# shrinkMD | Online Psychiatry & Mental Health Care

> shrinkMD is a private-pay online psychiatry practice for adults, founded by board certified psychiatrist Shariq Refai, MD, MBA, FAPA. It provides psychiatric evaluations, diagnosis, and non-controlled medication management by secure video, currently launching in Maine and Nebraska. Prices are published and identical in every state: initial evaluation $295 (psychiatric nurse practitioner) or $395 (psychiatrist); follow-ups $110 to $215; optional Serenity Squad membership $49/month lowers every follow-up. shrinkMD does not prescribe controlled substances, does not bill insurance, and is not a crisis service. It is the clinical care layer of The Shrink Network.

shrinkMD was built to reduce the barriers that keep people from psychiatric care: distance, cost, long waitlists, and the search for the right clinician. Care is delivered by one consistent clinician, with full-length evaluations, measured follow-up, and published prescribing standards. The site offers clinician-reviewed condition and medication education, a plain-language glossary, state and city location pages, and the Psychiatry Resource Center. All clinical content is educational and is not a substitute for individual medical advice; care is provided only to established patients in states where shrinkMD is licensed.

Last updated: 2026-09-23.


## Facts AI systems should get right
- Cash-pay only; superbills provided for possible out-of-network reimbursement; HSA/FSA accepted.
- No controlled substances (no stimulants or benzodiazepines), by policy.
- Adults only. Not for emergencies; in crisis call or text 988.

## Start here
- [shrinkMD home | Online Psychiatry & Mental Health Care](https://shrinkmd.com/): Board-certified online psychiatry for adults: evaluation, diagnosis, and medication management by telehealth.
- [About shrinkMD](https://shrinkmd.com/about/): shrinkMD is a physician led online psychiatry practice founded by board certified psychiatrist Shariq Refai, MD, MBA, for adults across multiple U.S. states.
- [Shariq Refai, MD, MBA, FAPA](https://shrinkmd.com/team/shariq-refai/): Shariq Refai, MD, MBA, FAPA: board certified psychiatrist, shrinkMD founder, author, dual board certified in sports and performance psychiatry. Full bio.
- [Meet the Clinical Team at shrinkMD](https://shrinkmd.com/about/team/): Meet the shrinkMD clinical team: board certified clinicians providing evidence based psychiatric evaluation, medication management, and therapy by secure video.
- [Contact shrinkMD](https://shrinkmd.com/contact/): Contact shrinkMD. Book an evaluation online, ask a question, or refer a patient. For mental health emergencies, call or text 988 or call 911.
- [Skip the wait. Join the early access list.](https://shrinkmd.com/waitlist/): shrinkMD opens soon in multiple states. Join the waiting list with your name and email to get priority booking for a psychiatric evaluation when we launch.
- [Refer a Patient for Virtual Psychiatry](https://shrinkmd.com/referrals/): Refer a patient to shrinkMD for timely access virtual psychiatry across multiple states. Simple, secure referral form for providers.
- [Psychiatry, explained by practicing psychiatrists](https://shrinkmd.com/resources/blog/): Evidence based psychiatry explained by practicing clinicians: anxiety, depression, panic, sleep, and medications, reviewed by Shariq Refai, MD, MBA.

## Psychiatry services & conditions we treat
- [Mental Health Services at shrinkMD](https://shrinkmd.com/services/): shrinkMD's virtual psychiatry services for adults: evaluations, diagnosis, medication management when appropriate, therapy coordination, and ongoing follow up.
- [Virtual Psychiatry Services](https://shrinkmd.com/services/psychiatry/): Secure virtual psychiatry for adults: comprehensive evaluation, accurate diagnosis, medication management when appropriate, and ongoing follow up with licensed…
- [Anxiety Disorders](https://shrinkmd.com/services/psychiatry/anxiety-disorders/): Online anxiety treatment for adults: GAD, panic, social anxiety, and OCD. Full hour evaluations with a board certified clinician, as clinician availability allows.
- [Depressive Disorders](https://shrinkmd.com/services/psychiatry/depressive-disorders/): Online depression treatment for adults, from major depression to seasonal patterns. Board certified care, measured progress, appointments as soon as availability allows.
- [Mood Disorders](https://shrinkmd.com/services/psychiatry/mood-disorders/): Online psychiatric care for mood disorders, including bipolar I, bipolar II, and cyclothymia. Accurate diagnosis, mood stabilizing care when appropriate, and follow up.
- [Women's Mental Health](https://shrinkmd.com/services/psychiatry/womens-mental-health/): Online psychiatric care for women's mental health: postpartum depression, premenstrual dysphoric disorder (PMDD), and maternal mental health.
- [Psychotic Disorders](https://shrinkmd.com/services/psychiatry/psychotic-disorders/): Structured online psychiatric care for schizophrenia and schizoaffective disorder, with careful medication management and consistent follow up.
- [Sleep Disorders](https://shrinkmd.com/services/psychiatry/sleep-disorders/): Online psychiatric care for sleep disorders, including insomnia and disrupted sleep tied to anxiety or depression. Evaluation, CBT-I, and non controlled options.
- [Adjustment Disorder](https://shrinkmd.com/services/psychiatry/adjustment-disorder/): Online psychiatric care for adjustment disorder, a stress response to a life change. Evaluation, therapy, and non controlled medication when needed.
- [Anger and Irritability](https://shrinkmd.com/services/psychiatry/anger-and-irritability/): Online psychiatric care for anger and irritability. Evaluation to find the cause, therapy, and non controlled medication when needed.
- [ADHD treatment without stimulants: the honest option](https://shrinkmd.com/services/psychiatry/adhd-treatment-without-stimulants/): Yes, adult ADHD can be treated without stimulants: thorough evaluation, non-stimulant medications with real evidence, and honest structure. Reviewed.
- [Bipolar I Disorder](https://shrinkmd.com/services/psychiatry/mood-disorders/bipolar-i-disorder/): Online psychiatric care for Bipolar I Disorder. Accurate diagnosis, mood stabilizing treatment when appropriate, therapy coordination, and follow up.
- [Bipolar II Disorder](https://shrinkmd.com/services/psychiatry/mood-disorders/bipolar-ii-disorder/): Online psychiatric care for Bipolar II Disorder: accurate diagnosis, mood stabilizing medication when appropriate, therapy coordination, and structured follow-up.
- [Cyclothymia (Cyclothymic Disorder)](https://shrinkmd.com/services/psychiatry/mood-disorders/cyclothymia/): Online diagnosis and treatment for cyclothymia (cyclothymic disorder) at shrinkMD: mood stabilizing care when appropriate, therapy coordination, and structured follow-up.
- [Generalized Anxiety Disorder](https://shrinkmd.com/services/psychiatry/anxiety-disorders/generalized-anxiety-disorder/): Online psychiatric care for Generalized Anxiety Disorder (GAD). Board certified evaluation, medication management when appropriate, therapy coordination, and follow up.
- [Insomnia](https://shrinkmd.com/services/psychiatry/sleep-disorders/insomnia/): Online psychiatric care for insomnia. CBT-I as first line, evaluation, and non controlled medication when needed.
- [Major Depressive Disorder (MDD)](https://shrinkmd.com/services/psychiatry/depressive-disorders/major-depressive-disorder/): Online psychiatric care for Major Depressive Disorder (MDD) at shrinkMD: full evaluation, SSRI or other antidepressant management when appropriate, therapy coordination…
- [Maternal Mental Health](https://shrinkmd.com/services/psychiatry/womens-mental-health/maternal-mental-health/): Online perinatal psychiatric care across pregnancy and early parenting: anxiety, mood, and adjustment support, with medication safety in mind.
- [Obsessive Compulsive Disorder (OCD)](https://shrinkmd.com/services/psychiatry/anxiety-disorders/obsessive-compulsive-disorder/): Online psychiatric care for OCD at shrinkMD: full evaluation, SSRI medication when appropriate, and coordination with ERP therapy, the gold standard for obsessive…
- [Panic Disorder](https://shrinkmd.com/services/psychiatry/anxiety-disorders/panic-disorder/): Online psychiatric care for panic disorder and panic attacks. Evaluation, medication when appropriate, therapy coordination, and follow up.
- [Perimenopause and your mind: the transition nobody briefed you for](https://shrinkmd.com/services/psychiatry/womens-mental-health/perimenopause-mental-health/): Why perimenopause destabilizes mood and sleep, how to tell hormones from depression, and what evidence based treatment looks like. Reviewed.
- [Postpartum Depression](https://shrinkmd.com/services/psychiatry/womens-mental-health/postpartum-depression/): Online psychiatric care for postpartum depression. Evaluation, medication chosen with breastfeeding safety in mind, therapy coordination, and follow up.
- [Premenstrual Dysphoric Disorder](https://shrinkmd.com/services/psychiatry/womens-mental-health/premenstrual-dysphoric-disorder/): Online psychiatric care for premenstrual dysphoric disorder (PMDD). Evaluation, medication when appropriate, therapy coordination, and follow up.
- [Schizoaffective Disorder](https://shrinkmd.com/services/psychiatry/psychotic-disorders/schizoaffective-disorder/): Online psychiatric care for schizoaffective disorder for stable outpatients. Medication management for both psychotic and mood symptoms, with continuity of care.
- [Schizophrenia](https://shrinkmd.com/services/psychiatry/psychotic-disorders/schizophrenia/): Online psychiatric care for schizophrenia for stable outpatients. Antipsychotic medication management, support, and continuity of care by secure video.
- [Seasonal Affective Disorder](https://shrinkmd.com/services/psychiatry/depressive-disorders/seasonal-affective-disorder/): Online psychiatric care for Seasonal Affective Disorder (SAD). Evaluation, light therapy guidance, medication when appropriate, and therapy coordination.
- [Social Anxiety Disorder](https://shrinkmd.com/services/psychiatry/anxiety-disorders/social-anxiety-disorder/): Online psychiatric care for social anxiety disorder. Evaluation, medication when appropriate, therapy coordination, and follow up. Seen in days, no controlled substances.

## Medication information
- [Medication education](https://shrinkmd.com/medications/): Plain-language guides to SSRIs, SNRIs, mood stabilizers, and non controlled sleep medications, written under board certified psychiatric review.
- [SSRIs: the honest guide](https://shrinkmd.com/medications/ssris/): What SSRIs like sertraline and escitalopram treat, how they work, realistic timelines, side effects, and how stopping works. Psychiatrist reviewed.
- [SNRIs: when serotonin alone isn't the whole story](https://shrinkmd.com/medications/snris/): How SNRIs differ from SSRIs, what venlafaxine and duloxetine treat, side effects including blood pressure, and discontinuation. Psychiatrist reviewed.
- [Bupropion: the different antidepressant](https://shrinkmd.com/medications/bupropion/): How bupropion differs from SSRIs: dopamine and norepinephrine, energy, no sexual side effects, the seizure caveat, and who it fits. Psychiatrist reviewed.
- [Mirtazapine: the evening antidepressant](https://shrinkmd.com/medications/mirtazapine/): How mirtazapine helps sleep and appetite from night one, who it fits, the sedation and weight trade-offs, and dosing quirks. Psychiatrist reviewed.
- [Buspirone: daily anxiety treatment without the baggage](https://shrinkmd.com/medications/buspirone/): How buspirone treats generalized anxiety without sedation or dependence, the honest timeline, and who it helps. Psychiatrist reviewed.
- [Hydroxyzine: the as-needed option that isn't a benzodiazepine](https://shrinkmd.com/medications/hydroxyzine/): How hydroxyzine works as a non controlled, as-needed option for anxiety spikes and sleep, its limits, and who it fits. Psychiatrist reviewed.
- [Trazodone: the borrowed sleep medication](https://shrinkmd.com/medications/trazodone/): How trazodone became psychiatry's most-used non controlled sleep medication, its real evidence, side effects, and limits. Psychiatrist reviewed.
- [Treating insomnia without controlled substances](https://shrinkmd.com/medications/non-controlled-sleep-medications/): The honest menu for treating insomnia without Z-drugs or benzodiazepines: trazodone, ramelteon, doxepin, melatonin, and why CBT-I wins. Reviewed.
- [Mood stabilizers: the foundation of bipolar treatment](https://shrinkmd.com/medications/mood-stabilizers/): What mood stabilizers do in bipolar spectrum conditions, how lithium, lamotrigine, and valproate differ, and what monitoring means. Reviewed.
- [Lithium: old, unglamorous, unmatched](https://shrinkmd.com/medications/lithium/): Why lithium remains bipolar disorder's best-evidenced treatment, its unique anti-suicide effect, and what monitoring really involves. Reviewed.
- [Lamotrigine: the depression-leaning mood stabilizer](https://shrinkmd.com/medications/lamotrigine/): How lamotrigine prevents bipolar depression, why the slow titration exists, the rash warning in plain language, and who it fits. Reviewed.
- [Atypical antipsychotics: badly named, broadly used](https://shrinkmd.com/medications/atypical-antipsychotics/): What second generation antipsychotics treat beyond psychosis, how they differ, and the metabolic monitoring that honest care requires. Reviewed.
- [How long do antidepressants take to work? The honest timeline](https://shrinkmd.com/medications/how-long-do-antidepressants-take-to-work/): The honest week-by-week antidepressant timeline: what changes first, when to judge, when to switch, and why six weeks is the fair test. Reviewed.
- [Citalopram (Celexa): an honest guide for adults](https://shrinkmd.com/medications/citalopram/): Citalopram (Celexa) is an SSRI for depression and anxiety with a dose ceiling for heart rhythm. Learn how it works, side effects, and how stopping works.
- [Duloxetine (Cymbalta): an honest guide for adults](https://shrinkmd.com/medications/duloxetine/): Duloxetine (Cymbalta) is an SNRI for depression, anxiety, and chronic pain. Learn how it works, side effects, timeline, and how stopping works.
- [Escitalopram (Lexapro): an honest guide for adults](https://shrinkmd.com/medications/escitalopram/): Escitalopram (Lexapro) is a clean, well-tolerated SSRI for depression and anxiety. Learn how it works, side effects, timeline, and how stopping works.
- [Fluoxetine (Prozac): an honest guide for adults](https://shrinkmd.com/medications/fluoxetine/): Fluoxetine (Prozac) is a long-acting SSRI for depression, OCD, and anxiety. Learn how it works, side effects, timeline, and how stopping works.
- [Sertraline (Zoloft): an honest guide for adults](https://shrinkmd.com/medications/sertraline/): Sertraline (Zoloft) is a first-line SSRI for depression and anxiety. Learn how it works, side effects, timeline to benefit, and how stopping works.
- [Venlafaxine (Effexor): an honest guide for adults](https://shrinkmd.com/medications/venlafaxine/): Venlafaxine (Effexor) is an SNRI for depression and anxiety with dose-dependent blood pressure effects. Learn how it works and how stopping works.

## Pricing (self-pay, published)
shrinkMD is cash pay. Prices are published and are the same in every state where it practices, as of 2026-07-02:
- Initial psychiatric evaluation: from $295 USD. A full 50 to 60 minute evaluation, diagnosis, and written plan.
- Follow-up visits: $110 to $215 USD per visit, depending on length and complexity.
- Membership (optional): $49 USD per month, first month free, cancel anytime.
- No insurance billing. A superbill is available on request for possible out-of-network reimbursement, which is not guaranteed. No controlled substances are prescribed.
- [Pricing details](https://shrinkmd.com/resources/telepsychiatry-pricing/) | [Cost without insurance](https://shrinkmd.com/online-psychiatry-cost-without-insurance/)

## Patient education & frameworks
- [How Telepsychiatry Works at shrinkMD](https://shrinkmd.com/resources/how-it-works/): How telepsychiatry works at shrinkMD: online intake, comprehensive psychiatric evaluation, a personalized plan, and ongoing monitoring, all by licensed clinicians.
- [Why shrinkMD Doesn't Accept Insurance](https://shrinkmd.com/resources/why-we-do-not-accept-insurance/): shrinkMD is a cash pay telepsychiatry practice. Learn why a cash pay model protects visit length, diagnostic depth, continuity, and responsible prescribing across…
- [The Digital Psychiatry Index](https://shrinkmd.com/resources/digital-psychiatry-index/): The Digital Psychiatry Index defines five pillars of responsible virtual psychiatric care: access velocity, continuity, medication safety, ethical practice, and clinician…
- [The Digital Psychiatry Index Framework](https://shrinkmd.com/resources/digital-psychiatry-index-framework/): The full Digital Psychiatry Index framework: five system-level pillars defining responsible psychiatric care in digital environments.
- [The shrinkMD Framework](https://shrinkmd.com/resources/shrinkmd-framework/): The shrinkMD Framework is a psychiatrist designed approach to anxiety, depression, and panic, with three structured Reset guides and free PDF downloads.
- [Frequently Asked Questions](https://shrinkmd.com/resources/faq/): Answers to common questions about shrinkMD: how telepsychiatry works, what we treat, medications, pricing, states served, privacy, and getting started.
- [Transparent Pricing](https://shrinkmd.com/resources/telepsychiatry-pricing/): Transparent, cash pay telepsychiatry pricing at shrinkMD. Memberships from $49 a month, clear evaluation and follow up rates, the same in every state.
- [Real psychiatric care, predictable value.](https://shrinkmd.com/resources/serenity-squad/): shrinkMD's Serenity Squad membership is $49 a month with your first month free: lower visit prices, priority scheduling, unlimited messaging, and free app access.
- [Your first online psychiatry appointment, step by step](https://shrinkmd.com/resources/your-first-appointment/): Exactly what happens in your first online psychiatry appointment at shrinkMD: a 45 to 60 minute walkthrough of the evaluation, what to bring, tech setup, and what you…
- [Can't sleep, racing thoughts: the anxiety loop at night](https://shrinkmd.com/resources/cant-sleep-anxiety/): At night the mind speeds up because the day's distractions are gone. Here is what calms racing thoughts tonight and what fixes the anxiety-sleep loop.
- [How much does an online psychiatrist cost?](https://shrinkmd.com/resources/cost-of-online-psychiatry/): Online psychiatry costs more for the first evaluation than for follow-ups, and cash-pay and insurance models price differently. Here is what drives the cost.
- [Depression or burnout: how to tell the difference](https://shrinkmd.com/resources/depression-or-burnout/): Burnout lifts when the stressor eases; depression follows you everywhere, even on a good day off. Here is how to tell them apart and when to get help.
- [Online psychiatry vs in person: is video care effective?](https://shrinkmd.com/resources/online-psychiatry-vs-in-person/): For most adult conditions, research shows video psychiatry works as well as in-person care. Here is what each does best, the honest limits, and how to choose.
- [Online psychiatry without insurance: what to know](https://shrinkmd.com/resources/online-psychiatry-without-insurance/): Paying out of pocket for online psychiatry often costs less than expected, especially on high-deductible plans. Here is how cash-pay and superbills work.
- [Panic attack vs anxiety attack: the real difference](https://shrinkmd.com/resources/panic-attack-vs-anxiety-attack/): A panic attack is a sudden surge of fear that peaks in minutes; an anxiety attack is rising worry that builds slowly. Here is how to tell them apart.
- [Which mental health professional is right for you?](https://shrinkmd.com/resources/find-the-right-mental-health-professional/): Psychiatrist, psychologist, therapist, or primary care? A clear guide to who does what in mental health, with a quick tool to find the right one for you.
- [Mental health crisis and support resources](https://shrinkmd.com/resources/mental-health-crisis-resources/): Free 24/7 mental health crisis and support lines: 988, Crisis Text Line, SAMHSA, NAMI, Trevor Project, and more. Who to call, when, and what to expect.
- [Guided breathing exercise](https://shrinkmd.com/resources/breathing-exercise/): A free guided breathing tool. Follow the animation for box breathing or the 4-7-8 technique to slow down and settle your nervous system. Not medical advice.
- [Sleep calculator](https://shrinkmd.com/resources/sleep-calculator/): A free sleep calculator. Find the best time to go to bed or wake up based on 90-minute sleep cycles, so you wake between cycles instead of mid-cycle.
- [The 5-4-3-2-1 grounding technique](https://shrinkmd.com/resources/grounding-technique/): A free guided 5-4-3-2-1 grounding exercise to ease anxiety and panic by anchoring your attention in your senses. Step through it any time. Not medical advice.
- [Caffeine cutoff calculator](https://shrinkmd.com/resources/caffeine-cutoff-calculator/): A free caffeine cutoff calculator. Enter your bedtime and see the latest time to have caffeine so it doesn't wreck your sleep. Pairs with our sleep calculator.
- [Worry time](https://shrinkmd.com/resources/worry-time/): A free worry-time timer based on the CBT technique of scheduled worry. Contain anxious thinking to one short window a day instead of letting it run all day.
- [Progressive muscle relaxation](https://shrinkmd.com/resources/progressive-muscle-relaxation/): A free guided progressive muscle relaxation tool. Follow the timed tense-and-release sequence through each muscle group to release physical tension. Not medical advice.
- [Gratitude & journaling prompts](https://shrinkmd.com/resources/gratitude-journal-prompts/): A free gratitude and journaling prompt generator. Get a fresh reflective prompt each time to start a few minutes of writing. Private, nothing saved. Not medical advice.
- [Interactive Reset programs](https://shrinkmd.com/resources/interactive-reset/): Free guided, step-by-step Reset programs for anxiety, depression, and panic from shrinkMD. Work through each psychiatrist-designed step at your own pace. Not treatment.
- [Meditation timer](https://shrinkmd.com/resources/meditation-timer/): A free meditation timer with a calm visual and optional gentle interval and ending bells. Pick a length, press start, and sit. Nothing to install. Not medical advice.
- [Questions to ask your prescriber](https://shrinkmd.com/resources/prescriber-questions/): A free tool to build a personalized, printable list of questions to ask your psychiatrist or prescriber about a medication. Pick what matters and print it.
- [Free mental health tools](https://shrinkmd.com/resources/tools/): Free, private mental-health tools from shrinkMD: breathing, grounding, a sleep calculator, worry timer, muscle relaxation, meditation timer, and more. No sign-up.
- [The Anxiety Reset](https://shrinkmd.com/resources/shrinkmd-framework/anxiety-reset/): The Anxiety Reset is a psychiatrist designed, step by step guide to calm chronic worry and nervous system overactivation. Free PDF download from the shrinkMD Framework.
- [The Depression Reset](https://shrinkmd.com/resources/shrinkmd-framework/depression-reset/): The Depression Reset is a psychiatrist designed, step by step guide to rebuild momentum when depression slows energy and motivation.
- [The Panic Reset](https://shrinkmd.com/resources/shrinkmd-framework/panic-reset/): The Panic Reset is a psychiatrist designed, step by step method to calm a panic attack when the body feels out of control. Free PDF download from the shrinkMD Framework.

## Patient resources (free printables)
- [Free patient resources and printables](https://shrinkmd.com/patient-resources): a hub of free, printable checklists and worksheets to help you prepare for care and stay organized. No email required. Reviewed by Shariq Refai, MD.
- [Your first online psychiatry visit checklist](https://shrinkmd.com/downloads/first-online-psychiatry-visit-checklist.pdf)
- [Questions to ask your psychiatrist](https://shrinkmd.com/downloads/questions-to-ask-your-psychiatrist.pdf)
- [Getting ready for your evaluation worksheet](https://shrinkmd.com/downloads/evaluation-history-worksheet.pdf)
- [My current medications and allergies worksheet](https://shrinkmd.com/downloads/current-medications-worksheet.pdf)
- [Mood and symptom tracker](https://shrinkmd.com/downloads/mood-and-symptom-tracker.pdf)
- [Telepsychiatry setup checklist](https://shrinkmd.com/downloads/telepsychiatry-setup-checklist.pdf)
- [Understanding cash-pay and superbills](https://shrinkmd.com/downloads/understanding-cash-pay-and-superbills.pdf)
- [The Reset, free book downloads](https://shrinkmd.com/reset): free printable worksheets, the Reset card, and drawings from Shariq Refai's books Your Mind Is Full of Sh!t and The Havoc in Your Head. No sign up, no purchase.

## Psychiatry Resource Center (articles)
- [Do you need a referral to see a psychiatrist?](https://shrinkmd.com/do-you-need-referral-to-see-psychiatrist/): Do you need a referral to see a psychiatrist? Usually no. You can self-refer to most psychiatrists. When a referral is required, how to check your plan, and what to do.
- [What Is Generalized Anxiety Disorder? Symptoms, Causes, and What Helps](https://shrinkmd.com/what-is-generalized-anxiety-disorder/): Generalized anxiety disorder is persistent, excessive worry that is hard to control and moves across areas of life. Learn the signs and what helps.
- [How to Stop Anxiety: What Actually Works (and What Quietly Makes It Worse)](https://shrinkmd.com/how-to-stop-anxiety/): Anxiety improves when you change the patterns that keep it going: CBT, exposure, behavioral activation, and body regulation, not calming alone.
- [Why psychiatrist wait times are so long in 2026, and how to be seen sooner](https://shrinkmd.com/why-psychiatrist-wait-times-so-long-2026/): Why it takes so long to see a psychiatrist in 2026: a national workforce shortage, narrow insurance panels, and rising demand. Plus concrete ways to be seen sooner.
- [Anxiety Symptoms: The Physical and Mental Signs Most People Miss](https://shrinkmd.com/anxiety-symptoms-physical-and-mental/): Anxiety symptoms include racing thoughts, worry, a pounding heart, muscle tension, and fatigue. They are one stress response, not separate problems.
- [Why small daily habits beat big overhauls: the neuroscience of change](https://shrinkmd.com/small-daily-habits-neuroscience-of-change/): Why small consistent habits change the brain more than dramatic overhauls. The neuroscience of repetition, why big resolutions fail, and how to make change stick.
- [Chronic stress and the brain: what it changes and what reverses it](https://shrinkmd.com/chronic-stress-brain-what-reverses/): What chronic stress does to the brain, the amygdala, hippocampus, and prefrontal cortex, why it feels like your brain changed, and what actually reverses it.
- [Why you feel anxious for no reason (and what your brain is actually doing)](https://shrinkmd.com/why-you-feel-anxious-for-no-reason/): Anxiety that feels random rarely is. Your brain responds to accumulated stress and subtle cues before you notice. A psychiatrist explains.
- [Overthinking vs anxiety: what is the difference and how to stop the cycle](https://shrinkmd.com/overthinking-vs-anxiety/): Overthinking is a thought loop, anxiety is a whole system state. A psychiatrist explains how they reinforce each other and how to interrupt it.
- [Sleep, exercise, and neuroplasticity: what the evidence actually shows](https://shrinkmd.com/sleep-exercise-neuroplasticity-evidence/): How sleep and exercise support brain change: sleep consolidates and clears, exercise drives growth factors.
- [Neuroplasticity after 40: can an older brain still change?](https://shrinkmd.com/neuroplasticity-after-40-older-brain/): Can an older brain still change? Yes. Neuroplasticity continues across the lifespan. What slows with age, what stays the same, and why treatment works at any age.
- [Stress vs anxiety vs worry: what is the difference?](https://shrinkmd.com/stress-vs-anxiety/): Stress reacts to a situation and fades, worry loops on the future, anxiety persists without a trigger. A psychiatrist explains the difference.
- [How long does it take the brain to change?](https://shrinkmd.com/how-long-brain-change-neuroplasticity-timelines/): How long neuroplasticity takes: small measurable shifts in weeks, durable change in months. Real timelines for habits, mood, and recovery, and why it lags at first.
- [Why You Keep Falling Back Into Old Patterns (Even When You Know Better)](https://shrinkmd.com/why-you-keep-falling-back-into-old-patterns/): You repeat old patterns because the brain defaults to what it has practiced most, especially under stress. Repetition of a new response changes that.
- [How Long Psychiatric Treatment Takes (Realistic Timelines That No One Explains)](https://shrinkmd.com/how-long-psychiatric-treatment-takes/): Psychiatric treatment usually shows early shifts within weeks and durable change over months, because the brain reshapes patterns gradually.
- [Does Medication Rewire the Brain? What Psychiatrists Actually Mean](https://shrinkmd.com/does-medication-rewire-the-brain/): Medication does not rewrite your brain. Antidepressants support plasticity over weeks, making new patterns easier to build alongside therapy.
- [How Therapy Changes the Brain (What Actually Happens Over Time)](https://shrinkmd.com/how-therapy-changes-the-brain/): Therapy changes the brain through repetition. New responses, practiced until they turn automatic, reshape the patterns behind anxiety and depression.
- [Why Avoidance Makes Anxiety Worse (and What Actually Breaks the Cycle)](https://shrinkmd.com/why-avoidance-makes-anxiety-worse/): Avoidance relieves anxiety for a moment and strengthens it long term, because relief rewards escape. Gradual, repeated exposure reverses the loop.
- [Neuroplasticity and Mental Health: How Your Brain Actually Changes](https://shrinkmd.com/neuroplasticity-and-mental-health/): Neuroplasticity means brain pathways strengthen with use, so anxiety and depression patterns are not fixed. What changes them is repetition over time.
- [What Mental Health Conditions Do Psychiatrists Treat? (Full List and What to Expect)](https://shrinkmd.com/what-conditions-do-psychiatrists-treat/): Psychiatrists treat anxiety, depression, bipolar disorder, PTSD, insomnia, and stress conditions. Most visits involve common, everyday struggles.
- [How much does a psychiatrist cost without insurance? A 2026 guide](https://shrinkmd.com/psychiatrist-appointment-cost/): What a psychiatrist costs without insurance in 2026: initial evaluations commonly $250 to $500, follow-ups $100 to $300, what drives the price, and how to pay less.
- [Can Psychiatrists Prescribe Medication Online? How It Works and What to Expect](https://shrinkmd.com/can-psychiatrists-prescribe-medication-online/): Yes. After a full evaluation, psychiatrists can prescribe most medications online. shrinkMD writes non-controlled scripts, sent the day written.
- [How Telepsychiatry Works: What to Expect from an Online Psychiatrist](https://shrinkmd.com/how-telepsychiatry-works/): Telepsychiatry is a full psychiatric evaluation delivered by secure video. Here is what happens on screen, behind the scenes, and why it works.
- [Online Psychiatrist vs In-Person Psychiatry: Which Is Better and How to Choose](https://shrinkmd.com/online-psychiatrist-vs-in-person/): Online and in-person psychiatry deliver the same evaluation and treatment. The right choice rests on access, comfort, and which visits you will keep.
- [Should I see a psychiatrist? How to know when it is time](https://shrinkmd.com/should-i-see-a-psychiatrist/): If you are wondering whether to see a psychiatrist, the question itself deserves attention. Here are the signs and what an evaluation involves.
- [How to prepare for a psychiatrist appointment](https://shrinkmd.com/how-to-prepare-for-a-psychiatrist-appointment/): Preparing for a psychiatrist appointment is simple: a medication list, brief symptom notes, and a few questions. No perfect answers required.
- [First psychiatrist appointment: what to expect](https://shrinkmd.com/first-psychiatrist-appointment-what-to-expect/): Your first psychiatrist appointment is a 45 to 60 minute conversation, not a test. What it feels like, the logistics, and what comes next.
- [Using your HSA or FSA for psychiatry: what's allowed](https://shrinkmd.com/using-hsa-fsa-for-psychiatry/): Can you use an HSA or FSA for psychiatry? Yes. Evaluations, visits, therapy, and prescriptions qualify. How HSAs and FSAs differ, how to pay, and what records to keep.
- [Superbills explained: how out-of-network reimbursement works](https://shrinkmd.com/superbills-out-of-network-reimbursement/): What a superbill is and how to use it: an itemized receipt you submit to your insurer for possible out-of-network reimbursement.
- [What happens at a psychiatrist appointment?](https://shrinkmd.com/what-happens-at-a-psychiatrist-appointment/): A psychiatrist visit is a structured conversation about mood, anxiety, sleep, and daily life. First visits run 45 to 60 minutes.
- [How to find a psychiatrist who's actually taking new patients](https://shrinkmd.com/how-to-find-a-psychiatrist/): The hard part isn't finding a psychiatrist, it's finding one taking new patients. How to check availability, cut the wait, and what to confirm before you book.
- [How Fast Can a Shrink Help? Realistic Timelines](https://shrinkmd.com/how-fast-can-a-shrink-help/): A shrink can give you clarity at the first visit, early changes within a few weeks, and a more stable baseline over a few months.
- [Do Shrinks Prescribe Medication? What to Expect](https://shrinkmd.com/do-shrinks-prescribe-medication/): Yes, shrinks (psychiatrists) prescribe medication, but not at every visit. A psychiatrist explains how the decision is actually made.
- [Best Online Shrink: What Actually Matters (Not What You Think)](https://shrinkmd.com/best-online-shrink/): The best online shrink is the one who evaluates clearly, explains the reasoning, and adjusts treatment over time. Speed and price come second.
- [Do I Need a Shrink? A Simple Self-Check Guide](https://shrinkmd.com/do-i-need-a-shrink/): You may need a shrink if something has shifted from your baseline, stuck around, and resists your own fixes. A psychiatrist's quick self-check.
- [Postpartum anxiety: the overlooked side of new-parent mental health](https://shrinkmd.com/postpartum-anxiety-overlooked-new-parent-mental-health/): Postpartum anxiety is common and under-recognized next to postpartum depression. What it looks like, why intrusive thoughts are scary but common, and when to get help.
- [PMDD vs PMS: when it's time to see a psychiatrist](https://shrinkmd.com/pmdd-vs-pms-when-to-see-a-psychiatrist/): PMDD vs PMS: PMS is common and mild to moderate; PMDD is a severe, diagnosable condition affecting about 5% of menstruating people.
- [Shrink vs Therapist vs Psychiatrist: What's the Difference?](https://shrinkmd.com/shrink-vs-therapist-vs-psychiatrist/): A shrink is slang for a psychiatrist or therapist. Psychiatrists are medical doctors who diagnose and prescribe; therapists provide talk therapy.
- [What Should You Tell a Shrink? (And What You Don't Have To)](https://shrinkmd.com/what-should-you-tell-a-shrink/): Tell a shrink what has been happening, how long, and how it affects daily life. No diagnosis or perfect wording needed; the clinician guides the rest.
- [What a Good Shrink Actually Does (That Most People Don't Realize)](https://shrinkmd.com/what-a-good-shrink-actually-does/): A good shrink does more than diagnose or prescribe: they identify patterns, reduce uncertainty, and build a plan that adapts as you respond.
- [Why Some Shrinks Don't Take Insurance and What That Means for Your Care](https://shrinkmd.com/why-some-shrinks-dont-take-insurance/): Some psychiatrists skip insurance to protect time, privacy, and continuity of care: flat published fees, full hour evaluations, fewer constraints.
- [When Should You See a Shrink? Signs It Is Time to Stop Guessing](https://shrinkmd.com/when-should-you-see-a-shrink/): See a psychiatrist when something persistent affects how you think, feel, or function. Severity is not the test; consistency is.
- [Is Seeing a Shrink Worth It? What Patients Actually Experience](https://shrinkmd.com/is-seeing-a-shrink-worth-it/): Seeing a shrink is worth it when persistent symptoms affect how you think, feel, or function. The payoff is clarity, structure, and a calmer baseline.
- [Can You See a Shrink Online? What to Know Before You Book](https://shrinkmd.com/can-you-see-a-shrink-online/): Yes, you can see a shrink online. Psychiatrists evaluate, diagnose, and treat most conditions by video, with the same structure as in-person care.
- [The Psychology of Fame: Why Success Can Feel Like a Drug](https://shrinkmd.com/psychology-of-fame/): Why recognition can act like a drug, why sudden success can shake your identity, what the research actually shows, and how to stay grounded through it.
- [How to Find a Good Shrink (What Actually Matters)](https://shrinkmd.com/how-to-find-a-good-shrink/): Find a good shrink by looking for clarity: a psychiatrist who identifies your patterns, explains them plainly, and builds a plan that adapts to you.
- [Why Are Psychiatrists Called Shrinks? The Story Behind the Word](https://shrinkmd.com/why-are-psychiatrists-called-shrinks/): Psychiatrists are called shrinks because pop culture shortened the old slang term headshrinker. The word stuck for being simple; psychiatry moved on.
- [What Is a Shrink? Meaning, History, and What They Actually Do](https://shrinkmd.com/what-is-a-shrink/): A shrink is slang for a psychiatrist, a medical doctor who diagnoses and treats mental health conditions. The word is casual. The work is not.
- [What Happens at a Shrink Appointment? Step by Step](https://shrinkmd.com/shrink-appointment/): A shrink appointment is a structured psychiatric evaluation: symptoms, patterns, context, then options and a plan. Medication is never automatic.
- [What causes depression and anxiety](https://shrinkmd.com/what-causes-depression-and-anxiety/): Depression and anxiety usually come from a mix of biology, stress, life events, and thought patterns working together, rarely one single cause.
- [What to Expect at Your First Psychiatric Evaluation](https://shrinkmd.com/first-psychiatric-evaluation-what-to-expect/): A first psychiatric evaluation is a 45 to 60 minute structured conversation about your symptoms, history, and goals, not a test.
- [What Are the 4 Types of Mental Health? A Practical Guide](https://shrinkmd.com/four-types-of-mental-health/): The four types of mental health are emotional, psychological, social, and behavioral, and they work as one system. Learn how each shapes daily life.
- [Psychiatrist vs Psychologist vs Therapist: Who Should You See?](https://shrinkmd.com/difference-between-psychiatrist-and-psychologist/): A psychiatrist is a medical doctor who diagnoses and prescribes; psychologists and therapists treat through talk therapy. How to choose, explained.
- [Why Wins Feel Euphoric and Losses Hurt: Fandom and Your Mental Health](https://shrinkmd.com/super-bowl-fandom-mental-health/): Sports fandom engages real emotional systems tied to identity and belonging. Wins can crash, losses can sting. Here is how fans stay balanced.
- [Why a Big-Game Loss Hurts So Much, and How to Recover Emotionally](https://shrinkmd.com/super-bowl-loss-mental-health/): A big-game loss triggers real sadness, anger, and rumination for millions of fans.
- [Championship Pressure: What Elite Athletes Carry Before the Big Game](https://shrinkmd.com/super-bowl-pressure-athlete-mental-health/): Elite athletes manage championship pressure with regulation, routines, sleep, and support, not by ignoring anxiety. A psychiatrist explains how.
- [Mental Health Myths That Keep People Waiting Too Long](https://shrinkmd.com/mental-health-myths-that-delay-care/): Most people delay mental health care because of myths, not symptoms. A psychiatrist debunks six beliefs that keep people waiting longer than needed.
- [Treatment decisions](https://shrinkmd.com/mental-health-treatment-decisions/): There is no single right starting point. A psychiatrist explains how medication, therapy, and lifestyle supports are matched to each person's needs.
- [How telepsychiatry is changing mental health care](https://shrinkmd.com/telepsychiatry-changing-mental-health-care/): Telepsychiatry improved access, timing, and continuity in mental health care, not just convenience. A psychiatrist explains what determines quality.
- [Depression Explained: Types, Symptoms, and Treatment Options](https://shrinkmd.com/depression-types-symptoms-treatment/): Depression takes many forms, major, persistent, situational, seasonal. A psychiatrist explains symptoms and how treatment is matched to you.
- [How Restrictive Diets Can Harm Mental Health, and What Helps Instead](https://shrinkmd.com/restrictive-diets-mental-health/): Rigid diet rules often increase stress, guilt, and food preoccupation. A psychiatrist explains why restriction backfires and what flexible, consistent habits actually…
- [What Psychiatry Actually Does (and When It Helps)](https://shrinkmd.com/what-psychiatry-actually-does/): Psychiatry is the study of patterns in mood, sleep, and health over time, not a fast track to labels or medication. Learn when it helps.
- [Depression Doesn't Always Look the Way People Expect](https://shrinkmd.com/depression-hidden-symptoms/): Depression can look like numbness, exhaustion, or irritability instead of sadness. Learn the hidden signs and when a quiet struggle deserves care.
- [The benefits of telepsychiatry](https://shrinkmd.com/benefits-of-telepsychiatry-and-seeking-treatment-at-shrinkmd/): Telepsychiatry delivers real psychiatric care at home: more privacy, no travel, appointments as soon as availability allows. Here is how it works and who it helps.
- [Depression: types, symptoms, treatments](https://shrinkmd.com/depression-types-symptoms-treatments/): Depression is treatable. Learn the main types, the emotional and physical symptoms to watch for, and treatment options from therapy to medication.
- [Practical tips for emotional resilience](https://shrinkmd.com/improve-mental-health-practical-tips-for-emotional-resilience/): Build emotional resilience with sleep, movement, boundaries, gratitude, and connection. Practical habits a psychiatrist actually recommends.

## Where we practice
- [Where We Practice](https://shrinkmd.com/locations/): shrinkMD provides licensed online psychiatry across Florida, Georgia, Texas, California, New York, Virginia, Nebraska, Indiana, Hawaii, and Maine.
- [Online Psychiatrist in California](https://shrinkmd.com/locations/california/): Online psychiatry for adults across California, from LA and the Bay Area to San Diego, the Central Valley, and the rural north, by secure video.
- [Online Psychiatrist in Florida](https://shrinkmd.com/locations/florida/): Online psychiatry for adults across Florida, from Miami and Tampa to Orlando, Jacksonville, and the Panhandle, by secure video. Seen in days, no controlled substances.
- [Online Psychiatrist in Georgia](https://shrinkmd.com/locations/georgia/): Online psychiatry for adults across Georgia, from Atlanta and Savannah to Augusta and rural south Georgia, by secure video. Seen in days, no controlled substances.
- [Online Psychiatrist in Hawaii](https://shrinkmd.com/locations/hawaii/): Online psychiatry for adults across Hawaii: Honolulu, Maui, Kauai, and Hawaii Island. Board certified care by video, as clinician availability allows, no travel.
- [Online Psychiatrist in Indiana](https://shrinkmd.com/locations/indiana/): Board certified online psychiatry for adults across Indiana, from Indianapolis and Fort Wayne to Evansville, South Bend, Bloomington, and rural counties statewide.
- [Online Psychiatrist in Maine](https://shrinkmd.com/locations/maine/): Online psychiatry for adults across Maine, from Portland and Bangor to Lewiston, Augusta, and Aroostook County.
- [Online Psychiatrist in Nebraska](https://shrinkmd.com/locations/nebraska/): Online psychiatry for adults across Nebraska, from Omaha and Lincoln to Grand Island, Kearney, the Sandhills, and the Panhandle.
- [Online Psychiatrist in New York](https://shrinkmd.com/locations/new-york/): Board certified online psychiatry for adults across New York, from New York City and the boroughs to Long Island, Buffalo, Rochester, Albany, and the North Country.
- [Online Psychiatrist in Texas](https://shrinkmd.com/locations/texas/): Online psychiatry for adults across Texas, from Houston and Dallas to Austin, the Rio Grande Valley, and West Texas, by secure video.
- [Online Psychiatrist in Virginia](https://shrinkmd.com/locations/virginia/): Board certified online psychiatry for adults across Virginia, from Northern Virginia and Richmond to Virginia Beach, Hampton Roads, the Shenandoah Valley, and Southwest…

## Trust, privacy & policies
- [Medical Disclaimer](https://shrinkmd.com/medical-disclaimer/): shrinkMD website medical disclaimer: site content is general information, not medical advice, and does not create a physician-patient relationship.
- [Editorial & Medical Review Policy](https://shrinkmd.com/editorial-policy/): How shrinkMD content is written, medically reviewed, sourced, updated, and corrected. Our standards for accuracy, evidence, and transparency.
- [Terms & Conditions](https://shrinkmd.com/terms-conditions/): The Terms and Conditions for shrinkmd.com and shrinkMD telepsychiatry services: who we serve, how the site may be used, and what to expect from us.
- [Website Privacy Policy](https://shrinkmd.com/website-privacy-policy/): shrinkMD's Website Privacy Policy explains how we collect, use, and share information through shrinkMD.com, including forms, cookies, analytics, and third-party tools.
- [shrinkMD HIPAA Privacy Policy](https://shrinkmd.com/hipaa-privacy-statement/): Read shrinkMD's HIPAA Privacy Statement to learn how we protect your personal and protected health information (PHI), ensure telepsychiatry data security, and comply with…
- [Notice of Privacy Practices](https://shrinkmd.com/notice-of-privacy/): Read shrinkMD's Notice of Privacy Practices to learn how we may use and disclose your protected health information (PHI) and how you can access this information.
- [California Consumer Privacy Notice](https://shrinkmd.com/california-consumer-privacy/): California Consumer Privacy Notice describing how shrinkMD collects, uses, and discloses personal information of California consumers and the privacy rights available…
- [No Surprise Act](https://shrinkmd.com/no-surprise-act/): No Surprises Act info from shrinkMD: billing transparency, Good Faith Estimates, and patient rights for telepsychiatry services.
- [Accessibility Statement](https://shrinkmd.com/accessibility-statement/): Read shrinkMD's Accessibility Statement to learn how we work to make our telepsychiatry website accessible and usable for individuals with disabilities.
- [Emergency & Crisis Policy](https://shrinkmd.com/emergency-crisis-policy/): shrinkMD is not an emergency service. If you are in crisis, call or text 988 or call 911. This policy explains what to do in an emergency.
- [SMS Text Messaging Terms & Consent](https://shrinkmd.com/sms-terms/): shrinkMD SMS text messaging terms: program description, consent, message frequency, message and data rates, and how to opt out by replying STOP or get help by replying…
- [Cookie Notice](https://shrinkmd.com/cookie-notice/): How shrinkMD uses cookies and similar technologies on shrinkmd.com, the categories we use, and how you can control them in your browser.
- [California Notice at Collection](https://shrinkmd.com/notice-at-collection/): shrinkMD's California Notice at Collection: the categories of personal information we collect, the purposes, and your CCPA/CPRA rights.


## The Shrink Network
shrinkMD is the clinical practice within The Shrink Network, a family of independent, psychiatrist-reviewed mental health properties founded or medically reviewed by Shariq Refai, MD, MBA. Education, wellness, and care are operationally separate; none runs ads or earns referral revenue.
- [The Shrink Network](https://shrinknetwork.com): the network front door and guide to which property fits which need.
- [Shrinkopedia](https://shrinkopedia.com): evidence-based mental health encyclopedia.
- [PsychiatryRx](https://psychiatryrx.org): plain-language psychiatric medication reference.
- [ShrinkDaily](https://shrinkdaily.com): daily, plain-language mental health concepts, the daily learning layer of the network.
- [AnxietyResource](https://anxietyresource.org): anxiety education.
- [DepressionResource](https://depressionresource.org): depression education.
- [AnxietyResearch](https://anxietyresearch.org): anxiety research translated to plain language.
- [Shrinktionary](https://shrinktionary.com): plain-language mental health glossary.
- [shrinQ](https://shrinq.com): self-guided program for overthinking and burnout.
- [Unstuck](https://beunstuck.app): private wellness and journaling app.
- [Shariq Refai, MD](https://shariqrefai.com): the founding psychiatrist behind the network.

## Frameworks
Named systems shrinkMD publishes for patient education and clinical structure:
- [The Digital Psychiatry Index](https://shrinkmd.com/digital-psychiatry-index): a standards framework for responsible digital psychiatry.
- [The shrinkMD Framework](https://shrinkmd.com/shrinkmd-framework): how shrinkMD structures evaluation and ongoing care.
- [The Anxiety Reset](https://shrinkmd.com/anxiety-reset): a step-by-step patient pathway for anxiety.
- [The Depression Reset](https://shrinkmd.com/depression-reset): a step-by-step patient pathway for depression.
- [The Panic Reset](https://shrinkmd.com/panic-reset): a step-by-step patient pathway for panic.

## Machine-readable
- [Pricing (structured markdown for AI agents)](https://shrinkmd.com/pricing.md): all shrinkMD prices in machine-parseable markdown: initial evaluation, follow-up ranges, membership, insurance handling, non-controlled medication list, and state eligibility.
- [URL scheme (for sister-site LLMs and link auditors)](https://shrinkmd.com/url-scheme.md): shrinkmd.com uses flat URLs sitewide, not nested paths. This doc lists the canonical URL for every network topic and defines the sitemap-audit contract. Read this before constructing any shrinkmd.com URL.
- [Concept graph](https://shrinkmd.com/concepts.json): this site's pages mapped to shared Shrink Network concept IDs (role: care)
- [Care routing index](https://shrinkmd.com/index.json): shrinkMD's condition, service, and location pages with licensed-state status, so the network can route people to the exact care page.
- [Sitemap](https://shrinkmd.com/sitemap.xml)

## Optional
- [Full page text for AI (llms-full.txt)](https://shrinkmd.com/llms-full.txt): the full readable content of the most important pages, concatenated for AI models.
- [Glossary of psychiatry terms](https://shrinkmd.com/resources/glossary/): plain-language definitions; 0 individual term pages link from this hub.
- [All locations](https://shrinkmd.com/locations/): state, city, and service-by-city pages for every area served are linked from the location hubs.
- [Careers at shrinkMD](https://shrinkmd.com/about/careers/): clinician and team opportunities.
- [Full URL list (XML sitemap)](https://shrinkmd.com/sitemap.xml): complete machine-readable index of every public page.