Women’s Mental Health Counseling
Perimenopause & Menopause-Related Anxiety, Panic, Brain Fog, Insomnia, Mood Swings And More, Counseling & Coaching services for NYC & NY State residents
Assessment & Guidance To Support Optimal Mental health needs of women in Mid-life and beyond
If your doctor tells you “it’s normal and just part of getting older,” please fire that doctor, and find one who is trained to value the quality of your life. Hormones impact all aspects of your wellbeing, including your mental health. This is the case from the onset of puberty and beyond menopause. I offer education and support for hormone-related anxiety, depression, irritability, insomnia, brain fog, low energy, and whatever feels different for you at this time in your life. Because I see too many women suffering at this transition, and not enough research, education and validation for the struggle.
And yet, we have receptors for sex hormones throughout the body and brain, and neurotransmitters are directly impacted by the changes in hormones. We know that estrogen has protective effects against psychotic symptoms of schizophrenia because of its modulating effect on neurotransmitters, especially dopamine. Some women have their first presentation of schizophrenia at menopause. It’s an important discussion for women to have with their doctors, who may or may not understand this
Even though menopause is not considered a disorder, it sure can feel like it for many women who suffer symptoms related to a hormonal life-phase. And these, sometimes debilitating complaints can last for a decade and more. A mental health expert can provide you with an assessment and resources, so you can feel well before, during and in the years that follow menopause. As a licensed psychotherapist with a private practice in Manhattan, I see many women who begin to have complaints, feel “off” or really struggle with anxiety and depression. Many women seek treatment and have their first presentation of anxiety, depression, insomnia and difficulty coping around the time of perimenopause and menopause, whether natural, premature or medically-induced after hysterectomy or chemotherapy. Sadly, the medical profession has been slow to make these important connections for women, largely because women’s health is under-researched, and women experience shame as a result of our youth-obsessed culture, therefore, they suffer in silence. Women are becoming informed (perhaps social media plays a part), and learning to advocate for their own health and well-being. Suffering as a result of “medical gaslighting” and tolerating suffering is no longer an option for women who prioritize and desire a more satisfying quality of life.
Like many mental health professionals, I learned very little about the impact of hormones on mental health in graduate school and beyond. And yet, we have receptors for sex hormones throughout the body and brain, and neurotransmitters are directly impacted by changes in hormones. It makes sense that many women develop mental health symptoms, or have an existing condition exacerbated with the hormonal surges, fluctuations and depletion. In fact, postpartum depression is the result of the dramatic decline in estrogen and progesterone following delivery.
Are you struggling with mental health challenges such as anxiety, Panic, brain fog, insomnia and mood swings as you enter perimenopause or menopause?
Perimenopause and menopause naturally occurs for all women between the ages of 40 to 55. It also occurs prematurely in young women, and medically, as a result of hysterectomy and/or chemotherapy. As ovaries begin to fail, women experience a depletion in the female reproductive hormones estrogen, progesterone and testosterone. It is believed that seventy percent of women begin these changes in their 40’s. These women are likely in the midst of raising family, taking care of elderly parents and/or working. Some common symptoms include: anxiety, depression, insomnia, brain fog and memory issues, all of which have a negative emotional and psychological effect on the quality of their lives.
It’s not just Estrogen, Progesterone and Testosterone that declines at this time. Many other important hormonal systems are disrupted during this very stressful time, including changes in cortisol, thyroid and more.
Common complaints at medical menopause, premature menopause, perimenopause, menopause and the. years beyond the transition: (You may have none of these, many or nearly all)
Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling
Irregular heart beat
Irritability
Mood swings, sudden tears
Trouble sleeping through the night (with or without night sweats)
Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles
Loss of libido
Dry vagina
Crashing fatigue
Anxiety, feeling ill at ease
Feelings of dread, apprehension, doom
Difficulty concentrating, disorientation, mental confusion
Disturbing memory lapses
Incontinence, especially upon sneezing, laughing; urge incontinence
Itchy, crawly skin
Aching, sore joints, muscles and tendons
Increased tension in muscles
Breast tenderness
Headache change: increase or decrease
Gastrointestinal distress, indigestion, flatulence, gas pain, nausea
Sudden bouts of bloat
Depression
Exacerbation of existing conditions
Increase in allergies
Weight gain
Hair loss or thinning, head, pubic, or whole body; increase in facial hair
Dizziness, light-headedness, episodes of loss of balance
Changes in body odor
Electric shock sensation under the skin and in the head
Tingling in the extremities
Gum problems, increased bleeding
Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor
Osteoporosis (after several years)
Changes in fingernails: softer, crack or break easier
Tinnitus: ringing in ears, bells, 'whooshing,' buzzing etc.
Accelerated aging
(Symptom excerpt from Project Aware)
Did I learn about the impact of hormones on Mental Health in graduate school? Absolutely not!
Like many mental health professionals, I learned very little about the impact of hormones on mental health in graduate school and beyond. And yet, we have receptors for sex hormones throughout the body and brain, and neurotransmitters are directly impacted by changes in hormones. It makes sense that many women develop mental health symptoms, or have an existing condition exacerbated with the hormonal surges, fluctuations and depletion. In fact, postpartum depression is the result of the dramatic decline in estrogen and progesterone following delivery.
We know that estrogen has protective effects against psychotic symptoms of schizophrenia because of its modulating effect on neurotransmitters, especially dopamine. Some women have their first presentation of schizophrenia at menopause. It’s an important discussion for women to have with their doctors, who may or may not understand this.
Do all women suffer mental heath changes at menopause?
Women are impacted by hormones throughout the lifespan, and yet many suffer in silence, sometimes for decades, without fully understanding that the quality of their lives could be improved by making lifestyle changes, and even replacing sex hormones. For some women, the change in hormonal status is a minor inconvenience, for others, these hormonal changes are life-altering—affecting self-worth, mental health, physical well-being, professional endeavors and relationships.
The suffering is real, it is not in your head, and you shouldn’t feel gaslit by your doctor. If your doctor is misinformed, lazy, or a dinosaur and disregards your very real symptoms, find another up-to-date provider. Your doctor may also be operating from the very flawed Women’s Health Initiative study (which actually did more harm to women’s health!). Currently, there are modern, safe and effective treatment options that offer women vitality, good health and quality of life. Options such as natural safe hormones, herbs, acupuncture, and seeking counseling or psychiatric support as needed can restore vitality and well-being.
Can therapy help improve my mental health during menopause and hormone-related transitions?
Absolutely, therapy with a mental health professional who understands the role of reproductive hormones on the body, can help premenopausal and menopausal women feel better and find solutions. Research suggests that CBT can help with the management of night sweats and hot flashes. CBT also helps women manage negative thoughts and emotions that surface at this time. Support with lifestyle changes and resources are an integral part of menopause counseling and coaching.
What happens to our hormone levels before, during and after menopause?
What you need to know is that during the menopausal transition, estrogen (estradiol & estrone), progesterone, and to a lesser degree, testosterone decreases. Which leads to anxiety, irritability, and depression in many women, not all. The body still needs estrogen, however but it will never have the estradiol that it had in youth. At some point, ovaries, in their diminished, retirement capacity, still produce very small amounts of estrogen, as do the adrenals and fat cells which convert/create estrogen via the enzyme aromatase. Post-menopause hormone levels are drastically reduced compared to pre-menopausal levels, with the primary estrogen being estrone. Many theorize that this is why women gain weight post menopause. The body is trying desperately to make estrogen.
What is the link between menopause and depression, and is it normal to feel anxious or depressed during hormonal transitions?
Because of changes in hormones and brain chemicals, many women develop mood symptoms, as well as anxiety and panic disorder and will be helped to seek mental health counseling, lifestyle coaching or psychiatric support. A licensed therapist can be a resource for you at this time and even make an appropriate referral. Menopause-related depression symptoms include: changes in eating and sleeping patterns, loss of interest in life-activities, difficulty functioning properly at work or in your daily life, feeling of sadness. Depression at this time may develop if you have: a prior history of depression, bipolar disorder or schizophrenia, a history of postpartum depression, struggled with PMS or PMDD. Lifestyle factors such as alcohol misuse, poor sleep hygiene, poor nutrition, lack of exercise and high levels of unmanaged stress
What about mood swings at perimenopause and menopause?
Yes, women complain about mood swings during hormonal changes, which are exacerbated by difficulty sleeping due to increased anxiety, depression and changes in body temperature, aka hot flashes.
When should I seek mental health counseling help during menopause?
It’s time to seek mental help when your anxiety or depression impacts your everyday life, work and relationships. Finding help sooner rather than later is the best course of action. Here are some signs that you need to see a mental health professional: suicidal thoughts, depressed daily for more than two weeks, difficulty coping, feeling alone with your struggle.
How will I know if it’s menopause or something else?
It’s not always easy to tease out what’s going on. Complaints are typically increased anxiety, mood instability, irritability, inability to handle the demands of their life, and sometimes even psychosis. Women also have other competing stressors in their lives, such as caretaking, relationship demands, work and raising children, but a declining hormone system can certainly contribute to a lack of vitality, energy and resilience. A hormone-savvy doctor can do a baseline test, and follow-up testing to help you track your experience. Fortunately, working with a licensed mental health practitioner who is educated about how sex hormones impact neurotransmitters and many other systems in the body, can help you struggle less, feel supported and help you decide if hormones or natural remedies are a next step.
Some other common reasons women seek Holistic Psychotherapy at this time in their lives?
Women seek therapy and counseling for many reasons as they face unique psychological and emotional challenges throughout their lifespan. Modern women struggle to make time to pursue creative passions and endeavors that would provide much-needed spirit and soul nourishment. Many women present to the outside world as “together,” yet on the inside, they suffer. If you find yourself experiencing overwhelm, extreme stress, role change, anxiety, infertility, postpartum depression or mood issues related to hormonal shifts, you are not alone, and there is no shame in asking for help. Mid-life also presents unique challenges for women, such as, caring for aging parents, children leaving for college or empty nest, changes in job status, as examples. When women are also challenged by changes in hormones, they can feel less well in general, therefore less resourced and resilient, which makes coping with life-transitions and changes even more difficult.
Your baby is healthy and beautiful, but you are unable to fully enjoy this experience because of Postpartum Depression…
Women who suffer from postpartum depression struggle to express feelings of shame or guilt when they are unable to experience the joys of motherhood. It’s important for a new mom who is struggling with postpartum depression to have a safe and validating environment to gain healing support, in addition to referrals for medication to better ensure healing and well-being. New moms can benefit from learning self-care techniques and coping strategies during this challenging time. Depending on your unique situation, couples counseling is offered so that both of you feel supported as you adjust to your new life with your baby. I work with highly-skilled psychiatrists and nurse practitioners should you need medication for support.
HOLISTIC PSYCHOTHERAPY & WELLNESS NYC
Philosophy
For nearly twenty years, this holistically-oriented NYC Psychotherapy & Wellness Practice has blended what I’ve found to be the most effective practices in psychology, neurobiology, attachment, alternative practices, nutrition, coaching and mind-body medicine working with individuals and couples. As a holistic psychotherapist, I believe it’s important to address the root cause of emotional and psychological suffering. It’s important to know that we all make the most therapeutic progress in a compassionate and non-judgmental environment. I make every effort to ensure patient comfort and ease. Countless studies have shown that finding the right "fit" with a therapist is more important than the technique that is used. As a trauma-trained therapist I am influenced by humanist and existential philosophy, relational theory, attachment theory, psychoanalytic concepts, mindfulness, and somatic, mind and body psychology. My couple and marriage counseling work is influenced by Gottman Method, Internal Family Systems and Emotionally Focused Therapy (EFT). As neuroscience now shows us, the body and mind are inextricably linked—my 20+ years of experience with mindfulness, yoga therapy, and meditation greatly influence my work as a mental health provider. A Holistic and comprehensive therapy model ensures that you thrive in the many aspects of your life—including your relationship with your self and others. You will enjoy a more satisfying, rewarding, and joyful life, no matter your struggles, challenges, or diagnoses. I enjoy continuing education, and I’ve received extensive training and certification in a range of evidence-based and cutting-edge approaches to offer you this holistic model of care. Together, we work with practices designed to create an environment that supports optimal physical and mental health wellbeing. Lasting change and transformation is possible when given the right tools to thrive.
Training
Somatic Experiencing® International (in progress)
Eating Disorders, Compulsions & Addictions (EDCAS) Certification
William Alanson White Institute of Psychiatry, Psychoanalysis & Psychology
EMDR Advanced Level EMDR Practitioner - Laurel Parnell PhD
Brainspotting - Lisa Schwarz, MEd
Positive Neuroplasticity Training Certification - Rick Hanson PhD
Nutrition and Integrative Medicine for Mental Health - Leslie Korn PhD
IFS Immersion: Integrating Internal Family Systems Across Clinical Applications - Frank Anderson, PhD
Dialectical Behavior Therapy - Behavior Tech Institute
Advanced CBT Certification - New York University
Psychodynamic Psychotherapy Certification - New York University
Advanced Clinical Practice Certification - New York University
Clinical Approaches to the Addictions - Certification New York University
Clinical Practice with Adolescents - Certification New York University
Mindful Self-Compassion Training - Christopher K. Germer, PhD & Kristen Neff PhD
Executive Life Coaching - New York University
Institute for Life Coach Training
Urban Zen Integrative Therapy Training Program
Institute For Integrative Nutrition
Additional Professional Training: Gottman Institute for Couples, Emotionally Focused Therapy, Hypnosis for Trauma & PTSD, Focusing Institute, Whole Body Focusing with Glenn Fleisch, Ph.D
Ongoing workshops: Ester Perel, Bessel van der Kolk, MD, Dan Siegel, MD, Peter Levine, Ph.D, Gabor Mate, MD, Richard Schwartz, PhD, Sue Johnson, IFS, Somatic Experiencing, Trauma-Focused Treatment, Yoga Therapy, Phoenix Rising Yoga Therapy
Expertise
Depression (major, postpartum depression, SAD, bipolar disorder, atypical depression, dysthymia, situational depression, chronic sadness)
Anxiety (panic disorder, generalized anxiety, phobias, social anxiety, PTSD, fear, worry, insomnia, emotional regulation), stress management, insomnia
Women’s hormonal health, perimenopause and menopause mental health assessment/coaching, chronic pain
Trauma resolution and PTSD therapy
Crisis counseling, life-challenges, transitions and overwhelm
Obstacles, blocking beliefs and feeling “stuck” in your life
Dysfunctional relationship dynamics and patterns in professional and personal relationships, communication difficulties, divorce, separation
Fear of success and fear of failure, harshly critical of oneself and others
Spiritual or existential concerns, shadow work, life purpose, energetic blocks, boundary work
Difficulties with work and life balance
Addictions, behavioral addictions, substance abuse, alcoholism and compulsions
Performance blocks, perfectionism, self-blame, negative self-image and self-sabotage
Feeling unworthy, undeserving, “not enough”, personal empowerment, identification of needs and trouble saying “no”
Compliance, accommodation, conflict avoidance, communication difficulties and impasses
Narcissistic abuse identification and recovery
Empath and highly sensitive person (HSP) coaching
Codependency, family conflict resolution, submissiveness and recovery from family enmeshment, ACOA adult children of alcoholics
Grief, loss and bereavement
Recovery and post-rehab support (for individuals in all stages of recovery from addictions, alcohol, eating disorders, anxiety, depression, trauma, pre-rehab, post-rehab, residential step-down support, wellness planning, new habit maintenance and self-care)
EMDR Therapy, Trauma Resolution, Unblocking & Manifesting
Celebrity mental health expertise and high-profile, VIP clients, therapy for entrepreneurs, executives, creatives, medical professionals
Modalities
Psychoanalytic, Relational & Interpersonal Psychotherapy
Attachment-Focused Couple Therapy (traditional, non-traditional, alternative lifestyle couples)
Cognitive Behavioral Therapy (CBT), DBT Skills
Solution-Focused Brief Therapy Consultation
Advanced level EMDR Therapy, Parts Therapy, Integrated Internal Family Systems (IFS)
Couple Therapy (Traditional, Non Traditional Couples)
Sexual Counseling (Traditional & Alternative Lifestyle)
Somatic Psychotherapy
Positive Psychology, Positive Neuroplasticity Coaching
Nutrition & Integrative Medicine For Mental Health
Transformational & Wellness Coaching
Urban Zen Integrative Therapy, Reiki, Energy Medicine
Nutrition & Integrative Medicine For Mental Health, Nutritional Amino Acid Protocols (using precursor amino acids, fatty acids, herbal medicine, supplement recommendations for mood, anxiety, ADHD, addictions, cravings, brain fog, PTSD, and more)
Clinical Hypnosis
Transform
If traditional “talk” therapy has not been enough to resolve your distressing symptoms, it might be time to try a different model of care. I’ve trained in many modalities, but I find myself returning to EMDR again and again. EMDR Therapy changed my practice years ago because it works and it changes lives. It is the one treatment method that is consistently powerful and transformative for my patients, especially when other highly-effective therapies such as IFS, CBT and Somatic Experiencing are integrated into sessions. Therapy is highly-individualized, and depending on your unique needs, chosen therapy modalities may include: EMDR, Psychodynamic Psychotherapy, CBT, Internal Family Systems, Mindfulness and Somatic Experiencing®. I completed EMDRIA-approved EMDR advanced Levels I & II training and supervision many years ago and have used it in my New York City psychotherapy private practice consistently and with excellent results.
EMDR therapy is highly-effective at getting to the root cause of underlying beliefs and blocks that cause many to not benefit from traditional therapy or life coaching. EMDR treatment can elegantly help you transform surviving into thriving so you can lead a life without disruptive symptoms. Reprocessing difficult, disturbing or traumatic memories with EMDR leads to enhanced resiliency and vitality in the nervous system. EMDR treatment is an extensively researched and evidence-based method to help people recover from distressing life experiences, trauma, anxiety, panic, phobias, accidents, medical trauma and much more. EMDR is not just for trauma, it is also an excellent technique to enhance performance for athletes and creatives, or work and professional endeavors. It is especially helpful for clients who have worked hard in therapy or coaching, and find themselves wrestling with the same obstacles and patterns that initially led them to find a therapist or coach. We learned during the pandemic that EMDR can be offered to many patients virtually. Virtual EMDR is an effective and powerful tool to add to your therapy healing journey, as an adjunct to your existing therapy or as a stand-alone solution. LEARN MORE ABOUT EMDR
Teletherapy
faqs about online therapy in nYC: how does remote therapy/video therapy work?
While the technology for telemedicine has been available for decades, the pandemic made virtual therapy a necessity. Never did we imagine that so many individuals would benefit from online virtual therapy, but they did. Like many NYC therapists, I’ve been conducting virtual sessions for some time now, so I’m quite comfortable working with technology. Teletherapy is not a good fit for every person seeking counseling, and many simply prefer to conduct psychotherapy sessions in-person.
How does Online therapy work?
This New York City holistic psychotherapy and wellness practice understands that busy New Yorkers can’t always take time out of their day or week to commute to NYC therapy suites. Virtual therapy, as well as telephone therapy, is a modern option that has become the preferred way to conduct therapy and counseling for many, especially those who work or travel, couples with young children and different schedules, young adults, college students and expats. Online sessions make therapy easier for individuals struggling with social anxiety, agoraphobia, chronic illness, physical disabilities and those who reside in various parts of New York. After scheduling your online virtual session, I’ll send you a session link from my secure, HIPPA-compliant platform SimplePractice. You click on the link to my online waiting room and I admit you to my private virtual therapy office. It’s up to you to create an emotionally safe space in your home or office for our conversations. All you need is robust access to the internet. You can use your computer, IOS/Android phone, iPad, or any other tablet-enabled device. Most laptops have a built in videocam and mic, which makes it very easy.
What kind of therapy is offered virtually?
Online sessions are treated the same way as face-to-face sessions, using the same evidence-based therapy modalities, including Cognitive Behavioral Therapy (CBT), EMDR, Internal Family Systems (IFS), trauma therapy, psychodynamic psychotherapy, somatic psychotherapy, life coaching, wellness coaching and stress management. In fact, we’ve learned that remote EMDR can be just as effective for trauma resolution and other concerns as in-person EMDR. Of course, not everyone or every situation should be treated remotely, therefore, it’s important to reach out to potential therapists to determine if your situation is appropriate for virtual therapy. If you feel hesitant about discussing issues over video, you can even turn your webcam off, so that you can see your therapist but not be seen. Research now demonstrates that therapy sessions conduced by telehealth are just as effective as face to face therapy. Read the research.
Who can benefit from virtual therapy?
Just about anyone can enjoy private, confidential and convenient access to high-quality therapy. The decision to seek therapy with a highly-experienced psychotherapist can help you have healthier relationships, gain new perspectives, reach your goals and remain resilient during stressful and challenging times. Therapy can help you feel less alone with your problems, as well as feel supported as you work to improve your circumstances. Life in New York City offers a unique set of challenges. A fast-paced lifestyle and hectic schedules lead to high levels of stress and little time for rejuvenation and restoration of the nervous system. If you are experiencing feelings of anxiety and depression, loneliness, loss or are struggling with substance use or unresolved trauma PTSD, you are not alone. Holistic Psychotherapy & Wellness Manhattan offers highly-effective, evidence-based counseling and therapy practices, as well as an integrative psychotherapy philosophy that incorporates a range of helpful, healing strategies, individualized to meet your unique needs. Because I am a licensed psychotherapist in New York, I can see you whether you live in the NYC metro area or anywhere in the state. You have many modern options to help you get the therapy you need, including BetterHelp, TalkSpace, and of course, all the licensed psychotherapists and psychologists on Psychology Today who continue to offer high-quality therapy in the US and worldwide.
Using you health insurance benefits to assist with the cost of therapy
Holistic Psychotherapy & Wellness Manhattan is In-Network with BCBS & Aetna, and Out-of-Network with most health insurances. I have also been reimbursed by Aetna, Cigna, BCBS, Emblem, Oxford, United and many more for out-of-network mental health services. Most of my clients are compensated for about 50-100% of my fees. Your insurance will refund a large portion of each session, as long as you have met your Out-of-Network deductible. If you have an Out-of-Network plan and have met your Out-of-Network deductible, your health plan will mail the partial refund in the form of a check to your home within a few weeks after each appointment.
How can an Integrative Psychotherapy & Wellness Practice enhance your life?
Gain support through a personal crisis, transition, loss, trauma or challenging situation that causes personal or relational distress
Heal codependency and feel empowered, autonomous, safe and secure in your life as self-esteem naturally increases
Find relief for sadness, depression and chronic depression with interpersonal psychotherapy, cognitive behavioral therapy and EMDR
Uncover unconscious conflicts and blocking beliefs that may be sabotaging your success and happiness
Address dissociation, body image, eating disorders, compulsions, addictions, substance use or abuse and obsessions
Learn to identify important thoughts, feelings, emotions, motivations and unconscious internal conflicts with insight-oriented therapy
Develop enhanced self-awareness as well as empathy and compassion for self and others with relational therapy
Break through blocks in intimacy, detach from unhealthy relationships and break patterns of repetition in significant relationships
Learn to identify triggers that lead to anger, confusion and relationship dysfunction in couple and relationship counseling
Develop effective, assertive communication skills to benefit personal and professional relationships
Learn more adaptive coping skills, self-care rituals, self-acceptance and mindfulness to create a healthy work-life balance
Uncover patterns of crippling perfectionism that interfere with achievement, success and personal happiness using EMDR
Process and heal painful feelings of loneliness, disappointment, sadness, loss, grief, guilt, shame, anger, envy and fear
Resolve trauma and abuse symptoms, develop healthier boundaries and heal early attachment wounds with EMDR Therapy
Recommendations for protocols using precursor amino acids, fatty acids, herbal medicine, supplements for mood, anxiety, ADHD, addictions, cravings, brain fog, PTSD
Diagnose & identify reproductive hormone-related (peri-menopause, menopause) anxiety, depression, insomnia, brain fog, low energy, pain, migraines, IBS, fibromyalgia
Learn self-care, meditation, breathing techniques, energy medicine & somatic therapy practices to regulate the nervous system
Obtain consultations for referrals to psychopharmacologists, psychiatrists, psychologists and other allied professionals