Mental health care through every reproductive season.

Reproductive transitions touch nearly every part of how you feel. Hormones shift, sleep gets thin, identity changes, and the people around you often expect you to feel only joy. When anxiety, sadness, irritability, intrusive thoughts, or a sense of not being yourself show up instead, it can be confusing and isolating. None of it means you're a bad parent or a weak person. It means your mind and body are under real strain, and that strain responds to care.

We work with people through pregnancy, the postpartum year, and other reproductive transitions, including premenstrual dysphoric disorder (PMDD) and the mood changes of perimenopause. Some of what we see is depression or anxiety. Some is obsessive-compulsive in nature, with frightening intrusive thoughts that feel deeply out of character. We meet all of it without judgment, and we name it plainly so you can understand what's happening.

Decisions about medication during pregnancy and breastfeeding are personal and individual. There's no single right answer that fits everyone, and we'll never hand you a blanket reassurance or a blanket warning. Instead we weigh the specific risks and benefits with you, together, and coordinate with your OB, midwife, or your baby's pediatrician so everyone is working from the same plan.

What this can look like

• Persistent sadness, tearfulness, or emptiness that doesn't lift, before or after the baby arrives
• Anxiety, racing thoughts, or worry about the baby's health that feels constant and hard to switch off
• Intrusive, frightening thoughts that feel out of character, often about harm coming to the baby
• Irritability, anger, or a short fuse that surprises you, sometimes around your menstrual cycle
• Trouble bonding with the baby, or feeling numb when you expected to feel connected
• Sleep and appetite changes beyond what a newborn or a cycle would explain
• Mood shifts, hot flashes, or a sense of not recognizing yourself during perimenopause

How we evaluate

We start with a careful, unhurried history. We ask about your mood, sleep, anxiety, and any intrusive thoughts, and we ask gently about thoughts of harming yourself or the baby, because those questions help us keep you safe, not judge you. We look at where you are in your reproductive timeline, your prior mental health history, your current medications, and medical factors like thyroid changes and anemia that can imitate or worsen mood symptoms. The goal is to understand the whole picture so the plan treats the right target rather than a quick label.

How we treat

Treatment is individualized and built with you. For many people, therapy is a central part of getting better, and where therapy is the right first step we help coordinate with or refer you to a therapist who works in perinatal and women's mental health. On the psychiatric side, we provide evaluation and medication management. When medication is being considered during pregnancy or breastfeeding, we make that decision together, weighing the risks of treating against the risks of untreated illness for both you and your baby, and we coordinate with your OB or pediatrician. We don't make blanket safety claims about any medication in pregnancy. Some people do well with therapy and support alone, some with medication, and many with a combination, and we adjust as we learn what works for you.