PTSD and trauma care online, at a pace set by you

What trauma does to a life

Trauma is not only the event. It is what the nervous system keeps doing afterward: scanning rooms, startling at sounds, sleeping in fragments, avoiding the places and conversations that might touch it, going numb in the middle of ordinary days. PTSD can follow a single event, a car crash, an assault, a medical emergency, combat. It can also follow years of smaller ones: a childhood home, a relationship, a job where vigilance was survival.

Many people arrive here unsure whether what happened "counts." It counts if it is still running your sleep, your temper, your concentration, or your ability to be close to people. Others arrive with a diagnosis they have carried for years and treatment that helped partly, or helped until it stopped. Both starting points are workable, and neither requires you to retell everything at the first visit to be believed.

Trauma also travels with company: depression, anxiety, insomnia, and substance use are frequent companions, and treating any one of them while ignoring the trauma underneath tends to stall. Care here treats the whole picture in one course of treatment, which is the point of a practice where one clinician does both the therapy and the prescribing.

Medication as support, not the main event

For PTSD, therapy does the central work, and medication earns its place around it: settling sleep so the days are survivable, easing the anxiety and depression that so often travel with trauma, and lowering the baseline arousal enough that therapy can actually proceed. Those decisions are made by the clinician sitting in the therapy with you, who hears what the nights are like in your own words rather than in a refill questionnaire.

Because the same person prescribes and listens, a medication that flattens you gets caught as a therapy problem, not just a side effect, and one that finally lets you sleep is recognized for what it unlocks. If your questions are mainly about the medication side, sleep, mood, and steadiness, the medication practice covers medication support for sleep and mood in more depth, with the same clinician behind it.

Safety and pacing, in practice

You control the depth and the speed. Nothing is retraumatized here for the sake of a method: grounding skills come before memory work, sessions end steadier than they start, and between visits you have the patient portal and Spruce for contact on practice days. The free, private screeners can help you take stock before a first conversation, and if you are in crisis now, use the crisis resources page or call or text 988 first. Care can wait an hour; safety cannot.

Sleep, the body, and the long tail

Ask trauma patients what they want back first and the answer is usually sleep. Nightmares, fragmented nights, and a startle response that treats every sound as a threat leave people running on fumes, and exhausted brains do not do therapy well. Sleep is therefore treated as a clinical priority from the first visit, not a footnote: what the nights look like shapes the medication conversation, the session pacing, and the order everything else gets addressed in.

The body keeps its own records too. Chronic tension, pain, and stress physiology can all be trauma's long tail, and each can also have ordinary medical causes that deserve checking rather than assuming. A clinician whose first career was diagnostic imaging reads that overlap carefully: targeted labs are part of the picture when the story suggests them, so a thyroid problem is not mistaken for a trauma symptom, or the reverse.