Trauma, sleep disruption, and burnout show up together far more often than separately. Trauma interferes with sleep. Poor sleep amplifies trauma symptoms and drives burnout. Burnout erodes the energy you need to process anything. The three feed each other, which is why treating them in parallel works better than treating any of them alone.
At Midwest Mind & Body Healthcare in Papillion, we provide evidence-based medication management for post-traumatic stress disorder, adjustment disorders, chronic insomnia, circadian-rhythm issues, and the mood and anxiety components of burnout. For trauma-specific psychotherapies (EMDR, CPT, Prolonged Exposure, Somatic Experiencing), we refer to trauma-trained therapy partners in our Omaha-area care network. Medication plus trauma-focused therapy is the gold-standard combination.
Our founder, Kim Wohlwend, MSN, APRN, is a dual ANCC board-certified Family Nurse Practitioner and Psychiatric-Mental Health Nurse Practitioner. Because sleep and burnout often have medical contributors (thyroid, hormones, iron, vitamin D, sleep apnea), the family-NP side of the practice matters: we can work up those contributors rather than treating symptoms without knowing the cause.
Who We Help
What we treat in this space.
Because trauma, sleep, and burnout are so often connected, we treat them as a cluster rather than three separate silos. Here is the range of conditions we address.
Trauma-related conditions
Post-Traumatic Stress Disorder (PTSD)
Re-experiencing (flashbacks, nightmares, intrusive memories), avoidance, negative changes in cognition and mood, and hyperarousal following a traumatic event. Lasting more than a month and interfering with life.
Complex PTSD (CPTSD)
Trauma symptoms plus disturbances in self-organization (emotional dysregulation, negative self-concept, relationship difficulty) typically following prolonged or repeated trauma such as childhood abuse.
Acute Stress Disorder
Trauma-related symptoms in the first month after a traumatic event. Early evaluation can reduce risk of progressing to PTSD.
Adjustment Disorder
Significant distress or functional impairment after a life stressor (job loss, divorce, medical diagnosis, relocation) that exceeds what would be expected. Responsive to brief intervention.
Sleep disorders
Chronic Insomnia
Difficulty falling asleep, staying asleep, or early-morning waking, 3 or more nights per week for 3 or more months, with daytime impairment. Treated with CBT-I (gold standard) plus medication when needed.
Anxiety-Related Insomnia
Racing thoughts at bedtime that prevent sleep onset. Usually responds to treating the underlying anxiety plus targeted sleep strategies. See our anxiety page.
Depression-Related Sleep Problems
Early-morning awakening, fragmented sleep, or hypersomnia as part of depression. Treating depression often restores sleep; sometimes adjunct sleep support is needed.
Trauma-Related Nightmares
Recurrent distressing dreams tied to traumatic experience. Responsive to prazosin plus trauma-focused therapy.
Perimenopausal Sleep Disruption
Night sweats, early waking, and insomnia tied to hormonal change. Addressed with attention to both hormones and sleep. See our perimenopausal mood page.
Circadian-Rhythm Issues
Shift-work disorder, delayed or advanced sleep phase, and jet lag. Treated with circadian-targeted strategies including timed melatonin, light exposure, and chronotherapy.
Burnout & chronic stress
Work-Related Burnout
Chronic exhaustion, cynicism about work, and reduced professional efficacy. Common in healthcare workers, educators, first responders, and parents. Not a moral failing; usually a structural problem with a physiological cost.
Caregiver Burnout
Emotional and physical exhaustion from caring for a chronically ill family member, young children, or aging parents. Often combined with anxiety, depression, and sleep disruption.
Chronic Stress Presentations
Somatic complaints, fatigue, irritability, sleep disruption, and cognitive "fog" that do not yet meet criteria for depression or anxiety but are disrupting daily function.
Burnout with Depression
When burnout tips into clinical depression. Treatment includes both addressing the stressors (often structural) and treating the depression medically.
Our Approach
How we treat these as a cluster.
Comprehensive evaluation
60-minute first visit. Symptom history, sleep pattern, trauma history (at the depth you're ready for), medical history, substances, and life context. Labs when indicated (thyroid, ferritin, vitamin D, B12) to rule out medical contributors.
Medication + therapy referral
For PTSD, SSRIs or SNRIs plus prazosin for nightmares, combined with referral to a trauma-trained therapist for EMDR, CPT, or PE. For insomnia, CBT-I first-line plus thoughtful medication. For burnout, treatment of mood/anxiety components plus structural strategies.
Ongoing follow-up
Close follow-up during titration, then at a cadence that fits your life. Direct access to your clinician through the patient portal between visits.
Treatment Options
Medication when appropriate. Referral when needed.
PTSD medications
- SSRIs. Sertraline (Zoloft) and paroxetine (Paxil) are FDA-approved for PTSD. Fluoxetine is also commonly used off-label.
- SNRIs. Venlafaxine (Effexor XR) has strong evidence for PTSD.
- Prazosin. Alpha-1 blocker used specifically for trauma-related nightmares. Taken at bedtime.
- Adjunctive options. Low-dose atypical antipsychotics and certain sleep agents when specific symptoms persist.
Insomnia medications
- Trazodone. Low-dose sedating antidepressant. Non-addictive. Commonly used for sleep initiation and maintenance.
- Doxepin. Low-dose tricyclic antidepressant (3 to 6 mg) approved for sleep maintenance.
- Ramelteon. Melatonin-receptor agonist. Non-addictive. Useful for sleep-onset insomnia.
- Mirtazapine. When insomnia comes with depression and appetite loss.
- Z-drugs (zolpidem, eszopiclone, zaleplon). Effective short-term but generally not appropriate long-term. We use these carefully and usually for brief periods.
- Melatonin. OTC but often miss-dosed. Low dose (0.3 to 1 mg) taken 3 to 4 hours before desired sleep time is the evidence-based approach for circadian issues.
Burnout
Burnout is a structural problem with physiological effects. Effective care addresses both.
- Medical. Antidepressants or anxiolytics when mood or anxiety components are significant. Sleep support when insomnia is a driver. Workup for medical contributors (thyroid, anemia, vitamin deficiencies, perimenopause).
- Structural. Honest conversation about what is unsustainable and what can change. Burnout rarely resolves with self-care alone if the underlying demands continue.
- Recovery. Sleep, movement, nutrition, social connection, and time away from the stressor. We support realistic recovery plans, not aspirational ones.
For trauma-focused therapy (EMDR, CPT, Prolonged Exposure, Somatic Experiencing) and CBT-I, we refer to specialty-trained therapy partners in our Omaha-area care network.
Pricing & Insurance
Transparent pricing. Insurance accepted.
Insurance
- Aetna
- Blue Cross Blue Shield
- UnitedHealthcare (including UMR)
- Midlands Choice
- Nebraska Total Care (Medicaid)
Self-Pay
- Clear, flat pricing. No subscription.
- Good-faith estimate provided on request.
- Currently out of network with Medicare, Cigna, and Tricare.
Plan coverage, copay, and deductible vary by patient. We recommend verifying your mental-health benefits before your first visit.
Serving the Omaha metro.
In-person appointments at our Papillion, Nebraska office; secure telehealth anywhere in Nebraska. Mental-health services are licensed in Nebraska only.
FAQ
Common questions.
Do you treat PTSD in Papillion?
Yes. We manage medication for PTSD, acute stress disorder, adjustment disorder, and CPTSD in adults 18 and over. For trauma-focused therapy (EMDR, CPT, PE), we refer to trauma-trained therapy partners in our care network. Medication plus trauma-focused therapy is the gold-standard combination.
What medications are used for PTSD?
SSRIs (sertraline and paroxetine are FDA-approved), SNRIs (venlafaxine), and prazosin for nightmares are the most evidence-supported. Benzodiazepines are generally avoided in PTSD because they can worsen outcomes.
Do you treat insomnia?
Yes. Treatment includes sleep-hygiene and behavioral strategies (CBT-I is gold-standard), evaluation of contributing factors, and medication when appropriate (trazodone, doxepin, ramelteon, or short courses of hypnotics when used carefully).
Do you prescribe sleeping pills?
When clinically appropriate, yes, but we use them carefully. Non-addictive options like trazodone and doxepin are often preferred. Z-drugs are effective short-term but usually not appropriate long-term. For primary insomnia, CBT-I works better than medication long-term.
What is burnout and how is it treated?
Burnout is chronic exhaustion, cynicism, and reduced sense of accomplishment, usually tied to work or caregiving. Treatment combines addressing the underlying stressors, medication for mood or anxiety components when prominent, and lifestyle changes.
Do you accept insurance?
Yes. In-network with Aetna, Blue Cross Blue Shield, UnitedHealthcare (including UMR), Midlands Choice, and Nebraska Total Care (Medicaid). Self-pay is $300 initial, $150 follow-up.
Can I get this treatment by telehealth in Nebraska?
Yes. Medication management is available by secure telehealth for patients physically located in Nebraska. In-person visits are available at our Papillion office.
Do you offer EMDR or trauma-focused therapy directly?
We provide medication management and supportive strategies during visits. For EMDR, CPT, Prolonged Exposure, or Somatic Experiencing, we refer to trauma-trained therapy partners in our care network.
These don't have to be your normal.
Evidence-based care for trauma, sleep, and burnout from a dual ANCC board-certified nurse practitioner. Insurance accepted. Most new patients seen within 1 to 2 weeks in Papillion or by Nebraska telehealth.
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