Conditions we care for
Depression care for when the standard playbook hasn't worked.
From first-time depression to treatment-resistant cases that have cycled through multiple medications, we offer the full range of evidence-based care, including ketamine-assisted psychotherapy and FDA-approved Spravato.
- 2 locations · Cedar Rapids · St. Thomas
- In-person · Telehealth available
When medication alone has not been enough
"We build a treatment plan around what your depression actually needs."
What this looks like
Depression is not one thing.
Some patients describe it as a flat grey. Others say it is the exhaustion of dragging themselves through a day. Others describe a deep, painful sadness that has no clear source. For some it has been there since adolescence. For others it arrived after a loss, a diagnosis, a postpartum period, or a chapter of life that quietly broke them.
Most patients who walk into our clinic for depression have already tried something. An SSRI. A round of talk therapy. A friend’s recommendation. Sometimes several. They are not new to this. What they are looking for is something that actually works.
We treat the full range, from people seeking their first conversation with a psychiatrist to people who have tried four medications and want to know what is next. For treatment-resistant cases we offer interventions most psychiatry practices do not, including ketamine-assisted psychotherapy and Spravato.
Not just neurotransmitters
Inflammation, sleep, thyroid, trauma, gut health, and meaning.
How we treat depression
The full spectrum of evidence-based depression care.
We sequence treatments based on where you are. First-time depression usually starts with therapy and conventional medication. Treatment-resistant cases often call for ketamine or Spravato.
Psychiatry & Therapy
Medication management with thoughtful prescribing and, where appropriate, deprescribing. Evidence-based therapies including CBT, behavioral activation, interpersonal therapy, and trauma-focused work where depression is tied to older wounds.
Spravato (Esketamine)
FDA-approved esketamine nasal spray, administered in our clinic with the required monitoring period. Indicated for treatment-resistant depression and depressive symptoms in adults with major depressive disorder with suicidal ideation. Often covered by insurance.
Ketamine-Assisted Psychotherapy (KAP)
Intramuscular or IV ketamine paired with prepared psychotherapy. This is not an infusion-clinic model. Every medicine session is bookended by preparation and integration therapy. Effective for many cases of treatment-resistant depression.
Functional & Integrative Workup
Depression can be driven or worsened by thyroid dysfunction, inflammation, nutrient deficiencies, sleep apnea, hormonal shifts, and the medications themselves. We screen for these as part of evaluating you.
How treatment works
From your first call to ongoing care.
No surprises. Here is exactly what the path from your first call to ongoing treatment looks like at our clinic.
01
Reach out.
Book online or call us at (319) 800-2125 (Cedar Rapids) or (340) 244-9658 (St. Thomas). A free 15-minute consultation is the easiest way to start if you are not sure where to begin.
02
Initial evaluation.
A 60 to 90 minute conversation with a clinician. Full psychiatric and medical history, a review of what you have already tried, and a conversation about what you actually want out of treatment.
03
Your individualized plan.
We build a treatment plan with you, not for you. It may include therapy, medication, ketamine-assisted psychotherapy, functional medicine workups, or a combination. We explain the why behind every recommendation.
04
Treatment begins.
You start the plan we built together. Sessions are scheduled around your life. In-person at our Cedar Rapids or St. Thomas clinics, or via secure telehealth where appropriate.
05
Ongoing care and adjustment.
Mental health is not linear. We check in, measure progress, adjust the plan when things change, and coordinate with your other providers when that helps.
Forms of depression we commonly treat.
Depression has many faces. Treatment is rarely one-size-fits-all, and the plan we build with you will reflect which kind you actually have.
Under the depression umbrella
Frequently asked
Questions about depression treatment.
If your question isn’t here, our team can walk you through it. Call (319) 800-2125 or request a free 15-minute consultation.
01What is treatment-resistant depression?
Generally defined as depression that has not adequately responded to at least two trials of antidepressant medication at appropriate doses and durations. If you have tried multiple medications and still feel stuck, you may be a candidate for Spravato or ketamine-assisted psychotherapy.
02What is the difference between Spravato and ketamine?
Spravato (esketamine) is an FDA-approved nasal spray for treatment-resistant depression. It is administered in-office under monitoring and is often covered by insurance. Ketamine is delivered intramuscularly or intravenously, used off-label, and paired with psychotherapy in our model. Different patients are better candidates for one or the other; we help you figure out which.
03How quickly does ketamine or Spravato work?
Many patients notice improvement within hours to days of their first session, which is faster than conventional antidepressants. Sustained improvement requires a course of treatment, typically multiple sessions over weeks, plus integration therapy in the case of KAP.
04Will I have to stop my current antidepressant?
Usually no. Most patients continue their existing medications during ketamine or Spravato treatment. We coordinate with your prescriber if you have one outside our clinic, and may adjust medications over time as your treatment progresses.
05Is this covered by insurance?
Spravato is often covered by commercial insurance and Medicare. Ketamine-assisted psychotherapy is generally not covered, though some HSA and FSA accounts can be used. We discuss cost upfront before any treatment begins and offer financing options.
06Do you treat adolescents with depression?
Yes, we see adolescents for psychiatry and therapy. Ketamine and Spravato have specific age and clinical criteria, and we evaluate each case individually.
07What if I am having thoughts of suicide?
If you are in immediate crisis, call or text 988, or go to your nearest emergency room. If you are not in immediate crisis but having thoughts of suicide, please tell us at intake. Spravato is specifically FDA-approved for depressive symptoms with suicidal ideation, and many patients in this situation find rapid relief.
In a crisis right now?
If you or someone you love is in a life-threatening situation, please do not use this site. Reach out immediately — help is available 24/7, free, and confidential.
Take the next step
Ready when you are.
Whether you’re booking your first visit or just want to talk to someone — we’re here.