Free consult
A 15-minute phone call to decide whether a psychiatric evaluation fits what is happening. No card required.
§ 01 Burnout & occupational stress
When the job becomes the exposure.
I work with Washington adults who are still performing at work while quietly coming apart: sleep gone thin, fuse gone short, the caring switched off. Psychiatric evaluation that takes the job seriously as a cause, not just a backdrop.
No card required for the consultation request. We use the call to decide whether medication management is the right next step.
At a glance
Burnout and occupational stress psychiatry here means a 60-minute telehealth evaluation ($250) for adults physically in Washington State, with 30-minute follow-ups ($150) when medication makes sense. The work is separating what is treatable (insomnia, anxiety, depression that has taken root) from what belongs to the job itself, and being honest about both. The first step is a free 15-minute phone call.
§ 02 What this care is
A psychiatric look at an occupational injury.
Burnout is what chronic, unrelieved work stress does to a person: the depletion, the cynicism, the slipping grip you can feel but not fix. By the time most people consider a psychiatric evaluation, it has stopped being a feeling about work and started being a fact of the body: nights that do not restore, a fuse that keeps shortening, a flatness that follows you home.
The evaluation looks at the whole picture: workload and role, sleep, anxiety, irritability, mood, concentration, substances, medical contributors, and what has already been tried. The goal is not to help you tolerate an impossible situation indefinitely. It is to treat what is treatable, and to name what is not.
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 full work-stress context, medication review, and an initial plan.
$150 follow-up
Thirty-minute visits to review sleep, mood, anxiety, irritability, side effects, and what to adjust.
§ 03 The system is also a patient
Medication can treat the injury. It cannot negotiate with what keeps causing it.
The World Health Organization classifies burnout as an occupational phenomenon: something that happens between a person and a workplace, not a defect inside the person. That framing matters clinically. If the job is the exposure, then part of what you are feeling is a dose problem, and no prescription changes the dose.
So in a sense this work has two patients. There is you: your sleep, your mood, your nervous system, all genuinely treatable. And there is the system you work inside, which I cannot prescribe for, but which we will look at honestly, because treatment plans that pretend the job is incidental tend to fail politely.
What medication can do
- Restore sleep when work dread keeps the night thin and the 4 a.m. rehearsal running.
- Treat the depression or anxiety disorder that chronic stress has set in motion.
- Lower the physiological alarm, so decisions about the job get made from a steadier baseline.
What it cannot do
- Fix understaffing, an impossible quota, a hostile manager, or moral injury.
- Make a sixty-hour week biologically sustainable.
- Substitute for rest, boundaries, leave, or, sometimes, leaving.
Sometimes the most useful sentence in an evaluation is a clean division: this part is depression, and it is treatable here; this part is the job, and no prescription will reach it. You deserve a prescriber willing to say both halves out loud.
§ 04 The differential
Burnout, depression, or both.
They overlap heavily and often coexist, but they are not the same condition, and the difference changes the plan.
Where it follows you
Burnout tends to be domain-specific. The flatness centers on work; other parts of life can still light up, at least at first.
Depression is global. It follows you into the weekend, the vacation, the things you used to love.
What distance does
Burnout usually eases with real distance from the stressor. Two weeks genuinely away can feel like a different life.
Depression does not respect time off. If the vacation changes nothing, that is diagnostic information.
How it talks about you
Burnout says the job is impossible.
Depression says you are the problem. Worthlessness, guilt, and hopeless thinking point toward depression, and they deserve direct treatment.
In practice, many people arrive with both: a burnout that ran long enough to set off a depressive episode. The evaluation untangles them, because the treatable half should not have to wait for the job to change. And if the hopelessness has reached thoughts of self-harm, do not wait for an appointment: call or text 988 now.
§ 05 Common presentations
How it looks when it is no longer just stress.
By the time burnout reaches a psychiatric evaluation, it is rarely one symptom. It is a pattern across sleep, mood, and the body.
01
Sunday-afternoon dread that starts earlier every week.
02
Lying awake rehearsing tomorrow's conversations with people who exhaust you.
03
A fuse so short that the people you love meet the worst of you.
04
Cynicism where the care used to be; going through motions you once meant.
05
Mistakes and forgetfulness from a mind too tired to hold the thread.
06
Performing impeccably at work, then having nothing left in the parking lot.
07
More caffeine, more alcohol, more screens; less of anything that restores.
08
The quiet math of how many more years of this you have in you.
§ 06 What this is not
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 workplace repair
Medication cannot fix an unsafe workplace, impossible workload, discrimination, moral injury, or structural mismatch. I will not pretend otherwise.
Not therapy replacement
Medication can support therapy, rest, and behavioral change, but it does not replace them.
Not controlled substances
I do not prescribe controlled substances: no stimulants for the fatigue, no benzodiazepines for the edge, no zolpidem (Ambien) or other controlled sleep medications for the nights. This holds for every patient.
§ 07 Related paths
Anxiety and sleep
When the rumination has moved into the night and the anxiety-insomnia loop is running on work fuel.
Explore anxiety and sleep careDepression care
When the flatness has gone global and the weekends stopped helping, depression may be the truer name.
Explore depression careAdjustment
When the burnout sits inside a larger transition: a role ending, an identity shifting, a chapter closing.
Explore adjustment careVeterans services
For veterans whose occupational stress began in uniform and never fully clocked out.
Explore veterans careMen, work, and mismatch
A journal essay on modern work, relationships, and why high-functioning people burn down slowly.
Read the article§ 08 Questions
Is burnout a reason to see a psychiatric prescriber?
Sometimes. Burnout itself is an occupational phenomenon, not a psychiatric diagnosis. But chronic work stress often sets treatable conditions in motion: insomnia, anxiety, panic, and depression. A careful evaluation separates what medication can reach from what belongs to the job.
Will medication fix my job?
No. Medication cannot fix an unsafe workplace, an impossible workload, moral injury, or a structural mismatch between you and the role. It can treat the insomnia, anxiety, or depression the job has set in motion, so decisions about the job get made from a steadier baseline.
How do you tell burnout from depression?
Burnout tends to be domain-specific and eases with real distance from the stressor. Depression is global: it follows you into weekends and vacations, and it brings worthlessness, guilt, and hopeless thinking. Many people arrive with both at once, and the evaluation untangles them because the treatable half should not have to wait for the job to change.
What if I am still functioning at work?
Functioning does not mean the load is sustainable. Plenty of people perform impeccably right up until they cannot. We look at sleep, recovery, mood, irritability, concentration, relationships, and what it is costing you to keep going.
What is the first step?
Request a free 15-minute phone consultation. No card is required for that call, and we use it to decide whether a full psychiatric evaluation makes sense.
The work matters. So does the person doing it.
A free 15-minute phone call is enough to tell whether an evaluation makes sense. No card, no obligation.
Book a free 15-minute consultation