Dr. Jennifer Okwerekwu is a Harvard-trained reproductive psychiatrist who splits her time between building her private practice on the East Coast and flying to the West Coast to work in a psychiatric emergency room. But her most important role? Mom.
Dr. Okwerekwu lives with her husband Peter and her two daughters, Josephine (4) and Noelle (2) just outside of Albany, New York. “I grew up in the Capital District and I left after high school to attend Harvard College. I then completed a Master’s degree at Columbia University in Narrative Medicine, and went on to the University of Virginia for medical school. After returning to Harvard to complete my 4-year-residency in psychiatry and additional two years of subspecialty training in reproductive psychiatry at Brigham & Women’s Hospital, we relocated back home to raise our girls,” shares Dr. Okwerekwu.
Below, we chatted with this incredibly accomplished and hard-working mom about her work in reproductive psychiatry, her family life (including that bicoastal commute!) and more.
Can you please tell us a bit about your private practice?
When I’m in New York I’m building my online private practice in reproductive psychiatry and women’s mental health. I focus on the mental health issues that women experience across the reproductive life cycle.
What an interesting specialty. What exactly does that cover?
As a board-certified psychiatrist I can diagnose and treat all the major mental health conditions–things like trauma and stress disorders, anxiety disorders, mood disorders, ADHD etc. But what most people don’t understand is that women’s mental health is not just general psychiatry for women. It’s informed by the understanding of the biological influence of female reproductive hormones in addition to psychological and social realities of identifying as a woman.
As a reproductive psychiatrist, I have expertise in treating mental illness as it is influenced by periods of hormonal transition, from the onset of menstruation through menopause. I help patients struggling with menstrually related conditions like PMS and PMDD or even struggling through the menopausal transition at the end of the reproductive life cycle. Hormonal changes during perimenopause make patients more vulnerable to anxiety, depression and insomnia. These symptoms are compounded by the social realities of this chapter of your life (when you might be taxed by the stressful demands of caring for both aging parents and your kids). In the middle of the reproductive life cycle is the perinatal period and all the issues surrounding pregnancy. I help patients optimize their mental health and manage psychiatric medications as they journey through infertility treatments, pregnancy or breastfeeding.
I also treat mental health concerns on the other side of pregnancy, like postpartum depression, anxiety, and OCD. In my practice I also hold space for women’s health conditions like endometriosis, having fibroids or PCOS. These conditions are quite common and can be associated with mental health challenges and may impact a patient’s experience of pelvic pain, fuel their anxieties about fertility, and compromise their self-esteem.
Do you see people virtually or in-person?
I see patients online throughout the states of New York, California, Illinois and Massachusetts. I do see New York residents in person when I’m prescribing them controlled medications like stimulants or benzodiazepines. In the other states, I coordinate with the patient’s PCP or OBGYN if controlled substances are needed. But for my most part my patients are happy to be seen virtually in the comfort of their own homes.
Such a rich and varied practice. Yet you also work in a psychiatric ER on the West Coast – can you please share a bit about that unique commute?
Yes! I fly out to California (near San Francisco) for 5 days every other week, and I do a bunch of double shifts during that time. The beautiful thing is that when I’m home I have time to build my practice. So, yes, I have a very unusual commute! Both medicine and motherhood are very demanding, but my unusual schedule has also afforded me the flexibility to be present with my kids. I’m able to attend their swim lessons and dance classes, which I didn’t always think was possible for a physician mom. I’m happy I get to share these moments with them.
Wow—how do you make this work?
It really takes a village. My husband is a great father and holds down the fort when I’m away, which is not easy when you’re outnumbered by toddlers. We have wonderful babysitters and I also feel blessed to be able to lean on my family. My mom, my cousin – also both doctors– help my husband and I with drop offs, picks ups and some babysitting too.
So glad that you have that support! Why did you decide to leave Boston and move back to your hometown area?
As life happens, you hone in on what’s most important. I had kids and became a mom, I thought, wow I really need my mom. With the pandemic, we thought about whether we were really taking advantage of what Boston had to offer, and if that outweighed family support. It didn’t. So for us, the move was about being closer to family and achieving a better quality of life.
Anything else you’d like to share?
Half of our population is female yet women’s health issues generally fall by the wayside. Mental healthcare is not one-size fits all. Women deserve doctors that have specific expertise in our neuroendocrine systems and appreciate the social realities that impact our wellbeing.
When you become a mom, for example, people talk about diapers or strollers but not about the biological and psychological shifts that occur as you grow into your new role as a mom. The same thing goes for the biological, cognitive and social shifts that occur with the perimenopausal transition. It leaves women feeling isolated and wondering if there is something wrong with them.
It’s a testament to the strength of women, but we suffer in silence. Why struggle when you don’t need to? Sometimes you just need someone to lean on to lift that burden. Sometimes you just need someone to say, this experience is very common and these are the tools to help.
Love that. What is the process like of beginning to work with you?
When a patient reaches out I offer a complimentary 15 minute meet and greet, so I can learn about them, what they are struggling with, and the type of support they are looking for. I also tell them about my practice and what I can offer. And then, if it seems like a good fit, we move ahead with scheduling. I recognize that seeking care out-of-network is an investment and I want to be respectful of that.
I see people in two different capacities: consultation and on-going care. There are not many fellowship trained reproductive psychiatrists in this country, so part of my work is enhancing the capacity of other doctors and mental health professionals to take care of their patients. So If a patient is already working with a general psychiatrist, but wants to get pregnant for example, I’ll see them for an extensive evaluation and write up an integrated treatment plan to share with that doctor so they can continue to work together. I write the play, but they run the ball.
If someone wants to become my patient, our work involves creating a similar treatment plan. I offer longer appointment times so patients feel heard and understood. Together we develop a deep understanding of what is causing their symptoms across physical, mental, emotional and spiritual domains– and develop a common language or diagnosis around that. Initially, I like to see my patients every two to four weeks. That timeline lets us determine if the interventions, which can include medication, supplements, lifestyle changes or therapy, are working. As patients get better we stretch out those visits and transition into a wellness maintenance mode.