Depression Treatment Portland, Oregon

Depression is a debilitating condition that can affect a person’s work relationships and their relationships with their family. It is one of the most common mood disorders people suffer from in the United States. It can cause problems for people at work and can stop them from living up to their full potential. At Synergy Mental Wellness, we use a combination of therapy and medication to treat depression. 

Symptoms of Major Depression

There are differing degrees of depression a person can suffer from. Major Depressive Disorder or Clinical Depression is considered the worst. There are several symptoms a mental health professional will look for to determine if you are depressed.  

  • Moodiness
  • Irritability 
  • Loss of concentration 
  • Unexplained pain 
  • Insomnia 
  • Changes in appetite

If you recognize any of these symptoms in yourself or a loved one, give our office a call. When we diagnose you, we will ask about your medical history and a series of questions. 

We will give you a DSM-5 evaluation when you arrive. The Diagnostic and Statistical Manual 5 (DSM-5) is a system for classifying mental disorders. The standards are based on research from hundreds of experts. 

We will ask about your medical history and any allergies you may have. We want to determine the method of mental health treatment that is correct for you. We will look for specifiers. These are symptoms that narrow down the type of depression you are suffering from. Different types of depression include:

Melancholic Features 

If you find yourself waking up earlier and earlier in the morning in a bad mood, or if the things that used to make you happy simply do not anymore, the type of depression you have may be considered melancholic. People who suffer from this type of depression can lose their appetite and feel guilty for no reason. They may also speak of suicidal ideation. 

Anxious Distress

When a person is restless all of the time or finds themselves constantly worrying about losing control of their life, they may have anxious distress depression. 

Mixed Features

Some people have mixed symptoms when they are suffering from depression. They may exhibit manic tendencies. They might seem more energetic to those around them and then suddenly seem listless. This type of depression can be misdiagnosed as bipolar disorder. 

Psychotic Features 

In some rare cases, a person with MDD may exhibit psychotic tendencies. If you have hallucinations or experience delusions, it may be considered depression with psychotic features. We always conduct extensive research before prescribing a patient any kind of antipsychotic drug. 

Atypical Features 

If a person has moments of happiness and levity it does not mean they are cured. Some people have atypical systems like feeling great for a short period of time and depressed shortly after. They may overeat and feel listless much of the time. 


When someone is severely depressed they may go into a catatonic state where they will not move. They also may experience an involuntary movement of certain limbs or muscles. 

Seasonal Depression 

Seasonal Affective Disorder is common in Portland, Oregon, because it is so dark and gloomy in the Fall and Winter. If your mood is severely affected by the weather, there are several treatments that may help you. Some of these methods involve exposure to different kinds of light. You may not require medication. 

Peripartum Depression

Most people know there is such a thing as postpartum depression. A woman will often feel depressed and hopeless after she gives birth. However, psychologists today have discovered women are often depressed both before and after they give birth. 

Treatment-Resistant Depression 

There are some patients for which traditional depression treatments like medicine and therapy do not work. If you are taking your medications as directed and are not getting results, a mental health professional may try alternative medicines. If those do not work, we can send you to a physician for a full exam. This can determine if you have any medical conditions causing the physical symptoms of depression.

Treatments We Offer

At Synergy Mental Wellness, we take a holistic approach to medicine. We begin with a full examination and a therapy session. It is our goal to help you overcome depression and live a full life. 

Our therapeutic process is very interactive. Our owner Michael “Mike” Boas, is a Board Certified Psychiatric Mental Health Nurse Practitioner who believes in having the patient and the mental health care provider decide on a treatment plan together.

We offer convenient online therapy sessions that are completely confidential. We have taken measures to use the most secure platform available. 

Talk Therapy

We will always begin with an individual therapy session, where we can discuss your depression and how it affects your daily life. We offer cognitive behavioral therapy where we can teach you coping skills for dealing with your condition. We even offer family therapy, where we can help your family members understand your depression.

The study of psychology has a long and storied history. There are many different types of talk therapy. For many years therapists employed a psychoanalysis approach. Now, there are several different types of psychoanalysis.

Psychoanalytic Therapies 

Psychoanalysis was designed to understand the way the unconscious and conscious mind interacted with one another. It often took many years of therapy to understand a person’s thought process based on this interaction. 

Psychoanalysis gave birth to psychodynamic therapy, which searches for the unconscious reasons for your feelings and behaviors. 

Interpersonal therapy is often used to treat depression by focusing on disputes you may have with another person. It focuses on understanding triggers and where they come from. It is unusual because it is time limited. 

Humanistic therapy offers patients empathy, and a therapist will often listen to their clients talk without judgment. It focuses largely on the present, rather than the past. 

Existential therapy is an offshoot of humanistic therapy. It helps patients discover the meaning of life and their role in the world. 

Behavioral Therapies

Behavioral therapy is designed to remove unhealthy behaviors and thought patterns and reinforce healthy ones. Cognitive behavioral therapy involves treating depression by increasing self-awareness and changing certain thought and behavior patterns. It teaches patients to act as their own therapists when needed. The vast majority of therapists today use behavioral therapy. 

Practitioners of behavioral therapy believe changing a person’s behavior will often change their thoughts and feelings. A very simple example of this is if you are feeling depressed, you may not feel like exercising. However, if you exercise, the endorphins will be released, and you will feel better. 

Cognitive behavioral therapy focuses on cognitive distortions, which are thought patterns that are very destructive to a person’s well-being. It also focuses on changing the behaviors a depressed person may exhibit. A depressed person may exhibit either compulsive or avoidant behavior.

Compulsive behavior includes:

  • Abusing alcohol or drugs.
  • Working more than you should
  • Overeating.

Avoidant behavior Includes:

  • Isolating yourself from others.
  • Procrastinating.
  • Not working.

Cognitive Analytical therapy may be used in your treatment. This incorporates elements of psychoanalysis and behavioral therapy. 

Michael Boas believes every patient is different, and no single type of therapy can be used to help everyone. At Synergy Mental Wellness, we use the type of therapy that will work best for you. 

Medications Used for Depression

Different psychotropic drugs are used to treat mental health conditions. Several medications can be used to treat patients. Psychiatrists and psychiatric nurse practitioners can prescribe these medications to you. 

Selective Serotonin Reuptake Inhibitors

Serotonin is a monoamine neurotransmitter that sometimes acts as a hormone. A neurotransmitter acts as a messenger from the nervous system to other parts of the body. Hormones are released by adrenal glands in your body. It transports messages from your cells to the rest of your body. It plays a fundamental role in your mood. Low levels of serotonin may cause depression. SSRIs help to block the reabsorption of this chemical. There are several SSRIs you may have heard of including Lexapro. Prozac, and Paxil.  


Serotonin and Norepinephrine Reuptake Inhibitors

Norepinephrine is a neurotransmitter, and a hormone as well. Norepinephrine controls functions such as mood and sleep cycles. If you have too little of it, it may cause depression. Medication can block the reabsorption of serotonin, and norepinephrine as well. Names for this kind of medication include Cymbalta, Fetzima, Pristiq, Khedezla, or Effexor.

Tricyclic and Tetracyclic Antidepressants

These drugs are amongst the oldest on the market and are still occasionally used to treat depression. They block serotonin, norepinephrine, and other neurotransmitters. This can cause side effects such as low blood pressure and blurred vision. However, they are the only medication that is effective for some people. One of the most commonly prescribed kinds of these kinds of medication is Anafranil. 

Atypical Antidepressants

Atypical antidepressants are medications that cannot be classified with other antidepressants, even though they have essentially the same function. Mirtazapine is one of these medications. It increases various brain activities and restores mental balance. Its active ingredient is tetracyclic piperazino-azepine. It blocks the reabsorption of serotonin and norepinephrine. However, the medication is thought to absorb into your system more effectively than other common antidepressants.

If a patient is suffering from anxiety and depression, this medication is often recommended. This is because it is thought to reduce anxiety in people with depression and generalized anxiety disorder. Its commercial name is Remeron.


Bupropion is another drug used to treat depression. It is also often used to help people quit smoking. It blocks the absorption of neurotransmitters, similar to other antidepressants. However, it focuses on blocking the absorption of Norepinephrine. Its commercial name is Wellbutrin. 

Bupropion may be especially effective for Seasonal Affective Disorder. It is in trials to treat Attention Deficit Disorder.

Monoamine Oxidase antidepressant Inhibitors

MAOIs were an early form of antidepressant. There is an enzyme in the brain called monoamine oxidase which removes norepinephrine, serotonin, and dopamine from the brain. MAOIs prevent this process from happening. When monoamine oxidase is blocked it can cause side effects such as dizziness and muscle cramps. MAOIs are used when other drugs are shown to be ineffective. 

Why You Should Choose Us

Depression is a serious mental health condition that can cause harm if left untreated. Our owner Michael Boas has a master’s degree in nursing, so he can both administer therapy and prescribe drugs.

Unlike some other mental health providers, he always considers his patient’s opinions. We consider you a partner in deciding what kind of treatment is best for you. We offer telehealth psychiatric services, so you can have a therapy session no matter where you are.

We are an out-of-pocket provider. You will never have to worry about an insurance payment failing and you will always know the bottom line cost of our services.

You deserve to feel good about yourself, and your loved ones should not have to worry about your state of mental health. Give us a call today. It is your first step to a brighter future.