Depression, anhedonia, and the slow drift into "fine." Standard first-line options, augmentation when warranted, and a frank discussion of TMS, ketamine, and other tools when first-line plans stall.
Beyond "feeling sad"
Most high-performers don't present with classic depression. They present with loss of drive, blunted reward, irritability, sleep changes, and the quiet feeling that nothing is interesting anymore. We screen for that pattern explicitly.
Treatment sequence
- First-line: FDA-approved antidepressant classes. Choice driven by symptom profile, side effects, and what you've tried before.
- Augmentation: Evidence-based combination and adjunctive strategies when monotherapy isn't enough.
- Treatment-resistant depression: Honest discussion of TMS, IV/IN ketamine, esketamine (Spravato). Referral coordination where appropriate.
Burnout is not depression — but they share territory. We separate them, because the treatments differ.
Book a visit
Initial intake is 60 minutes, $400 self-pay. Superbills available for out-of-network reimbursement. Book online.