Integrated Counseling Services
Professional Counseling & Alternative Therapy
Meet Psychiatric Nurse Practitioner, Rachel Adams
I believe that the better you feel, the more productive, fulfilled and happy you are in your everyday life. At Integrated Counseling and Wellness, we employ a<a href=”http://www.integratedcounselingandwellness.com/about-us/clinical-wellness-staff/”> team of trusted professionals</a> who are able to address health concerns holistically, healing mind, body, and spirit. As a psychiatric nurse practitioner, I use evidence-based treatments and am licensed to prescribe mental health medication for a variety of illnesses. Often, my clients receive treatment from me in conjunction with other services at the clinic, including counseling, lifestyle changes and natural remedies, such as massage therapy and acupuncture. Our services here provide you with the unique opportunity to address mental health concerns comprehensively.
The need for quality mental health care in Idaho is high. Suicide is the second leading cause of death here, making depression and other mental illnesses a state-wide health crisis. This means that if you’re struggling, you are not alone: At times, we all struggle and need guidance. Seeking help for mental health issues can not only improve your life but also save your life. As Kwame Floyd said,<em> </em>“It’s not what you go through that defines you; you can’t help that. It’s what you do AFTER you’ve gone through it that really tests who you are.” It’s our aim here to facilitate a supportive, knowledgeable environment that promotes your long-term healing and growth.
I’ve been in the mental health field for 20 years. I’ve seen how hard life can be for individuals with mental illnesses, which is why I seek to provide the best care possible. Unlike a conventional doctor’s office—where you may not have a lot of time delving into your concerns—we have a supportive team that works collaboratively to provide you with the correct diagnosis, as well as useful resources to further your journey to enhanced overall well-being. With the right expertise and guidance, it’s possible to experience symptom reduction and enjoy more ease and calm in your life.
What Are Appointments With You Like?
Our initial appointment will last approximately one hour, and during this time, we’ll go through your entire mental, physical and family health and medication history. We’ll spend some time discussing your symptoms, sensations, and discomfort. I have a great deal of experience speaking in-depth with patients, and through our one-on-one conversation, I’ll validate your concerns, help you understand what you’re experiencing and provide you with a proper diagnosis. Having worked a licensed practical nurse, a registered nurse and received training as family practice practitioner, I’m able to recognize a wide variety of symptoms, diseases and disorders and how they interact with your system.
We will meet privately in a counseling office. Privacy and patient confidentiality are very important here. Although our team works collaboratively, we only do so in a controlled environment. I seek to provide a safe, supportive and comfortable atmosphere where you feel open to share whatever is bothering you. Throughout our time together, you and I will be on the same team working toward the same goal—reducing your symptoms and improving your overall life.
I have extensive experience working with patients from different walks of life, including veterans and court-mandated patients. In my office, you will be judged based on your symptoms and not on your appearance or past experiences. The more honest and open you are with me, the better I can provide you with an accurate diagnosis and the right resources for your particular needs, personality and goals. Depending on your situation, I may suggest that you participate in therapy, make positive lifestyle changes like diet and exercise, practice relaxation techniques, and more.
During our follow-up visits, which at first will occur every 2 to 4 weeks for a half hour, we will discuss how you’re responding to the medication. Our visits will become less frequent as your symptoms stabilize. The benefit of being treated at Integrated Counseling and Wellness is that you’re surrounded by a rich repertoire of resources. The compassionate and skilled staff allows for dynamic treatment approaches that can lead to holistic healing. If there’s something you can do to promote better health and long-term wellness, we will talk about it and find solutions that reduce or even resolve your symptoms. When we all work collaboratively and act as a community, you can have the support, resources, and knowledge you need to set yourself up for a successful recovery.
Understanding Your Medications
I firmly believe that understanding the medications that you are given is the first step towards treatment compliance. This, in turn, leads to a more successful treatment journey with an improved outlook on life. There are 6 main groups of psychiatric medications, including:
- Antidepressants – Utilized for the treatment of disparate disorders such as clinical depression, borderline personality disorder, and certain eating disorders.
- Antipsychotics – Utilized for the treatment of psychotic issues, such as schizophrenia or similar symptoms occurring as part of other disorders.
- Anxiolytics – Also known as anti-anxiety medications, these are utilized for the treatment of a variety of chronic and acute anxiety disorders, from general anxiety to panic attacks.
- Depressants – Utilized as sedatives, anesthetics, and hypnotics in a variety of psychiatric applications.
- Mood Stabilizers – Utilized for the treatment of sudden, intense mood swings, a symptom of issues such as bipolar disorder, schizophrenia, or borderline personality disorder.
- Stimulants – Utilized for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy to help regulate thought processes.
These medications are specially designed to assist with each patient’s progress of psychotherapy, and dosage, scheduling, etc. are exclusive to you and you alone. That is why it’s critical to only take medications prescribed by your doctor (if any) and report any problems with your medicine as soon as possible in order to make the necessary adjustments.
How Do People Respond to Antidepressants?
For reasons as-yet unexplained by relevant studies, some antidepressant medications work better at curbing or eliminating depression symptoms for some patients than they do for others. In order to determine whether a medication is indeed right for you, it is important to take based on your doctor’s specifications for up to 4 to 6 weeks.
Because some antidepressants begin to improve symptoms quickly, patients stop taking them too soon. However, the body must adjust to the change in order for depression not to return, and hence you must never stop taking a medication without supervision from your doctor. Stopping too quickly may also cause withdrawal symptoms, although antidepressants themselves are not addictive.
What are the Possible Side-Effects of Antidepressants?
As with the benefits of antidepressants, the side-effects of these medications vary from case to case. Common side effects include:
- Weight gain
- Bowel problems
Problematic symptoms that should be reported to your doctor include:
- Increased depression
- Suicidal thoughts
- Panic attacks
- Lack of impulse control
Finally, taking certain antidepressants together with migraine medications may cause increased agitation, hallucinations, fever, and hypertension.
How Do People Respond to Anti-Anxiety Medications?
Anti-anxiety medications such as benzodiazepines are effective in relieving anxiety and take effect more quickly than the antidepressant medications (or buspirone) often prescribed for anxiety. However, people can build up a tolerance to benzodiazepines if they are taken over a long period of time and may need higher and higher doses to get the same effect. Some people may even become dependent on them. To avoid these problems, doctors usually prescribe benzodiazepines for short periods, a practice that is especially helpful for older adults (read the NIMH article: Despite Risks, Benzodiazepine Use Highest in Older People), people who have substance abuse problems and people who become dependent on medication easily. If people suddenly stop taking benzodiazepines, they may have withdrawal symptoms or their anxiety may return. Therefore, benzodiazepines should be tapered off slowly.
How Do People Respond to Stimulants?
Prescription stimulants are absolutely safe when taken under the supervision of your doctor, delivering a calming effect to sufferers of ADHD and helping them to focus. Furthermore, addiction should never be an issue if antidepressants are taken as prescribed. In fact, studies show that adolescents with ADHD are at a lower risk of drug abuse when taking their medications than those who are not.
What are the Possible Side-Effects of Stimulants?
Despite the general safety of stimulants, there are certain side-effects to consider:
- Loss of appetite
- Pain in the head or stomach
- Motor or verbal tics – rare
- Lack of emotion – rare
Fortunately, most side-effects are not serious and can be eliminated by lowering the dosage of the stimulant – with a doctor’s discretion.
What are the possible side effects of anti-anxiety medications?
Like other medications, anti-anxiety medications may cause side effects. Some of these side effects and risks are serious. The most common side effects of benzodiazepines are drowsiness and dizziness.
Other possible side effects include:
- Blurred vision
Tell your doctor if any of these symptoms are severe or do not go away:
- Problems with coordination
- Difficulty thinking or remembering
- Increased saliva
- Muscle or joint pain
- Frequent urination
- Blurred vision
- Changes in sex drive or ability (The American Society of Health-System Pharmacists, Inc, 2010)
If you experience any of the symptoms below, call your doctor immediately:
- Swelling of the eyes, face, lips, tongue, or throat
- Difficulty breathing or swallowing
- Yellowing of the skin or eyes
- Difficulty speaking
- Yellowing of the skin or eyes
- Thoughts of suicide or harming yourself
- Difficulty breathing
Common side effects of beta-blockers include:
- Cold hands
- Dizziness or light-headedness
Beta-blockers generally are not recommended for people with asthma or diabetes because they may worsen symptoms related to both.
Possible side effects of buspirone include:
- Trouble sleeping
How do people respond to antipsychotics?
Certain symptoms, such as feeling agitated and having hallucinations, usually go away within days of starting an antipsychotic medication. Symptoms like delusions usually go away within a few weeks, but the full effects of the medication may not be seen for up to six weeks. Every patient responds differently, so it may take several trials of different antipsychotic medications to find the one that works best.
Some people may have a relapse—meaning their symptoms come back or get worse. Usually relapses happen when people stop taking their medication, or when they only take it sometimes. Some people stop taking the medication because they feel better or they may feel that they don’t need it anymore, but no one should stop taking an antipsychotic medication without talking to his or her doctor.When a doctor says it is okay to stop taking a medication, it should be gradually tapered off— never stopped suddenly. Many people must stay on an antipsychotic continuously for months or years in order to stay well; treatment should be personalized for each individual.
What are the possible side effects of antipsychotics?
Antipsychotics have many side effects (or adverse events) and risks. The FDA lists the following side effects of antipsychotic medicines:
- Weight gain (the risk is higher with some atypical antipsychotic medicines)
- Dry mouth
- Blurred vision
- Low blood pressure
- Uncontrollable movements, such as tics and tremors (the risk is higher with typical antipsychotic medicines)
- A low number of white blood cells, which fight infections
A person taking an atypical antipsychotic medication should have his or her weight, glucose levels, and lipid levels monitored regularly by a doctor.
Typical antipsychotic medications can also cause additional side effects related to physical movements, such as:
- Persistent muscle spasms
Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD). TD causes muscle movements, commonly around the mouth, that a person can’t control. TD can range from mild to severe, and in some people, the problem cannot be cured. Sometimes people with TD recover partially or fully after they stop taking typical antipsychotic medication. People who think that they might have TD should check with their doctor before stopping their medication. TD rarely occurs while taking atypical antipsychotics.
Antipsychotics may cause other side effects that are not included in this list above. To report any serious adverse effects associated with the use of these medicines, please contact the FDA MedWatch program . For more information about the risks and side effects of antipsychotic medications, please visit Drugs@FDA .
What are mood stabilizers?
Mood stabilizers are used primarily to treat bipolar disorder, mood swings associated with other mental disorders, and in some cases, to augment the effect of other medications used to treat depression. Lithium , which is an an effective mood stabilizer, is approved for the treatment of mania and the maintenance treatment of bipolar disorder. A number of cohort studies describe anti-suicide benefits of lithium for individuals on long-term maintenance. Mood stabilizers work by decreasing abnormal activity in the brain and are also sometimes used to treat:
- Depression (usually along with an antidepressant)
- Schizoaffective Disorder
- Disorders of impulse control
- Certain mental illnesses in children
Anticonvulsant medications are also used as mood stabilizers. They were originally developed to treat seizures, but they were found to help control unstable moods as well. One anticonvulsant commonly used as a mood stabilizer is valproic acid (also called divalproex sodium). For some people, especially those with “mixed” symptoms of mania and depression or those with rapid-cycling bipolar disorder, valproic acid may work better than lithium. Other anticonvulsants used as mood stabilizers include:
What are the possible side effects of mood stabilizers?
Mood stabilizers can cause several side effects, and some of them may become serious, especially at excessively high blood levels. These side effects include:
- Itching, rash
- Excessive thirst
- Frequent urination
- Tremor (shakiness) of the hands
- Nausea and vomiting
- Slurred speech
- Fast, slow, irregular, or pounding heartbeat
- Changes in vision
- Hallucinations (seeing things or hearing voices that do not exist)
- Loss of coordination
- Swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs.
If a person with bipolar disorder is being treated with lithium, he or she should visit the doctor regularly to check the lithium levels his or her blood and make sure the kidneys and the thyroid are working normally.
Lithium is eliminated from the body through the kidney, so the dose may need to be lowered in older people with reduced kidney function. Also, loss of water from the body, such as through sweating or diarrhea, can cause the lithium level to rise, requiring a temporary lowering of the daily dose. Although kidney functions are checked periodically during lithium treatment, actual damage to the kidney is uncommon in people whose blood levels of lithium have stayed within the therapeutic range.
Mood stabilizers may cause other side effects that are not included in this list. To report any serious adverse effects associated with the use of these medicines, please contact the FDA MedWatch program using the contact information at the bottom of this page. For more information about the risks and side effects of each individual medication, please see Drugs@FDA .
Some possible side effects linked anticonvulsants (such as valproic acid) include:
- Changes in appetite
- Weight changes
- Back pain
- Mood swings
- Abnormal thinking
- Uncontrollable shaking of a part of the body
- Loss of coordination
- Uncontrollable movements of the eyes
- Blurred or double vision
- Ringing in the ears
- Hair loss
These medications may also:
- Cause damage to the liver or pancreas, so people taking it should see their doctors regularly
- Increase testosterone (a male hormone) levels in teenage girls and lead to a condition called polycystic ovarian syndrome (a disease that can affect fertility and make the menstrual cycle become irregular)
Medications for common adult health problems, such as diabetes, high blood pressure, anxiety, and depression may interact badly with anticonvulsants. In this case, a doctor can offer other medication options.
For more information about the risks and side effects of each medication, please see Drugs@FDA .
Schedule An Appointment
If you’re interested in making an appointment with Dr. Rachel Adams, or would like to learn more about psychiatric medicine or the Integrated Counseling and Wellness facility or staff in Rexburg, Idaho, please call 208-357-3104 to schedule an appointment. Dr. Rachel Adams holds appointments on Fridays during normal business hours.
Dr. Rachel Adams is a psychiatric nurse practitioner at Integrated Counseling and Wellness in Rexburg, ID. She is certified through the American Association of Nurse Practitioners as a family nurse practitioner (FNP) and through the American Nurses Credentialing Center as a psychiatric-mental health nurse practitioner (PMHNP). She received her doctor of nursing practice (DNP) and psychiatric-mental health nurse practitioner (PMHNP) postgraduate education from Oregon Health and Sciences University and her masters in nursing from Idaho State University. Her licensure from the Drug Enforcement Administration and National Plan & Provider Enumeration System are current. She has been in the mental health profession for 20 years. In the past, she has worked as a psychiatric technician, a nurse, a mental health practitioner and as a nursing professor. She has worked in state hospitals, the Department of Health and Welfare and behavioral health centers, and at universities as a nursing instructor and clinical assistant professor. In her spare time, she teaches Sunday school, volunteers during events at the local library and enjoys spending time with her friends and family, especially her nieces and nephews.
At Integrated Counseling and Wellness, we are committed to finding a solution that works for you. We are pro-wellness and appreciate the ways in which both modern medications and herbal therapies can assist you in reaching your wellness goals. These two approaches need not be mutually exclusive!
Our goal is to help you meet 100% of your mental, emotional, and relational goals, not just help you limp through life. Often this goal is unobtainable; nevertheless it remains our goal. We are committed to doing everything ethically in our power to assist you in becoming and staying as well as you wish to be.
Integrated Counseling and Wellness provides yoga classes as a means to finding balance, peace, and wellness in life. Yoga translated means “To Yoke” or “Union”. Through the practice of yoga, one can literally find a union of mind, body and spirit and a greater connection to the world around them.
Integrated Counseling and Wellness offers a number of additional counseling options including yoga, nutritional supplementing, cranial electrotherapy stimulation, and herbal therapy. And we believe that each one is worth checking out!