Free consult
A 15-minute phone call to decide whether psychiatric medication management fits what is happening. No card required.
§ 01 Anxiety & sleep
When night becomes the second shift.
Private psychiatric telehealth for Washington adults navigating anxiety, panic, insomnia, nighttime rumination, and the exhausting loop between stress and sleep loss.
No card required for the consultation request. We use the call to decide whether medication management is the right next step.
At a glance
Anxiety and insomnia psychiatry here means a 60-minute telehealth evaluation for Washington adults, followed by 30-minute medication-management visits when appropriate. Care focuses on panic, rumination, hyperarousal, and disrupted sleep without benzodiazepines or controlled sleep medications.
§ 02 What this care is
Medication management for the anxiety-sleep loop.
We look at the specific pattern: panic, nighttime activation, early-morning waking, racing thoughts, medication history, caffeine and alcohol effects, circadian rhythm, and the way stress shows up in the body.
The goal is not to sedate you through the night. The goal is to reduce physiological alarm, protect sleep architecture, and make the rest of your life easier to regulate.
This is a private cash-pay practice for adults physically located in Washington State. I do not accept or bill insurance. Superbills are available for possible out-of-network reimbursement when applicable.
$250 intake
A 60-minute psychiatric evaluation with history, medication review, sleep/anxiety targets, and an initial plan.
$150 follow-up
Thirty-minute follow-ups to review response, side effects, sleep quality, panic frequency, and next adjustments.
§ 03 Common presentations
The body is tired, but the alarm stays on.
These patterns are often biological, not moral. The work is to understand the loop precisely enough to interrupt it.
01
Racing thoughts, panic, dread, or body tension that intensifies at night.
02
Difficulty falling asleep even when you are exhausted.
03
Waking at 2 or 3 AM with cortisol-like activation.
04
Light, fragmented sleep that never feels restorative.
05
Next-day anxiety worsened by poor sleep.
06
Medication frustration after brief visits or overly sedating options.
07
Work stress, grief, trauma, or burnout showing up as nighttime vigilance.
08
The fear that another bad night will start the cycle again.
§ 04 Medication can help with
Lowering activation without flattening you.
Medication is most useful when it has a clear target and a way to measure whether it is helping.
Physiological anxiety
Chest tightness, panic, muscle tension, nausea, dread, and the sense that the body is preparing for threat.
Sleep architecture
Helping sleep become more restorative rather than simply forcing unconsciousness.
Daytime resilience
Improving the next-day threshold for stress, irritability, rumination, and overwhelm.
§ 05 What this is not
Clear boundaries keep the care honest.
Not crisis care
If you are in acute danger or thinking of harming yourself or someone else, call 988, 911, or go to the nearest emergency department.
Not controlled substances
I do not prescribe stimulants, benzodiazepines, or controlled sleep medications. Controlled-substance prescribing is not part of this practice.
Not therapy replacement
Medication can support therapy, sleep work, and behavioral change, but it does not replace them.
Not one-size-fits-all
We track symptoms, response, side effects, and sleep quality rather than guessing from a template.
§ 06 Related reading
Breaking the Midnight Echo Chamber
A practical framework for the anxiety-insomnia loop and why sleep loss worsens daytime stress.
Read the articleQuestions before you start?
If you are unsure whether medication management is appropriate, that is exactly what the free consultation is for.
Free 15-min consultTrauma and sleep
For many people, insomnia and nighttime vigilance are part of a broader threat-response pattern.
Explore trauma careDepression overlap
Poor sleep, rumination, and anxiety can deepen low mood, motivation loss, and cognitive slowing.
Explore depression careAdjustment and sleep
Life transitions after service, illness, or loss often get louder at night, tightening the anxiety-insomnia loop.
Explore adjustment careVeterans services
For veterans when hypervigilance, transition stress, and disrupted sleep travel together.
Explore veterans care§ 07 Questions
Do I need to know whether this is anxiety or insomnia first?
No. The two often reinforce each other. We start with the pattern: when symptoms show up, what sleep looks like, what you have tried, and what the body is doing.
Will medication just knock me out?
That is not the goal. Sedation is not the same as restorative sleep. The work is to target anxiety, arousal, circadian disruption, and sleep architecture carefully.
Are benzodiazepines or controlled sleep medications part of this care?
No. I do not prescribe benzodiazepines, stimulants, or controlled sleep medications. I do prescribe across non-controlled outpatient psychiatry and will be direct if your goals require a different prescribing setup.
What is the first step?
Request a free 15-minute consultation. No card is required for that call, and we use it to decide whether a full psychiatric evaluation makes sense.
A better night can start with a clearer plan.
A short consultation is enough to decide whether this kind of psychiatric care fits what is happening.
Book a free 15-minute consultation