Adult Psychiatry

What Is Adult Psychiatry?

Adult psychiatry is medical specialty focused on the diagnosis, treatment, and ongoing management of mental health conditions in adults. A psychiatrist is a medical doctor (MD or DO) with additional training in psychiatric diagnosis and treatment. Unlike therapists or counselors, psychiatrists can perform medical evaluations, order laboratory tests, prescribe medication, and manage complex medication interactions and side effects.

Modern adult psychiatry operates on a biopsychosocial model, meaning we address not just brain chemistry and medication, but also your life circumstances, relationships, trauma history, coping skills, and values. A comprehensive psychiatric approach integrates all of these elements rather than reducing mental health to medication alone.

The Scope of Adult Psychiatry

Adult psychiatric care includes:

• Diagnostic assessment: Thorough evaluation to establish accurate diagnosis, rule out medical causes, and assess severity and safety.
• Medication evaluation and prescription: When clinically appropriate, recommending and prescribing psychiatric medication with attention to efficacy, side effects, and interactions with other drugs.
• Medication management: Regular follow-up to monitor how medication is working, adjust doses, switch medications if needed, and manage side effects.
• Treatment planning: Developing a broader care plan that may include therapy, lifestyle changes, medical evaluations, or specialty referral.
• Therapy coordination: Working with your therapist (if you have one) to ensure psychiatric and psychological treatment align.
• Medical monitoring: Ordering labs, monitoring for metabolic or cardiovascular effects of medication, and coordinating with your primary care physician.
• Crisis intervention: Availability for urgent psychiatric concerns that arise between regular appointments.

When to See a Psychiatrist

Adult Psychiatry vs Primary Care vs Therapist

Knowing which type of provider to see can be confusing. Here's how these roles differ:

*Note: Some states allow psychologists with specialized postdoctoral training (PharmD level) to prescribe medications, but this is rare and does not apply to LCSW/LPC providers.

When to Consider Adult Psychiatry

You may benefit from seeing an adult psychiatrist if:

• You have a new diagnosis that needs careful evaluation and treatment planning
• Your depression, anxiety, or other condition has not improved with initial medication from your PCP
• You're taking multiple psychiatric medications and need a specialist to ensure safe interactions
• You have a complex medical history (heart disease, kidney disease, pregnancy) that complicates medication choice
• You experience side effects from medication and need alternatives or strategies to manage them
• You have been diagnosed with bipolar disorder, OCD, PTSD, schizophrenia, or other serious mental illness requiring specialized management
• Your psychiatric symptoms are not matching the expected treatment response (treatment-resistant depression, for example)
• You benefit from coordinated care where your psychiatrist and therapist communicate regularly

Conditions We Treat

Dr. Thangada provides comprehensive psychiatric care for adults with a wide range of mental health conditions. Below is an overview of common presentations.

Mood Disorders

• Major Depressive Disorder — Persistent low mood, loss of interest, sleep disruption, guilt, and difficulty concentrating. Treated with SSRIs, SNRIs, or other antidepressants, often combined with therapy.
• Bipolar Disorder — Cycling between depression and elevated mood (mania or hypomania), often requiring mood stabilizers. Accurate diagnosis and specialized medication management are essential.
• Persistent Depressive Disorder (Dysthymia) — Chronic, milder depression lasting 2+ years. Often responds to medication, therapy, or combination treatment.

Anxiety Disorders

• Generalized Anxiety Disorder (GAD) — Persistent worry across multiple life domains. First-line treatments include SSRIs and cognitive behavioral therapy.
• Social Anxiety Disorder — Intense fear of social situations and judgment. Responds well to SSRIs combined with exposure-based therapy.
• Panic Disorder — Recurrent panic attacks with fear of future attacks. Treated with SSRIs and cognitive-behavioral techniques.
• Agoraphobia — Anxiety about being in situations where escape is difficult. Often co-occurs with panic disorder.

Attention and Executive Function

• Adult ADHD — Inattention, impulsivity, and/or hyperactivity persisting from childhood into adulthood. Often underdiagnosed in adults. Treated with stimulant or non-stimulant medications plus behavioral strategies.

Trauma and Stress Disorders

• Post-Traumatic Stress Disorder (PTSD) — Intrusive memories, avoidance, negative mood/cognition, and hyperarousal following trauma. Treated with trauma-focused therapy (CPT, PE) and/or medication.
• Adjustment Disorders — Emotional or behavioral difficulty following a life stressor (loss, major life change). Usually time-limited with support.

Obsessive-Compulsive and Related Disorders

• Obsessive-Compulsive Disorder (OCD) — Intrusive thoughts and repetitive behaviors. Treated with SSRIs at higher doses than depression, combined with exposure and response prevention therapy.
• Body Dysmorphic Disorder — Preoccupation with perceived flaws in physical appearance. Often responds to SSRIs and cognitive-behavioral therapy.

Psychotic Disorders

• Schizophrenia and Schizoaffective Disorder — Hallucinations, delusions, disorganized thinking, or negative symptoms. Require antipsychotic medication and often long-term psychiatric monitoring.

Sleep and Wakefulness Disorders

• Insomnia — Difficulty initiating or maintaining sleep. Addressed through sleep hygiene, cognitive-behavioral therapy for insomnia (CBT-I), and sometimes short-term medication.

Eating Disorders

• Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder — Disturbed eating patterns and body image. Require multidisciplinary treatment (psychiatry, nutrition, therapy) and medical monitoring.

Personality Disorders

• Borderline, Narcissistic, Avoidant, and Other Personality Disorders — Stable patterns of maladaptive thinking and behavior. Primarily treated with psychotherapy; medication addresses specific symptoms.

Substance Use Disorders

• Alcohol, Opioid, Stimulant, and Other Substance Use — Compulsive use despite consequences. Treated with behavioral interventions, medication-assisted treatment (methadone, buprenorphine, naltrexone), and support groups.

Our Approach at KwikPsych

Thorough Diagnostic Evaluation

Many adults receive a psychiatric diagnosis without a comprehensive evaluation. At KwikPsych, your first visit includes a detailed history covering your symptom presentation, onset, previous treatments, family psychiatric history, medical history, substance use, trauma history, and current life circumstances. We also screen for medical conditions that could mimic psychiatric symptoms (thyroid disease, anemia, sleep apnea) and may order labs if appropriate.

Accurate diagnosis matters because it guides treatment. A person presenting with sadness might have major depression, bipolar depression, substance use, medical illness, or adjustment disorder — each requiring a different approach.

Evidence-Based Medication Decisions

When medication is appropriate, Dr. Thangada recommends treatments supported by clinical research. This means starting with first-line agents (usually SSRIs for depression/anxiety), optimizing doses before switching, and considering medication combinations when monotherapy hasn't worked. We also discuss mechanism of action, expected timeline to benefit, common side effects, and monitoring requirements.

Measurement-Informed Treatment

Rather than relying solely on your subjective report, we use validated symptom rating scales (PHQ-9 for depression, GAD-7 for anxiety, and others) to objectively track your progress. These measures help us know whether treatment is working and guide dose adjustments or medication changes.

Safety as a Priority

Psychiatric safety — including suicide risk, substance use, medication interactions, and medical complications — is assessed and monitored consistently. If your safety becomes a concern, we have protocols for urgent intervention and crisis coordination.

Coordinated, Collaborative Care

You are the center of your care. We coordinate with your therapist, primary care physician, and other providers involved in your treatment. We provide regular updates (with your permission) and welcome input from people important to your recovery.

What to Expect at Your First Visit

Before Your Visit

We'll ask you to complete a detailed intake form covering psychiatric history, medical history, medications, substance use, family history, and current concerns. You can complete this online or by paper when you arrive. This helps us use your appointment time efficiently for discussion rather than just data collection.

During Your Visit (45 to 60 Minutes)

1. Symptom Review: Dr. Thangada will ask in detail about your symptoms, when they started, what makes them better or worse, and how they're affecting your life.

2. Psychiatric and Medical History: We review any previous psychiatric diagnoses, treatments (therapy or medication), how you responded to them, medical conditions, medications, allergies, substance use, and trauma history.

3. Family Psychiatric History: Mental illness often runs in families, and family history helps inform diagnosis and treatment choices.

4. Current Life Circumstances: Work stress, relationships, housing, financial situation, and other life factors all influence mental health and treatment planning.

5. Risk Assessment: We ask about suicidal or homicidal thoughts, self-harm, substance use, and safety concerns. These questions are standard and essential.

6. Physical Exam and Labs (if indicated): Sometimes we perform a brief physical examination or order blood work to rule out medical causes (thyroid disease, vitamin deficiency, etc.).

7. Diagnostic Formulation and Treatment Planning: Dr. Thangada will share her diagnostic impression, explain the reasoning, and discuss treatment options. This may include medication, therapy referral, lifestyle recommendations, or further evaluation.

After Your Visit

You'll leave with a clear understanding of your diagnosis, the recommended treatment plan, and what to expect next. If medication is prescribed, we discuss how to take it, when to expect improvement, what side effects might occur, and when to follow up.

Medication Management

Medication as Part of a Broader Plan

Psychiatric medication is most effective when combined with other treatment — therapy, lifestyle changes, social support, and meaningful activity. At KwikPsych, we don't use medication as a standalone answer. Instead, we work collaboratively to address the whole picture.

Common First-Line Medications

For Depression and Anxiety: SSRIs (sertraline, escitalopram, paroxetine) and SNRIs (venlafaxine, duloxetine) are typically first-line because they have good evidence, tolerable side effect profiles, and lower overdose risk than older antidepressants.

For Bipolar Disorder: Mood stabilizers like lithium, valproate, or lamotrigine are core treatments. Antipsychotics may be added for acute mania or to manage psychotic symptoms.

For ADHD: Stimulants (methylphenidate, amphetamine) are first-line with strong evidence. Non-stimulant options (atomoxetine, guanfacine) are used when stimulants aren't effective or appropriate.

For Insomnia: First-line treatment is cognitive-behavioral therapy for insomnia (CBT-I). Medication is used short-term if needed, with options including melatonin, trazodone, or benzodiazepine receptor agonists.

Monitoring and Adjustment

Most psychiatric medications take 4 to 8 weeks to show full benefit. We typically schedule follow-up at 2 to 4 weeks to check early tolerability, then again at 6 to 8 weeks to assess efficacy. If improvement is insufficient, we may increase the dose, add another medication, or switch medications entirely.

For medications requiring monitoring (lithium, some mood stabilizers, antipsychotics), we order periodic blood work and metabolic screening to ensure safety.

Therapy Coordination

Psychiatry and psychotherapy work best together. If you're seeing a therapist, we actively coordinate:

• Dr. Thangada and your therapist communicate (with your permission) about your progress and treatment plan.
• We discuss which conditions benefit most from therapy (trauma, anxiety, personality patterns) versus medication (neurotransmitter imbalances) versus both.
• If you need a therapy referral, we can recommend qualified providers practicing evidence-based modalities (CBT, ACT, trauma-focused therapy, etc.).
• We coordinate medication timing and any adjustments with therapy milestones.

Telehealth Psychiatry

For Texas residents, KwikPsych offers secure telehealth psychiatry visits. Telehealth psychiatric care is effective for initial evaluation, medication management, and ongoing follow-up.

How Telehealth Visits Work

You'll use a HIPAA-compliant secure video platform to connect with Dr. Thangada from home or another private location. The visit follows the same structure as in-person: full history, discussion, assessment, and treatment planning. Internet connectivity and a quiet, private space are recommended.

What Telehealth Is Best For

• Follow-up medication management visits
• Initial evaluation (if you provide a complete intake form beforehand)
• Patients with transportation barriers, mobility limitations, or scheduling constraints

Limitations of Telehealth

• We cannot perform physical examination or order in-person lab work as easily as in-office.
• Crisis situations may require in-person or emergency department evaluation.
• Severe psychiatric symptoms sometimes benefit from in-person assessment.

Texas law requires that you be located in Texas during telehealth visits.

Insurance & Cost

Fees

• Initial psychiatric evaluation: $299 (45 to 60 minutes)
• Follow-up visit: $179 (15 to 30 minutes, typically every 4 to 12 weeks)

Insurance Coverage

KwikPsych is in-network with the following major insurance plans:

• Aetna
• Blue Cross Blue Shield Texas (BCBS TX)
• Cigna
• UnitedHealthcare
• Superior HealthPlan / Ambetter
• Baylor Scott & White
• Oscar
• First Health Network
• Optum
• Medicare

Your actual out-of-pocket cost depends on your deductible, copay, and coinsurance. We recommend verifying your benefits before your visit. You can call our office at 737-367-1230 or use our online insurance verification tool.

Self-Pay

Patients without insurance or who prefer to self-pay can access care at the standard fees listed above. We also offer a self-pay discount for patients paying in full at time of service.

How to Get Started

Getting started with adult psychiatry at KwikPsych is straightforward:

Step 1: Request an Appointment

Request an appointment online or call 737-367-1230 during business hours. Let us know you're interested in an adult psychiatry evaluation and whether you prefer in-person or telehealth. Same-week and same-day appointments are often available.

Step 2: Complete Your Intake

You'll receive a detailed intake form by email or paper. This covers your psychiatric history, medical history, medications, substance use, and current concerns. Completing this beforehand makes your first appointment more efficient.

Step 3: Your Initial Evaluation

At your first visit (45 to 60 minutes), Dr. Thangada will conduct a comprehensive evaluation, establish your diagnosis, and discuss treatment options. Whether you need medication, therapy referral, both, or neither will be clear by the end of the visit.

Step 4: Ongoing Care

Most patients schedule follow-up visits every 4 to 12 weeks depending on their needs. Between visits, we're available for urgent concerns. As you improve or stabilize, visits may space out further or transition to as-needed appointments.

Frequently Asked Questions