Online depression treatment

Therapy matched to the problem

We match the approach to what's keeping the depression going — CBT to change the thought patterns that feed low mood, behavioral activation to rebuild momentum when everything feels like too much, and interpersonal therapy when grief, conflict, or isolation are at the center. The aim is skills you can use between sessions.

Medication management

When medication makes sense, we use non-controlled options such as SSRIs and SNRIs, chosen for your history and started at a sensible dose. Finding the right fit can take some adjusting, so we explain what to expect in the first few weeks and monitor closely — including for any early worsening of mood or new thoughts of self-harm, which can occasionally occur when starting an antidepressant, particularly in adults under 25 — and we tell you exactly what to watch for and how to reach us. We don't prescribe controlled substances like Xanax.

A coordinated plan

Your prescriber and therapist work from the same plan, so medication and therapy reinforce each other rather than running on separate tracks. For depression that hasn't responded to earlier attempts, that coordination is often where progress comes from — revisiting the diagnosis, the dose, and what's been tried before.

From first visit to a steady plan

Intake & evaluation

We take a full history — mood, sleep, energy, appetite, concentration, and how long this has been going on — and we screen specifically for any past manic or hypomanic periods before reaching for an antidepressant. This is also where we look at thyroid, medications, and substance use that can cause or deepen depression, and ask directly about thoughts of suicide.

Your plan, together

Your clinician walks you through a clear plan and the reasoning behind each choice, with what to expect in the first few weeks, including how long an antidepressant typically takes to help. If earlier treatments haven't worked, we talk through what that points to and what to try next.

Follow-up & adjustment

Depression is treatable, but the first medication isn't always the right one, so we track your response through regular check-ins and adjust the dose, switch agents, or add a therapy focus as needed — then space visits out as you stabilize. For treatment-resistant depression, this is where augmentation strategies come in, along with referrals to in-person specialists for interventional options like TMS or ketamine/esketamine — delivered in a supervised setting, not prescribed for home use.

We use validated screeners like the PHQ-9 to set a baseline and track your response over time, so treatment decisions reflect how you're actually doing — not a single impression in one visit.

Before settling on a plan we screen for what mimics or drives depression — untreated sleep problems, grief, ADHD, and especially any past manic or hypomanic periods, because an antidepressant given alone to someone who is actually bipolar can make things worse.

When medication fits, we generally begin with an SSRI at a reasonable dose, explain what to expect in the first few weeks, and monitor closely. We don't prescribe controlled substances like Xanax.

If earlier antidepressants haven't worked, we revisit the diagnosis and past trials, then use evidence-based strategies — switching agents, augmentation, and referrals for interventional options — rather than repeating what didn't help.

Both bring low mood, low energy, poor sleep, and trouble concentrating, and the depressive phase of bipolar disorder can look identical to ordinary depression. The distinguishing feature is a history of even one manic or hypomanic episode — a stretch of racing thoughts, decreased need for sleep, or unusual drive — which points to bipolar disorder instead. Because those highs are easy to under-report, we ask about them directly, since an antidepressant given without a mood stabilizer can tip a bipolar person into mania.

The two overlap heavily and frequently co-occur — both can bring poor sleep, difficulty concentrating, fatigue, and irritability. What separates them is the core experience: depression centers on low mood, loss of interest, and hopelessness, whereas anxiety centers on excessive worry, restlessness, and a keyed-up sense of dread about what's ahead. When both are present we treat them together, since the same plan often addresses each.

Both can follow a loss or major life change and bring sadness, tearfulness, and trouble sleeping, so they're easy to conflate. The tell is course and reach: grief tends to come in waves tied to reminders of the loss, with self-worth mostly intact, whereas major depression is a more pervasive, sustained low mood with worthlessness, loss of interest across the board, and often thoughts of death. Grief and adjustment reactions can deepen into a clinical depression, which is why we take the timeline seriously rather than assuming time alone will fix it.

Insurance & cost

Coverage and cost

We're in-network with major commercial plans — including Aetna, Cigna, UnitedHealthcare/Optum, Anthem/Blue Cross Blue Shield, and Humana — and Medicare where our clinicians are licensed. We verify your benefits before your first appointment, so you know your cost up front. Prefer not to use insurance? Transparent self-pay rates are available.