Trauma & PTSD Treatment in Michigan — Telehealth Psychiatric Evaluation & Medication Management
If a past experience — or years of repeated experiences — is still shaping how you feel, think, sleep, and move through the world today, psychiatric evaluation and medication management can be a meaningful part of recovery.
Skye Mental Health provides telehealth psychiatric evaluation and medication management for trauma, PTSD, and Complex PTSD in adults and teenagers across Michigan. Both providers — Dr. Jennifer Sam, DNP, PMHNP-BC and Darla Dane, PMHNP-BC — are board-certified Psychiatric Mental Health Nurse Practitioners with extensive clinical experience evaluating and treating trauma-related conditions at the psychiatric level. All appointments are conducted by video via Zoom across Michigan.
Understanding the difference — trauma responses, Acute Stress Disorder, and PTSD
One of the most important things a psychiatric evaluation establishes is where on the clinical spectrum a patient's experience falls. Not every difficult experience produces PTSD. Not every trauma response requires the same treatment. Understanding the distinctions matters because the diagnosis determines the treatment approach.
Trauma responses A trauma response is the brain and nervous system's immediate reaction to an overwhelming experience — one that exceeds the person's capacity to process and integrate it in the moment. Trauma responses include shock, emotional numbness, hyperarousal, intrusive memories, avoidance, and difficulty functioning. These responses are neurologically normal — they are the brain's survival mechanism activating in response to perceived threat. They become clinically significant when they persist, intensify, or begin to significantly impair functioning beyond the immediate aftermath of the event.
Not everyone who experiences trauma develops a diagnosable condition. Protective factors — social support, prior resilience, the nature of the trauma, and access to timely care — influence whether trauma responses resolve naturally or consolidate into a clinical disorder. When they do not resolve, clinical evaluation is appropriate.
Acute Stress Disorder (ASD) Acute Stress Disorder is diagnosed when trauma symptoms — intrusive memories, dissociation, avoidance, hyperarousal, and negative mood — appear within three days of a traumatic event and persist for between three days and one month. ASD is the brain's acute trauma response in its most concentrated form. It is clinically significant because approximately half of people who develop ASD go on to develop PTSD if left untreated. Early psychiatric evaluation and intervention during the ASD window can meaningfully reduce that risk.
Post-Traumatic Stress Disorder (PTSD) PTSD is diagnosed when trauma symptoms persist beyond one month following a traumatic event and cause significant impairment in social, occupational, or other areas of functioning. PTSD involves four symptom clusters: intrusion symptoms such as flashbacks and nightmares, avoidance of trauma-related stimuli, negative alterations in cognition and mood, and alterations in arousal and reactivity such as hypervigilance and exaggerated startle response. PTSD can develop immediately following a trauma or emerge months or even years later — delayed-onset PTSD is a recognized and clinically important presentation.
PTSD is not a sign of weakness or inadequate resilience. It is a neurological condition in which the brain's fear-processing system — the amygdala and its relationship with the hippocampus and prefrontal cortex — has been altered by overwhelming experience in ways that do not self-correct without intervention.
Complex PTSD (C-PTSD) Complex PTSD develops not from a single traumatic event but from prolonged, repeated exposure to trauma — most commonly childhood abuse or neglect, domestic violence, human trafficking, prolonged captivity, or long-term exposure to war or community violence. C-PTSD shares the core symptom clusters of PTSD but additionally involves profound disturbances in self-perception, emotional regulation, and relational functioning that reflect the chronic nature of the trauma experienced.
People with C-PTSD often describe a pervasive sense of shame and worthlessness, difficulty trusting others, intense and rapidly shifting emotional states, a feeling of being permanently damaged, and a disrupted sense of identity that predates any specific memory of trauma. C-PTSD is frequently misdiagnosed as borderline personality disorder, bipolar disorder, or treatment-resistant depression — conditions that share surface features but have different origins and require different treatment approaches.
Skye Mental Health evaluates and treats Complex PTSD. Accurate diagnosis — distinguishing C-PTSD from the conditions it resembles — is one of the most important things a thorough psychiatric evaluation can accomplish for this patient population.
Who this is for:
Adults and teenagers ages 12–17 experiencing trauma, PTSD, or Complex PTSD in Michigan
Provider: Dr. Jennifer Sam, DNP, PMHNP-BC and Darla Dane, PMHNP-BC
Appointment type: Telehealth video via Zoom
New patient wait: Approximately 3 days
Insurance: Most major Michigan plans accepted (see complete list here)
Self-pay: $200 initial evaluation | $100 follow-up
Types of trauma Skye Mental Health evaluates in patients
Trauma is not limited to combat or acute physical events. The following experiences are all recognized sources of clinically significant trauma:
Childhood abuse — physical, emotional, or sexual
Childhood neglect — emotional or physical
Domestic violence or intimate partner violence
Sexual assault or rape
Serious accidents or medical trauma
Sudden loss of a loved one
Witnessing violence or death
Natural disasters
Community violence
Medical procedures or illness — particularly in childhood or involving ICU care
Workplace trauma or harassment
Prolonged emotional abuse in relationships
Cumulative racial or identity-based trauma
A trauma does not need to be dramatic or visible to others to be clinically significant. If an experience overwhelmed your capacity to cope at the time and its effects are still present in your nervous system, emotions, relationships, or sense of self today — that experience warrants clinical evaluation.
10 signs your trauma response may need psychiatric-level care
1. Intrusive memories, flashbacks, or nightmares that will not stop Involuntary re-experiencing of a traumatic event — through vivid intrusive memories, flashbacks in which the event feels as though it is happening again, or recurring nightmares — is one of the most diagnostically significant symptoms of PTSD. These are not voluntary thoughts the person is dwelling on. They are neurological events produced by a trauma-sensitized amygdala that has not distinguished past from present.
2. Persistent hypervigilance — feeling constantly on edge or unsafe A nervous system that remains in a state of heightened alert long after the traumatic event has passed — scanning environments for threat, startling easily at sounds or movement, being unable to relax even in objectively safe situations — is a hallmark of PTSD. Hypervigilance is exhausting and pervasive, affecting relationships, sleep, concentration, and physical health.
3. Avoidance of people, places, or situations that trigger memories Organizing life around avoiding anything that reminds you of the traumatic experience — certain locations, people, conversations, smells, sounds, or media — is a core PTSD symptom and one of the most functionally limiting. Avoidance provides short-term relief and long-term maintenance of the trauma response. It does not reduce PTSD over time.
4. Emotional numbness or feeling detached from your life A sense of emotional flatness, of going through the motions without genuinely feeling present in your own life, of being disconnected from people you care about, or of being unable to access positive emotions — is a trauma response that reflects the brain's protective numbing of overwhelming feeling. It is frequently mistaken for depression, which it may accompany.
5. Intense emotional reactions that feel out of proportion Rage, shame, or grief that erupts suddenly and intensely in response to triggers that seem small to others — but that connect, consciously or not, to the original traumatic experience. Emotional dysregulation in trauma is neurological. The trauma-sensitized brain responds to perceived threat with the full force of the original survival response, even when the actual threat is minimal.
6. Negative beliefs about yourself or the world that took hold after the trauma Pervasive beliefs such as "I am permanently damaged," "I cannot trust anyone," "I am responsible for what happened," "the world is completely dangerous," or "I do not deserve good things" — that were not present before the trauma and that have shaped your sense of self and your relationships since. These cognitive alterations are a core component of PTSD and C-PTSD and are directly addressable through psychiatric treatment.
7. Significant changes in sleep — particularly nightmares and hyperarousal at night Difficulty falling asleep because the nervous system cannot downregulate, waking frequently, or being jolted awake by nightmares that replay or reference the traumatic experience. Trauma-related sleep disruption compounds every other symptom and significantly impairs the brain's capacity to process and regulate emotion.
8. Feeling permanently different from other people A pervasive sense of having been changed by what happened — of being set apart from people who have not experienced trauma, of being unable to fully connect or relate, of carrying something others cannot see or understand. This sense of fundamental difference is particularly prominent in C-PTSD and is one of the most isolating aspects of living with unaddressed trauma.
9. Physical symptoms with no clear medical explanation Chronic pain, gastrointestinal problems, headaches, fatigue, and autoimmune symptoms are all associated with chronic trauma and PTSD. The body keeps the score — a phrase that has become clinical shorthand for the well-documented ways in which unprocessed trauma is stored somatically. Physical symptoms that have been medically evaluated without a clear cause warrant a trauma-informed psychiatric assessment.
10. Relationships that are consistently destabilized by fear, mistrust, or emotional reactivity Difficulty trusting partners, friends, or authority figures. Intense fear of abandonment. Cycles of idealization and devaluation in close relationships. Withdrawal from intimacy. These relational patterns — particularly prominent in C-PTSD — reflect a nervous system that learned, through repeated traumatic experience, that relationships are not safe. They are addressable through psychiatric treatment combined with appropriate therapeutic support.
Trauma in teenagers
Dr. Jennifer Sam, DNP, PMHNP-BC — Skye's dedicated teen and adolescent specialist — evaluates and treats trauma and PTSD in patients ages 12–17 across Michigan. Trauma in teenagers is one of the most commonly misread clinical presentations in adolescent psychiatry. It frequently presents as ADHD-like inattention and impulsivity, defiance and anger, academic decline, or depression — before the underlying trauma origin is identified. If your teenager has been through something difficult and is struggling in ways that don't fully respond to the diagnosis they have been given, a trauma-informed psychiatric evaluation may be the missing piece.
If your teenager is struggling, learn more about Skye's teen psychiatry here which explains the signs, the evaluation process, and what to expect.
How Skye Mental Health treats trauma, PTSD, and Complex PTSD
The initial evaluation
Treatment begins with a comprehensive 60-minute psychiatric evaluation. For trauma-related conditions, this evaluation is specifically designed to understand not just which symptoms are present but their relationship to the patient's history — when they began, what events preceded them, how they have evolved over time, and how they are currently affecting functioning across multiple domains of life.
Accurate diagnosis at this stage is particularly important for trauma. C-PTSD is frequently misdiagnosed as borderline personality disorder, bipolar disorder, or treatment-resistant depression — each of which leads to a different treatment path. Establishing the correct diagnosis before prescribing is what ensures the treatment plan that follows is appropriate to what is actually driving the symptoms.
A note on the relationship between psychiatric medication and therapy Psychiatric medication for trauma and PTSD does not erase memories or eliminate the psychological work of recovery. What it does is reduce the neurological intensity of trauma symptoms — decreasing hyperarousal, improving sleep, reducing the frequency and vividness of intrusive symptoms, and stabilizing mood and emotional regulation — in ways that make it possible to engage more effectively with therapeutic work.
Medication and therapy work better together than either does alone for trauma-related conditions. Skye Mental Health focuses on the psychiatric medication component. If trauma-focused therapy — such as EMDR, Cognitive Processing Therapy, or Prolonged Exposure — is appropriate for your situation, your provider can discuss referral options for therapists in Michigan who specialize in trauma treatment.
Medication options for trauma and PTSD
SSRIs — first-line treatment for PTSD Sertraline and paroxetine are the only FDA-approved medications specifically indicated for PTSD. SSRIs address the serotonergic dysregulation associated with trauma and reduce intrusion symptoms, avoidance, and hyperarousal over time. They build therapeutic effect over 4–8 weeks and are the appropriate starting point for most patients with PTSD.
SNRIs Venlafaxine is an evidence-based alternative to SSRIs for PTSD, particularly when depression or anxiety co-occurs with trauma symptoms. SNRIs act on both serotonin and norepinephrine pathways, which may provide broader symptom coverage for patients with prominent physical symptoms of hyperarousal.
Prazosin An alpha-1 blocker with significant evidence for reducing trauma-related nightmares and improving sleep quality in PTSD. Prazosin is frequently used as an adjunct to an SSRI when nightmares and sleep disruption are prominent and persistent. It works by blocking norepinephrine receptors involved in the stress response during sleep.
Mood stabilizers For patients with C-PTSD whose presentations include significant emotional dysregulation and mood instability — features that can resemble bipolar disorder — mood stabilizers such as lamotrigine or valproate may be appropriate as part of the treatment plan. Accurate diagnosis distinguishing C-PTSD from bipolar disorder is what determines whether mood stabilization is indicated.
Atypical antipsychotics Used as augmentation agents for PTSD that has not responded adequately to first-line treatment — particularly when hyperarousal, paranoia, or dissociative symptoms are prominent. Quetiapine and risperidone have evidence for use in treatment-resistant PTSD.
Anti-anxiety medications For patients with prominent anxiety symptoms alongside PTSD, buspirone or hydroxyzine may be used as non-habit-forming adjuncts. Benzodiazepines are generally used with caution in PTSD — while they provide acute relief of anxiety symptoms, evidence suggests they may interfere with fear extinction and trauma processing over time and carry dependency risk.
Ongoing medication management Trauma and PTSD treatment is not a one-appointment process. Follow-up appointments of 30 minutes or longer are used to assess your response, adjust medication, manage side effects, and monitor your overall clinical picture over time. Many patients with C-PTSD require longer-term medication management as part of a comprehensive treatment approach.
Why your primary care doctor may not be the right clinician for trauma and PTSD treatment
Primary care physicians are often the first point of contact when trauma symptoms emerge. For mild presentations or straightforward PTSD following a single identifiable event, primary care can be an appropriate starting point. For moderate to severe PTSD, Complex PTSD, or trauma that co-occurs with depression, anxiety, or other psychiatric conditions, specialist-level psychiatric care provides a meaningfully different level of evaluation and treatment.
Trauma-informed evaluation Distinguishing between PTSD, C-PTSD, depression, bipolar disorder, and borderline personality disorder — conditions that frequently share surface features with trauma-related presentations — requires a thorough, specialist-level evaluation that a standard primary care appointment cannot accommodate.
Psychopharmacology expertise Navigating the medication options for PTSD — knowing when to use prazosin for nightmares, when to augment with a mood stabilizer, when to add an atypical antipsychotic, and which combinations are evidence-based — requires specialized psychiatric training.
Recognition of trauma as the primary driver Trauma is frequently treated as a secondary concern — addressed only after the depression or anxiety it produces has been treated. A trauma-informed psychiatric evaluation starts from the trauma itself and works outward, identifying how it is driving the full symptom picture rather than treating each symptom in isolation.
Frequently asked questions about trauma and PTSD treatment at Skye Mental Health
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A trauma response is the immediate neurological reaction to an overwhelming experience — shock, hyperarousal, avoidance, and intrusive memories. Acute Stress Disorder is diagnosed when these symptoms persist between three days and one month following a traumatic event. PTSD is diagnosed when symptoms persist beyond one month and cause significant functional impairment. Not everyone who experiences trauma develops ASD or PTSD, but early evaluation during the ASD window can meaningfully reduce the risk of PTSD developing.
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Complex PTSD develops from prolonged, repeated trauma — such as childhood abuse, domestic violence, or long-term neglect — rather than a single traumatic event. C-PTSD shares the core symptom clusters of PTSD but additionally involves profound disturbances in self-perception, emotional regulation, and relational functioning. C-PTSD is frequently misdiagnosed as borderline personality disorder or bipolar disorder. Skye Mental Health evaluates and treats Complex PTSD, and accurate diagnosis is a central goal of the initial psychiatric evaluation.
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Yes. The effects of childhood trauma — including childhood abuse, neglect, and adverse childhood experiences — frequently persist into adulthood and are among the most common drivers of the presentations Skye evaluates. Adults carrying the neurological and psychological effects of childhood trauma are an important part of the patient population both providers see.
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Skye Mental Health prescribes a range of psychiatric medications for PTSD including SSRIs — the only FDA-approved medications specifically indicated for PTSD — SNRIs, prazosin for trauma-related nightmares, mood stabilizers for emotional dysregulation, and atypical antipsychotics for treatment-resistant presentations. Medication selection is based on your specific symptom pattern, diagnosis, and individual clinical picture.
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No. Skye Mental Health focuses on psychiatric evaluation and medication management — not standalone talk therapy or trauma-focused therapy modalities such as EMDR, Cognitive Processing Therapy, or Prolonged Exposure. These therapies are evidence-based and often an important complement to psychiatric medication for trauma. If trauma-focused therapy is appropriate for your situation, your provider can discuss referral options for therapists in Michigan who specialize in trauma treatment.
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Yes. Dr. Jennifer Sam, DNP, PMHNP-BC evaluates and treats trauma and PTSD in teenagers ages 12–17 across Michigan. Trauma in teenagers frequently presents as inattention, impulsivity, anger, or academic decline before the underlying trauma origin is identified. New patients are typically seen within 3 days.
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Yes. Skye Mental Health accepts most major insurance plans in Michigan including Blue Cross Blue Shield of Michigan, Blue Care Network, Aetna, Cigna, United Healthcare, Optum, MESSA, and Oscar. Self-pay rates are $200 for the initial evaluation and $100 for follow-up sessions. HSA, FSA, and FRA cards are accepted.