The evaluation process
Depression in adults rarely arrives as a clean clinical picture. It overlaps with anxiety, sleep disturbance, ADHD, perinatal mood changes, grief, and burnout. Treatment that ignores those overlaps tends to disappoint — which is why our first visit is built to look at the whole picture rather than reach for a prescription first.
A full unhurried intake covers a structured DSM-5 symptom review, the PHQ-9 for baseline severity, a careful look at sleep, substance use, medication history, and prior treatment responses. We screen for conditions that often travel with depression: generalized anxiety, panic, ADHD, PTSD, postpartum mood, and bipolar-spectrum signals that change which medications are safe.
A treatment plan is discussed before you leave. If medication is the right next step, we usually start that day or within a few days — and we follow up on a clear interval (2 weeks during a start or change, 4–6 weeks while dialing in, every few months once stable). PHQ-9 tracking between visits keeps us honest about whether what we're doing is actually working.
Medication options
Medication choice depends on your symptom pattern, side-effect profile, prior responses, and what you're willing to live with. We prescribe across all major antidepressant classes:
- SSRIs: Sertraline (Zoloft), escitalopram (Lexapro), fluoxetine (Prozac), citalopram, paroxetine — first-line for most patients
- SNRIs: Duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine — useful when anxiety, pain, or significant fatigue are prominent
- Atypicals: Bupropion (Wellbutrin) for low energy and motivation; mirtazapine (Remeron) for sleep and appetite
- Augmentation: Adding aripiprazole, lithium, or a thyroid agent when monotherapy isn't quite getting there
For treatment-resistant patients, we discuss next-step options including TMS (transcranial magnetic stimulation), esketamine (Spravato), and referral to in-person specialty providers — and we coordinate care if you pursue them.
Serving Tigard and Washington County
Tigard sits in the Portland metro area's southwest corridor, served by I-5, OR-217, and Highway 99W. We see adults from Tigard as well as Tualatin, King City, Beaverton, Sherwood, Lake Oswego, and Durham — mostly by secure-video telehealth. Our patient base in the area skews toward Portland-metro families, Nike and Intel employees, healthcare workers across the major systems, and professionals working from home.
Patients who'd prefer to be seen in person can book at our nearest office: Newberg — about 25 minutes from Tigard.
Coordination with primary care is routine. We send a visit summary to your PCP at Providence St. Vincent, Legacy Meridian Park, and Kaiser Permanente clinics (or your independent provider) within one business day when you request it.
Insurance & self-pay
We are in-network with ten major plans: Moda, PacificSource, Regence BlueCross BlueShield, Cigna / Evernorth, Aetna, Providence, MultiPlan / Claritev, First Health, First Choice, and Optum. Most Tigard patients pay a specialist copay ($20–$60 typical) per visit.
We do not accept Medicaid or Oregon Health Plan (OHP). Self-pay rates are available by phone. Superbills available for out-of-network reimbursement. Good Faith Estimates provided before your first visit.
Frequently asked questions
How do I get started with depression treatment in Tigard?
Book a new-patient telehealth visit online or by phone. Most patients are seen within about a week. The first visit is a comprehensive evaluation; if medication is appropriate, we usually start that day or within a few days.
Will I need to see someone in-person?
Not for most patients. Antidepressant medications are not controlled substances, which means they can be prescribed by telehealth without special restrictions. In-person visits are also available at our Newberg office (about 25 minutes) if you'd prefer that.
What happens if the first medication doesn't work?
It's common — only about 60% of patients respond to their first antidepressant. We use measurement-based care (PHQ-9 tracking) to see whether the medication is actually helping, and we switch or augment on a clear, evidence-based timeline rather than guessing.
Do you accept insurance for depression treatment?
Yes — we are in-network with Moda, PacificSource, Regence BCBS, Cigna / Evernorth, Aetna, Providence, MultiPlan / Claritev, First Health, First Choice, and Optum. Medicaid and Oregon Health Plan are not accepted.