REFRESH DALLAS · DEPRESSION
Depression is medical.
The mornings that are heavier than the day before. The dinner you couldn't taste. The conversations that feel performed. Many of our patients have been told they should be able to think their way out of this. They have not been able to. We do not believe they should have to.
In-network with most major insurance · Same-week availability · Psychiatric specialists
THE CONDITION
It is not a character flaw.
Depression is a clinical condition with biological and environmental contributors. The biology is real. The brain in depression genuinely processes signals differently. We work with the brain you have, not a version that should be more resilient.
Depression looks different from person to person. Some patients cannot get out of bed. Others go to work, perform well, and feel nothing. Anhedonia, the loss of pleasure in what used to give pleasure, is one of the clearest signs and one of the most disorienting to live with.
Depression rarely arrives alone. It often travels with anxiety, with chronic insomnia, with grief, with hormonal shifts, with ADHD that has gone uncovered for years. The depression is one part of a larger picture, and we treat the picture.
OUR APPROACH
A real evaluation and a real plan.
The first visit is longer than most because it has to be. We take a real history. Past episodes if any. Family pattern. Current medications and what they have done. Sleep, alcohol use, hormonal context. The questions that determine which kind of depression you have, because they are not all the same condition.
When medication is part of the plan, the choice depends on you. There is no default. The first-line options work for many patients and we start there when it makes sense. When they do not work, or when the side effects are wrong, we change course. The patient who needs a different class of medication gets that medication. The patient who would benefit from a deprescribing conversation gets that conversation.
Therapy and medication together produce better outcomes for depression than either does alone. We are a psychiatry practice, so therapy happens with a partner provider. If you already have a therapist, we coordinate. If you do not, we can refer.
SCOPE OF CARE
Where this is not the right fit.
We are an outpatient practice, which means there are levels of care we don't provide ourselves. Inpatient stabilization. Intensive outpatient programming. Specialty treatments like ECT and TMS. When one of those is the right next step, we'll point you to the practices that do this work well, and we'll be ready to take over the longer-term care from there.
FAQ
Questions.
Antidepressants are slow medicine. Most people notice changes well before the full effect arrives. At your first follow-up we have enough to know whether the medication is working or whether we should change something.
This is more common than most people realize. We start by asking what has been tried, at what dose, and for how long. Sometimes the answer is changing class. Sometimes the answer is augmenting. Sometimes the answer is a careful deprescribing conversation about what isn't working before adding more.
Often, no. After a first episode many patients are able to taper carefully off medication after a period of stable remission. After multiple episodes, longer-term care is often the better choice. We have this conversation with each patient and revisit it as the situation changes.
For mild depression, often, yes. For moderate and severe depression, the outcomes are stronger with medication and therapy together. We can talk about where you land and what makes sense.
If this is an emergency, or if you are worried about your safety right now, please reach out for support that can meet the moment. You can call or text 988 anytime to reach the Suicide and Crisis Lifeline, or go to your nearest emergency department. When you are ready for outpatient care, we will be here.
Depression is treatable. Most patients we see improve substantially. Some get to a place they did not believe was possible.