Expert diagnosis and evidence-based treatment for a wide range of psychiatric conditions.
Telehealth psychiatry available throughout Minnesota
Anxiety disorders are among the most prevalent psychiatric conditions and often co-occur with depression, substance use, and other psychiatric diagnoses. Our evaluation goes beyond symptom checklists to identify the underlying mechanisms — whether rooted in disease, behavior, temperament, or life experience — that drive each patient's anxiety.
Persistent, excessive worry across multiple domains of life — work, health, relationships — often accompanied by muscle tension, restlessness, and difficulty concentrating. GAD is frequently underdiagnosed when it presents alongside depression. Learn about evaluation →
Recurrent, unexpected panic attacks — intense surges of fear with palpitations, shortness of breath, dizziness, and a sense of impending doom. Panic disorder often leads to avoidance behaviors that progressively narrow a patient's world.
Intrusive re-experiencing, avoidance, hyperarousal, and negative cognitive shifts following exposure to traumatic events. PTSD requires careful diagnostic distinction from adjustment disorders, complex grief, and personality-driven responses to adversity.
Marked fear or anxiety about social situations in which the individual may be scrutinized or judged. Social anxiety disorder often causes significant avoidance of professional, academic, and interpersonal settings — and is frequently misattributed to introversion or shyness.
Intense, irrational fear responses to specific objects, situations, or environments — including specific phobias and agoraphobia. Phobias are highly treatable but often dismissed or accommodated rather than addressed.
Intrusive, distressing obsessions and repetitive compulsions that consume significant time and impair daily functioning. OCD sits at the intersection of disease and behavioral perspectives, requiring a nuanced treatment approach combining pharmacotherapy and behavioral intervention.
Mood disorders are core disease-perspective conditions that alter the fundamental neurobiology of affect regulation. Accurate diagnosis — distinguishing unipolar from bipolar spectrum, characterizing chronicity, and identifying treatment resistance — is essential for effective pharmacotherapy and long-term stabilization.
Persistent depressed mood, anhedonia, psychomotor changes, cognitive impairment, and neurovegetative symptoms lasting two weeks or more. MDD ranges from single episodes to recurrent, treatment-resistant presentations requiring complex pharmacological strategies. Medication management →
Episodic disturbances of mood encompassing manic, hypomanic, and depressive states. Bipolar I, Bipolar II, and cyclothymic disorder each require distinct treatment approaches. Accurate diagnosis is critical — misidentification as unipolar depression leads to ineffective or harmful treatment. Pharmacogenomic testing →
Chronic, low-grade depressive symptoms lasting two years or more — formerly known as dysthymia. Often overlooked because patients adapt to their baseline, PDD erodes quality of life slowly and responds to targeted pharmacotherapy when accurately identified.
Persistent suicidal thoughts that may or may not be tied to a discrete depressive episode. Chronic suicidality requires comprehensive risk formulation — integrating disease, dimensional, and life-story perspectives — to develop a durable safety and treatment plan.
A major depressive episode occurring during pregnancy or in the weeks following delivery, postpartum depression goes far beyond "baby blues." It involves severe mood disturbance, bonding difficulties, and functional impairment requiring prompt pharmacological and supportive intervention.
A recurrent pattern of major depressive episodes with seasonal onset — most commonly in fall and winter months. Particularly prevalent in northern latitudes, SAD responds to a combination of pharmacotherapy, light therapy, and behavioral activation strategies.
A severe, cyclical mood disorder marked by pronounced irritability, dysphoria, anxiety, and affective lability in the luteal phase of the menstrual cycle. PMDD is a DSM-5 depressive disorder — distinct from PMS — that is highly responsive to targeted pharmacotherapy including SSRIs and hormonal interventions.
Psychotic spectrum disorders represent some of the most severe and complex conditions in psychiatry. Accurate differential diagnosis — distinguishing primary psychotic disorders from mood-congruent psychosis, substance-induced states, and medical etiologies — is essential for selecting the appropriate antipsychotic regimen and long-term management strategy.
A chronic psychotic disorder characterized by positive symptoms (delusions, hallucinations, disorganized thinking), negative symptoms (avolition, flat affect, alogia), and cognitive impairment. Schizophrenia requires long-term antipsychotic management, careful metabolic monitoring, and integrated psychosocial support.
A condition at the intersection of schizophrenia and mood disorders, involving concurrent psychotic and prominent affective episodes. Schizoaffective disorder — bipolar or depressive type — demands a dual treatment strategy addressing both psychosis and mood instability simultaneously.
Brief psychotic disorder, substance-induced psychotic disorder, psychotic disorder due to a medical condition, and unspecified psychotic presentations. Thorough diagnostic workup — including medical, substance, and neurological evaluation — is critical to identify the etiology and guide appropriate intervention.
Addiction is best understood through the behavioral perspective — a framework that identifies the reinforcing cycle driving continued use despite consequences. Cognitive Works brings dual board certification in Addiction Psychiatry and Addiction Medicine, with deep expertise in both the neurobiology and behavioral mechanisms of substance use and compulsive behaviors.
From problematic drinking patterns to severe dependence with physiological withdrawal, alcohol use disorder is among the most consequential and treatable addictions. Treatment integrates pharmacotherapy (naltrexone, acamprosate, disulfiram) with behavioral intervention. Addiction assessment →
Increasingly prevalent with legalization, cannabis use disorder involves compulsive use despite social, occupational, or psychological consequences. Withdrawal symptoms — irritability, insomnia, decreased appetite — are real and clinically significant.
Compulsive use of amphetamines, methamphetamine, cocaine, or prescription stimulants. Stimulant use disorder frequently co-occurs with mood disorders and ADHD, demanding careful diagnostic disentanglement before effective treatment can begin.
One of the most tenacious substance addictions, nicotine dependence involves powerful neuroadaptation and withdrawal. Evidence-based pharmacotherapy — varenicline, bupropion, nicotine replacement — combined with behavioral strategies significantly improves quit rates.
Dependence on benzodiazepines, barbiturates, or other sedative-hypnotics — often iatrogenic in origin. Sedative withdrawal carries serious medical risk including seizures. Treatment requires careful, medically supervised tapering protocols and concurrent management of the underlying anxiety or insomnia that initiated use.
Recognized by the ICD-11 as an impulse control disorder, compulsive sexual behavior involves a persistent pattern of failure to control intense sexual urges, resulting in repetitive behavior that causes marked distress or impairment in personal and social functioning.
Compulsive pornography consumption that escalates in frequency, intensity, or content despite negative consequences on relationships, work, and psychological well-being. While not yet a standalone DSM-5 diagnosis, it is a clinically significant behavioral pattern warranting evaluation and treatment.
Recognized by the WHO as "gaming disorder," this pattern involves impaired control over gaming, increasing priority given to gaming over other activities, and continuation or escalation despite negative consequences. Particularly prevalent in adolescents and young adults.
Persistent and recurrent problematic gambling behavior leading to clinically significant distress or impairment. Gambling disorder is the prototypical behavioral addiction — well-established in the DSM-5 — and often co-occurs with mood disorders and substance use.
These represent areas of particular clinical depth — complex presentations that require subspecialty-level expertise spanning psychiatry, internal medicine, and consultation-liaison practice.
Systematic evaluation and rational simplification of complex multi-medication regimens. Many patients arrive on numerous psychiatric medications accumulated over years of care — often with redundancies, interactions, or medications continued without clear indication. Expert deprescribing can reduce side-effect burden while preserving or improving efficacy.
Comprehensive re-evaluation for patients with unclear, conflicting, or long-standing misdiagnoses. Diagnostic clarification integrates detailed history, collateral information, longitudinal course analysis, and the Four Perspectives framework to arrive at an accurate formulation — often revealing missed bipolar spectrum, personality, or comorbid conditions. Second opinion consultation →
Depression, anxiety, delirium, and cognitive changes in the context of chronic medical conditions — cancer, autoimmune disease, chronic pain, neurological illness. Consultation-liaison expertise ensures psychiatric treatment accounts for medical comorbidities, drug interactions, and the physiological impact of systemic disease on the brain.
Excessive preoccupation with physical symptoms accompanied by disproportionate health-related anxiety and behaviors. Somatic symptom disorder requires a nuanced approach that validates the patient's distress while addressing the psychological mechanisms that amplify and perpetuate somatic experiences.
Neurological symptoms — weakness, paralysis, tremor, sensory loss, non-epileptic seizures — that are incompatible with recognized neurological disease. Now termed functional neurological symptom disorder, this condition requires close collaboration between psychiatry and neurology for accurate diagnosis and effective treatment.
Pre- and post-transplant psychiatric evaluation and management. Transplant candidates require psychosocial screening for adherence risk, substance use history, and psychiatric stability. Post-transplant care addresses immunosuppressant-related neuropsychiatric effects, adjustment, and long-term psychological well-being.
Psychiatric evaluation and ongoing management for patients undergoing or recovering from bariatric surgery. This includes pre-surgical psychological clearance, assessment of eating pathology, management of post-surgical mood changes, and monitoring for transfer addictions and altered medication absorption.
Comprehensive psychiatric care during pregnancy and the postpartum period, addressing mood disorders, anxiety, psychosis, and medication safety in the context of conception, pregnancy, lactation, and early motherhood. Perinatal psychiatry requires careful risk-benefit analysis of psychotropic medications and close coordination with obstetric providers.
Genetic testing to guide psychiatric medication selection, dosing, and tolerability. Pharmacogenomic analysis identifies how a patient's unique genetic profile affects drug metabolism, efficacy, and side-effect risk — enabling precision prescribing that reduces trial-and-error and accelerates response to treatment. Learn about PGx testing →
Cognitive Works treats a wide range of psychiatric conditions across five categories: Anxiety Spectrum (GAD, panic disorder, PTSD, social anxiety, phobias, OCD), Mood Spectrum (major depression, bipolar disorder, dysthymia, postpartum depression, SAD, PMDD), Psychotic Spectrum (schizophrenia, schizoaffective disorder), Addictive Disorders (alcohol, cannabis, stimulant, nicotine, and sedative use disorders, plus behavioral addictions), and Special Conditions (polypharmacy, diagnostic clarification, transplant psychiatry, bariatric psychiatry).
Yes. Cognitive Works provides all psychiatric services via secure, HIPAA-compliant telehealth for patients located throughout Minnesota. This includes comprehensive evaluations, medication management, and ongoing follow-up care — accessible from anywhere in the state.
Cognitive Works is led by a psychiatrist who holds board certification in four specialties: General Adult Psychiatry, Consultation-Liaison Psychiatry, Addiction Psychiatry, and Addiction Medicine. This breadth of certification reflects advanced training and expertise across multiple areas of psychiatric practice.
Yes. Cognitive Works specializes in complex and treatment-resistant mood disorders, including major depression that has not responded to initial therapies. The practice offers advanced pharmacological strategies, diagnostic clarification, and pharmacogenomic testing to guide treatment.
Yes. Cognitive Works provides integrated treatment for co-occurring psychiatric and substance use disorders — including alcohol, cannabis, stimulant, nicotine, and sedative use disorders, as well as behavioral addictions such as gambling and compulsive sexual behavior.
You can request an appointment online, call 952-300-6277, or email contact@cognitiveworks.org. New patient evaluations are conducted via telehealth for residents throughout Minnesota.