Now Accepting New Patients in Nevada
CARISSIMI
Mental Health & Wellness PLLC
Integrative psychiatry for adults with ADHD, the LGBTQ+ community, and anyone in the middle of a big life change, who feel like they’ve been doing life on hard mode and are seeking holistic support that goes beyond a prescription.
If you feel like you were never handed a manual for how to navigate things, this is care that is realistic, personal, and never one-size-fits-all from a provider who's happy to laugh with you along the way through the hard moments.
An integrative psychiatry practice specializing in ADHD, anxiety, and the kind of care that treats the whole person, not just the diagnosis.
I help people playing life on hard mode, whether that's ADHD, anxiety, or a transition nobody handed them a manual for, stop white-knuckling their way through everything and start actually feeling like themselves again.
I Specialize In:
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ADHD
Especially when it's diagnosed later in life
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Anxiety & Depression
That often turn out to be executive dysfunction in disguise
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LGBTQ+ Care
Affirming psychiatric care
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Insomnia
Sleep support and sleep optimization
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Life Transitions
New parents and adults navigating major life changes
Hi, I’m Nicole Carissimi, PMHNP.
I'm a psychiatric nurse practitioner, a mom, a hobby-enthusiast, and an ADHDer who didn't figure that out until I was treating patients who sounded exactly like me. Before that, I spent years fumbling in the dark: decent grades but "could've done better if she tried," as well anxiety I quieted with alcohol until I got sober.
So when you tell me you've tried many solutions, you’ve been dismissed, you’ve had to just keep going even though it feels like life is on “hard mode,”, I believe you, I see you, and in many ways I understand you. I built this practice around what I wish I'd had: a provider who actually listens, tells you the truth, and knows that for many people, the problem isn't effort, it's the plan.
If you're ready for care that gets to the root of what's happening, not just a prescription and a pat on the back, you’re in the right place.
Is This You?
Do you feel like you're doing everything right, but somehow still falling behind?
Maybe… you've made the lists. Set the reminders. Tried the calendar apps, the productivity hacks, the four cups of coffee just to feel like a functioning adult. And somehow, it still doesn't click the way it seems to for everyone else. You've started to wonder if you're just lazy, or if something else is actually going on.
Maybe… you've tried therapy before, and it helped a little, but it never quite targeted the thing that's actually in your way.
Maybe… you've tried medication that didn't work, because you were only ever given a small dose of the wrong thing.
Maybe… you've spent hours on TikTok or Reddit looking for answers, only to find advice that works for everyone except you.
Maybe… you're exhausted in a way that sleep doesn't fix. Your patience is running thin at work, at home, or both, and the walls between them are starting to blur.
Maybe… you're part of the LGBTQ+ community and you're tired of explaining yourself to providers who don't get it, or bracing for judgment that shouldn't be part of your care in the first place.
Maybe… you just became a parent, and nobody prepared you for this version of hard. Everyone warned you about the sleepless nights. Nobody warned you about the rest of it.
If any of this sounds familiar, you're not lazy, and you're not broken. You're likely dealing with something real that hasn't been properly named or treated yet, and you deserve care that actually gets to the root of it.
Pick Your Player
Different characters, same game: life on hard mode. Choose the one that sounds most like you.
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ADHD
Diagnosed at 12, diagnosed at 42, or "wait, is this ADHD?" Let's build a plan around your actual brain, not someone else's productivity hack.
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LGBTQ+ Care
Care where you don't have to explain yourself before you get help. Affirming, informed, and always learning, because good LGBTQ+ care shouldn't be a scavenger hunt.
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Life Transitions
New baby, new city, new everything. Nobody handed you a manual, so let's write one together.
Regardless of which “player” you are, you are someone who is high functioning and has already tried many solutions to help yourself.
You've made the lists, set the reminders, and bought the planner. It lasted about a week.
You're running on caffeine and sheer stubbornness, and it's still not enough.
You often feel “othered” in the world around you, like it just wasn’t set up for how you function.
You’re not afraid of hard work but you’re exhausted and frustrated of trying so hard and having nothing that has enough of a meaningful impact.
At this point, you want specialized help from someone who understands you and is going to take a whole-person, integrative approach. And I’m here to help figure it out with you!
“Struggling when you don't have to doesn't get you bonus points. If there's an easier way through, take it.”
— Nicole Carissimi, PMHNP
MY APPROACH
You're not a diagnosis. You're not a checklist of symptoms. You're a person who's been doing all the work, just maybe not in the right direction, and you're ready for that to change.
That's why I don't believe in one-size-fits-all care. My approach rarely fits in one bottle.
I believe in slowing down, actually listening, and building a plan around you: your habits, your sleep, your real life, not a textbook.
Medication can be a game changer, but it's rarely the whole game. So here's what's in my toolkit, mixed and matched to fit your real life:
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We take an integrative approach looking at the whole person including lifestyle habits, environment, history and more. I focus on small realistic changes that fit you and will stick, rather than an idealistic checklist of habits or overhauling your life in one week.
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I hated exercise for years, until I found rock climbing. Now I've run a 5K and a 8K, which past me would not believe. We'll find your version, because if it isn't fun, you won't do it.
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I often start my appointments talking about video games, your latest knitting project or life updates. And while we always focus on the issues at hand, I’m someone who is authentic, honest, realistic, and often finds that a good laugh never hurts, even amidst the hard moments.
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Thoughtful, not cookie-cutter. Plenty of "failed" meds just never got the right dose or combination.
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Many supplements and other evidence-informed options, can be layered in alongside your meds or used on their own when appropriate. I also add labs when helpful to make sure we understand the full picture.
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Most of my patients struggle with sleep and it is a serious factor that I heavily focus on because I know the impact it can have.
I offer a free 15-minute consultation to learn about you, your goals, and how I might support your healing journey.
Before booking, I invite you to review the services page to get a sense of appointment types and fees.