Treatment
Biological & genetic psychiatry
Psychiatric illness is brain illness, and the brain is an organ with a chemistry, a metabolism, and a genome. This practice treats all three, drawing on Dr. Giddens’s training in neuropharmacology and brain imaging at the National Institutes of Health, so that treatment fits the person rather than the average patient in a trial.
Clinical approach
Advanced Psychopharmacology
Evidence-based medication management informed by clinical research.
Integrated Psychotherapy
Medication and therapy planned together, so a steadier brain can make use of what therapy teaches.
Metabolic Psychiatry
Treating the body’s energy supply, from insulin and inflammation to sleep and nutrition, as part of brain health.
Genomic Medicine
Genetic testing to match medication and dose to your own biology.
The right medication, chosen deliberately
Advanced psychopharmacology
Most medication decisions in psychiatry are made by trial and error. Here they are made from the mechanism up. Dr. Giddens spent her research years at the NIH studying how medications act on the brain’s dopamine system, including PET imaging of D1 and D2 receptors in people taking methylphenidate and in people treated for opioid use disorder, and she brings that understanding to the consulting room. Medication choices weigh receptor pharmacology, half-life, interactions with the patient’s other medications, effects on sleep and appetite, and the realistic course of side effects, and every change is measured with rating scales rather than impressions. Particular depth in stimulants and non-stimulants for ADHD, medications for alcohol, opioid, and nicotine use disorders, antidepressant selection and augmentation, and the careful use of sleep medications.
Therapy and biology, pulling in the same direction
Integrated psychotherapy
Medication changes what the brain can do; therapy changes what a person does with it. Neither works as well alone. In this practice the two are planned together by one physician, so that a course of CBT, IPT, or psychodynamic work begins when the biology is stable enough to make use of it, and medication is adjusted in light of what therapy reveals. Sleep is treated as part of both: a patient who is not sleeping cannot consolidate what therapy teaches, and CBT-I is often the first intervention offered.
The brain as a high-energy organ
Metabolic psychiatry
The brain uses a fifth of the body’s energy, and when that supply is disturbed, by insulin resistance, chronic inflammation, disrupted sleep, or micronutrient deficiency, mood, attention, and motivation fail with it. Dr. Giddens’s research with colleagues at the NIH has examined how adiposity and inflammation alter metabolic profiles in people with opioid use disorder, and how rest–activity rhythms track with brain function. In practice this means a first-visit laboratory panel that looks at glucose and lipid metabolism, inflammatory markers, thyroid function, vitamin D and ferritin, and B12 and folate; attention to the metabolic effects of psychiatric medications themselves; and treatment of sleep and circadian rhythm as metabolic interventions in their own right. Where a metabolic medication or a dietary approach is indicated, it is coordinated with the patient’s primary care physician or endocrinologist.
Your genome as a guide, not a verdict
Genomic medicine
Pharmacogenomic testing reads the genes that govern how a person metabolizes medications, chiefly the liver enzymes CYP2D6 and CYP2C19, and flags where a standard dose is likely to be too much, too little, or slow to take effect. It is most useful after a medication has failed or caused unexpected side effects, and before starting agents where metabolism matters most. Dr. Giddens uses these results as one input among several: they narrow the field and explain past failures, but they do not choose the drug, and she is candid about what the evidence does and does not support. Testing is arranged through established clinical laboratories, and results are reviewed with the patient in plain language.
How these fit together
- Every new patient receives a medication history, a metabolic and nutritional laboratory panel, and a structured sleep assessment at the first visit, with mobile actigraphy for appropriate sleep disorders or concerns.
- Pharmacogenomic testing is offered when history suggests it will change a decision, not routinely.
- Therapy and medication are planned as one treatment, reviewed together at each visit.
- Findings and plans are shared with the patient’s other physicians, with permission, so biological care is coordinated across the whole team.