Understanding Depression
Low mood, loss of interest, fatigue, and motivation collapse that linger beyond a hard week.
Depression is a neurochemical and behavioral condition, not a character flaw. We assess the biology with labs, address acute symptoms with psychiatry, and rebuild momentum with therapy and lifestyle protocols. Treatment-resistant cases get deeper investigation — not a prescription refill.
Depression care at a glance
- Who we treat
- Adults 18+
- Where
- In person in Scottsdale, AZ · Telehealth in AZ, NY, KS, MN, OR, WA
- Insurance
- Commercial insurance accepted for psychiatry and therapy
- Care team
- Psychiatry, therapy, and primary care clinicians working as one team — not a single provider
How it shows up
Depression is more than sadness. It's a flattening — loss of interest, low energy, motivation collapse, changes in sleep and appetite, and a sense that everything takes more than it should. It can creep in slowly until you've forgotten what your baseline felt like.
What's driving it
Depression is a neurochemical, hormonal, and behavioral condition, not a character flaw. It can be driven by thyroid dysfunction, nutrient deficiencies, hormonal shifts, chronic stress, and sleep disorders — which is why a real evaluation includes labs, not just a conversation. Treatment-resistant cases deserve deeper investigation, not another prescription refill.
When to seek help
If low mood and loss of interest have lasted more than a couple of weeks, or if you notice hopelessness or thoughts of not wanting to be here, reach out now. Depression is highly treatable, and the right plan is built around your biology, not a default protocol.
Who We Typically See
Someone who's still functioning but running on empty: going through the motions, losing interest in things they love, sleeping too much or too little. Many have tried one or two medications that didn't fully work and are wondering if anything will.
Treatment Options at a Glance
When the first prescription didn’t work, there are more doors.
We look at energy, sleep, side effects, and what you’ve already tried, then choose from a much wider toolkit.
SSRIs & SNRIs
What it targets
Mood, anxiety, and energy.
Common first steps, matched to your symptoms and side-effect priorities.
Bupropion (Wellbutrin)
What it targets
Low energy, motivation, and focus.
Little to no sexual side effects or weight gain.
Mirtazapine
What it targets
Depression with poor sleep and appetite.
Helpful when insomnia is a big part of the picture.
Treatment-resistant options
What it targets
Depression that hasn’t responded to first-line care.
Augmentation strategies and newer rapid-acting options such as Auvelity, with referral for esketamine when indicated.
Therapy (CBT, behavioral activation)
What it targets
Withdrawal, negative thinking, and lost routines.
Combining therapy with medication outperforms either alone.
Medical drivers
What it targets
Thyroid, testosterone, vitamin D, iron, and sleep.
Treatable biology often hides behind depression.
Options are prescribed only when clinically appropriate, after evaluation by a licensed provider.
The evidence
The PHQ-9 is the standard 9-item depression screener used in primary care; about 1 in 12 U.S. adults experiences depression in a given year.
Source: Kroenke et al., 2001; CDC
Quick Self-Check
Could it be Depression?
Answer a few questions to see whether your responses point toward Depression or toward something else. Either way, we'll help you take the next step.
Over the past two weeks, how often have you experienced each of the following?
01Little interest or pleasure in doing things you usually enjoy
02Feeling down, depressed, or hopeless
03Low energy or fatigue that slows you down
04Trouble concentrating or making decisions
05Changes in sleep, appetite, or moving slower or faster than usual
Depression — Frequently Asked
Common questions about Depression.
How do I know if it is depression or just a rough patch?
If low mood, loss of interest, fatigue, or changes in sleep and appetite last more than two weeks and affect daily life, a proper evaluation is worthwhile.
What if treatment has not worked before?
Treatment-resistant depression deserves deeper investigation — labs for thyroid, hormones, and nutrients, a review of diagnosis (including bipolar), and a broader plan than another refill.
Is depression treatment covered by insurance?
Commercial insurance is accepted for psychiatry and therapy. Care is available in Scottsdale, AZ and nationwide via telehealth.
Medically reviewed by
Jacob Johns, NP, MSN, PMHNP
PRX Psychiatric Nurse Practitioner
Psychiatric nurse practitioner with a background in crisis care and inpatient psychiatry; trained in CBT and motivational interviewing.
Take the next step.
Whether the screening pointed here or somewhere else, the right next move is a conversation. Reach out and we'll help you find your path.
Get started