Sarah Ritter, PMHNP

Psychiatric Nurse Practitioner

Director of Psychiatry at Snow Lake Counseling PLLC.

Populations served: Adults

Ages: 18+

Specialties: ADHD, Anxiety, ASD, Body Positivity, Depression, LGBTQ+, Medication Management, OCD, Mood Disorders, Sleep or Insomnia, Stress, Trauma and PTSD, Veterans

Availability: In person & virtually starting this August

Pronouns: She/Her

My Therapeutic Approach

I help adults who are living with neurodivergence along with its' mood and medical complications as well as depression, anxiety, OCD, bipolar disorder, PTSD, C-PTSD, who are open to integrative evidenced-based treatments to reduce or resolve their concerning symptoms, feel more confident, and live a healthier life.  My own mental health journey is informed by successfully managing my own inattentive type ADHD and connective tissue disorder without the need for traditional pharmaceuticals. 

​I am a fully licensed, ANCC board-certified, psychiatric and mental health nurse practitioner with over 10 years experience in mental health. My education includes a Master's in Nursing from the University of Illinois at Chicago and a Master's degree in Clinical Psychology from Eastern Illinois University. I currently serve as a preceptor for Rush University's DNP program in the psychiatric specialty and as a peer-reviewer for the Journal of Psychosocial Nursing.  

I am also currently a fellow through Psychiatry Re-defined headed by Dr. James Greenblatt who is a nationally recognized thought leader in functional psychiatry. ​I have worked in a variety of traditional psychiatric treatment settings. These include inpatient psychiatric hospitals, psychiatric services for medically hospitalized patients (a.k.a., psychosomatic medicine or consult liaison psychiatry), in-person outpatient psychiatry, and telehealth outpatient psychiatry.

Why  Integrative and Functional Psychiatry?

In 2010, the NIMH (National Institutes of Mental Health) stopped funding research based on DSM-5 diagnostic categories in favor of research that studies novel mechanisms of dysfunction. Thomas Insel, former director of NIMH writes "Diagnostic categories based on clinical consensus fail to align with findings emerging from clinical neuroscience and genetics. The boundaries of these categories have not been predictive of treatment response. And, perhaps most important, these categories, based upon presenting signs and symptoms, may not capture fundamental underlying mechanisms of dysfunction. One consequence has been to slow the development of new treatments targeted to underlying pathophysiological mechanisms" (Insel et al., 2010). Therefore, "treatment as usual" is not only out of date with cutting edge research, but may be of limited benefit and/or an imprecise treatment as most psychotropic medication treatments are based on clinical presentations of symptoms as outlined by DSM diagnostic categories.  

While mental illness is still conceptualized by researchers as a Bio-Psycho-Social phenomenon, we are living in a revolution in understanding of the biological underpinnings of mental illness. Kaplan et al. (2015) writes, "The current revolution is broader, consisting of the rapidly accumulating knowledge of how inflammation, microbiome imbalance (gut dysbiosis), oxidative stress, and impaired mitochondrial output affect brain function. Suitable interventions for fighting inflammation, restoring normal gut function, reducing oxidative stress, and improving mitochondrial metabolism incorporate lifestyle variables, including nutrients and probiotics. 

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"He that takes medicine and neglects diet wastes the skills of the physician."

Traditional Chinese proverb

 FAQs

  • Mental health and physical health have been artificially separated by traditional Western medicine. This thinking has led to biological treatments for mental health that are limited in effectiveness, full of side effects, and difficult to stop. I believe that mental health is evolving as research is pointing toward more connections between mind and body. Comprehensive mental health treatment should be integrated with nutrition, exercise, mindfulness meditation, and talk therapy, with less emphasis on pharmaceutical medications. While no treatment is inherently bad, a limited viewpoint does not serve the health of the whole person. As an experienced, board certified, mental health professional of over 10 years, I want to show you how to take the middle path to mental health in order to achieve life changing insights and lasting solutions!​

  • Specialty functional psychiatry lab workup is available to examine general health, levels of key nutrients connected with mental health conditions and genetic differences if you desire. This lab work up is more extensive than what you may experience with a medical physician and is usually only done with functional medicine physicians. If there are underlying health conditions present, I will provide guidance for you to seek appropriate care. If nutritional deficiencies are present such as iron, magnesium, vitamin D, B-vitamins, micronutrients, and gut health abnormalities we will correct them. If you so choose, we can discuss evidenced-based, pharmaceutical-quality nutraceuticals depending on your individual situation. 

  • We can discuss ways to incorporate a healthy diet designed for mental health using common sense solutions to fit your situation. We may also discuss your work-life balance, stress levels, and personal values in order to determine ways to enhance your quality of life. Mindfulness meditation and exercise habits as it relates to your mental health are also areas to examine. 

  • If nutritional and lifestyle approaches aren’t the right fit for you or if you’re simply curious about other options, we can explore psychotropic medications together, such as antidepressants, sleep aids, or mood stabilizers. As a psychiatric nurse practitioner, I’ve seen how thoughtfully prescribed medication, when paired with therapy, can lead to truly transformative outcomes. In many cases, these treatments can be life-changing and even life-saving.

    That said, I also recognize that medications can come with side effects, and they’re not the right choice for everyone. My goal is to support you in finding what feels safe, effective, and aligned with your values. We’ll make these decisions together as a team, and you will always have full autonomy over what you choose to take or not take as part of your care.

  • Sarah is licensed in Illinois, Colorado, and Oregon.

References

Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., Sanislow, C., & Wang, P. (2010). Research domain criteria (rdoc): Toward a new classification framework for research on Mental Disorders. American Journal of Psychiatry, 167(7), 748–751. https://doi.org/10.1176/appi.ajp.2010.09091379

Kaplan, B. J., Rucklidge, J. J., Romijn, A., & McLeod, K. (2015). The Emerging Field of Nutritional Mental Health: Inflammation, the Microbiome, Oxidative Stress, and Mitochondrial Function. Clinical Psychological Science, 3(6), 964–980. https://doi.org/10.1177/2167702614555413