Hormonal mood psychiatry for perimenopausal women — telehealth across Virginia.
Your brain changed
before anyone told you
it was coming.
Psychiatric care for women at the intersection of hormonal transition and mental health — where conventional psychiatry has always fallen short, and where the women who needed it most were left without a map.
It worked. Until it didn't.
You are not in crisis. You still show up.
You are somewhere between 40 and 52
and have never felt this far from yourself.
Your doctor says the labs are fine.
Your brain changed —
and no one told you that was coming.
This is not a new illness.
This is a hormonal transition quietly rewriting
the neurochemistry your medication was written for.
Traditional psychiatry sees a treatment failure.
This practice sees a woman whose body moved into
a new chapter before anyone gave her the map.
The women who need this most
are the least likely to receive it.
The research is clear. The disparities are documented. The women carrying the greatest burden of hormonal mood disruption are the least likely to be screened, treated, or believed.
Not a menopause clinic.
A different kind of care entirely.
- Psychiatric evaluation through a hormonal lens
- Assessment of why medications stopped working
- Adjustment of psychiatric care for the body you have right now
- Understanding of how hormonal shifts affect neurotransmitters
- Integrative treatment — medication, botanicals, and narrative work
- Coordination with your OB/GYN or primary care
- Cultural attunement for Caribbean-rooted and bicultural women
- Unhurried 90-minute evaluations — the full picture, not a symptom list
- Primary hormone therapy prescribing (HRT)
- Gynecologic procedures and examinations
- Bone density and cardiovascular management
- Vaginal health and genitourinary procedures
How care works here
The 90-Minute Depth Evaluation
Your first appointment is 90 minutes. Not 20. We assess your psychiatric history, your hormonal picture, your medication timeline, your sleep, your story, and the cultural architecture you carry. Nothing is rushed. Nothing is skipped.
The Five-Lens Formulation
Every client at DepthWorks is understood through five lenses simultaneously: biological, nervous system, narrative, cultural, and meaning. For hormonal mood presentations, each lens has a specific addition — because the woman who was never given the map needs the whole terrain named, not just the diagnosis.
Integrative Medication Management
Where medication is indicated, it is prescribed with precision — and adjusted for the hormonal context, not in isolation from it. Botanical and nutraceutical support is woven into treatment from the beginning: targeted, evidence-informed, and never an afterthought.
Narrative and Identity Work
Perimenopause is not only a biological event. For the woman who has spent decades being the strong one, this transition often arrives at the intersection of hormonal disruption and identity disruption simultaneously. The narrative work is a clinical intervention — not an add-on.
Collaborative Care Coordination
When HRT or gynecologic consultation is indicated, I facilitate that conversation — and I send your full clinical picture to the receiving provider, not a diagnosis alone. You should not have to explain yourself in two separate rooms.
The silence
that was taught.
In many Caribbean, African, and South Asian households, menopause was not spoken about. It was pushed through. It was the change of life — something a strong woman managed quietly, without complaint, without help. The women who came before you carried this in silence. It cost them something.
The strength was real. The silence was not required.
Care here understands where you come from. It does not ask you to explain your culture away in order to receive good medicine.
Care built for the body
you actually have right now.
Unhurried evaluation
90 minutes for your initial appointment. The full hormonal and psychiatric picture — not a 20-minute intake and a refill.
Hormonal-psychiatric integration
Your medication is reviewed in the context of your hormonal stage — not independently. What works at 35 may need adjustment at 47.
Botanical and integrative layer
Evidence-based botanical and nutraceutical support for the nervous system — woven in from the beginning, never offered as an afterthought.
Cultural attunement
You do not have to explain the world you came from. It is already part of how care is held here.
Narrative and identity work
The story of this transition — what it means, what it's taking, and what it might be making room for — is treated as clinical material.
Telehealth across Virginia
Accessible, private, unhurried care from wherever you are. Superbills provided for out-of-network reimbursement.
long before I had the clinical language to explain why.
I know the world you came from.
I come from it too.
I built this practice because too many high-functioning women —
women who look like us — are navigating one of the most significant
transitions of their lives without a clinician who understands
the full picture of what they're carrying."
Patria Alexander, APRN, PMHNP-BC · Founder, DepthWorks Psychiatry · Caribbean-rooted · Army veteran · Integrative psychiatric nurse practitioner serving women across Virginia via telehealth.
Frequently asked
If something here named
what you have been
privately carrying —
That recognition is the beginning. The next step is simply a conversation. Not a commitment. Not a diagnosis. Just a conversation with a clinician who already understands something of where you come from.
Schedule Your Consultation