Dr. David Hjellen
Child, Adolescent and Adult Psychiatrist
I specialize in helping patients whose psychiatric conditions don’t follow a straightforward path - individuals with overlapping mental health and medical concerns, complex neurological or hormonal contributors, rare genetic findings, or histories of unique or limited medication response. Many of the individuals I work with have been through multiple providers, attempted a range of treatments, and still haven’t found the clarity or improvement they were seeking. I’ve built my practice specifically around these kinds of complex, treatment-resistant, or diagnostically difficult cases.
Born and raised in Anchorage, I completed my undergraduate training at Alaska Pacific University before moving into medicine and psychiatry. I trained and worked in over thirty hospitals and clinics across the country - including Cincinnati Children’s Hospital, Henry Ford Hospital, The New England Medical Center, and Seattle Children’s Hospital. I returned to Anchorage in 2010 and began working with youth in crisis at North Star Hospital, where I also served as clinical faculty with Washington State University.
Over the years, I’ve sought out diverse clinical experiences to deepen my diagnostic range and maintain flexibility in my thinking—particularly for cases that don’t follow standard patterns. My work has included roles with juvenile justice programs such as McLaughlin Youth Center, participation in TMS-related care models, training in FAA psychiatric evaluations, forensic psychiatric consultations, and lectures delivered to provider groups throughout Anchorage. These experiences have helped me sharpen clinical judgment across a wide spectrum of presentations and reinforced my belief that complex cases often require a broader lens and a more individualized approach.
Since 2018, I’ve transitioned into full-time outpatient practice, where I’ve increasingly focused on cases requiring diagnostic precision, thorough investigation, and deeper collaboration. I use a two-step model for new evaluations. In the first appointment, I focus on the patient’s narrative and lived experience. I do this before reviewing any outside records, so that my initial understanding isn’t biased by another provider’s interpretation.
In the second appointment, I integrate the external data—medical records, collateral input, prior evaluations, scoring tools, then walk the patient (and family, when involved) through a structured diagnostic review. This isn’t just a summary - it's a collaborative process. I assume that if I bring psychiatric expertise and the patient brings expertise in their own experience, then we should be able to arrive at a shared understanding. When done well, this process feels more like two specialists from different fields discussing a case than a traditional one-directional evaluation. This typically resolves any diagnostic ambiguity and improves the understanding of the case for all parties - including myself. The end result is elevated diagnostic accuracy and patient engagement - two of the most important predictors of successful outcomes.
After reaching a shared framework for understanding what’s happening, we move into a discussion of treatment options. This discussion isn’t prescriptive. I outline a range of approaches; non-medication options, lifestyle modifications, and of course medications. The discussion is tailored to the individual’s goals and context. Together, we determine what feels most appropriate and what aligns most with the patient's priorities at that time, not necessarily mine. If time allows I will also discuss long-term trajectories: what the case might look like if left untreated, what risks to monitor for, and what indicators might warrant re-engagement in the future - even if no changes are made immediately. Many people feel ready to decide on a treatment path by the end of that second meeting. Others who take the information home, talk to family, look up information, and return with more questions before making a decision. Either approach is valid. There’s no expectation or pressure to start a treatment in that meeting. It should be clear that the only “agenda” I have is to provide the information someone needs to make the decision that feels right for them.
In the end, complex psychiatric work is not just about getting the diagnosis “right” - it’s about building a shared understanding that patients can identify with, and constructing a plan that respects the reality of their experience. I’ve found that when the process starts with the patient and ends with a collaborative strategy, outcomes improve - even in the most challenging cases.