Under Treatment of Major Depression Common

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People with major depression can seem OK to others because they often will themselves to “put on a face”. The painful reality is an internal pain that is often pervasive, despite what would seem to be good circumstances. People with depression experience a decreased ability to experience joy – what used to be fun simply is not. Every day tasks feel like lifting lead weights. Depression is the leading cause of suicide. We help people quickly and effectively overcome depression everyday. We are writing this blog because despite years of outreach, this common brain illness continues to be under-treated. A new study published in the British Journal of Psychiatry reiterates that Major Depressive Disorder is a leading cause of disability worldwide. In the current study, the authors looked at the number of people who met criteria for Major Depression and then of those, what percent were aware that they needed treatment, and then of those what received care that met minimum standards. Even in the high income countries, only 1 in 5 people who knew they had a problem received even “minimally adequate” care. These numbers are frightening. While we need to make sure people know when to seek help, we also need to improve community standards. We are experts in diagnosing and treating depression, whether it be severe or moderate, routine or Bipolar. We believe in providing personal comprehensive evaluations that include over an hour of direct doctor time to understand how biology, genetics, diet and other lifestyle factors might be causing problems. When medication is needed we have the expertise to choose the best treatment for the person. We also have the expertise to safely stop psychiatric medications, and to choose other options. Our patients don’t receive medically adequate care – they receive state of the art care. While we can’t personally treat everyone, we teach others through out the globe and support organizations that specialize in under-served populations. Let us know how we can help you.

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Accelerated TMS - Neuronavigation TMS - Esketamine/Spravato

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The first thing to know is that depression is not the same thing as being sad. When something bad happens, it is normal to feel sad. Signs that you may need help are if the sadness is present almost all day, everyday for several weeks, or if you are unable to enjoy the things that used to be fun in your life. Often, changes in sleep and appetite are also signs that may be part of the illness we call depression. The Personal Health Questionnaire (PHQ) might help.

Our expertise is in understanding the complexity of depression and anxiety disorders and providing comprehensive patient focused diagnosis and treatment recommendations. We combine decades of experience with state of the art science to get you well. We spend a full hour of physician time on the first visit, which is not possible in primary care. This allows us to really understand what is happening with you and design a personalized plan that fits your life. Therapy is very helpful as a place to learn new coping skills and to discuss stressful life situations or long-standing problems with how you behave that are not working for you. However, therapists cannot prescribe medication or offer TMS or other biological treatments. If you might need a medical perspective, you should consider starting with us. Many of our patients are referred to us by their therapists for our medical perspective, and we likewise include therapy in many of our treatment suggestions.

Anxiety often goes hand in hand with depression, but for some people anxiety is the main problem. Mild anxiety can often be treated by therapy alone, especially therapies that are designed specifically to teach patients how to change their thoughts about anxiety provoking ideas or situations. One example is Cognitive Behavioral Therapy (CBT). If your anxiety is interfering with your life, you might want to make an appointment with one of our psychiatrists for a full evaluation so we can set you on the right path. We have expertise in generalized anxiety disorder, panic disorder and obsessive compulsive disorder (OCD).

We are trained and board-certified as adult psychiatrists so our typical age range is 18 years and up. However, since Covid, there has been an intense need for additional psychiatric care for children and adolescents. As such, on a case by case basis, we will see teenagers 16 and up if they’re in therapy and are still in need of evaluation and medical treatment for depression, anxiety, or ADHD and if they can safely be treated as an outpatient.

For new patients, we provide an initial phone conversation free of charge in order to assess if our services are right for you. We believe that we are very good at what we do, but we are not always able to provide the ideal care setting for all patients. We value your time and your money and do not want to set up an appointment if you might be better served elsewhere. Click here to contact us.

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We made the choice to not be “in network” with any insurance company in order to provide the most tailored treatment possible without compromise. However, if you have “out of network” benefits, you may be eligible for reimbursement from your insurance company. Plans vary, so check with your carrier if this is something you are interested in. We will provide a receipt with the service and diagnosis codes that insurance companies use to reimburse you.

Payment is required by cash or credit card at, or before, the time of service.

Assistance is available to verify insurance coverage to obtain preauthorization for TMS, Esketamine, and Spravato medication.

You will be greeted by someone on our team, offered coffee, tea, soda or water and a comfortable chair and given a clip board with new patient forms. These take about 10 minutes and include your contact information, our office policies and questions about how you have been feeling. You are welcome to have the forms before your appointment. You will then be greeted by Dr. Marangell or Al Jurdi and escorted to their office. First appointments usually last an hour and most of the time you will leave with a treatment plan that you and your doctor have agreed is best for you.

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