About me!

The Story Behind the Practice

I didn't start my career expecting to work with high achievers. I started it in hospitals — inpatient psychiatric units, emergency departments, interdisciplinary floors where people arrived in crisis. What I noticed over nearly a decade of that work wasn't what you might expect. The patients who concerned me most weren't always the ones in the most obvious distress. They were the ones who had learned — often since childhood — to hold it together extraordinarily well. The attorney who came in after a breakdown that no one at their firm saw coming. The physician who had spent years treating everyone else's nervous system while completely ignoring their own. The executive whose anxiety had been reframed as drive for so long that they genuinely weren't sure where ambition ended, and suffering began.

These patients kept finding me. And eventually I stopped thinking of it as a coincidence.

I pursued my PMHNP because I wanted to treat the whole person — not just write a prescription and hand someone a referral slip. Traditional psychiatry, as it's often practiced, is efficient by design: fifteen minutes, a symptom checklist, a medication adjustment. I understand why the system works that way. I also know it leaves a significant gap, especially for the kind of patients I care most about — the ones who are too busy, too private, or too skeptical to see three different providers across two billing relationships. As a PMHNP, I can prescribe, manage medications, and deliver psychotherapy in the same relationship. That integration isn't common. For patients with complex trauma, I believe it matters deeply.

EMDR found me through my patients before I fully understood it myself. I watched people who had spent years in talk therapy — intelligent, self-aware people who could articulate every pattern they had — process and release things in EMDR that conversation alone had never touched. The research on it is among the strongest in the trauma field. But what convinced me wasn't the research. It was watching someone's nervous system do something that insight alone couldn't do. I pursued advanced training because I wanted to offer that to every patient who needed it, without sending them elsewhere.

I intentionally built this practice as a cash-pay, telehealth model. Many of my patients are in professions where a mental health claim on their insurance record carries real risk — licensure, credentialing, security clearance. Others simply want care that isn't shaped by what an insurer will approve. I wanted to create a space where the clinical decisions are made between my patient and me, and nowhere else. If you've spent your whole career performing at a high level while quietly carrying something that never fully resolved — I built this for you.

David Irias is a board-certified Psychiatric Mental Health Nurse Practitioner licensed in California and Washington. He provides integrated psychiatric care and EMDR therapy via telehealth to high-achieving professionals.

David Irias, MSN, APRN

PMHNP Certified

Licensed provider in California & Washington | EMDR & Financial Therapy