Our philosophy.

Terrain Psychiatry is an integrative medical practice leveraging standard of care psychiatry with evidence-based nutrition and lifestyle wisdom to restore whole body health.

We specialize in integrative solutions for low mood, stress and anxiety, loss of focus, and insomnia, but can collaborate with you to address an array of mental health concerns.

Our mission is to offer personalized treatment tailored to your needs and a holistic frame of care for your specific life context. We hold a preventive mindset that aims to protect and optimize your neurocognitive status for decades to come.

Our treatment approach incorporates psychotherapy, dietary review and nutrition counseling, strategic supplementation, and exercise and lifestyle planning. We also give attention to circadian rhythm regulation as a core pillar of health.

Zachary McDonald, MD MPH

Dr McDonald is the Founder and Medical Director of Terrain Psychiatry. He is board certified by the American Board of Psychiatry and Neurology. He completed general psychiatry residency training at the University of Oklahoma School of Community Medicine in Tulsa in June 2024, serving as Chief Resident.

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He is a graduate of the University of North Carolina School of Medicine at Chapel Hill. He also earned a Master of Public Health from the UNC Gillings School of Global Public Health focused on physician leadership and preventive care. He obtained undergraduate degrees from the University of Oklahoma in zoology and international relations, and was elected Phi Beta Kappa. He is a fifth generation Oklahoman and a proud member of the Choctaw Nation. Outside of medicine, Dr McDonald enjoys road trips, strength training, and the outdoors.

  • Terrain Psychiatry seeks to provide a high-quality patient experience from the moment of first contact through to the completion of treatment. We provide increased value via the ease of scheduling (no months long waiting list), our accessibility and responsiveness, our modern, user-friendly technology systems, and our integrative approach to care. Though we do not offer concierge services at this time, we are a small, high touch, boutique practice by design.

  • Terrain caters to a broad range of issues in adults aged 18-64 and offers flexible scheduling options for college students and busy professionals. We welcome you whether you are seeking mental health care for the first time or are already established with another physician or provider. Our ethos is to expand the focus of outpatient psychiatric care by increasing emphasis on lifestyle, nutrition, supplementation, and other integrative approaches to meet your goals. Dr McDonald will work within your personal value system and preferences to create a realistic and multifaceted treatment plan that is well suited to your starting point.

  • Not at this time. Services are delivered 100% via HIPAA compliant virtual visits (Zoom most commonly). The practice is based in Tulsa.

  • Dr McDonald completed training in cognitive behavioral therapy (CBT) and psychodynamic psychotherapy as part of his psychiatric residency training. He has a special interest in dynamic therapy as well as brief CBT for insomnia.

  • Pharmacotherapy can be useful to stabilize acute psychiatric conditions, and in some disorders maintain stability over time, but should be one pillar of a broader treatment plan, which may include but is not limited to attention to nutrition status, physical activity level, sleep quality, relationships, and psychospiritual health. He welcomes the medication hesitant, or individuals that want to avoid medication and associated side effects risks altogether, though these individuals may not experience as robust treatment outcomes.

  • Benzodiazepines: Dr McDonald does not prescribe benzodiazepines due to current telehealth regulations. Thus he is unable to accept patients that desire benzos as treatment or assume management of active benzo prescriptions.

    Stimulants: Dr McDonald views stimulants as a useful but incomplete therapy for ADHD. He supports judicious use of stimulants in those that have an ADHD diagnosis confirmed via psychological testing or direct serial evaluations, and which results in demonstrable impairments. He has a professional interest in maximizing treatment response for disorders such as ADHD, anxiety, and panic attacks with behavioral modifications, lifestyle change, and focused therapy.