FAQ

Yes, we offer convenient telepsychiatry and telehealth appointments to serve patients throughout the Portland metro area, as well as those seeking mental health support in Washington and Alaska. This flexible option allows you to receive expert care for depression, anxiety, ADHD, and more from the comfort of your own home.

Center of Excellence is committed to providing affordable mental health in Portland. We work with various insurance providers to help minimize out-of-pocket costs for our patients. Please contact our office to verify if we accept your specific insurance plan.

Most insurance plans provide coverage for essential mental health treatments, including therapy and medication management. Coverage often extends to treatments for depression, anxiety, PTSD, and bipolar disorder. We recommend contacting your insurance carrier or our office directly to confirm the details of your specific mental health benefits.

Scheduling an appointment at the Center of Excellence is simple. Prospective patients can call or text us at 503-832-0945 to speak with a member of our team. We strive to return all inquiries within 24 hours to ensure you receive timely support for your mental health treatment.

Absolutely. We welcome patients for in-person appointments at our Beaverton, OR clinic. Our physical office provides a compassionate and judgment-free environment for personalized psychiatric evaluations, ADHD testing, and addiction recovery services.

Our clinic is centrally located at 12655 SW Center Street, Suite 150, Beaverton, OR 97005, serving the Beaverton and greater Portland metro area. Our location is designed to be a convenient destination for those seeking a whole-person approach to mental and emotional health.

Depression is highly treatable through evidence-based depression treatment in Portland, which often combines psychotherapy with medication management. Many patients achieve long-term remission and return to their full quality of life.

While online quizzes can provide initial insights, we offer clinical depression testing and psychiatric assessments at our Portland clinic to ensure you receive a personalized and medically sound treatment plan.

Yes, we specialize in teen mood disorder treatment in Washington and Portland, addressing the unique way depression symptoms—like extreme irritability or social withdrawal—manifest in adolescents and children.

While everyone feels "down" occasionally, clinical depression is marked by symptoms that last at least two weeks and interfere with your daily life. If you are wondering "Do I have depression?", a professional psychiatric evaluation is the most reliable way to receive an accurate diagnosis.

Symptoms include persistent sadness, irritability, "brain fog," and physical aches. The causes of depression are often a complex interaction of brain chemistry (neurotransmitters), genetics, and environmental stressors.

Depression is primarily a mood disorder characterized by low energy and sadness, while anxiety involves persistent worry and physical tension. Bipolar disorder is distinguished by alternating cycles of depression and mania (periods of unusually high energy and mood).

Ketamine is a rising search topic and an emerging option for individuals who have not found relief through traditional depression treatments. As a Center of Excellence in Mental Health, we continually evaluate advanced psychiatric services to offer our patients the best possible outcomes.

Women and girls are often underdiagnosed because they tend to display "inattentive" symptoms—like daydreaming or disorganization—rather than outwardly disruptive hyperactivity. They may also become "master maskers" of their struggles.

Therapy (like CBT) addresses underlying emotional issues, trauma, or anxiety. ADHD coaching is action-oriented, focusing on practical skills for time management, organization, and daily productivity.

Yes, we provide comprehensive clinical ADHD testing and treatment in Portland, ensuring a personalized plan that may include medication management, coaching, or therapy.

"ADD" is an older term now clinically referred to as ADHD, predominantly inattentive presentation. This type is marked by distractibility and forgetfulness without the physical hyperactivity.

It is common for ADHD to co-occur with anxiety, depression, and substance use disorders. A dual diagnosis approach is essential for effective mental health treatment in Portland.

Yes. Non-medication options include specialized ADHD coaching, mindfulness meditation, executive function training, and lifestyle changes like exercise and improved sleep hygiene.

Common signs include feeling restless or "on edge," persistent worry that is difficult to control, trouble sleeping, and difficulty concentrating.

Yes, anxiety often triggers a "fight or flight" response, releasing stress hormones like adrenaline and cortisol. This can cause a racing heart, sweating, dizziness, nausea, muscle tension, and rapid breathing.

Yes, PTSD is treatable with specialized mental health treatment in Portland, including EMDR (Eye Movement Desensitization and Reprocessing) and Trauma-Focused CBT.

Common symptoms include intrusive flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the traumatic event.

Psychosis can be caused by a variety of factors, including mental health disorders, severe stress, trauma, substance use, sleep deprivation, neurological conditions, or certain medical illnesses. In many cases, psychosis results from a combination of biological, psychological, and environmental factors.

Psychosis is more common than many people realize. Research suggests that about 3 out of every 100 people will experience a psychotic episode at some point in their lives. It can affect individuals of any age, though it often begins in late adolescence or early adulthood.

Psychosis refers to symptoms involving a loss of contact with reality. Schizophrenia is a specific mental health disorder in which psychosis is a core feature. Not everyone who experiences psychosis has schizophrenia, and psychosis can occur independently or as part of other conditions.

Yes. Severe stress, emotional trauma, abuse, or major life events can trigger psychosis in some individuals—especially those with underlying vulnerabilities. Trauma-related psychosis may be temporary but still requires professional support.

Treatment for psychosis often includes:

Antipsychotic medications

Individual therapy (such as CBT)

Trauma-informed care

Family education and support

Lifestyle and stress-management strategies

Yes. Psychosis can occur without schizophrenia. It may be related to mood disorders, trauma, substance use, medical conditions, or brief psychotic episodes. A thorough evaluation helps determine the underlying cause and best treatment approach.

Psychosis is a mental health condition that affects how a person perceives reality. It can involve hallucinations, delusions, disorganized thinking, or changes in behavior. Psychosis is a symptom or experience, not a disease itself, and it can occur as part of several mental health or medical conditions.

Common psychosis symptoms include:

Hallucinations (seeing, hearing, or sensing things others don’t)

Delusions (fixed beliefs that aren’t based in reality)

Disorganized or racing thoughts

Difficulty concentrating or communicating

Social withdrawal or emotional changes

Psychosis itself is not a diagnosis. It is a symptom or clinical experience that can occur in conditions such as schizophrenia, bipolar disorder, major depression with psychotic features, PTSD, or substance-induced disorders. A mental health professional determines the underlying cause.

Early or prodromal signs of psychosis may include:

Increased anxiety or paranoia

Social withdrawal

Decline in work or school performance

Trouble sleeping or concentrating

Feeling disconnected or emotionally flat

Yes, psychosis is highly treatable, especially when addressed early. Many people recover fully or learn to manage symptoms effectively with the right combination of care, therapy, and support.

Recovery time varies. Some people improve within weeks or months, while others may need longer-term treatment. Early intervention significantly improves recovery outcomes and reduces the likelihood of future episodes.

There is no single cause of schizophrenia. Research shows it develops from a combination of genetic, biological, and environmental factors, including:

Family history of schizophrenia

Brain chemistry and structure differences

Prenatal or birth complications

Exposure to extreme stress or trauma

Substance use, particularly during adolescence

Schizophrenia typically develops in late adolescence or early adulthood. Symptoms often appear:

Late teens to early 20s for men

Early 20s to early 30s for women

Schizophrenia is diagnosed through a comprehensive mental health evaluation. This typically includes:

Clinical interviews

Symptom history

Behavioral observations

Medical assessments to rule out other causes

Schizophrenia affects approximately 1% of the global population. While relatively uncommon, it occurs across all cultures, ethnicities, and socioeconomic groups.

No. Schizophrenia is not the same as split personality, which is a common myth. Split personality refers to dissociative identity disorder, a completely different condition. Psychosis is a symptom that can occur in schizophrenia but also appears in other mental health disorders.

Early or prodromal symptoms may include:

Social withdrawal or isolation

Decline in school or work performance

Changes in sleep or mood

Difficulty thinking clearly

Increased suspicion or anxiety

Schizophrenia is a chronic mental health disorder that affects how a person thinks, feels, and perceives reality. It may involve psychosis, including hallucinations and delusions, along with cognitive and emotional challenges. Schizophrenia is a medical condition, not a personality flaw or character weakness.

Symptoms of schizophrenia generally fall into three categories:

Positive symptoms (added experiences):

Hallucinations

Delusions

Disorganized speech or behavior

Negative symptoms (loss of normal function):

Reduced emotional expression

Social withdrawal

Lack of motivation

Cognitive symptoms:

Difficulty concentrating

Memory challenges

Trouble with decision-making

There is currently no cure for schizophrenia, but it is treatable. Many individuals successfully manage symptoms and live fulfilling lives with ongoing care, therapy, medication, and support.

Effective schizophrenia treatment often includes a combination of:

Antipsychotic medications

Individual therapy (such as cognitive behavioral therapy)

Psychosocial rehabilitation

Family education and support

Lifestyle and stress-management strategies

Genetics play a role in schizophrenia risk, but it is not directly inherited. Having a family member with schizophrenia increases risk, but most people with a genetic predisposition never develop the disorder.

Most people with schizophrenia are not dangerous. In fact, individuals with schizophrenia are more likely to be victims of violence than perpetrators. With proper treatment and support, the vast majority live safely and peacefully within their communities.

There is no single cause of bipolar disorder. Research suggests it develops due to a combination of:

Genetic factors

Brain chemistry and structure differences

Environmental stressors

Trauma or major life events

Sleep disruption and substance use

Bipolar disorder is diagnosed through a comprehensive psychiatric evaluation, which may include:

Clinical interviews

Detailed symptom history

Mood tracking over time

Medical tests to rule out other conditions

The main types include:

Bipolar I Disorder

At least one manic episode

Depressive episodes often occur but are not required for diagnosis

Bipolar II Disorder

At least one hypomanic episode

At least one major depressive episode

No full manic episodes

Cyclothymic Disorder (Cyclothymia)

Chronic mood fluctuations with milder symptoms

Episodes last for at least two years

A depressive episode involves persistent low mood or loss of interest lasting at least two weeks, often accompanied by fatigue, hopelessness, sleep disturbances, and difficulty functioning.

There is no cure for bipolar disorder, but it is highly treatable. With consistent treatment, many individuals achieve long-term mood stability and lead productive, fulfilling lives.

Bipolar disorder involves episodic mood changes over time.

Major depression does not include mania or hypomania.

Borderline personality disorder involves persistent emotional instability and interpersonal challenges rather than distinct mood episodes.

Warning signs may include:

Drastic mood changes

Risk-taking behavior

Sleep disruption

Withdrawal or emotional numbness

Difficulty maintaining routines

Bipolar disorder is a chronic mental health condition characterized by alternating episodes of mania or hypomania and depression. These mood episodes affect energy, activity levels, thinking, and behavior, often causing significant impairment if untreated.

Symptoms vary by episode type and individual but typically include:

Manic Symptoms

Elevated or irritable mood

Increased energy or activity

Reduced need for sleep

Racing thoughts or rapid speech

Impulsive or risky behavior

Hypomanic Symptoms

Similar to mania but less severe

Increased productivity or sociability

Noticeable changes without major impairment

Depressive Symptoms

Persistent sadness or emptiness

Fatigue or low energy

Loss of interest or pleasure

Changes in appetite or sleep

Feelings of hopelessness or guilt

Difficulty concentrating

Yes, bipolar disorder has a strong genetic component. Individuals with a parent or sibling with bipolar disorder have an increased risk. However, genetics alone do not determine whether someone will develop the condition.

A manic episode is a period of abnormally elevated or irritable mood and increased energy lasting at least one week and causing significant impairment or hospitalization. Mania can involve impulsive decisions, financial risk, and loss of judgment.

A mixed episode occurs when manic and depressive symptoms happen at the same time, such as high energy combined with hopelessness or agitation. These episodes can be especially distressing and require prompt treatment.

Treatment often includes:

Mood stabilizers (e.g., lithium)

Atypical antipsychotics

Antidepressants (used cautiously and usually alongside mood stabilizers)

Bipolar disorder can impact:

Work and academic performance

Relationships and communication

Sleep patterns and energy levels

Decision-making and impulse control

Effective treatment often includes:

Medication management

Psychotherapy (CBT, psychoeducation)

Lifestyle structure and sleep regulation

Stress management

Family and peer support

Suboxone is primarily prescribed for:

Opioid use disorder (dependence on heroin, fentanyl, or prescription opioids)

Medication-assisted treatment (MAT) programs

Suboxone usually begins working within 30 to 60 minutes, relieving withdrawal symptoms and cravings. Buprenorphine can remain detectable in the body for several days, depending on dosage, metabolism, and testing method.

Possible side effects include:

Headache

Nausea or constipation

Sweating

Fatigue or drowsiness

Sleep disturbances

Standard drug screens do not typically detect Suboxone unless the test specifically checks for buprenorphine. Patients prescribed Suboxone should disclose their medication if drug testing is required.

Yes, transitioning from methadone to Suboxone is possible but must be done carefully. Patients typically need to reduce methadone dosage and begin Suboxone once mild withdrawal symptoms appear. This process should always be supervised by a medical professional.

Suboxone works by partially activating opioid receptors in the brain. Buprenorphine eases cravings and withdrawal without producing the full opioid “high,” while naloxone blocks opioid effects if the medication is misused. This combination helps stabilize brain chemistry and supports long-term recovery.

The length of Suboxone treatment varies by individual. Some people use it short-term to manage withdrawal, while others benefit from long-term or maintenance treatment lasting months or years. Treatment duration should be determined collaboratively with a healthcare provider.

Suboxone can cause physical dependence, but it is not considered addictive in the same way as full opioids. When taken as prescribed, it significantly reduces the risk of misuse and overdose and is considered a safe, evidence-based treatment.

Stopping Suboxone abruptly can lead to withdrawal symptoms, such as anxiety, muscle aches, nausea, and insomnia. Tapering gradually under medical supervision is recommended to minimize discomfort and reduce relapse risk.

Suboxone can be prescribed by licensed healthcare providers who meet federal and state requirements. Most private insurance plans, Medicaid, and Medicare cover Suboxone, though coverage details may vary.

Suboxone may be used during pregnancy when the benefits outweigh the risks, though some providers prefer buprenorphine-only formulations. Breastfeeding is often considered safe under medical supervision. Individual treatment decisions should be made with an experienced provider.

Suboxone as Part of Long-Term Recovery

Suboxone is a proven, effective tool in opioid addiction treatment. When combined with counseling, behavioral therapy, and medical oversight, it supports lasting recovery, reduces overdose risk, and helps individuals regain stability and quality of life.

Vivitrol is FDA-approved to treat:

Opioid use disorder (after complete detox)

Alcohol use disorder

Vivitrol may be appropriate for individuals who:

Have completed opioid detox and are opioid-free

Want a non-opioid, non-addictive treatment option

Struggle with alcohol dependence

Prefer a monthly injection over daily medication

Common side effects may include:

Injection site pain or swelling

Nausea or headache

Fatigue

Dizziness

Muscle or joint pain

Serious but rare risks include liver injury or severe injection site reactions. Medical monitoring helps reduce these risks.

Vivitrol itself does not show up on standard drug screens. However, specialized testing can detect naltrexone if specifically requested.

No. Vivitrol cannot be taken with Suboxone or buprenorphine. Because Vivitrol blocks opioid receptors, combining these medications can trigger immediate withdrawal.

Vivitrol works by blocking opioid receptors in the brain. This prevents opioids from producing euphoria or pain relief, which helps discourage relapse. For alcohol dependence, Vivitrol reduces the rewarding effects of alcohol, making it easier to avoid drinking.

Vivitrol is given as a once-monthly intramuscular injection, usually in the gluteal muscle. Unlike daily medications, Vivitrol provides continuous protection for approximately 28–30 days per dose.

Vivitrol remains active in the body for about one month. Injections are typically scheduled every 4 weeks to maintain consistent opioid receptor blockade.

No. Vivitrol is not addictive and does not cause physical dependence. It contains no opioids and does not produce withdrawal symptoms when discontinued.

Patients must be opioid-free for at least 7 to 10 days before receiving Vivitrol. Starting Vivitrol too soon can cause precipitated withdrawal, which can be severe and dangerous.

Switching from Suboxone to Vivitrol requires:

Gradual tapering off buprenorphine

A medically supervised opioid-free period

Confirmation of opioid-free status before injection

Switching from Vivitrol to Suboxone requires waiting until the medication wears off (about 30 days). Both transitions should be managed by an experienced healthcare provider.

Vivitrol as Part of Medication-Assisted Treatment (MAT)

Vivitrol is a powerful option for individuals seeking opioid-free recovery support. When combined with therapy, monitoring, and relapse-prevention strategies, it can significantly reduce cravings and improve long-term recovery outcomes.

Mental illness and addiction frequently co-occur due to overlapping risk factors such as genetics, brain chemistry, trauma, chronic stress, and environmental influences. Many individuals use substances to cope with untreated mental health symptoms, while long-term substance use can also trigger or worsen psychiatric conditions.

Diagnosis requires a comprehensive clinical assessment conducted by a licensed mental health or addiction professional. Providers evaluate psychiatric symptoms, substance use history, medical background, and functional impairment. Accurate diagnosis often takes time, especially when symptoms overlap or substances mask mental health conditions.

The most effective treatment approach is integrated dual diagnosis care, which treats mental health and substance use disorders simultaneously. This may include:

Individual and group therapy

Medication management

Trauma-informed care

Cognitive behavioral therapy (CBT)

Dialectical behavior therapy (DBT)

Medication-assisted treatment (MAT)

Case management and life skills support

Mental health symptoms can increase cravings and relapse risk, while substance use can intensify anxiety, depression, mood swings, or psychosis. This creates a cycle where each condition fuels the other, making untreated co-occurring disorders more complex and harder to manage.

Several mental health conditions are frequently diagnosed alongside substance use disorders, including:

Depression

Anxiety disorders

Bipolar disorder

Post-traumatic stress disorder (PTSD)

Schizophrenia and psychotic disorders

Attention-deficit/hyperactivity disorder (ADHD)

Borderline personality disorder

Co-occurring disorders are very common. According to national data, nearly half of individuals with a substance use disorder also have a mental health condition, and vice versa. The likelihood increases when conditions go untreated or when trauma and long-term stress are involved.

Clinicians may use evidence-based screening and assessment tools such as:

Structured clinical interviews

DSM-5 diagnostic criteria

Mental health questionnaires (PHQ-9, GAD-7, AUDIT, DAST)

Substance use assessments

Trauma and psychosocial history evaluations

Yes. Integrated treatment is highly effective when both conditions are addressed together. Individuals who receive coordinated mental health and addiction care experience better outcomes, fewer relapses, improved stability, and higher quality of life compared to treating one condition alone.

Support from loved ones plays a critical role in recovery. Helpful ways to support include:

Encouraging professional treatment

Learning about dual diagnosis

Practicing patience and empathy

Avoiding enabling behaviors

Participating in family therapy or support groups

Helping with structure, accountability, and emotional support

Why Integrated Care Matters for Co-Occurring Disorders

Co-occurring disorders require specialized, coordinated treatment. Addressing both mental health and substance use together leads to better long-term recovery outcomes, reduced relapse rates, and improved emotional well-being.

Co-occurring disorders require specialized, coordinated treatment. Addressing both mental health and substance use together leads to better long-term recovery outcomes, reduced relapse rates, and improved emotional well-being.