, perimenopause and other hormone shifts, autoimmune conditions, and medication side effects can all look exactly like depression, anxiety, or ADHD. These are common, treatable, and routinely missed. We look for them first.
Pharmacogenomic (genetic) testing
Your genes affect how quickly you metabolize psychiatric medications — which is part of why one person does well on a standard dose while another gets side effects at half of it. When several medications haven't worked, or you want a smarter starting point, genetic testing replaces trial-and-error with information.
Labs, when they'll actually change something
Thyroid panels, inflammatory markers, metabolic and nutrient status — ordered when the history suggests they matter, not reflexively. The point isn't more testing. It's testing that answers a specific question about your symptoms.
The whole person, not just the mind
Sleep, nutrition, movement, hormones, relationships, stress, and the things that give your life meaning all shape how you feel — and all of them are treatable levers. A plan that ignores them is working with one hand tied.
Medication isn't always the answer
We prescribe every day, and medication helps enormous numbers of people. But it isn't the only tool, and it shouldn't continue by default. If something is no longer earning its place, we taper it carefully — slowly enough that withdrawal doesn't get mistaken for relapse.
Evidence-based options beyond prescriptions
Certain supplements, nutrition strategies, light and circadian work, and behavioral approaches have real research behind them for mood, anxiety, and sleep. We'll tell you which ones have evidence, which don't, and which interact with your medications — instead of leaving you to sort it out from the internet.
You're allowed to ask whether this is right
People get second opinions in every other area of medicine without anyone taking offense. In psychiatry it happens far less — partly because it's rarely offered.
If a diagnosis never quite fit, if several medications haven't helped, or if you're on a combination nobody has revisited in years, we offer standalone consultations. We'll review your history and records, give you a clear assessment, and put written recommendations in your hands that you can take back to your current provider. There's no obligation to switch.
Start with a conversation that isn't rushed
Your first visit is a comprehensive evaluation — your history, your symptoms, your physical health, and your goals. Adolescents and adults, by secure video anywhere in Washington State.
Most major insurance accepted · Out-of-pocket rates available · New patients welcome