A careful evaluation, a plan that looks beyond the prescription pad, and medication that is reassessed rather than renewed on autopilot. All by video, at a flat price.
Tyler Patten, APRN, PMHNP-BC — board-certified psychiatric nurse practitioner
Book Now →Depression isn’t just sadness. For many people it looks like flatness: losing interest in things that used to matter, sleeping too much or too little, struggling to get started in the morning, and a fog that makes work and relationships feel heavy. When that lasts for weeks and doesn’t lift with rest or a good weekend, it deserves a real evaluation.
Depression is common across Utah, Idaho and Nevada, and psychiatric care is not. All three states sit near the bottom nationally for psychiatric prescribers per resident, and rural communities have the fewest options of all. As a result, a lot of depression is treated with a single prescription from a busy primary care visit and then left alone for years.
That is a big part of what we do. Some people come to us for a first evaluation; many come because an antidepressant stopped working, never quite worked, or was started so long ago that no one remembers why.
Low mood or loss of interest most days for two weeks or more, with changes in sleep, energy or appetite.
A lower-grade, long-running depression that has started to feel like your personality.
Mood and energy that reliably drop in the darker months.
The most common combination we see, treated together rather than one at a time.
Losing benefit from an antidepressant you’ve taken for years, or side effects you’ve put up with too long.
Two or more medication trials without a real improvement, which calls for a fresh look at the diagnosis and the plan.
Depression rarely has a single cause, so I look at the whole person. That means sleep, physical activity, nutrition and gut health, alcohol, chronic stress, and medical contributors. When it’s useful, I order cash-pay lab work — thyroid, vitamin D, B12, iron and others — because treatable deficiencies and hormone problems are easy to miss.
Medication helps many people, and I won’t talk you out of it when it’s the right tool. Options include SSRIs, SNRIs, bupropion, mirtazapine and add-on strategies when one medication isn’t enough. I’m just as willing to simplify: reducing a dose, switching, or carefully tapering a medication that no longer serves you.
I also screen for bipolar disorder before starting or changing an antidepressant, because an antidepressant alone can make bipolar depression worse. I don’t prescribe controlled substances.
You need to be physically located in one of these states during each video visit.
Utah has one of the highest antidepressant prescribing rates in the country. If you’ve been on the same medication for years without a real reassessment, that’s exactly the kind of visit we specialize in.
With the fewest psychiatrists per person in the country, Idaho leaves much of depression care to primary care. We take over or co-manage medication for adults anywhere in the state.
In Nevada, long valley waitlists and rural distances both delay depression care. Video visits and short follow-ups keep treatment moving.
Further reading:
Book a 60-minute evaluation with Tyler Patten, PMHNP-BC. Most new patients are seen within two weeks.
Book Now →Questions first? Call or text (435) 625-3098 or email office@affordablepsych.org.