Major depressive disorder
Persistent low mood and loss of interest, with a clear impact on daily life.
Conditions WE TReat · DEPRESSION · Columbus, OH
Depression treatment when medication hasn't worked
TMS, Spravato, and IV ketamine led by a board-certified psychiatrist in Columbus, Ohio since 2017.
Ask us anything
Which one sounds like you
Depression Isn't One Condition
Where it came from, how long it's lasted and what sits alongside it all change what's likely to help. Find the group that sounds like you.
Most common
Depression
Depression
itself
Persistent depressive disorder
Dysthymia. Two years or more of lower-grade depression, often described as "I've always been like this."
Seasonal affective disorder
Arrives with the shorter days and lifts in spring. An Ohio winter pattern.
Past the first rounds
Treatment hasn't held
Treatment-resistant depression
Two or more antidepressants without adequate response. Spravato is the only medication FDA-approved for it.
Depression with anxiety
Deep TMS is FDA-cleared for depression with comorbid anxiety symptoms. Both treated in one course.
Age and life stage
Specific circumstances
Bipolar depression, or something not listed here? Call 614-933-4200 and we'll tell you honestly if we're not the right place.
Treatments
Five Routes, Not One
Which one you're offered depends on your history. They can also be combined.
Medication management
Psychiatrist-led
Psychiatric prescribing and review with Kayla Cartwright, PMHNP-BC. Often the right starting point.
Format
First visit in person, follow-ups by telehealth
Self-pay
$200 initial, $100 follow-up
Insurance
Credentialing in progress
Standard Deep TMS
FDA-cleared
Magnetic pulses stimulate the brain region tied to mood. Nothing enters your bloodstream.
Course
36 sessions, 5 days a week
Session
20 to 30 minutes, drive yourself home
Insurance
Most plans
Accelerated TMS
FDA-cleared device
The same protocol compressed into one working week.
Course
50 sessions over 5 days
Per day
Ten short sessions
Insurance
Self-pay only
Spravato (esketamine)
FDA-approved for TRD
A nasal spray taken in-clinic under supervision. The only drug FDA-approved for treatment-resistant depression.
Setting
In-clinic, no driving after
Insurance
Insurance, with prior auth
IV Ketamine
Off-label use
An in-clinic infusion, and usually the fastest-acting option we offer. Approved as an anesthetic, so its use for depression is off-label.
Course
Six-session series
Visit
2 to 3 hours, no driving after
Insurance
Self-pay only
Is this you?
Who We Can help, And Who We Can't
What you've already tried matters more than your diagnosis. If we're not the right place, we'll tell you.
- Your meds come from your family doctor and you still don't feel well
- You've been on the same prescription for years, unreviewed
- A medication helped, but the side effects didn't
- Two or more antidepressants haven't held
- TMS or Spravato elsewhere didn't work for you
- You're in crisis. Call or text 988
- You're under 15
- You want talk therapy on its own. We'll refer you on
- You need inpatient or emergency care
Our promise
Two Things We Commit to
1
We won't repeat what's already failed you
The recommendation follows your history, not our preference. Dr. Blair or a psychiatric NP explains why.
2
If it isn't working, we'll say so
Scored at baseline, midpoint and end. No pushing you through a course that isn't helping.
Frequently asked
What patients ask before reaching out.
Do I need a referral?
No, not for any of our treatments. Contact us directly. If you already have a psychiatrist or therapist, we coordinate with them with your permission.
Do I have to stop my antidepressants?
Usually not. TMS, Spravato and IV ketamine generally run alongside existing medication rather than replacing it. We review your full list at the evaluation.
How long before I'd notice a difference?
It varies by treatment and by person. Some people notice something in the first fortnight, most not until week three or four. We track it with PHQ-9 and MADRS scores at baseline, midpoint and end, so you'll know either way rather than guessing.
Will insurance cover it?
For depression, most major plans cover TMS, including Medicare, Ohio Medicaid and VA. Spravato is covered with prior authorization. Accelerated TMS and IV ketamine are self-pay. We verify your benefits free and put it in writing.
My meds come from my family doctor. Is that a problem?
Not at all, and it's a common reason people come to us. Primary care handles a lot of depression well, but if you're still struggling, a psychiatric review often finds something worth changing. That's what medication management is for.
Who will I see?
Dr. Mark Blair or one of our psychiatric nurse practitioners. Both are credentialed to run initial consultations and build treatment plans, with Dr. Blair providing clinical oversight on all cases.
