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What is Depression?

Depression & Treatment

Depression & Treatment

You are not alone.

At Heading we specialize in the treatment of depression.

Depression is often described as a cloud that comes over one’s life, blocking the sun. Sometimes depression can be sourced back to the onset of a particularly difficult time in life, but sometimes people experiencing depression cannot attribute their feelings to a particular circumstance or continue to struggle with their mood even after circumstances in their life have changed, or experience symptoms somewhat inexplicably. No matter the cause, known or unknown, depression makes life difficult, can be debilitating and sometimes life threatening, and is a mental health issue that should be taken seriously.


Depression experience is often characterized by feelings of sadness, an inability to experience pleasure, low mood, and a lack of motivation or energy. While everyone may feel down or “blue” at times, depression is much more persistent and should not be seen as a sign of weakness or something that can simply be overcome. In fact Depression is a leading cause of disability, and for those suffering from long-standing depression it can cause significant lapses in work and employment, further impacting their ability to engage in adequate care. 


Depression is a widespread issue in the United States, affecting over 16 million adults in 2016, according to the National Institute of Mental Health. There are different forms of depression, including Major Depressive Disorder, Seasonal Affective Disorder, which is related to seasonal changes, Bipolar Depression, and Treatment-Resistant depression. Given its prevalence, it is important to emphasize that no one should suffer alone, and that is why Heading is here to help.




Depression can manifest in various forms, and one of the most commonly diagnosed types is Major Depressive Disorder (MDD). Major depression differs from regular depression in terms of severity and duration. While regular depression may have milder symptoms and last for a shorter period of time, Major Depressive Disorder involves more intense and persistent symptoms that significantly impair daily functioning. It is crucial to recognize the distinction between the two, as proper diagnosis and treatment can be tailored accordingly.




When it comes to treating depression, a combination of medication and psychotherapy, known as combination therapy, is often recommended. Medication is utilized to alleviate certain symptoms of depression, such as low mood, loss of appetite, or disrupted sleep patterns. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed in these cases.


Psychotherapy, particularly Cognitive Behavioral Therapy (CBT), plays a vital role in combination therapy. CBT aims to identify and modify negative thought patterns and behaviors that contribute to depression. By working with a therapist, individuals can develop healthier coping strategies, challenge distorted thinking, and learn effective problem-solving techniques. Psychotherapy helps individuals gain insights into their emotions and provides them with the tools to manage depressive symptoms.


For many people whose depression becomes major or severe, combination therapy is more effective than a single line of treatment alone.  However many people find that coordination of care between a therapist and psychiatrist can be time-consuming and difficult.  This is one reason why Psychiatrists and Therapists at Heading work together through the phases of care for those seeking more than one line of treatment. 




In some cases, individuals with Major Depressive Disorder may not experience significant improvement even after receiving appropriate treatment. This is known as treatment-resistant depression. Treatment-resistant depression is diagnosed when symptoms persist despite adequate trials of different antidepressant medications and psychotherapy approaches.


When faced with treatment-resistant depression, it is crucial to consult with a mental health professional who can reassess the treatment plan. The therapist may recommend alternative medication options, such as different classes of antidepressants or augmentation strategies, which involve combining multiple medications to enhance their effectiveness. Additionally, other therapeutic modalities like Spravato®, IM Ketamine, or  or transcranial magnetic stimulation (TMS) may be considered for individuals who do not respond to conventional treatments.


Remember, depression is a treatable condition, and there is hope for recovery, even in cases of treatment-resistant depression. Seeking professional help and exploring different treatment options can lead to significant improvements in symptoms and overall well-being.


We are here to provide support and renewed hope that healing is possible. Together, we can work towards breaking free from the grip of depression and rediscovering the brightness in your life.



Blog depression Ketamine spravato

Preparing : A Guide to Your First Ketamine Treatment and Spravato® Treatment

Preparing for a Transformative Ketamine Therapy Experience

Preparing for a Transformative Ketamine Therapy Experience

A Guide to Your First Ketamine Treatment and Spravato® Treatment

Why Ketamine?

Ketamine therapy and its derivative, Spravato®, have emerged as promising treatments for individuals struggling with major depression and other mental health conditions. These innovative therapies offer new hope for those who have not found relief with traditional antidepressants. If you’re considering ketamine treatment, it’s essential to prepare yourself adequately for this potentially life-changing experience. 

In this blog, we will explore the key aspects of preparing for a ketamine therapy session, while incorporating insights from Dr. Arif Noorbaksh, a psychiatrist at Heading Health in Dallas, Texas, and Austin, Texas.


Understanding Ketamine Therapy

Ketamine therapy involves the controlled administration of ketamine, a dissociative anesthetic, to induce an altered state of consciousness, which many compare to a psychedelic experience, and interacts with the brain through the glutamate system which is different than many antidepressants which address serotonin reuptake. Spravato®, a nasal spray formulation of esketamine, a variant of ketamine, has been approved by the FDA for treatment-resistant depression specifically. 


Ketamine introduces windows of neuroplasticity, even after the immediate dissociative effects have worn off, empowering patients to reexamine thoughts, behaviors, and patterns that are proving detrimental to their mental health. This aspect of Ketamine therapy is one reason why very often those who are seeking Ketamine treatment are also seeing a therapist who understand their treatment and can help them integrate it into their therapy sessions, optimizing results. 


Dr. Noorbaksh also explains, “Ketamine and Spravato® appointments typically last a couple hours. Feeling safe, comfortable, and prepared is important for the process.” 


The purpose is to promote psychological exploration, facilitate emotional healing, and alleviate symptoms of depression and thus feeling safe, informed, and well cared for during your treatment not only makes the experience more pleasant but it actually aides in the effectiveness of treatment itself.  


Creating a Safe and Comfortable Environment

Dr. Noorbaksh emphasizes the significance of ensuring a safe, comfortable environment during ketamine therapy sessions. 


He advises, “Some people feel a little queasy from treatment. It’s helpful for a patient to eat earlier in the day to avoid hunger, but also not within two hours before treatment to reduce nausea.” 


To enhance your comfort, he suggests bringing along comfort items such as comfortable clothes, an eye mask, a favorite playlist with headphones, and even a pillow and blanket. These items can help you relax and feel at ease as you allow the medication to take effect.


Addressing Coffee, Alcohol, Medications and Other Substances:

Dr. Noorbaksh also highlights the importance of discussing medications and substances with your healthcare provider prior to undergoing ketamine therapy. He shares, “At Heading we have a full consultation to determine appropriate treatment. Also prior to Ketamine and Spravato® treatments we advise patients regarding alcohol and caffeine use, and other medications – including over the counter medications – to ensure safety before, during, and after treatment.” 


Open communication with your healthcare provider about your current medications, including over-the-counter drugs, alcohol, and caffeine, is crucial to ensure the safety and effectiveness of the treatment. It is helpful to have your medical history, medication list, known allergies, and a willingness to discuss substance use on hand when connecting with a doctor about Ketamine therapy.


Proper Planning for Transportation

Dr. Noorbaksh stresses the importance of arranging safe transportation to and from your ketamine therapy sessions. He advises patients to make suitable arrangements, as they will not be able to drive after treatment. 


“Patients should leave their own car at home, make safe travel arrangements as they cannot drive after treatment, and must get a good night’s rest before resuming normal activities, including driving, the next day,” he explains. 


By planning ahead, you prioritize your well-being and the safety of yourself and others.


Ketamine Therapy in Austin, Texas, and Dallas, Texas

If you’re considering ketamine therapy in the Austin, Texas, or Dallas, Texas areas, Heading Health offers comprehensive treatment options including Ketamine therapy, psychiatry and medication management, and psychotherapy. 


With the guidance of experienced professionals like you can embark on a transformative journey toward mental wellness with a care plan personalized to meet your needs.


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