Conditions · Women’s mental health
Women’s mental health psychiatry in Texas and California.
Perimenopause, postpartum, PMDD, and the mood side of PCOS. Private, evidence-based care from a psychiatrist double board-certified by the American Board of Psychiatry and Neurology, by secure video, for ages 12 to 70.
Hormones and mood
Your hormones and your mood are on the same team.
Hormones and mood are deeply connected. When estrogen and progesterone shift, in the weeks after a birth, in the days before a period, or across the years around menopause, sleep, focus, energy, and anxiety can shift with them. Dr. McDade treats these hormone-linked mood and anxiety conditions for women and teens by secure video across Texas and California. You might recognize some of these.
- Anxiety or low mood that tracks your cycle
- Anger or tears in the weeks after a birth
- Intrusive thoughts you would never act on
- Sleep that breaks for no clear reason
- Brain fog that arrived with your forties
- Irritability that lifts when your period starts
- Feeling wired and exhausted at the same time
- Normal labs while you feel anything but normal
These conditions are common, recognized, and treatable. The Centers for Disease Control and Prevention reports that about 1 in 8 women experience symptoms of depression after giving birth.
Perimenopause
Is it perimenopause, or is it depression?
Often it is both, and the answer changes your treatment. Perimenopause can begin years before periods end, sometimes before any hot flash. Dr. McDade evaluates your history, your cycle, and your symptoms together, and coordinates with your OB-GYN or primary care clinician when hormone therapy is part of the conversation. You get a clear answer and a plan, not a guess.
- New anxiety or panic in your forties or fifties
- Irritability that feels out of character
- Sleep that breaks at 3 a.m. and will not return
- Brain fog in the middle of a normal workday
Postpartum
Postpartum depression and anxiety, named and treated.
The months after a birth can bring more than tiredness, and symptoms can also begin during pregnancy. These signs are common and treatable. Dr. McDade is fellowship trained in child and adolescent psychiatry, understands the whole family picture, and talks through medication decisions while nursing with you openly. If you ever have thoughts of harming yourself, call or text 988 now.
- Worry that will not switch off
- Intrusive thoughts that frighten you
- Tearfulness, anger, or feeling numb
- Trouble bonding, or guilt that you cannot
PMDD
PMDD. When it is more than PMS.
PMDD stands for premenstrual dysphoric disorder, a recognized diagnosis in the DSM-5-TR. The on-off pattern is the clue. Dr. McDade uses symptom tracking across cycles to confirm it, then builds a plan that may include medication timed to your cycle. Many women are told for years that it is just PMS. It has a name, and it responds to treatment.
- Mood that drops hard the week before your period
- Irritability and conflict that strain relationships
- Despair or anxiety that eases once bleeding starts
- The same pattern, cycle after cycle
PCOS
PCOS and your mood.
PCOS is a hormonal and metabolic condition your OB-GYN or endocrinologist manages. The mood side deserves its own care. Women with PCOS experience depression and anxiety at higher rates, and Dr. McDade treats the psychiatric symptoms that travel with PCOS while coordinating with the clinicians managing the rest, so the two plans work together instead of side by side.
- Low mood or anxiety alongside a PCOS diagnosis
- Sleep and energy thrown off by irregular cycles
- Frustration with a body that will not cooperate
- Feeling dismissed when you raise the mood side
Treatment
How Dr. McDade treats hormone-linked mood conditions.
Treatment starts with the pattern. Dr. McDade maps your symptoms against your cycle, your reproductive stage, and your history, because timing is the strongest clue in this corner of psychiatry. From there, care usually centers on evidence-based medication management, sometimes timed to your cycle for PMDD, with steady follow-up that adjusts as your body changes. The diagnosis has to be right. Care that treats stress will miss a pattern that is actually PMDD, and care that blames hormones alone can miss true depression.
“When a woman says she does not feel like herself, that is a finding, not a footnote.”
Who this is for
Care built for women who carry a lot.
Many of the women in this practice are physicians, attorneys, executives, founders, and the person everyone else depends on. They are used to holding it together, and they want care that is discreet, precise, and respectful of a full calendar. Visits run on time, by secure video, from wherever you are in Texas or California. And if your life looks nothing like that, you are just as welcome here. These conditions do not check titles.
Care with Dr. McDade
What your care looks like.
Your first visit is unhurried, and runs 60 to 90 minutes, so there is time to get the story right. You leave with a clear diagnosis and a plan built with you, and follow-up visits of 15 to 30 minutes keep it working as your life and your body change.
Care is self-pay or billed to Aetna, with a good faith estimate before you begin. If therapy, labs, or a different specialist would serve you better, she says so and helps you get there. Ongoing care fits secure video well. Meet Dr. McDade.
Questions, answered
Women’s mental health FAQ.
Do you prescribe hormone replacement therapy?
No. Hormone therapy stays with your OB-GYN or primary care clinician. Dr. McDade manages the psychiatric side, including antidepressants and other evidence-based medications, and coordinates with your other clinicians so the plans fit together.
Can PMDD really be treated by video?
Yes. PMDD care relies on your history, careful symptom tracking across cycles, and medication management, all of which work well by secure video. You track, you meet, and the plan adjusts with you.
Do you treat postpartum anxiety, or only depression?
Both. Postpartum anxiety, intrusive thoughts, and anger presentations are just as real as low mood, and they respond to treatment. Care can begin during pregnancy or at any point after birth.
Do I need hormone labs before my first visit?
No. These conditions are diagnosed from your history and your symptom pattern. When labs would genuinely help, Dr. McDade coordinates them with your other clinicians.
What if I am not sure which of these fits me?
That is exactly what the first visit is for. You describe what your weeks actually feel like, and Dr. McDade sorts out the pattern with you. You do not need to arrive with the answer.
The weeks after a birth can bring thoughts that frighten you. Help is immediate and judgment free. Health & Harmony Psychiatry does not provide emergency care. If you are in crisis or thinking about harming yourself, call or text 988, or call 911.
Begin when you are ready
You do not have to sort this out alone.
Book a private first visit with Dr. McDade, or reach our team with a question. Care is available across Texas and California by secure video.