An In-Depth Interview With Dr. Saherwala

Dr. Zainab Saherwala doesn’t do things halfway. Whether it’s delving into complex psychiatric cases or advocating for better mental health in the community, she throws herself in with a full-hearted enthusiasm. 

“I’ve always kind of been a nerd,” she admits with a laugh, recalling how she regularly sketches out diagrams for patients to explain how their medications work. To her, clarity matters, and she’s willing to take the time to make sure every detail is understood.

This thoroughness defines her professional approach. For Dr. Saherwala, no case is too complicated. She’s known for exploring every angle — social, medical, psychological — and taking that extra step when faced with a difficult case. It’s not unusual for her to spend hours sifting through research or searching PubMed for rare case studies that offer new insights. 

“I never take shortcuts,” she says, and her patients know it.

While still in training, she encountered a patient who was an engineer, struggling to open up. Despite knowing little about engineering, she spent hours learning about the intricacies of the profession, then used those details to build rapport. Five sessions later, the patient felt comfortable to talk about their struggles.

“It’s important that they see I’m not just blindly treating them,” she says. “I try to meet patients where they’re at, and that’s a foundation. Everything builds from there.”

Therapy at the Heart of Care

Dr. Saherwala’s sessions often begin with a simple but revealing question: “Why now? Why are you approaching me for treatment now?”

It’s a question that she finds especially powerful. “It can uncover so much about the patient and really set a stage on what they are hoping to achieve with their treatment,” she explains. This approach helps her understand patients' goals and motivations, providing a clearer path forward in their care.

For Dr. Saherwala, therapy is at the heart of almost every patient interaction. “I feel like everyone could benefit from some kind of therapy,” she emphasizes. As a practitioner with a deep appreciation for psychodynamic therapy, she integrates this approach into most sessions, helping patients uncover how past experiences shape present challenges. She also weaves in elements of other therapies when it suits a patient’s needs, tailoring her approach to each individual’s situation.

When it comes to medication, Dr. Saherwala is deliberate and cautious. Her philosophy is “less is more,” preferring to avoid excessive use of medications, or what she calls “polypharmacy”.

“I’ve seen patients come to me on 10 or 15 medications that all interact with each other and cause more harm than good,” she says. “I really support slow medication adjustments and working with patients within their comfort level. As slow as they want to go, I’m their advocate — I don’t use medications carelessly.”

As part of this approach, Dr. Saherwala always tries to educate patients on how their medications work, including through visual drawings. “Without that understanding, sometimes we lose faith in the treatment,” she says. “When patients can see it, they can also learn to trust the process.”

To her, the ideal combination is using therapy to help patients better understand their struggles while using medication to support that deeper work.

“My approach is to get to the root of the problem, because insight is what’s necessary for true and lasting change,” she says. “Medications certainly have a role in treatment, but I do believe that the combination of medication and therapy is what causes the most effective results.”

Born to be a Psychiatrist

This balanced approach to psychiatry, and indeed her pathway into the profession itself, was forged early in Dr. Saherwala’s life. “I actually grew up in a household with family members that worked in mental health and psychiatry,” she recalls.

“It’s all I knew growing up. Even as an elementary school kid, it was what I experienced sitting at the dining room table having breakfast in the morning — conversations about mental health and the impact of medication and how it affects society and culture. So I was very blessed to be exposed to something like that.”

Watching her relatives soothe troubled minds and manage the complexities of anxiety and agitation left a lasting impression on her, and the desire to support people with mental health struggles became woven into her own personality.

That interest deepened in high school, where she had the opportunity to study psychology and even visit a psychiatric state hospital. The field trip, she explains, was designed to teach students about the often harsh history of mental health treatment in America. “It was really alarming to see the state of mental health that many years ago … the isolation and the solitude the patients experienced,” she says. The experience left a mark, solidifying her commitment to advocating for compassionate care and making sure patients receive the best treatment available.

By the time she entered medical school at the Kansas City University of Medicine, Dr. Saherwala knew she wanted to keep her options open, even considering family medicine. But in every rotation, her interest in mental health kept resurfacing. She recalls a particular moment during a surgery rotation when her patient was waiting to have a mastectomy. “What really gravitated me towards this case was actually talking to the patient before the surgery and learning about the psychological impact of breast cancer on her,” she shares.

A psychiatric rotation finally brought everything into focus. “I truly felt like this was where I was meant to be,” she says.

A ‘Most Rewarding’ Area of Psychiatry

One of Dr. Zainab Saherwala’s professional passions is working with patients who have intellectual and developmental disabilities, a specialization she honed during her residency at the Wright State University Boonshoft School of Medicine. She describes her time in a telepsychiatry clinic focused on this population as a pivotal experience.

Here, she managed complex cases involving patients with autism, obsessive-compulsive disorder (OCD), intermittent explosive disorder, and impulsivity — often non-verbal and struggling to express their needs. Working with these patients, she likens herself to a detective, piecing together a puzzle. “My job is to put clues together from medical history, collateral from families and caregivers, along with a clinical examination of a patient to try to figure out a diagnosis,” she explains.

The process is challenging, especially when traditional medication approaches don’t work the same way as they might with neurotypical adults. But for Dr. Saherwala, the challenge is worth it. “When you can get a patient feeling better and comfortable, manage their agitation, reduce their self-harm behavior, and put their caregivers at ease, there’s no better feeling,” she says. “It’s the most rewarding area of psychiatry that I’ve experienced so far.”

While it may at first glance seem that telepsychiatry may pose particular challenges when working with non-verbal patients, in Dr. Saherwala’s experience, the reality has been quite the opposite. She explains how it has allowed her to extend her reach to patients who might otherwise lack access to mental health care. “A lot of these patients live in rural areas where there are no psychiatrists or caregivers that could really help them with their mental health,” she notes.

Having worked almost exclusively through telepsychiatry since 2020, Dr. Saherwala finds it a natural fit and says the key is simply maintaining some of those essential elements of in-person care, like eye contact and being fully present.

Advocacy for Minority Communities — And Faith

Within the field of psychiatry, Dr. Zainab Saherwala’s professional interests have also been strongly shaped by her personal experiences. As a Muslim woman with a Southeast Asian background, she has a deep awareness of the mental health challenges faced by minority communities and the stigmatization of treatment that often persists.

Growing up, she saw firsthand how conditions like depression and anxiety were dismissed or ignored. Mental health struggles were often hidden, and seeking treatment viewed as a sign of weakness. This inspired her to become an advocate, educating patients and their families about the realities of mental health conditions and the benefits of therapy.

During her training, she sometimes worked in areas with little diversity and witnessed a significant lack of understanding around cultural nuances. “I noticed that there was a lot of racism and a huge cultural gap in understanding women within the Southeast Asian background, especially in Islam,” she explains. “There are certain religious and cultural practices, such as fasting during Ramadan, that really needs to be taken account of, especially if you’re taking mental health medications.”

Dr. Saherwala is particularly attuned to the unique struggles faced by Muslim women in the U.S. and how these can impact on mental health. “Islamophobia is a big one,” she notes, describing how Muslim women’s visible religious expression can make them targets of discrimination, which can in turn impact negatively on mental health.

She also highlights the challenges of navigating postpartum depression, often undetected due to cultural taboos around seeking help. “Typically, these patients don’t seek out mental health care until late,” she says, emphasizing the need for early intervention and culturally sensitive support.

“There’s a lot of societal and cultural pressure upon women to be a certain way, look a certain way, behave a certain way, so it can be very difficult navigating all of this,” she says. “But I feel that I can really help.”

Dr. Saherwala recognizes that for many patients, faith and spirituality play an important role in healing. “I think faith in general can be a great tool,” she says. “But more than faith, I think just the general belief that there is something that can empower us and give us strength from the outside.”

Having observed a surge in spirituality during the uncertainty of the COVID-19 pandemic, she now regularly helps patients explore how beliefs can help their mental health healing process. “People lost hope in everything — medicine, humanity, society — and it felt like the only thing left was faith,” she reflects. “It was really interesting to observe that as a psychiatrist. And to use faith and spirituality for my patients as a way to help them get better by talking about things that typically aren’t spoken about openly in mental health.”

Building Connections: A Personal Approach to Therapy

Ultimately for Dr. Saherwala, effective psychiatry means building a connection with her patients, and often involves incorporating their interests into the therapeutic process. This approach isn’t just about making patients comfortable; it’s about creating a truly personalized experience that resonates on a deeper level.

Whether a patient is grappling with a breakup or dealing with chronic illness, Dr. Saherwala finds ways to engage with their unique perspectives and interests, turning these into tools for insight and healing. As someone who appreciates music and art, she’s happy to sit down with a patient who finds meaning in a Taylor Swift song, exploring how its themes might reflect their own experiences. “I feel so happy to sit there with my patient and decode these lyrics and help them to understand the significance of these lyrics in their life and their relationship,” she says.

She also loves introducing patients to the Enneagram personality model, helping them understand how their personality traits impact their mental health. “We'll talk about their types and they’ll say, ‘I’m a Type Two.’ And I’ll say, ‘Okay, so you’re a helper. You love to help people and give, give, give. How does this affect your mental health? How does this affect your boundaries?’ At the end of the interview, they’ve learned so much about themselves and they’ve learned skills on how to manage anxiety about things that they can’t control.”

But whether it is discussions about attachment styles, love languages, or the therapeutic power of art, poetry, movies or running, Dr. Saherwala fundamentally seeks to tailor each session to be as unique as the individual in front of her. Above all, the goal is to help patients towards deeper understanding that can bring about meaningful change.

“I love seeing my patients’ faces light up when they achieve some type of insight of, ‘Oh, that’s why I am the way I am — it all makes sense now,’” she says. “There’s no better moment as a therapist or a psychiatrist than that. And I think that smile kind of sits with me for the rest of the day, because I really helped my patient make progress when they’ve had that light bulb moment.”

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This blog post is brought to you by Apraku Psychiatry.

Apraku Psychiatry is a private practice offering video appointments with Board-certified psychiatrists licensed in multiple states. To schedule a psychiatric evaluation with Dr. Saherwala, patients can complete the online booking form below.