Trauma and PTSD Therapists in Kanata, ON

Photo of Jennifer Jurkofsky, MA, RP, CCC, Registered Psychotherapist
Jennifer Jurkofsky
Registered Psychotherapist, MA, RP, CCC
Verified Verified
5 Endorsed
Kanata, ON K2K
Experiencing anxiety, depression, hardship, grief or trauma, low self-esteem, relationship troubles, or looking to discuss life’s issues? I am here for you. Though you are the expert in your life, struggling with sadness, stress or helplessness can make it hard to know what to do. I am here to listen, support, challenge, and help you find your way. I provide you with a safe, accepting, compassionate environment to process, heal, and grow.
Experiencing anxiety, depression, hardship, grief or trauma, low self-esteem, relationship troubles, or looking to discuss life’s issues? I am here for you. Though you are the expert in your life, struggling with sadness, stress or helplessness can make it hard to know what to do. I am here to listen, support, challenge, and help you find your way. I provide you with a safe, accepting, compassionate environment to process, heal, and grow.
(343) 305-1053 View (343) 305-1053
Photo of Deborah Boldt, MSW RSW, Registered Social Worker
Deborah Boldt
Registered Social Worker, MSW RSW
Verified Verified
Kanata, ON K2K
I am an experienced social worker/psychotherapist and certified trauma therapist.
Welcome! I provide in person (Ottawa) and virtual (Ontario) psychotherapy for individuals 18+ years of age. My areas of specialty are: Trauma, Anxiety, Depression, PTSD, Grief & Loss, Workplace Injuries, Life Span Transitions, Women and 2SLGBTQI
I am an experienced social worker/psychotherapist and certified trauma therapist.
Welcome! I provide in person (Ottawa) and virtual (Ontario) psychotherapy for individuals 18+ years of age. My areas of specialty are: Trauma, Anxiety, Depression, PTSD, Grief & Loss, Workplace Injuries, Life Span Transitions, Women and 2SLGBTQI
(343) 801-3804 View (343) 801-3804
Photo of Virginia Thurston, RP, RCAT, DKATI, ARCT, Registered Psychotherapist
Virginia Thurston
Registered Psychotherapist, RP, RCAT, DKATI, ARCT
Verified Verified
Kanata, ON K2K  (Online Only)
Do you feel like you're no longer sure who you are after a traumatic experience or period in your life? Do you find yourself feeling numb, lacking motivation, easily irritated, alienating those around you? You may have unresolved trauma, causing disruptions in your physical, emotional and mental well-being. This can show up in different ways: anxiety, sleep and eating disorders, depression, addictions, anger issues, self-isolation, autoimmune disorders, the list goes on. They are calls for help from yourself. If you're here, you might be feeling ready to find out how to put the pieces together and be whole again.
Do you feel like you're no longer sure who you are after a traumatic experience or period in your life? Do you find yourself feeling numb, lacking motivation, easily irritated, alienating those around you? You may have unresolved trauma, causing disruptions in your physical, emotional and mental well-being. This can show up in different ways: anxiety, sleep and eating disorders, depression, addictions, anger issues, self-isolation, autoimmune disorders, the list goes on. They are calls for help from yourself. If you're here, you might be feeling ready to find out how to put the pieces together and be whole again.
(343) 633-2820 View (343) 633-2820
Photo of Parul Shah - Embracing Empowerment Counselling Services, MSP, RSW, CCPA, DocCan
Embracing Empowerment Counselling Services
MSP, RSW, CCPA, DocCan
Verified Verified
Kanata, ON K2L
Parul Shah, is the Founder/ Psychotherapist/Registered Social Worker of Embracing Empowerment Counselling Services (EECS). Parul Shah is under the regulatory body of OCSWSSW since 2002. Areas of speciality are, PTSD/ Complexity of Trauma/Depression/Anxiety for , First Responders, Frontline Trauma Nurses, Doctors. NHL/competitive hockey players , Adults, Teens /Children (over 11). Other variety sets of struggles we deal with are, bullying, childhood trauma, passive/active suicidal ideation, workplace injuries/ toxic workplace environment. We continue to provide clinical supervision for clinicians and Grad students.
Parul Shah, is the Founder/ Psychotherapist/Registered Social Worker of Embracing Empowerment Counselling Services (EECS). Parul Shah is under the regulatory body of OCSWSSW since 2002. Areas of speciality are, PTSD/ Complexity of Trauma/Depression/Anxiety for , First Responders, Frontline Trauma Nurses, Doctors. NHL/competitive hockey players , Adults, Teens /Children (over 11). Other variety sets of struggles we deal with are, bullying, childhood trauma, passive/active suicidal ideation, workplace injuries/ toxic workplace environment. We continue to provide clinical supervision for clinicians and Grad students.
(613) 986-6737 View (613) 986-6737
Photo of Monica Forst, MEd, RP, CP, CCC, Registered Psychotherapist
Monica Forst
Registered Psychotherapist, MEd, RP, CP, CCC
Verified Verified
1 Endorsed
Kanata, ON K2K
My areas of expertise are Addictions, Childhood Trauma and Anger Management. I treat individuals, couples and groups. My approach is psychodynamic, using action methods, transactional analysis and schema focused therapy to help change harmful patterns from the past that are interfering with the present. Ideal age of clients is mid 20's to mid 60's.
My areas of expertise are Addictions, Childhood Trauma and Anger Management. I treat individuals, couples and groups. My approach is psychodynamic, using action methods, transactional analysis and schema focused therapy to help change harmful patterns from the past that are interfering with the present. Ideal age of clients is mid 20's to mid 60's.
(855) 974-4775 View (855) 974-4775
Photo of Jessa Hoffman, Registered Psychotherapist (Qualifying)
Jessa Hoffman
Registered Psychotherapist (Qualifying)
Verified Verified
1 Endorsed
Kanata, ON K2K
Many of the clients I work with struggle with stress, relationship difficulties, grief, and life transitions. These challenges often leave them feeling stuck, prompting them to seek support to regain a sense of balance, clarity, and resilience in their lives. Common goals of clients I work with include processing and working through unresolved trauma, building self-esteem and reducing self-doubt, and improving communication skills. They want to feel empowered to manage their emotions effectively, communicate more effectively in their relationships, and navigate significant life changes with confidence.
Many of the clients I work with struggle with stress, relationship difficulties, grief, and life transitions. These challenges often leave them feeling stuck, prompting them to seek support to regain a sense of balance, clarity, and resilience in their lives. Common goals of clients I work with include processing and working through unresolved trauma, building self-esteem and reducing self-doubt, and improving communication skills. They want to feel empowered to manage their emotions effectively, communicate more effectively in their relationships, and navigate significant life changes with confidence.
(343) 338-4900 View (343) 338-4900
Photo of Sandy Williams, MSW, RSW, Registered Social Worker
Sandy Williams
Registered Social Worker, MSW, RSW
Verified Verified
Kanata, ON K2K
"Trauma resolved is a great gift, returning us to the natural world of ebb and flow, harmony and love and compassion.
Warm hello, if you are on this site for yourself or a loved one, it may be helpful to know that people seek my services for help with stress, depression, anxiety, pain, trauma, grief and loss. I value the role of humour and compassion to support personal growth and optimal well-being. I believe that life's difficulties are workable and can teach us a lot if we can lean into the discomfort, interrupting our habitual patterns of avoidance, and to relate to our pain (physical or emotional) consciously and compassionately. It is my intention to support you to maximize your inner and outer resources.
"Trauma resolved is a great gift, returning us to the natural world of ebb and flow, harmony and love and compassion.
Warm hello, if you are on this site for yourself or a loved one, it may be helpful to know that people seek my services for help with stress, depression, anxiety, pain, trauma, grief and loss. I value the role of humour and compassion to support personal growth and optimal well-being. I believe that life's difficulties are workable and can teach us a lot if we can lean into the discomfort, interrupting our habitual patterns of avoidance, and to relate to our pain (physical or emotional) consciously and compassionately. It is my intention to support you to maximize your inner and outer resources.
(613) 371-0795 View (613) 371-0795
Photo of Tina Lorraine Wilston - MindSpa Mental Health Centre, MEd, RP, Registered Psychotherapist
MindSpa Mental Health Centre
Registered Psychotherapist, MEd, RP
Verified Verified
3 Endorsed
Kanata, ON K2K
MindSpa is a premier neurofeedback and psychotherapy centre dedicated to helping individuals achieve balance, healing, and personal growth. We believe in the power of the mind-body connection and strive to provide a supportive and nurturing environment for all our clients. Our team of highly trained and compassionate therapists and neurofeedback specialists are here to guide you on your journey towards emotional well-being and self-discovery. Whether you are seeking relief from anxiety, depression, trauma, or simply looking to enhance your overall mental performance, we have a range of services tailored to meet your specific needs.
MindSpa is a premier neurofeedback and psychotherapy centre dedicated to helping individuals achieve balance, healing, and personal growth. We believe in the power of the mind-body connection and strive to provide a supportive and nurturing environment for all our clients. Our team of highly trained and compassionate therapists and neurofeedback specialists are here to guide you on your journey towards emotional well-being and self-discovery. Whether you are seeking relief from anxiety, depression, trauma, or simply looking to enhance your overall mental performance, we have a range of services tailored to meet your specific needs.
(343) 801-0170 View (343) 801-0170
Photo of Aden Cosgrove, RSW, CCC, MACP, Registered Social Worker
Aden Cosgrove
Registered Social Worker, RSW, CCC, MACP
Verified Verified
2 Endorsed
Kanata, ON K2L  (Online Only)
My areas of experience in individual and relationship counselling are neurodiversity, asexuality and aromantic, trauma presentations, polyamory or non-monogamy, and kink. I am a trauma-informed neurodivergent social worker who decolonizes their practice. I have been working in social work practicing psychotherapy for 9 years, with more than 3 years in private practice. I am a confirmed non-insured health benefits mental health care provider so if you have NIHB, I will directly bill sessions for you.
My areas of experience in individual and relationship counselling are neurodiversity, asexuality and aromantic, trauma presentations, polyamory or non-monogamy, and kink. I am a trauma-informed neurodivergent social worker who decolonizes their practice. I have been working in social work practicing psychotherapy for 9 years, with more than 3 years in private practice. I am a confirmed non-insured health benefits mental health care provider so if you have NIHB, I will directly bill sessions for you.
(343) 304-6388 View (343) 304-6388
Photo of Jathina Blais, MSW, RSW, Registered Social Worker
Jathina Blais
Registered Social Worker, MSW, RSW
Verified Verified
1 Endorsed
Kanata, ON K2L
Waitlist for new clients
Many of us silently cope with difficulties in our lives. But you don't have to. Reaching out to a counsellor for support gives you the opportunity to explore what is holding you back and start improving your quality of life. People have the capacity to make positive changes in their lives with the right support and guidance. With support, you will tap into your strengths, find hope and heal emotional wounds. I work with individual adults who are experiencing mental health issues (anxiety, depression, etc), trauma, phobias, negative self-esteem, family of origin issues, work issues, and relationship issues.
Many of us silently cope with difficulties in our lives. But you don't have to. Reaching out to a counsellor for support gives you the opportunity to explore what is holding you back and start improving your quality of life. People have the capacity to make positive changes in their lives with the right support and guidance. With support, you will tap into your strengths, find hope and heal emotional wounds. I work with individual adults who are experiencing mental health issues (anxiety, depression, etc), trauma, phobias, negative self-esteem, family of origin issues, work issues, and relationship issues.
(613) 909-8056 View (613) 909-8056
Photo of Yan St-Louis, CD, Registered Psychotherapist (Qualifying)
Yan St-Louis
Registered Psychotherapist (Qualifying), CD
Verified Verified
1 Endorsed
Kanata, ON K2L
I am currently accepting new clients. As a Registered Psychotherapist (Qualifying), my areas of expertise include trauma, anxiety, stress, depression, workplace issues, as well as sports performance. Drawing from over 25 years of experience in various leadership roles and positions in environments that include municipal administration, the Canadian Armed Forces, and other private organizations, as well as from a long-standing involvement in youth competitive sports, I have a unique insight, understanding, and appreciation for the needs of the clients I serve.
I am currently accepting new clients. As a Registered Psychotherapist (Qualifying), my areas of expertise include trauma, anxiety, stress, depression, workplace issues, as well as sports performance. Drawing from over 25 years of experience in various leadership roles and positions in environments that include municipal administration, the Canadian Armed Forces, and other private organizations, as well as from a long-standing involvement in youth competitive sports, I have a unique insight, understanding, and appreciation for the needs of the clients I serve.
(343) 453-5131 View (343) 453-5131
Photo of Carly Ring, BMgmt, Registered Psychotherapist (Qualifying)
Carly Ring
Registered Psychotherapist (Qualifying), BMgmt
Verified Verified
2 Endorsed
Kanata, ON K2L
My areas of focus are trauma, PTSD, anxiety, depression, mood disorders, life transitions, and stress management.
I am accepting new clients. I have over 10 years of experience in the mental health field, from a frontline Primary Care Paramedic to a Registered Psychotherapist (Qualifying). My lived experiences as a first responder have instilled in me a profound understanding of operational stress injuries and mental health challenges experienced by public safety personnel. My unwavering passion is advocating for mental health awareness and supporting first responders, front-line healthcare workers, and public safety personnel professionals. I provided services to youth, adults, and couples.
My areas of focus are trauma, PTSD, anxiety, depression, mood disorders, life transitions, and stress management.
I am accepting new clients. I have over 10 years of experience in the mental health field, from a frontline Primary Care Paramedic to a Registered Psychotherapist (Qualifying). My lived experiences as a first responder have instilled in me a profound understanding of operational stress injuries and mental health challenges experienced by public safety personnel. My unwavering passion is advocating for mental health awareness and supporting first responders, front-line healthcare workers, and public safety personnel professionals. I provided services to youth, adults, and couples.
(343) 312-5303 View (343) 312-5303
Photo of Ruth Hawkins, BA, RP, Registered Psychotherapist
Ruth Hawkins
Registered Psychotherapist, BA, RP
Verified Verified
2 Endorsed
Kanata, ON K2K
If you are struggling with grief, depression, anxiety or the results of recent or past trauma, having a safe place to talk with a compassionate person can make all the difference in the world. My practice includes a collaborative partnership with Psychotherapy Matters—a virtual platform that connects therapists and their clients to psychiatrists, making the journey toward recovery less stressful.
If you are struggling with grief, depression, anxiety or the results of recent or past trauma, having a safe place to talk with a compassionate person can make all the difference in the world. My practice includes a collaborative partnership with Psychotherapy Matters—a virtual platform that connects therapists and their clients to psychiatrists, making the journey toward recovery less stressful.
(613) 704-1063 View (613) 704-1063
Photo of Angela Broadhead, RP, Registered Psychotherapist
Angela Broadhead
Registered Psychotherapist, RP
Verified Verified
Kanata, ON K2L
With specific expertise in trauma recovery, healing from abuse, navigating relationships, establishing healthy boundaries, and fostering self-love, I provide a safe and supportive environment where you can feel heard and understood.
Many of us don’t realize just how much painful events from our past still affect our lives today. They can affect the way we interact with others, our communication styles, the people we choose to form relationships with, and even sometimes our health. Things that once didn’t bother you may now make you more emotional, angry or overwhelmed. This may be a sign that you are running out of room to stuff your feelings. Or maybe you feel as though you have lost yourself, or just feel stuck. All of us need help at one time or another. If you are ready, I would be happy to help you on your path to feeling better and improving your life.
With specific expertise in trauma recovery, healing from abuse, navigating relationships, establishing healthy boundaries, and fostering self-love, I provide a safe and supportive environment where you can feel heard and understood.
Many of us don’t realize just how much painful events from our past still affect our lives today. They can affect the way we interact with others, our communication styles, the people we choose to form relationships with, and even sometimes our health. Things that once didn’t bother you may now make you more emotional, angry or overwhelmed. This may be a sign that you are running out of room to stuff your feelings. Or maybe you feel as though you have lost yourself, or just feel stuck. All of us need help at one time or another. If you are ready, I would be happy to help you on your path to feeling better and improving your life.
(343) 307-0242 View (343) 307-0242
Photo of Stacey Matthews, RSW, RP, Registered Psychotherapist
Stacey Matthews
Registered Psychotherapist, RSW, RP
Verified Verified
Kanata, ON K2M  (Online Only)
Our experiences, choices and life circumstances can weigh heavily upon us. When our circumstances feel overwhelming and we struggle to see our way through the stress and pain, reaching out for support can lead us to an alternate path of peace, understanding and happiness. I work with youth, adults, families and couples seeking support with challenges such as: anxiety, depression, trauma and post-traumatic stress, interpersonal difficulties such as relationship distress, attachment injuries and problematic interpersonal patterns, sleep difficulties, stress and anger management.
Our experiences, choices and life circumstances can weigh heavily upon us. When our circumstances feel overwhelming and we struggle to see our way through the stress and pain, reaching out for support can lead us to an alternate path of peace, understanding and happiness. I work with youth, adults, families and couples seeking support with challenges such as: anxiety, depression, trauma and post-traumatic stress, interpersonal difficulties such as relationship distress, attachment injuries and problematic interpersonal patterns, sleep difficulties, stress and anger management.
(343) 800-0077 View (343) 800-0077
Photo of Rahul James, MSW, RSW, Registered Social Worker
Rahul James
Registered Social Worker, MSW, RSW
Verified Verified
1 Endorsed
Kanata, ON K2L
My ideal client is someone who has experienced the depth of life's challenges, perhaps grappling with Trauma, PTSD, Grief, or Relationship Issues. They could be facing anxieties, behavioral concerns, or family conflicts stemming from diverse issues. These challenges have shaped them, but they haven’t defined them. Their goal? To find clarity, healing, and empowerment. They seek a therapeutic space that is both culturally sensitive and technically adept. They want to be seen, heard, and understood. They yearn for resilience, growth, and a renewed sense of purpose.
My ideal client is someone who has experienced the depth of life's challenges, perhaps grappling with Trauma, PTSD, Grief, or Relationship Issues. They could be facing anxieties, behavioral concerns, or family conflicts stemming from diverse issues. These challenges have shaped them, but they haven’t defined them. Their goal? To find clarity, healing, and empowerment. They seek a therapeutic space that is both culturally sensitive and technically adept. They want to be seen, heard, and understood. They yearn for resilience, growth, and a renewed sense of purpose.
(587) 842-0132 View (587) 842-0132
Photo of Breanna Trozzo, MACP, CCC, Registered Psychotherapist
Breanna Trozzo
Registered Psychotherapist, MACP, CCC
Verified Verified
2 Endorsed
Kanata, ON K2K
Waitlist for new clients
Life can be challenging, filled with obstacles and uncertainties that can take a toll on our well-being. I offer a welcoming space where you can feel safe sharing your story, thoughts, and feelings. I want you to know that I am here to provide the support you need in a way that is meaningful to you, within a compassionate space where you can explore, heal, and ultimately thrive. I work with those 16 years and older who are navigating a variety of challenges including, but not limited to, the impacts of various types of abuse, trauma, depression, anxiety, life transitions, shame, relationship issues, self-esteem, grief, and loss.
Life can be challenging, filled with obstacles and uncertainties that can take a toll on our well-being. I offer a welcoming space where you can feel safe sharing your story, thoughts, and feelings. I want you to know that I am here to provide the support you need in a way that is meaningful to you, within a compassionate space where you can explore, heal, and ultimately thrive. I work with those 16 years and older who are navigating a variety of challenges including, but not limited to, the impacts of various types of abuse, trauma, depression, anxiety, life transitions, shame, relationship issues, self-esteem, grief, and loss.
(343) 453-4658 View (343) 453-4658
Photo of Amanda Telford, MSW, RSW, CTIC, Registered Social Worker
Amanda Telford
Registered Social Worker, MSW, RSW, CTIC
Verified Verified
4 Endorsed
Kanata, ON K2K
Welcome to my profile. You have taken a difficult step in exploring your healing and recovery journey. You may be looking for support as you navigate stress, burnout, trauma, complex trauma, anxiety, depression, caregiver fatigue, ADHD or autism, addictions, and life transitions. Maybe you and your partner are experiencing challenges around communication, intimacy, parenting, elder care, work-life balance, differences in wants, needs, and life goals. Maybe you are a first responder/military/vet seeking a therapist who is truly able to deep dive with you, help regulate intrusive thoughts, and deeply process traumatic events.
Welcome to my profile. You have taken a difficult step in exploring your healing and recovery journey. You may be looking for support as you navigate stress, burnout, trauma, complex trauma, anxiety, depression, caregiver fatigue, ADHD or autism, addictions, and life transitions. Maybe you and your partner are experiencing challenges around communication, intimacy, parenting, elder care, work-life balance, differences in wants, needs, and life goals. Maybe you are a first responder/military/vet seeking a therapist who is truly able to deep dive with you, help regulate intrusive thoughts, and deeply process traumatic events.
(613) 801-3618 View (613) 801-3618
Photo of Aline Uwizeyimana, MA, RP(Q), Registered Psychotherapist (Qualifying)
Aline Uwizeyimana
Registered Psychotherapist (Qualifying), MA, RP(Q)
Verified Verified
2 Endorsed
Kanata, ON K2L
Life can be challenging at times and for most people, the last few years have been even more challenging. It takes courage to reflect on one’s life and seek professional assistance with difficult situations. I would like to applaud you for considering therapy as a step towards improving your wellness. I am passionate about offering support to individuals going through difficult times. It is an honour for me to be part of someone’s healing journey. I have experience working with individuals of diverse cultures, religions, genders and sexual orientations. I'm particularly interested in trauma, addiction and relationship challenges.
Life can be challenging at times and for most people, the last few years have been even more challenging. It takes courage to reflect on one’s life and seek professional assistance with difficult situations. I would like to applaud you for considering therapy as a step towards improving your wellness. I am passionate about offering support to individuals going through difficult times. It is an honour for me to be part of someone’s healing journey. I have experience working with individuals of diverse cultures, religions, genders and sexual orientations. I'm particularly interested in trauma, addiction and relationship challenges.
(343) 644-5205 View (343) 644-5205
Photo of Jacqueline Antonio, PhD, Psychologist
Jacqueline Antonio
Psychologist, PhD
Verified Verified
Kanata, ON K2T
Waitlist for new clients
Losses, persistent stresses, and trauma are among the situations in life that may lead us to feel overwhelmed, stuck, and discouraged. It would be my privilege to come alongside you to work towards achieving a more satisfying life, with increased hope, resilience, and success in navigating life's challenges. In my 22 years as a clinician/counselor, I have worked with a wide variety of issues such as depression, anxiety, burnout, trauma, relationship difficulties, and low self-esteem. I am honoured to provide therapeutic support to our Veterans.
Losses, persistent stresses, and trauma are among the situations in life that may lead us to feel overwhelmed, stuck, and discouraged. It would be my privilege to come alongside you to work towards achieving a more satisfying life, with increased hope, resilience, and success in navigating life's challenges. In my 22 years as a clinician/counselor, I have worked with a wide variety of issues such as depression, anxiety, burnout, trauma, relationship difficulties, and low self-esteem. I am honoured to provide therapeutic support to our Veterans.
(343) 307-0560 View (343) 307-0560

See more therapy options for Kanata

Trauma and PTSD Counsellors

When should I seek treatment for trauma?

Not everyone who undergoes trauma needs therapy to heal, but many do. If, after experiencing a traumatic event, you find yourself struggling with symptoms such as nightmares, dissociation, irritability, or emotional numbness—especially if these symptoms last more than a month and are severe enough to interfere with your daily functioning—you may benefit from seeking out therapy with a trauma-informed provider.

How long does trauma therapy take?

Different types of therapy for trauma unfold on different timelines. Prolonged exposure therapy and cognitive processing therapy, for example, each take about three months, while trauma-informed CBT may last anywhere from 8 to 25 sessions. Other approaches, especially those that are less structured or that incorporate elements from multiple modalities, may be more open-ended, though many patients report feeling better within the first few months of treatment.

What happens if trauma is left untreated?

Unaddressed trauma can have serious—even devastating—effects on relationships, career, and day-to-day functioning. Post-Traumatic Stress Disorder (PTSD) can lead people to distrust or lash out at others, making it difficult to maintain intimate relationships; it can also trigger symptoms such as flashbacks or hyperreactivity that can interfere with a person’s ability to function effectively, personally and/or professionally. Some sufferers turn to drugs to find relief. Symptoms may lessen on their own with time, but there is no guarantee that PTSD will resolve on its own.

Can PTSD come back after treatment?

It is possible for PTSD symptoms to recur months or years after successful treatment. This is because, like most mental health disorders, it is not possible to “cure” PTSD, and stressful life events may cause symptoms to recur in even the most resilient individuals. There is no shame in re-experiencing PTSD symptoms nor in returning to therapy when such relapses occur; indeed, many forms of trauma therapy explicitly encourage periodic “maintenance sessions” to reinforce coping skills and ensure that symptoms stay manageable.