Justin Ray, MSN, PMHNP-BC

Borderline Personality Disorder: Healing the Emotional Wounds Beneath the Surface

Borderline Personality Disorder (BPD) is a complex and often deeply misunderstood mental health condition. First formally recognized in the 1980s, it was initially thought to exist on the “borderline” between neurosis and psychosis—an outdated concept that contributed to years of stigma and mischaracterization.

Electroconvulsive Therapy (ECT): Separating Myth from Medicine

Electroconvulsive therapy is a medical treatment in which brief electrical stimulation is delivered to the brain to produce a controlled seizure, under full anesthesia. The procedure is carried out by a team that includes a psychiatrist and an anesthesiologist. It’s performed in a highly monitored and safe environment, either in a hospital or a specialized outpatient setting.

Rethinking ADHD Treatment: The Promise of Evening-Dosed Medication

Attention-Deficit/Hyperactivity Disorder (ADHD) affects millions of children, adolescents, and adults across the country. While symptoms like distractibility, impulsivity, and hyperactivity often take center stage, what’s less often talked about is the day-to-day disruption ADHD can cause—for both individuals and their families.

Raising the Bar: Abilify Maintena’s New Dosing Option and the Real-World Cost of Missed Opportunities

Should We Worry About Ileus with Pines and Cobenfy? Reconsidering the Risk

As the psychiatric community continues to explore Cobenfy (xanomeline/trospium chloride) as a novel option in the treatment of schizophrenia, questions have emerged regarding its safety when used in combination with antipsychotics from the “-pine” family—such as clozapine, olanzapine, and quetiapine.

Esketamine and the Prevention of Postpartum Depression: A Promising Step Forward in Maternal Mental Health

Could a single dose of esketamine during a C-section cut the risk of postpartum depression in half? Emerging research says yes—explore how this breakthrough could reshape maternal mental health care.

The Promise and the Setback: MDMA-Assisted Therapy for PTSD

The article discusses the promising results of MDMA-assisted therapy for PTSD presented by MAPS at the NPA Psychopharmacology Update

Understanding ADHD: Causes, Comorbidities, and Treatment Options

ADHD is a complex neurodevelopmental disorder influenced by genetic, neurobiological, and environmental factors.

Proactive Approaches to Managing Social Anxiety in Social Settings

This articles offers tips and strategies that can help manage anxiety in social settings.

Should We Worry About Ileus with Pines and Cobenfy? Reconsidering the Risk

As the psychiatric community continues to explore Cobenfy (xanomeline/trospium chloride) as a novel option in the treatment of schizophrenia, questions have emerged regarding its safety when used in combination with antipsychotics from the “-pine” family—such as clozapine, olanzapine, and quetiapine.

The Metabolic-Mood Connection: Could GLP-1 Receptor Agonists Reshape Psychiatry?

GLP-1 receptor agonists offer something rare in psychiatry: the ability to target both mind and body, addressing overlapping biological mechanisms in a single, integrated way

Breaking Barriers: Optimizing the Use of Long-Acting Injectables in Psychiatry

This article highlights how long-acting injectables are essential for stability in real-world psychiatry, yet remain underutilized due to systemic, insurance, and logistical obstacles that fail to reflect the clinical realities of severe mental illness.

Striatal Connectivity and Anhedonia

Anhedonia is the reduced ability or inability to experience pleasure from activities that are typically found enjoyable. This can include things like social interactions, eating, hobbies, music, or even physical intimacy.

June is PTSD Awareness Month: A Call to Acknowledge, Understand, and Act

PTSD is a human response to trauma, and while science offers promising treatments, government and industry delays demand action from those still fighting for veterans' healing.

Schizophrenia: A History of Treatment Challenges and a New Hope with Cobenfy

This article explores the history of schizophrenia treatment, highlighting the challenges of traditional antipsychotics and their side effects.

Why Anxiety Disorders Are So Difficult to Treat — And Why We Excel at It

Anxiety is complex. But with the right people in your corner, it becomes manageable. You don’t need to white-knuckle your way through it. You need a team that gets it—and gets you.

Bipolar Disorder vs. Borderline Personality Disorder: Key Distinctions and Similarities

Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) are two distinct mental health conditions that are often mixed up due to their overlapping symptoms. However, they have different underlying causes, diagnostic criteria, and treatment approaches. Understanding these differences and similarities is vital for correct diagnosis and successful treatment.

Anhedonia: The Overlooked Core of Depression

This article explores the critical role of anhedonia in depression, highlighting emerging treatments like SAINT TMS and vortioxetine that target the brain’s reward systems to restore motivation, engagement, and meaning in life.

The Significant Roles of Testosterone and Estrogen in Mental Health

This article discusses the impact testosterone and estrogen have on mood regulation and depression.

Beyond Physical Symptoms: Why All Medical Providers Must Recognize Neurotransmitters' Role in Mental Health

The article emphasizes the importance of medical providers recognizing the role of neurotransmitters in mental health. It explains that neurotransmitter imbalances can lead to psychiatric disorders such as depression, anxiety, and schizophrenia. By understanding the different types of neurotransmitters and their functions, providers can better screen for and address potential psychiatric conditions, ensuring patients receive appropriate care.

Raising the Bar: Abilify Maintena’s New Dosing Option and the Real-World Cost of Missed Opportunities

Why Do We Have Physical Symptoms with Mental Anxiety?

Anxiety is more than just a mental or emotional experience; it often manifests physically as well. Understanding why this happens can help you manage these symptoms more effectively.

Exploring the Glutamate Pathway: A New Frontier in Treating Depression

The article discusses the emerging role of the glutamate pathway in treating depression, particularly for those who do not respond to traditional antidepressants. It highlights two treatments, Spravato (esketamine) and Auvelity, which target glutamate activity to provide rapid relief and new hope for patients with treatment-resistant depression. These medications offer an alternative mechanism of action, potentially improving both mood and cognitive function, and represent a promising shift in depression treatment strategies.

Crochet Your Stress Away: How Your Hobbies Can Be Beneficial To Your Mental Health

The article highlights how engaging in hobbies, like crochet, can significantly improve mental health by reducing stress, enhancing focus, and promoting a sense of accomplishment.

Staying Ahead in Psychiatry: Psilocybin And Its Emerging Role In Mental Health Treatment

This articles discusses the history of psychedelic therapies and the groundbreaking innovations happening right now

The Comparison Game: The Worst Game We Ever Created

The article highlights the detrimental effects of social comparison on mental health, emphasizing the importance of redefining success on personal terms and celebrating individual progress rather than measuring against others.

First Break Psychosis: Why Timing, Treatment, and Tolerability Matter

Early detection and intervention in first-episode psychosis (FEP) significantly improve clinical, functional, and economic outcomes, with growing evidence supporting rapid treatment initiation

Will Antidepressants Change My Personality?

A common concern people have before starting antidepressants is: “Will this medication change who I am?” It’s a valid question—after all, your personality is what makes you unique.

Staying Ahead in Psychiatry: The Importance of Continuous Learning

Continuous learning is essential in psychiatry to provide effective, evidence-based care. South Chesapeake Psychiatry stays ahead by researching advancements like ITI-1549, a novel non-hallucinogenic psychedelic showing promise in treating mood and anxiety disorders. Their commitment to innovation ensures personalized, safe, and cutting-edge treatments for clients.

Advancing Depression Treatment: Real-World Applications of Glutamate Pathway Targeting

This article explores the transformative impact of Spravato (esketamine), a nasal spray targeting the glutamate system, in treating severe depression. Highlighting a case study, it underscores rapid symptom relief, the importance of individualized dosing, and sustained improvements, while addressing challenges like insurance access and advocating for personalized care.

The Rise of Osavampator: A New Contender in Adjunctive Depression Treatment

In a crowded market of SSRIs, SNRIs, and antipsychotic adjuncts, Osavampator represents a truly novel direction. Its efficacy is among the strongest seen in recent trials, its safety profile is remarkably clean, and its mechanism of action provides an opportunity to break from the limitations of monoamine-based therapy.

Amisulpride: The Antipsychotic Americans Can’t Have (But Maybe Should)

Amisulpride is a second-generation antipsychotic that’s been used for decades abroad for the treatment of schizophrenia and, at lower doses, persistent dysthymia.

Rethinking Depression: Are We Targeting the Right Neurotransmitters?

The article argues that traditional antidepressants targeting serotonin may overlook the root of depression, and suggests that newer treatments enhancing glutamate signaling—like Auvelity—may offer faster, more profound relief by promoting neuroplasticity and addressing the brain’s adaptability, not just its chemistry.

New Tools on the Horizon: Excitement Around CT-155 and Schizophrenia Care

The upcoming presentation of Boehringer Ingelheim’s CT-155 at the NEI Spring Congress marks a promising shift in schizophrenia care, targeting cognitive and functional recovery through an innovative prescription digital therapeutic

Exploring SPRAVATO Treatment: What You Need to Know

This article discusses Spravato (esketamine) —a revolutionary treatment offering new hope for individuals who have not found relief with conventional medications in treating their depression.

Rethinking ADHD Treatment: The Promise of Evening-Dosed Medication

Attention-Deficit/Hyperactivity Disorder (ADHD) affects millions of children, adolescents, and adults across the country. While symptoms like distractibility, impulsivity, and hyperactivity often take center stage, what’s less often talked about is the day-to-day disruption ADHD can cause—for both individuals and their families.

The Benefits of Magnesium for Sleep

This article discusses how magnesium can improve your quality of sleep and other benefits

The Importance of Patient Advocacy: A Personal Experience

Provider Amanda Snow, PMHNP, shares her personal experience being on the other side of healthcare and the frustrations and challenges patients face on the regular with other doctors offices.

What London Taxi Drivers Can Teach Us About the Brain, Psychiatry, and Glutamate

In 2000, neuroscientist Eleanor Maguire published a groundbreaking study that forever changed our understanding of the human brain. By scanning the brains of London taxi drivers, she provided one of the most compelling pieces of evidence for neuroplasticity

Medication Management for Anxiety: Finding the Right Balance

The article emphasizes the importance of a personalized and balanced approach to anxiety medication management, ensuring effectiveness while minimizing side effects.

Borderline Personality Disorder: Healing the Emotional Wounds Beneath the Surface

Borderline Personality Disorder (BPD) is a complex and often deeply misunderstood mental health condition. First formally recognized in the 1980s, it was initially thought to exist on the “borderline” between neurosis and psychosis—an outdated concept that contributed to years of stigma and mischaracterization.

PMHNP Psychiatric Assessments vs. Full Psychological Evaluations: What’s the Difference?

There are two types of evaluations- a psychiatric assessment and a full psychological evaluation. There are important distinction between them. While both types of assessments aim to understand your mental health needs, they differ in depth, purpose, and who conducts them.

Navigating PTSD Triggers: Coping Strategies for Daily Life

This article discusses effective coping strategies to help navigate PTSD triggers

Electroconvulsive Therapy (ECT): Separating Myth from Medicine

Electroconvulsive therapy is a medical treatment in which brief electrical stimulation is delivered to the brain to produce a controlled seizure, under full anesthesia. The procedure is carried out by a team that includes a psychiatrist and an anesthesiologist. It’s performed in a highly monitored and safe environment, either in a hospital or a specialized outpatient setting.

The Importance of Screening and Treating Depression in Patients with Autoimmune Disorders

Autoimmune disorders like lupus, rheumatoid arthritis, and inflammatory bowel disease not only affect physical health but also pose significant psychological challenges, often leading to Major Depressive Disorder (MDD). Screening and treating depression in these patients is crucial, as untreated depression can reduce the effectiveness of autoimmune treatments and worsen overall health outcomes. A comprehensive treatment approach combining psychiatric medications, psychotherapy, and autoimmune disorder management can improve quality of life for these individuals.

The Role of Neurotransmitters in Bipolar Disorder: A Professional Overview

This article explores the neurobiological foundations of bipolar disorder, focusing on the roles of five key neurotransmitters—dopamine, serotonin, norepinephrine, glutamate, and GABA—and their impact on the condition's symptoms and progression.