Patients often arrive with a question that sounds simple (“should I be on medication?”) and a story that almost never is. The work begins by slowing down enough to let the story matter, because the decision we reach together depends on it.
“Integrative” is a word that gets used loosely, so here is how I define it. To me, integrative care means drawing from different therapeutic modalities and considering the different aspects of a life that shape a person’s mental health. Medication is part of that, and so are life circumstances, relationships, unconscious dynamics, a sense of meaning, sleep, movement, nutrition, and the coping tools a person can build over time. I don’t treat these as competing options to choose from. I see them as parts of one continuous field, and I try to attend to them together.
Beyond the diagnosis
A diagnosis orients the way a map orients: it tells you roughly where you are. But two people who meet the same criteria for major depression can be standing in entirely different terrain. One is sleeping four hours a night and grieving a parent. The other is in a job that no longer fits the person they have become.
This is not a philosophical nicety; it is a practical one. The same symptoms can arise from, and respond to, very different drivers. A plan that fits the diagnosis but not the person is often technically correct and only half helpful.
Context is not a soft addition to the science. Context is what tells you which science to apply.
The full picture
When I ask about sleep, movement, food, relationships, and what gives your days meaning, I am not making small talk or offering generic wellness advice. These are not separate from the psychiatric picture; they are part of it.
The parts of a person are interconnected, and a plan that ignores that tends to come apart. If a medication I prescribe affects your metabolic health, that is something we account for from the start, not a separate problem we run into later. And if we never give exercise, steadier sleep, a change in circumstance, or uncovering what is driving things beneath the surface the same real chance we give an antidepressant, we are missing something.
Part of the work is also equipping you with coping skills you can use on your own: tools for the hard moments between appointments, when I am not in the room. Someone who leaves with a skill they can practice and return to has something a prescription alone cannot offer, a measure of agency over the next difficult stretch. Building that capacity is not a supplement to the treatment. It is part of it.
Despite a common belief, none of this competes with medication; it sits alongside it. There is no clean line between biology and the rest of a life. The two are inseparable, each continually shaping the other. Integrative care treats them as the single system they already are, drawing on each in the proportion a particular person actually needs.
What this looks like in a session
A first appointment runs 60 to 90 minutes, and we do not rush. I take a careful psychiatric history, and I also ask about the things that shape it: what your days revolve around, who you can rely on when things feel heavy, what you have already tried and quietly set aside.
From there, we shape a focused plan. It might involve medication. It might involve therapy. It often involves things that don’t look like treatment but function as it: a more consistent sleep window, a hard conversation, a coping tool practiced until it becomes automatic, a walk that becomes part of your routine. Sometimes it means creating space to feel, to reflect, to understand something that has been running quietly in the background. Whatever it includes, it is yours: not a protocol applied to a category, but a working hypothesis we refine together over time.