Complex psychiatric cases can seem impossible to treat. Many patients give up on trying after their third or fourth time in a psychiatric office. When there are no lab tests to determine an illness, otherwise ordinary people end up carrying years of accumulated mis-diagnosis — largely because the insurance based system doesn’t have time for them.

I work in the opposite direction. We start with the whole history — not the intake-form version, the real one: What was tried, what helped, what made things worse, and what was happening in your life each time something changed. Untangling a complex case is like unpacking after a move. Everything comes out of the boxes before you can tell what belongs. We find many things you’ve been carrying for years without realizing it.

The work and treatment that follows may include deprescribing — slowly and safely reducing what no longer earns its place. Some medications you may keep, but I will be honest about the limits. Complexity that took years to build does not come apart in a month, and I won’t pretend otherwise.

What I can offer is structural. One physician holding the whole picture — therapy and medication in the same room — and enough time to think about you between appointments. When something urgent happens, like a side effect, a bad week, a decision that can’t wait, you reach someone who already knows the story.