From mild situational depression to severe, treatment-resistant major depressive disorder — we offer a full spectrum of evidence-based treatments including medication management, TMS, and ketamine therapy.
Major Depressive Disorder (MDD) is one of the most common and burdensome medical conditions in the world. It is not a character flaw or a sign of weakness — it is a complex brain disorder influenced by genetics, neurochemistry, life experiences, and environment. Depression affects how you think, feel, sleep, eat, and function every single day.
Symptoms can include persistent sadness, loss of interest in activities you once loved, fatigue, difficulty concentrating, changes in sleep and appetite, feelings of worthlessness or guilt, and — in severe cases — thoughts of death or suicide. These symptoms must persist for at least two weeks to meet diagnostic criteria for MDD, and they must significantly impair daily functioning.
The good news: depression is highly treatable. With the right combination of approaches — and a psychiatrist who doesn't give up when the first treatment doesn't work — the vast majority of people with depression can achieve remission and reclaim their lives.
Start Your Evaluation TodayWe use a systematic, stepwise approach — always starting with a thorough evaluation and escalating to more advanced interventions when standard treatments aren't sufficient.
First-line treatment for most forms of depression. SSRIs, SNRIs, bupropion, mirtazapine, tricyclics, and MAOIs — prescribed carefully and monitored closely by board-certified psychiatrists.
Learn More →When 1–2 antidepressants haven't worked, FDA-cleared TMS therapy can activate underperforming mood circuits in the brain. Drug-free, non-invasive, and covered by most insurance plans.
Learn More →FDA-approved for treatment-resistant depression after two failed antidepressant trials. Nasal spray administered in-office, often covered by insurance.
Learn More →For the most severe, treatment-resistant cases — IV and IM ketamine provide rapid relief, sometimes within hours. Particularly valuable in cases involving acute suicidal ideation.
Learn More →Treatment-resistant depression (TRD) is generally defined as depression that has not responded adequately to at least two different antidepressant medications, each tried at an adequate dose for an adequate duration (typically 6–8 weeks). Approximately 30% of people with MDD have TRD. We specialize in this population.
The timeline varies significantly by individual and treatment type. Antidepressants typically take 4–8 weeks to reach full effect. TMS requires a 6–9 week course. Ketamine can produce effects within hours. Most people with depression require ongoing treatment — the goal is not just acute relief but long-term maintenance of wellness.
Research consistently shows that the combination of psychiatric medication and psychotherapy is more effective than either alone for moderate-to-severe depression. We work closely with therapists and can provide referrals to licensed counselors and psychologists in San Antonio who complement our psychiatric care.
Yes — psychiatric evaluation and medication management for depression is covered by all major insurance plans including Aetna, BCBS, Cigna, United Healthcare, Humana, Medicare, and TRICARE. Coverage for TMS and ketamine/Spravato varies. Our team will verify your specific benefits before recommending a treatment plan.
Our psychiatric team is here to find the right combination of treatments to help you feel like yourself again.
Mental Health Associates San Antonio is a proud member of Privia Medical Group — a high-performance physician network committed to coordinated, patient-first care across San Antonio and beyond.