Psychiatry & Therapy in Durham, NC
Wellness First Psychiatric Associates
A fee-for-service psychiatry and therapy practice serving Durham families and professionals, providing care with an experienced psychiatrist, nurse practitioners, and therapists.
Psychiatry that hasn't lost the human touch
Treating Trauma, PTSD, and Mood Disorders
Mental health is not just a diagnosis or a checklist of symptoms. It is the texture of your daily life — how you sleep, how you think, how you relate to the people you love, and how you carry stress when it inevitably arrives.
At Wellness First Psychiatric Associates, we approach care with curiosity and respect. We take the time to understand the whole person, not just the problem that brought you through the door. Thoughtful listening, careful evaluation, and individualized treatment are not luxuries here — they are the standard.
Anxiety
Anxiety can feel like constant tension, racing thoughts, difficulty sleeping, or a persistent sense that something bad might happen. Many people try to manage it quietly for years before reaching out.
Some anxiety is a normal and even protective part of being human. But when anxiety begins to limit your work, relationships, sleep, or ability to enjoy life, it may no longer be serving you — it may be controlling you.
At Wellness First Psychiatric Associates, we help patients understand what kind of anxiety they are experiencing and develop a thoughtful, individualized treatment plan that restores confidence and freedom.
Treatment may include psychotherapy, medication, or both. When medication is considered, we take a careful, conservative approach — discussing options thoroughly and tailoring treatment to your goals and comfort level.
Anxiety disorders are among the most common mental health conditions in the United States. You are not alone — nearly 1 in 5 adults experiences significant anxiety each year.
According to data from the National Institute of Mental Health (NIMH):
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About 19.1% of U.S. adults experience an anxiety disorder each year, which is nearly 1 in 5 adults.
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Over a lifetime, about 31.1% of adults in the U.S. will experience some form of anxiety disorder.
Depression
Depression is one of the more painful conditions we treat in psychiatry. It is often silent, not always apparent to others, exhausting, and demoralizing. At the heart of depression is the inability to respond to the small things in life that normally energize us. There is an old TV advertisement that captures this well: a man walks down a neighborhood street. The scene is filmed in black and white, yet as he passes a garden it suddenly bursts into color — color that we, the viewers, can enjoy, but which he sadly does not see. Scientists call this loss of pleasure “anhedonia.”
Treatment for depression often involves a combination of psychotherapy and medication. Antidepressant medications have been available for decades and, when thoughtfully prescribed, can be highly effective. In recent years, newer treatments have expanded our understanding of depression’s biological underpinnings. Ketamine-based therapies, including Spravato® (esketamine), have received FDA approval for treatment-resistant depression and may be appropriate in carefully selected cases.
Psychotherapy remains central. Much of the work involves facing loss — sometimes seeking alternatives where change is possible, and sometimes gradually learning to accept what cannot be altered. This process is closely related to what we call mourning, and it is often through this work that vitality begins to return.
About 8.4% of U.S. adults experienced a major depressive episode in 2020, according to the National Institute of Mental Health (NIMH). This translates to approximately 21 million adults.
Women are more likely to be diagnosed with depression than men, with 10.5% of women experiencing major depression in a year compared to 6.2% of men.
Depression is also more prevalent among adults aged 18–25, affecting approximately 17% of this age group.
Bipolar Disorder (BPD)
What Is Bipolar Disorder?
Bipolar disorder is a mood disorder characterized by recurrent changes in mood, energy, and activity level. These mood shifts occur along a spectrum of severity, ranging from milder mood instability to the more classic presentation of manic-depressive illness. The majority of individuals with bipolar disorder fall on the less severe end of this spectrum.
Bipolar depression is relatively common and does not necessarily involve greater impairment than other forms of depression. A common clinical challenge is that many people with bipolar disorder initially seek care because they feel depressed. When bipolar disorder is not recognized, treatment with standard antidepressant medications alone may be ineffective or destabilizing. Individuals with bipolar disorder typically require a more specialized treatment approach.
The exact cause of bipolar disorder is not fully understood. Current evidence suggests that a combination of genetic vulnerability, environmental stressors, and differences in brain structure and chemistry play a role. Manic or hypomanic episodes may involve symptoms such as increased energy, reduced need for sleep, and changes in judgment or behavior. In more severe cases, episodes can include a loss of contact with reality.
Treatment Options
Bipolar disorder is highly treatable, but its pharmacologic management involves important nuances. Because treatment differs significantly from that of unipolar depression, referral to a psychiatrist or mental health specialist is often appropriate when bipolar disorder is suspected.
Trauma and PTSD
Post traumatic stress disorder (PTSD) and trauma are obviously intertwined. Trauma is the insult; PTSD is its aftermath. A traumatic situation is one that a person must escape from, or risk being damaged. It is the classic fight-or-flight paradigm. We would do well to add “fright” to the latter two, and it is the latter that may be the most damaging. If you are experiencing PTSD, the numbness, hypervigilance, and unstable mood that are often part of the condition may have their origins in the fright response to the original situation.
In our practice we tend to view our patients as having lived in a traumatic world, and needing and wanting to rediscover a sense of safety in what we sometimes call the kind world. Imperfect as the latter is, it is a world of tolerance, second chances, and—more often than people expect—a world in which others are instinctively interested in helping when someone is distressed.
The therapeutic challenge for many patients is that it can be difficult to feel the comfort and safety of this kind world. Patients may remain psychologically rooted in the older traumatic world, even when their present circumstances invite them to experience greater security and support.
Traditional psychiatric medications can be helpful, and there is growing promise that newer options such as ketamine treatment, along with evolving research into psychedelic therapies, may help reduce the emotional reactivity that often accompanies trauma and PTSD.
Counseling and trauma-focused therapies, including modalities such as Eye Movement Desensitization and Reprocessing (EMDR), are also foundational components of treatment.