Understanding depression
Depression involves more than a difficult day or a temporary dip in mood. It can affect emotions, thinking, energy, and everyday functioning. Major depression and persistent depressive disorder differ in their patterns and duration. Depressive symptoms can also occur with other conditions, including bipolar disorder, making a thoughtful assessment important rather than assuming every period of low mood has the same cause.
What daily life can feel like
You might feel sad, empty, disconnected, or unusually irritable. Activities that once mattered may no longer bring much pleasure. Getting out of bed, answering a message, or deciding what to eat can take considerable effort. Sleep, appetite, concentration, and energy may change. Some people experience guilt or hopelessness; others notice physical discomfort or emotional numbness. In adolescents, irritability and changes in school engagement can be especially noticeable. Experiences vary, and no single symptom tells the whole story.
How depression can affect your life
Depression can make it difficult to keep up with work, learning, relationships, and personal care. A person may withdraw because social contact feels exhausting, not because they no longer care. Unfinished tasks can bring additional stress or self-criticism. Someone who appears productive may still be struggling internally. Symptoms are not a measure of character, effort, or how grateful a person is for the good things in their life.
How assessment and care can help
Assessment explores symptom patterns, physical health, medications, substance use, sleep, and previous treatment. It also considers any history of unusually elevated or irritable mood and increased energy. Psychotherapy, medication, or a combination may help, depending on the individual situation. A plan should account for preferences, potential adverse effects, and changes in functioning, not only symptom scores. When needs exceed routine outpatient care, more intensive support may be appropriate.
Examples of evidence-based psychotherapies include CBT, behavioral activation, and interpersonal therapy. These are possible treatment or referral options, not a claim that every modality is delivered within this practice.
When depression has been difficult to treat
If treatment has not brought sufficient relief, assessment revisits the diagnosis, prior treatment duration and response, side effects, other health concerns, and barriers to care. We plan to discuss GeneSight pharmacogenomic testing for selected adults when appropriate. It may add information about certain medication-related gene variants, but cannot identify the medication that will work best or guarantee improvement. More specialized treatment may require referral.
Exploring care at Mountain States Psychiatry
Our proposed Colorado practice serves adults and adolescents ages 12 and older with psychiatric assessment and individualized medication-management planning. There is room to discuss what has been difficult, what support you already have, and what you want care to address. An initial evaluation is a conversation about next steps, not a promise of a particular prescription or outcome. Visit New Patients and Insurance and Billing to review the proposed process and self-pay fees. Appointment requests remain unavailable in this preview. This information is educational, not a diagnosis.
Assessment & additional information
Comprehensive assessment and clinical tools
A comprehensive psychiatric evaluation starts with your story, not a questionnaire score. We review symptoms, daily functioning, medical and treatment history, sleep, substance use, safety, and possible overlapping conditions. An assessment also considers the timing and context of symptoms, strengths, supports, and what you want treatment to address.
Age-appropriate screening and symptom-rating tools can help clarify concerns and track progress, but they do not replace clinical diagnosis. A positive screen is not a diagnosis, and a low score does not necessarily rule out a concern. Tools are selected according to the person, clinical question, age range, and applicable licensing requirements.
Examples for clinician selection include PHQ-9 for depression and GAD-7 for anxiety, with developmentally appropriate alternatives when needed. Adult ADHD assessment may use an ASRS; adolescent assessment may draw on youth, parent, and teacher ratings. OCD severity may be tracked with Y-BOCS or CY-BOCS, rather than treating either as a stand-alone diagnostic screen.
For trauma symptoms, the adult PCL-5 or an age-validated youth measure may help assessment and monitoring. Adult alcohol or drug screening may use AUDIT-C or DAST-10; CRAFFT is designed for ages 12 through 21. Bipolar assessment emphasizes the history of mood episodes, sleep, energy, functioning, and changes over time, rather than relying on a screening score.
These are examples under clinical review, not a committed testing battery or a promise that every patient will receive every measure. No instrument questions are reproduced here. Any direct testing, consent, records review, and caregiver involvement will be selected and explained as appropriate.
Supporting resources
Planned testing and its limits
GeneSight is planned for discussion with selected adults when clinically appropriate, including when depression has been difficult to treat. This cheek-swab pharmacogenomic test examines selected gene variants that may affect how certain medicines are processed. Results may inform a medication discussion alongside previous response, side effects, other medicines, and health history. It does not diagnose depression, identify the medication that will work best, or guarantee improvement. Testing is not needed for everyone.
Evidence that pharmacogenomic testing improves depression outcomes remains limited. Genetic results are only one part of prescribing decisions. The American Academy of Child and Adolescent Psychiatry advises against using pharmacogenetic tests to select psychiatric medications in children and adolescents; an adult testing discussion should not be extended to all patients ages 12 and older. Availability, eligibility, costs, insurance coverage, consent, and handling of genetic information require confirmation before testing.
Supporting resources
Nutritional approaches
These are adjunctive options based primarily on adult research, not substitutes for psychiatric care or evidence of benefit in adolescents.
Enlyte: Medical Food
Enlyte is marketed as a medical food for the dietary management of major depressive disorder under medical supervision. It combines folate forms with other nutrients. A medical food is not an FDA-approved antidepressant. Research in a selected adult population suggests potential benefit, but does not establish that everyone will benefit or that Enlyte is equivalent to L-methylfolate alone. We can discuss whether it fits your nutritional needs and treatment plan. Before use, we review the formulation, medications, supplements, allergies, and vitamin B12 status. The manufacturer’s label lists fish, krill, and soy ingredients and warns that folate can obscure signs of B12 deficiency.
Supporting resources
Further information
Additional educational materials; inclusion is not a product endorsement.
L-Methylfolate
L-methylfolate is an active form of folate, a B vitamin involved in processes that support brain function. It has been studied as an addition to antidepressant treatment for adults whose depression has not improved enough with an SSRI. Some studies suggest benefit, but findings are not uniformly positive and evidence remains limited. It does not replace comprehensive depression care. We can review your nutritional history, medications, and supplements when considering whether it is appropriate. Formulations differ and should not be assumed interchangeable. Symptoms and tolerability should be monitored rather than assuming a vitamin-based approach is automatically effective or risk-free.
Supporting resources
Omega-3 Fatty Acids
Omega-3s, including EPA and DHA, are found in seafood and some supplements. Research on their use alongside depression treatment is mixed, and benefit remains uncertain. Some findings favor EPA-focused formulations, particularly alongside antidepressants, but improvement is not guaranteed. We can review your diet, the specific product, and whether supplementation fits your care plan. Considerations include digestive discomfort, product quality, allergies, and medication interactions. Tell your clinician if you take blood-thinning medication so any monitoring needs can be assessed. Omega-3s should not replace established depression treatment.
Supporting resources
SAMe
SAMe, or S-adenosyl-L-methionine, is made naturally in the body and is also sold as a dietary supplement. It has been studied for depression, but evidence for oral SAMe remains inconclusive and long-term safety is not well established. SAMe may worsen mania in bipolar disorder and may interact with antidepressants or other products that affect serotonin. It may also cause digestive upset or feel activating. Do not start SAMe or combine it with psychiatric medication without discussing it with your prescriber. Any consideration should include a review of mood history, medications, supplements, and individual risks.
Supporting resources
Supplement safety
Supplements are not substitutes for psychiatric care. Review medicines, health conditions, and pregnancy or breastfeeding considerations with a clinician before starting one. Natural does not mean risk-free: products can interact with medicines, and their contents and quality vary. Research in adults does not establish safety or benefit for children and teenagers.
For bipolar disorder, a supplement marketed for mood is not a replacement for established treatment. Some products, including SAMe, can worsen mania. This review does not recommend a supplement for ADHD, OCD, PTSD, or substance use disorder merely because a product is marketed for that condition. Nutritional deficiencies may warrant assessment, but treating a deficiency is different from claiming that a supplement treats a psychiatric disorder.
If alcohol use has contributed to nutritional problems, medical care may include thiamine when appropriate to prevent serious deficiency-related complications. Vitamins do not make alcohol withdrawal safe to manage independently. This educational information does not imply that Mountain States Psychiatry provides withdrawal-management services.
Further reading
Educational resources reviewed October 27, 2026. This information is not a diagnosis or an individualized treatment recommendation.
Planning your next step
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