Starting psychiatric medication for the first time, at your pace
Considering medication for the first time can bring up hope, doubt and a lot of questions. You deserve the time to explore them properly before deciding anything.
If you are thinking about starting psychiatric medication for the first time in New York, you may be weighing worries about side effects, identity, dependence or what it would mean to need help. I do not rush these decisions. We talk through your options openly, consider medication alongside therapy and holistic support, and if you choose to begin, we start low, go slowly and stay in close contact.
“Choosing to try medication is not giving up on yourself. Choosing not to is not failing either. What matters is that the choice is truly yours”
My role is to give you clear information and steady support, whichever direction you take.
What it means to be new to medication
Being new to psychiatric medication means approaching an unfamiliar decision, often during a hard time, and wanting someone knowledgeable and patient beside you.
People come to this question from very different places. Some have struggled for years and are finally open to medication. Others were recently encouraged by a therapist, doctor or friend to consider it. Some carry family stories, cultural messages or past experiences that make the idea feel loaded. All of this is welcome in our conversations. Exploring your feelings about medication is part of the clinical work, not a delay to it.
As a board-certified psychiatric nurse practitioner, I can assess what you are experiencing, discuss whether a diagnosis is relevant, and prescribe if that becomes the right step. Because I also work as a psychotherapist and somatic practitioner, medication is never the only option on the table. We consider what therapy, body-based work, lifestyle changes and, where appropriate, supplements reviewed for safety might offer, so that any decision is made with the full picture in view.
If you decide to begin, you will understand why I am suggesting a particular medication, what it is intended to help, what early side effects are common, and how we will know whether it is working. You can pause, ask more questions or change your mind at any point. Starting medication is the beginning of a collaborative process, not a commitment you cannot revisit.
Common worries, gently explored
Many first-time clients ask whether medication will change their personality, dull their creativity, affect their sex life or be hard to come off later. These are reasonable questions, and I answer them honestly rather than dismissing them. Some concerns are well founded for certain medications and can be planned around; others turn out to be based on outdated information. Either way, you deserve straight answers.
Starting low and going slowly
When someone is new to psychiatric medication, I generally begin cautiously and increase only if needed, giving your body time to adjust. Early weeks can bring mild, temporary side effects, and benefits often take a little while to appear. Regular check-ins during this period mean we can respond to how you actually feel, rather than following a rigid schedule.
Medication within a wider life
Medication can ease symptoms enough to make other things possible: sleeping better, engaging in therapy, returning to creative work, reconnecting with people. I see it as one support among several, chosen and shaped around your values, your identity and the life you want to be living.
This support may suit you if you are
You do not need to have decided anything to book a conversation. This work is for anyone curious, uncertain or cautious about psychiatric medication, including people who have had a brief, unhappy experience with it before and want a gentler second start.
- Curious but unsure about medication
- Anxious about side effects
- Worried about losing yourself
- Encouraged by a therapist to consider it
- Concerned about dependence
- Wanting therapy alongside any prescription
- Carrying stigma or family messages
- Hoping for a holistic perspective
- Seeking an affirming prescriber
Informed, unhurried first steps
My approach for people new to medication rests on honesty, education and patience. These are the elements that shape our early work together, whatever you eventually decide.
Space for every question
Longer sessions mean there is time for the questions you might feel awkward asking elsewhere. Nothing is too small or too basic. Understanding your options well is the foundation of a decision you can feel settled about.
All options considered
We look at medication alongside psychotherapy, somatic work, mindfulness, lifestyle changes and supplements that may support wellbeing. Seeing the whole range helps you decide what to try first, or how to combine approaches.
Clear explanations
If medication is suggested, I explain what it is, what it is intended to help, how quickly it tends to work, common early side effects, and what we would watch for. You will never be handed a prescription without context.
Close early follow-up
The first weeks on a new medication are when support matters most. We plan check-ins in advance so you have a clear point to share how things are going, and you know how to reach me in between.
Identity and values honoured
Your gender, sexuality, culture, creativity and relationship to your body all matter in this decision. I bring an affirming, non-judgemental perspective that takes your values seriously when weighing benefits and side effects.
Freedom to change your mind
Agreeing to try something does not lock you in. If a medication does not suit you, we can look at alternatives or a careful plan to stop it, always gradually and together rather than abruptly.
Common fears and how I respond
Many worries about starting medication come from stories, headlines or rushed past experiences. Here is how I approach some of the most common ones.
What people often fear
- Being rushed into a prescription
- Losing their personality
- Being on it forever
- Side effects being dismissed
- Therapy being replaced by pills
What working with me involves
- Time to decide, without pressure
- Close attention to how you feel
- Regular review of whether it is needed
- Side effects taken seriously
- Therapy and medication together
From first questions to a confident choice
The process moves at your speed, and you can pause at any stage.
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1
Free consultation 15 minutes
We talk briefly about what you are going through and your feelings about medication. You can ask any initial questions and get a sense of whether my way of working feels right for you.
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2
Thorough assessment
In a full session we explore your history, current symptoms, physical health, lifestyle and goals. This helps us understand what is happening and whether medication is likely to be useful, or whether another approach makes sense first.
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3
Exploring your options
I share my thoughts and the options I see, including non-medication approaches. You can take time to reflect, research and talk with people you trust. There is no deadline for deciding.
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A gentle start, if you choose
If you decide to begin medication, we start cautiously and arrange early follow-up. We review how you are feeling, adjust only gradually if needed, and keep therapy and holistic support part of the plan.
Francesca Rome-Marie, PMHNP-BC
I bring together psychiatry, psychotherapy, somatic work and whole-body health, informed by years in primary care and further study in gender theory, feminist thought, culture and visual art.
I keep a deliberately small caseload so that every client receives consistent, unhurried and genuinely attentive care, held within one relationship rather than split across several providers.
Clear, upfront rates
I don't accept insurance. Modern Holistic Psychiatry is an out-of-network provider, so sessions are paid for directly. Depending on your plan, you may be able to claim reimbursement through your out-of-network benefits.
Find out how much your insurance may coverNeed urgent support? If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
New to Medication FAQs
I am thinking about starting psychiatric medication for the first time in New York. Where do I begin?
Begin with a free 15-minute consultation. We will talk about what you are experiencing and how you feel about medication, without any expectation that you will start. If it seems a good fit, a full assessment follows. I support clients across New York State and keep a small caseload so there is genuine time for your questions.
Do I have to start medication if I book an assessment?
No. An assessment is a chance to understand what is going on and to hear your options. Many people choose to start with therapy, somatic work or lifestyle changes, and revisit medication later if needed. Others decide medication makes sense now. Both are valid choices, and I will support whichever feels right to you.
Will medication change who I am?
The goal of psychiatric medication is to ease symptoms such as overwhelming anxiety or low mood, not to change your personality. Some people do notice side effects such as feeling emotionally muted, and if that happens it is important to tell me so we can respond. Starting cautiously and checking in often helps us catch this early.
What side effects should I expect at the start?
That depends on the medication, and I discuss the specifics with you before you begin. Many early side effects are mild and ease within the first weeks as your body adjusts. I will tell you what is common, what would be worth contacting me about, and what to do if something concerns you between appointments.
How long would I need to stay on medication?
There is no single answer. Some people take medication for a defined period while they stabilise and build other supports; others find longer-term treatment helpful. We review regularly whether it is still serving you. If the time comes to stop, we plan a gradual, monitored reduction together rather than stopping suddenly.
I tried medication once and hated it. Is it worth trying again?
It might be. A poor first experience can come from a medication that did not suit you, a dose increased too quickly, or too little support during the early weeks. We would look carefully at what happened and what you learned from it. You remain free to decide that medication is not for you, and I will respect that.
Can I have therapy and medication with the same person?
Yes. As a psychiatric nurse practitioner who also practises psychotherapy and somatic work, I can hold both within one relationship. For people new to medication this can be especially reassuring, because the feelings that come up about starting treatment can be explored in the same space where decisions are made.
Curious about medication but not sure yet?
Book a free 15-minute consultation. We can talk through your questions with no pressure and no expectation that you decide anything on the call.