Free consult
A 15-minute phone call to decide whether psychiatric medication management fits what is happening. No card required.
§ 01 Depression psychiatry
When life gets heavy and stays heavy.
Private psychiatric telehealth for Washington adults navigating persistent low mood, low motivation, cognitive slowing, sleep changes, anxiety overlap, and medication questions.
No card required for the consultation request. We use the call to decide whether medication management is the right next step.
At a glance
Depression psychiatry here means private telehealth evaluation and medication management for Washington adults with persistent low mood, low motivation, sleep changes, anxiety overlap, or questions about past medication response. The first step is formulation, including screening for bipolar-spectrum patterns when indicated.
§ 02 What this care is
Medication management after careful formulation.
We look at the whole pattern: mood, sleep, appetite, energy, concentration, anxiety, trauma history, grief, burnout, medical contributors, and the medication history that may or may not have helped.
The goal is not to reduce a complex life to a prescription. The goal is to understand whether medication can reduce the biological load enough for recovery to become more possible.
This is a private cash-pay practice for adults physically located in Washington State. I do not accept or bill insurance. Superbills are available for possible out-of-network reimbursement when applicable.
$250 intake
A 60-minute psychiatric evaluation with history, medication review, target symptoms, and an initial plan.
$150 follow-up
Thirty-minute follow-ups to review response, side effects, mood, sleep, energy, and functioning.
§ 03 Common presentations
Not just sadness. Often a change in the whole system.
Depression can look like low mood, but it can also look like shutdown, irritability, sleep disruption, indecision, or a body that will not move.
01
Persistent low mood, emptiness, numbness, or loss of interest.
02
Low motivation, fatigue, cognitive slowing, or decision paralysis.
03
Sleep and appetite changes that keep the cycle going.
04
Anxiety, rumination, guilt, shame, or a harsh internal narrative.
05
Depression after grief, burnout, trauma, illness, or major transition.
06
Medication trials that helped partly, stopped working, or caused side effects.
07
Concern that depression might overlap with bipolar-spectrum activation.
08
Functioning on the outside while privately running out of range.
§ 04 Medication can help with
Reducing the load enough to move.
Medication is most useful when the target is clear and the response is measured over time.
Mood load
Lowering the depressive weight that makes ordinary tasks, relationships, and decisions feel unreachable.
Sleep and energy
Supporting the biological rhythms that affect motivation, concentration, appetite, and recovery.
Anxiety overlap
Addressing rumination, dread, agitation, and physiological anxiety when they travel with depression.
§ 05 What this is not
Boundaries keep the care clear.
Not crisis care
If you are in acute danger or thinking of harming yourself or someone else, call 988, 911, or go to the nearest emergency department.
Not therapy replacement
Medication can support therapy and behavior change, but it does not replace psychotherapy or community support.
Not one-size-fits-all
We consider bipolar-spectrum history, trauma, grief, sleep, medical contributors, and prior medication response.
Not controlled substances
I do not prescribe stimulants, benzodiazepines, or controlled sleep medications. Controlled-substance prescribing is not part of this practice.
§ 06 Related paths
Anxiety and sleep
For many people, depression is bound up with insomnia, rumination, panic, or nighttime activation.
Explore anxiety and sleep careTrauma and PTSD
Shutdown, numbness, grief, and threat physiology can overlap with depressive symptoms.
Explore trauma careAdjustment
Major transitions after service, illness, or loss can surface as depression, insomnia, or emotional flatness.
Explore adjustment careVeterans services
For veterans when low mood overlaps with post-service transition, sleep disruption, or irritability.
Explore veterans care§ 07 Questions
What if I am not sure this is depression?
You do not need to arrive with the perfect label. The evaluation looks at mood, sleep, anxiety, grief, trauma, medical contributors, medications, and whether bipolar-spectrum features need to be ruled out.
Will you just start an antidepressant?
No. Antidepressants can be helpful for some people, but the first step is formulation. We look at history, risks, side effects, activation, prior response, and the target symptoms before choosing a plan.
Can medication help if depression has been present for years?
Sometimes, yes. Long-standing symptoms do not mean the system is fixed in place. Medication can reduce specific burdens around mood, sleep, anxiety, energy, and functioning.
What is the first step?
Request a free 15-minute consultation. No card is required for that call, and we use it to decide whether a full psychiatric evaluation makes sense.
If the weight is not lifting, we can start there.
A short consultation is enough to decide whether this kind of psychiatric care fits what is happening.
Book a free 15-minute consultation