Patients navigating the hormonal transition may present with mood changes, anxiety, depression, irritability, or rage that feels disproportionate to the moment. Many describe vasomotor symptoms disrupting sleep and mood, fatigue, weight gain, and cognitive changes such as brain fog, word-finding trouble, and memory lapses that can be frightening, along with a sense of not being themselves. Genitourinary symptoms often strain intimacy and relationships, and patients are tired of not being taken seriously. My work includes health psychological and relational assessment, nervous system and sleep-focused stabilization, grief and identity work, and values-based reauthoring of this stage of their lives.

Patients navigating cancer, autoimmune disorders, or other serious and chronic complex conditions often carry anticipatory grief and a persistent undercurrent of fear around prognosis or recurrence. Many describe "scanxiety," the spike of dread that builds before scans or test results and doesn't fully resolve even with good news. Some experience medical trauma responses after difficult procedures, hospitalizations, flares, or a diagnostic process that took years to reach an answer. Depression is common when fatigue, pain, or a loss of functional capacity makes daily life feel unrecognizable. Patients may feel body image or body-trust concerns, which often follow surgery, hair loss, or the effects of chronic pain. Underneath much of this is a quiet strain on identity and relationships that patients rarely name but carry constantly. My work moves through understanding illness and distress, medical trauma and nervous system stabilization, anticipatory grief, body-image support, identity, and self-advocacy.

Adults presenting with anxiety, depression, grief, or trauma often show up with distinct but overlapping symptoms. Anxiety can appear as chronic worry, panic, or a persistent sense of feeling activated. Depressive episodes can show as low energy, isolation, flat affect, or a loss of interest in life. Prolonged grief, or grief that follows a sudden, traumatic loss, often complicates an already hard bereavement process. Trauma responses can appear as hypervigilance and a nervous system braced in fear long after the triggering event has passed.

All four also surface in the body, showing up as unexplained aches and pains, fatigue, heart palpitations, GI distress, and headaches. These presentations frequently co-occur rather than appear in isolation. Treatment moves through screening and risk assessment, nervous system regulation skill building, mindfulness, stabilization, and presentation-specific processing.

I recognize that symptoms show up uniquely for each patient, and differently throughout our work together. To offer support, I follow a general clinical framework I've developed for each specific focus area, and I flex to meet each patient's needs. I'm clear about my scope of practice, and refer on when a patient's care needs exceed my expertise. With patient consent, I'm glad to coordinate directly with you or your team to collaborate on our shared patients' care.

I trained at Naropa University in Transpersonal Counseling Psychology and Bastyr University in Health Psychology, and I've been in private practice for almost 15 years.

Licensed in: LPC Oregon #C4615 & LMHC Washington #LH61416228
In-network with: UnitedHealthcare, UMR, and Optum, PacificSource, MODA, Regence Blue Cross/Blue Shield
Monday to Thursday, 9am to 5pm
Manzanita, OR (in-person) and telehealth throughout Oregon & Washington
Phone (voicemail): (206) 390-6249, I return calls within 1-2 business days
Personal email: chrystal@holisticnw.com
For new patient inquiries: info@holisticnw.com
Physical address: 298 Laneda Ave, Suite 4, Manzanita, OR 97130
Mailing address: PO Box 579, Manzanita, OR 97130