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Integrative Psychiatry, Educator, Bipolar & Neurodivergence Advocate: Miriam Dineen, MMS, PA-C, CAQ-Psych
- Feb 24
- 3 min read
Origin Story
Miriam Dineen didn’t begin her career in psychiatry.
She started in infectious disease. Then hospital medicine. Then integrative medicine.
When the pandemic hit and mental health demand surged, she stepped fully into psychiatry — reading the DSM cover to cover, immersing herself in study, and earning her CAQ by choice, not necessity.
Today, she practices outpatient psychiatry in North Carolina, integrates lifestyle medicine into mental health care, teaches PA students, speaks nationally, and advocates for earlier recognition of bipolar disorder and neurodivergence.
Her through-line? Grit, depth, and meaningful work.
The Non-Linear Path (and Why It Matters)
Miriam intentionally chose PA school because she wanted flexibility across specialties. She didn’t want to decide “forever” on day one.
Her early career included:
Infectious disease with a focus on HIV care, gender-affirming care, and primary care
Hospital medicine, including admissions, discharges, wound care, and psychiatric overlap
Integrative medicine, focusing on inflammation, hormones, nutrition, and root-cause analysis
Psychiatry wasn’t a sudden shift — it was an evolution.
“I realized I had already been doing psychiatry. I just wasn’t in a psychiatry practice.”
Her medical foundation sharpened her psychiatric care. She sees behavioral health not as separate from medicine — but deeply interwoven with it.
Integrative Psychiatry (Without the Buzzwords)
Miriam doesn’t run an “integrative psychiatry clinic.” She integrates it into everyday practice.
That means:
Discussing light exposure and circadian rhythms
Exploring sleep patterns
Addressing nutrition and inflammation
Considering hormonal influences
Reinforcing lifestyle structure in pediatrics
Meeting patients where they are on the wellness spectrum
Especially in children and adolescents, she emphasizes reinforcing foundational habits early — before adulthood fragments them.
Lifestyle is not separate from mental health. It is foundational to it.
The Pandemic Pivot
When COVID overwhelmed the mental health system, Miriam stepped in fully.
She:
Read the DSM cover to cover
Immersed herself in psychiatric education
Studied relentlessly
Took the CAQ as soon as eligible
She did not need the CAQ for her job.
She chose it because she valued the knowledge base.
That distinction matters.
Certification can be about professional identity and rigor — not just credentialing requirements.
Mentorship That Builds Leaders
Under the supervision of psychiatrist Chris Aiken, Miriam experienced structured, consistent mentorship:
Two hours of weekly lectures
Deep psychopharmacology training
Culture of journal clubs and discussion
Emphasis on academic growth
She didn’t just receive mentorship — she multiplied it.
Today she:
Guest lectures at Wake Forest and High Point University PA programs
Precepts PA students
Speaks at state and national conferences
Runs journal clubs
Educates peers on bipolar disorder and psychiatric topics
Education sustains clinical longevity.
Clinical Focus Areas
Bipolar Disorder
Miriam is especially passionate about bipolar disorder because:
Average diagnosis is delayed 5–10 years
Misdiagnosis remains common
Earlier recognition dramatically changes outcomes
She now lectures on bipolar disorder at conferences, advocating for earlier screening and diagnostic precision.
Adolescents & Neurodivergence
Another core focus:
Neurodivergent adolescents
Reframing misunderstood behaviors
Reducing stigma
Supporting marginalized populations early in their mental health journey
“Being at the beginning of someone’s mental health journey can be pivotal.”
Early validation changes trajectories.
Telehealth With Intention
Miriam’s practice blends:
In-person visits when clinically optimal
Telehealth for medication follow-ups and accessibility
Telemedicine is not a convenience — it is a tool for equity.
It supports:
Busy families
Working parents
Patients with transportation barriers
Individuals hesitant to seek in-person care
The key is intentional use, not default overuse.
Burnout Prevention: Diversify, Don’t Retreat
Miriam’s burnout prevention strategy may surprise you.
She doesn’t reduce work — she diversifies it.
In addition to clinical care, she:
Lectures
Speaks at conferences
Runs journal clubs
Precepts students
Engages in professional education
Diversification creates meaning.
And meaning protects longevity.
Speaking at Psych Congress Elevate
Miriam will be speaking at Psych Congress Elevate on:
Sex addiction and intimacy disorders.
A complex, often stigmatized topic that intersects psychiatry, sexual health, trauma, and neurobiology.
Her approach is consistent with her career pattern:Dive deep. Study thoroughly. Break it down clearly.
Her words for younger PAs?
“My secret sauce is grit.”
Shareable Takeaways
You don’t have to start in psychiatry to become excellent at it.
Integrative care is often already embedded in strong psychiatric practice.
Read the DSM. Yes — the entire book.
CAQ can be about mastery, not just employment.
Bipolar disorder is commonly delayed in diagnosis — education matters.
Neurodivergent adolescents deserve reframing, not stigma.
Burnout prevention may mean expanding your professional identity.
Grit outperforms perfection.
Connect With Miriam
If you’re a PA exploring psychiatry, integrative medicine, education, or leadership — Miriam’s path is proof that careers evolve through curiosity and courage.
Catch the full interview on Mindset Matters and share it with a PA who is considering the leap into psychiatry.
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