Depression & mood disorders
When the heaviness doesn't lift, you deserve more than a refill.
Depression is common, and so is being treated for it without anyone really looking. At R3 you get an unhurried evaluation, a careful look for medical causes and missed diagnoses, and a plan you helped build. Women are our specialty. Men and partners are welcome too.
What we treat
Depression
Low mood, loss of interest in things you used to enjoy, heaviness, irritability, hopelessness, changes in sleep and appetite, trouble concentrating, or simply feeling nothing at all. Depression shows up differently in different people. In women it often arrives with anxiety, in men it often looks like anger, and in high achievers it hides behind a full calendar.
Depression that keeps coming back, or never fully left
Recurrent episodes, or a low-grade gray that has lasted for years. If you've been "fine, mostly" for as long as you can remember, that's worth a real look. Persistent low mood is treatable, and most people don't realize how much better they can feel.
Treatment-resistant depression
If you've tried two or more medications without lasting relief, you're not out of options and you're not broken. A fresh evaluation revisits the diagnosis, checks for medical contributors that may have been missed, and can use GeneSight genetic testing to see how your body processes different medications before choosing the next step.
Bipolar spectrum and other mood disorders
Getting this right matters, because antidepressants alone can make bipolar depression worse. A thorough history of mood episodes, energy and sleep patterns, impulsive periods, and family history comes before any prescription. If a mood disorder has been missed for years, finding it is often the turning point.
Depression tied to hormones and life stage
Depression during pregnancy or after birth, before a period, or in perimenopause has its own patterns and its own treatments. See pregnancy and postpartum and PMDD and reproductive psychiatry.
How we help
- A 60 to 90 minute evaluation that hears the whole story, including every treatment that didn't work and why.
- Labs when they're warranted: thyroid, iron, vitamin D and B12, and blood sugar can all mimic or worsen depression.
- Medication started low and adjusted slowly, with monthly follow-ups until you're stable.
- Integrative support for sleep, movement, nutrition, supplements and stress.
- Therapy referrals and coordination with your other providers.
Most visits happen by secure video anywhere in North Carolina. The office in Clayton is there when you'd rather be in the room.
If you're thinking about ending your life, or you don't feel safe, please call or text 988 now or go to the nearest emergency room. R3 is not an emergency service, but we want to know afterward so we can follow up with you.
I've tried antidepressants before and they didn't work. Is there any point trying again?
Yes. A medication that fails is information, not a verdict. We revisit the diagnosis, check for medical contributors such as thyroid or iron problems, consider whether a mood disorder on the bipolar spectrum was missed, and can use GeneSight genetic testing to narrow the next choice.
How do you tell depression from bipolar disorder?
By taking a careful history of mood episodes over your whole life, including periods of unusually high energy, little need for sleep, racing thoughts or impulsive decisions, along with family history. Getting this right matters because antidepressants alone can worsen bipolar depression.
Will I need medication forever?
It depends. A first episode of depression is often treated for a season and then tapered. Recurrent depression and bipolar disorder are usually managed long term, because staying well is the goal. We reassess together at every visit.
Can depression be caused by something physical?
Often it's worsened or mimicked by one. Thyroid disease, iron deficiency, low vitamin D or B12, sleep disorders and hormonal shifts in the postpartum period or perimenopause can all look like depression. We check before we treat.
Renewing minds · Restoring balance · Reviving hope
Ready to be heard?
Request an appointment and our care coordinator will reach out to verify your benefits and get you scheduled. Not ready yet? Call us, or send a question. No pressure.
R3 is not an emergency service. If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.