"I'm not sad. I'm just… nothing."
Anhedonia — the loss of pleasure and interest — is often the primary symptom in adult depression. Very treatable, just under-recognized.
Depression · Specialty area
Low mood. Burnout. Brain fog. Not just "sad."
Depression in adults rarely looks like the textbook picture. Motivation loss, irritability, sleep changes, numbness, physical heaviness — we take all of it seriously, and build a plan that works for your actual life.
Who we see
Depression has many disguises.
"I can still work. I just can't do anything else."
"Functional depression" is common in high-performers. The productivity stays; everything else flattens. It's still worth treating.
"I tried [SSRI] years ago and it didn't help."
One medication isn't a verdict on all medications. Different classes work on different neurochemistry — we'll try a different tool.
"I'm postpartum and I don't feel like myself."
Perinatal mood changes are medical, not a personal failing. We work with postpartum depression and anxiety — including while breastfeeding.
"My depression + ADHD + trauma are all tangled up."
Comorbidity is normal. We treat the whole picture — usually starting with whichever piece is loudest.
"I've tried 3 meds and nothing's working."
Treatment-resistant depression needs a different approach: augmentation, different class, rule-out of contributors (sleep apnea, thyroid, substances), and sometimes referral to TMS or ketamine.
What we look for
Depression is a symptom, not a diagnosis-in-a-box.
The first question isn't "what medication?" — it's "what's actually making you feel this way?"
Before (or alongside) starting medication, we systematically rule out:
- Thyroid disorders — one of the most common reversible contributors
- Vitamin D, B12, iron deficiency — cheap to check, frequently relevant
- Sleep apnea — untreated OSA causes textbook "depression"
- Medication side effects — beta-blockers, hormonal contraception, others
- Alcohol & cannabis — both are depressants, both often missed
- Undiagnosed ADHD — chronic overwhelm and self-blame look like depression
- Trauma history — unprocessed trauma drives chronic low mood in many adults
Some patients get meaningful relief from addressing the above alone. Others benefit from medication, therapy, or both. Our job is to figure out which — with you.
Treatment
Matching the tool to the person.
No "first-line SSRI by default." The right starting point depends on your history, your side-effect sensitivities, and what you want to optimize for.
Medication
Every major class available.
- SSRIs — Lexapro, Zoloft, Prozac
- SNRIs — Effexor, Cymbalta
- Bupropion — when motivation/fatigue dominate
- Mirtazapine — when sleep + appetite matter
- Atypicals + augmentation for treatment-resistant
We pick the medication to match the symptom profile — not just cycle through a protocol.
Therapy
Depth & evidence.
- Short-term CBT & behavioral activation
- Trauma-informed care for trauma-rooted depression
- Coordination with your outside therapist when helpful
Therapy is available in-house and by referral. For many patients, the combination works better than either alone.
When meds aren't enough
Treatment-resistant options.
- Augmentation (aripiprazole, lithium, thyroid)
- Class switch & cross-titration
- Referral to TMS (covered by most plans)
- Referral to ketamine/esketamine when appropriate
- Re-investigation of contributors
We have a curated referral list. You won't be stranded.
What patients say
Hope, when nothing else had worked.
Methodical, measured, and never giving up on the idea that you can feel better.
★★★★★
“Ravi saved my life. I’m not the type of person prone to hyperbole, so I don’t make that statement lightly. He takes a methodical approach, with a strong concern for not creating any harm.”
★★★★★
“Seeing Dr. H has been life-changing and possibly life-saving. He’s incredibly flexible and caring — and he takes my insurance, which makes seeing him that much easier.”
★★★★★
“Dr. Hariprasad changed my life. He adjusted to meet my extremely busy schedule with in-person and video appointments. Very highly recommended, without reservation.”
From patients’ own published reviews. Names shown as they chose to publish them.
Begin
Start with a 2-minute application.
No commitment — we verify insurance first.
Most patients apply online — it’s the fastest way in. Prefer to talk first? A free 15-minute call works too. We verify insurance, send you next steps, and never bill you until you've said yes.