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        Frequently asked questions

        About therapy

        What kind of doctors treat mental health conditions?

        Psychiatrists, psychologists, therapists, and primary care physicians can all help get you the care you need. Psychiatrists are medical doctors who specialize in mental and emotional health. Psychiatrists are able to prescribe medication to treat mental health conditions. Psychologists, on the other hand, are professionals who offer a range of mental health services - particularly talk therapy. Suitable for young children and adults alike, psychologists use talk therapy and psychotherapy to get to the root of your mental health condition and enhance your wellness and well-being. Psychologists are not able to prescribe medications.

        What kinds of conditions do mental health experts treat?

        Doctors who specialize in psychiatry are trained to treat depression, anxiety, and a range of behavioral health and emotional concerns.

        Psychologists can treat these disorders, as well as provide counseling services. If you're looking for couples therapy, sex therapy, or stress management therapy, a psychologist could be the doctor for you.

        Connect with mental health professionals on Sesame who can assess your condition, manage your symptoms, and develop a treatment plan for you.

        What is a therapist?

        A therapist is a medical professional that uses psychotherapy (generally called talk therapy) to help relieve the emotional distress and mental health issues of their patients. Many trained professionals fall under the broad umbrella of "therapist" including psychiatrists, social workers, mental health clinicians, life coaches, and licensed counselors. Therapists can treat a wide range of mental health disorders that include anxiety, depression, eating disorders, and relationship problems. Therapists can also help you gain tools to better handle stress, or set and achieve major goals.

        What is a therapist for?

        Therapy is a great tool to help you track your emotions, reduce stress, work on goals like quitting smoking, guide you through major life decisions, hone skills like communication, or address problem areas in your life. Talk therapy has been widely received as an effective health care treatment for many different mental health conditions including:
        - Substance abuse
        - Eating disorders
        - Self-esteem issues
        - Relationship problems
        - Behavior issues

        What types of therapists are there?

        Therapists specialize in treating a wide range of conditions. Some of the most common therapy specializations include:

        Psychotherapists: Psychotherapists help people deal with mental health issues such as depression, anxiety, stress, addiction, and insomnia.

        Marriage and family therapists: Marriage and family therapists practice solution-based approaches to working through patterns of behavior within a family unit.

        Social workers: Licensed clinical social workers (LCSW) work in many different settings including schools, hospitals, human service agencies, private practices, and mental health clinics to help you cope with everyday problems.

        Licensed professional counselors (LPC): Licensed professional counselors hold a master’s degree in mental health services and provide treatment options for a wide variety of mental health issues within local communities including services for veterans, active-duty military personnel, and their families.

        Licensed mental health counselors (LMHC): Also known as licensed professional counselors, LHMCs provide talk therapy to families, couples, and individuals.

        Couples therapists: Couples therapists provide counsel to couples seeking to improve their relationship and gain the tools needed to recognize and resolve conflicts.

        Marriage and family therapists: Licensed marriage and family therapists (LMFT) provide therapy to some or all members of a family unit to help with relationship issues. Family therapy is often short-term therapy with a finite amount of visits. Marriage counselors can also assist couples looking to end their relationship affably.

        What is psychiatry?

        Psychiatry is a branch of medicine that focuses on emotional and mental health, as well as behavioral disorders. Psychiatrists treat mental health conditions like anxiety, phobias, obsessive-compulsive disorder (OCD), eating disorders, addiction and substance abuse, depression, autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), and bipolar disorders.

        Psychiatrists are mental health professionals trained to diagnose and treat these disorders. They use tools like psychotherapy (talk therapy) to help relieve patients' emotional distress and address their mental health concerns. Psychiatrists can also help create treatment plans to help you handle stress or reach major milestones. When necessary, your psychiatrist may prescribe medication. All prescriptions are at the sole discretion of your doctor.

        Connect with a real, quality psychiatrist on Sesame who can assess your condition, manage your symptoms, and craft a treatment plan that works for you - all for one affordable, upfront price.

        Can I see a psychiatrist online?

        Yes! Telehealth platforms like Sesame now make it easier than ever to see mental health care providers for psychiatry consults and therapy sessions. Mental health professionals on Sesame offer a wide range of psychiatry services such as:
        - Talk therapy
        - Psychiatric evaluations
        - Behavioral health consultations
        - Couples therapy


        In addition, licensed mental health care providers on Sesame can address and treat mental health conditions such as:
        - Anxiety disorder
        - Depression
        - Post-traumatic stress disorder (PTSD)
        - Bipolar disorder
        - Obsessive/ Compulsive Disorder (OCD)
        - Adult attention-deficit/hyperactivity disorder (ADHD)
        - Schizophrenia


        This is not a complete list of psychiatric services offered by providers on Sesame. Use our search bar to look for the specific type of psychiatric care or treatment and book an appointment at your convenience. Most care providers will request an initial consultation to discuss your symptoms or concerns. After a consult, providers on Sesame can refer you to a specialist, or schedule follow-up appointments for further care.

        What are common psychiatry subspecialties?

        While all psychiatrists can provide medical advice and care, there are a number of psychiatry subfields that address particular conditions, areas, or age groups. These include:

        Psychotherapy: During these sessions, also known as talk therapy, you speak with a psychotherapist or counselor to help reduce symptoms from depression, anxiety, or other mental health conditions.

        Child and adolescent psychiatry: This is a specialized form of psychiatry that focuses on disorders related to childhood development.

        Geriatric psychiatry: The study of mental, emotional, and behavioral health as it relates to older adults.

        Forensic (legal) psychiatry: The assessment and treatment of mental disorders as they relate to the law.

        Addiction psychiatry: A form of psychiatry that focuses on the diagnosis, treatment, and prevention of disorders related to addiction.

        Psychopharmacology: The study of treating mental health disorders with the use of medication.

        What is the difference between counseling and therapy?

        Counseling psychology (or psychological counseling) is a form of mental health care provided as a general practice or as a specialty clinical health care service. Counseling helps patients deal with specific issues over a period of time. Examples of these types of instances include:

        Grief counseling: A patient may see a counseling psychologist who specializes in grief to help cope with the loss of a loved one.

        Career counseling: A patient may want to undergo career counseling to work through career goals, stress related to work, or depression about work.

        Couples counseling: Couples may seek couples therapy with a licensed professional counselor to talk about issues related to marriage or the improvement of communication in a relationship.

        There are a number of different types of counseling that can address individual needs and specific needs of a group. But most counseling sessions center around a specific issue or difficulty. Counseling may be a more short-term relationship, as opposed to long-term therapy.

        Psychotherapy (or therapy) is often a long-term mental health care service that addresses the well-being of the individual. In some cases, therapy and counseling are interchangeable, but some counselors work through specific needs while therapists help a patient with how they interact and relate to the world. Therapists may help with depression, anxiety, and underlying patterns of action, where a counselor will work on issues related to the topics above. These sessions often take place on a more long-term basis.

        What are the different types of counseling?

        Counseling services can help with a variety of issues and difficulties related to mental health and emotional well-being. A patient may seek counseling for any number of situations, but some of the major types of counseling include:

        - Individual mental health counseling: Mental health counselors deal with patients on an individual basis. They may assist patients with depression, emotional issues, behavioral problems, or stress management. Mental health counselors are licensed professionals that help individuals toward mental wellness through personalized sessions addressing the issues listed above.

        - Substance abuse counseling: Substance abuse counselors help patients deal with chemical dependency, substance abuse, and the underlying causes of addictive behavior. Substance abuse counselors may work with individuals or groups in group counseling. A substance abuse counselor may help patients develop coping mechanisms, create goals, and give referrals to support groups.

        - Couples counseling/ couples therapy: Counselors working with couples will usually meet with both partners to help with relationship distress. Examples of relationship distress may include a history of domestic violence, communication issues, parenting conflicts, and intimacy problems.

        - Group Counseling: Group counseling brings together a group of individuals, usually dealing with a common issue, to discuss, interact, and work together under the supervision of a group counselor. These groups act as support groups, giving individual patients a safe space to work out problems and speak freely. Examples of group counseling examples include academic support groups, individuals coping with divorce or grief, or individuals dealing with substance abuse issues.

        - Family therapy/ counseling: Family counseling helps families improve communication and resolve conflicts in the family unit. Family counseling may deal with issues between parents, children, and parents, or the wider family. These counseling services can also help family members deal with mental illness in the family or domestic abuse.

        - Career counseling: Career counselors help clients work toward career goals while identifying strengths and areas for growth. Career counseling may help clients deal with stress management, anxiety, and mental wellness in the workplace. These counseling sessions can also help clients determine interests, and personality types to place the individual in a conducive work environment.

        Counseling sessions help individuals work through or deal with an issue in their personal, social, or work-life. Counseling is usually centered around a specific issue or need of the patient/ client, unlike therapy which addresses the individual's thoughts, and behavioral patterns.

        Does Sesame work with insurance?

        In short, you do not need insurance to use Sesame. Sesame offers transparent upfront prices for patients without insurance.

        Sesame services are paid directly, separate from health insurance.

        If your insurance includes a health savings account (HSA) or flexible spending account (FSA), you can use your funds from these accounts to pay for care on Sesame. Some of these plans include a debit card you can use to pay upfront, and others require you to submit your receipt after your purchase.

        If your insurance includes out-of-network coverage and/or a deductible, you may be able to submit your receipt from Sesame for reimbursement. Eligibility is determined by your insurance company and will vary depending on your plan. And you can always use your insurance to pay for medications picked up at your local pharmacy. Our team is here to help you - call us at 1 (877) 947-6411 with any questions.

        How do I know if I'm booking with a quality therapist?

        Therapists on Sesame are reviewed by real users like you who give honest, straightforward feedback. Therapists, like every clinician on Sesame, undergo a rigorous vetting process, which guarantees that every visit you book is the best visit ever.

        Can I refill a prescription for antidepressants on Sesame?

        Don't expect your therapist to write you a prescription during your visit. That's what clinicians do. While therapists can't prescribe medication, Sesame's network of clinicians can refill simple things like antidepressants and other non-controlled substances over video. Keep in mind that refills are always at the discretion of the clinician.

        What is anxiety?

        Anxiety is a condition described as the excessive feeling of worry, unease, or dread. Anxiety can be treated by a primary care physician, therapist, psychologist, and psychiatrist. Having anxiety about a situation or an impending event without a clear-cut outcome is a normal part of life. You may feel anxious before a major deadline at work while studying for a looming test, or while facing a big decision at home. Though most people feel anxious at some point in their daily life, when it becomes intense, episodic, and unmanageable, it may be due to an underlying anxiety disorder.

        Not all those who have anxiety disorders are triggered by the same thing. There are many types of anxiety disorders including generalized anxiety disorder, separation anxiety disorder, social anxiety disorder, and many types of phobias.

        What causes anxiety?

        Though the causes of anxiety aren’t yet fully understood, anxiety does have a host of triggers including social situations, trauma, life events, specific phobias, medicine, and medical conditions. There are a lot of risk factors that make a person more likely to have an anxiety disorder.

        These include:

        - Personality: Research has shown that some personality types may be more prone to bouts of anxiety.

        - Mental health disorders: Some mental health disorders such as depression are often linked to anxiety.

        - Traumatic experiences: Individuals who are exposed to traumatic events as children are at higher risk for developing anxiety as an adult.

        - Stress: Stress from an illness, work deadlines, divorces, or deaths in the family can make one more likely to have anxiety.

        - Genetics: Anxiety can be passed down through the family genes. If a person has a blood relative who suffers from an anxiety disorder there is a chance that person will also have an anxiety disorder at some point in their life.

        - Drugs or Alcohol: The withdrawal, use, or misuse of a drug can put a person at a higher risk for anxiety.

        Book an in-person or video visit with a doctor through Sesame at clear prices, without the hassle of insurance. Know your price. Know what to expect. Simple. Clear. Quality care.

        Are there different types of anxiety disorders?

        Yes. The most common anxiety disorders include:

        Generalized anxiety disorder (GAD): Generalized anxiety disorder is described as a chronic feeling of exaggerated worry or anxiety, though there may be no obvious source of what's causing it. These anxiety attacks are often episodic. People who have GAD may also have other anxiety disorders, as well as depression.

        Obsessive-compulsive disorder (OCD): A person with OCD may have frequent manic thoughts (obsessive) and/or behavior (compulsive). Behaviors such as washing your hands many times, checking light switches, alarms, or the oven repeatedly, and/or the need to have something in a particular order to clear obsessive thoughts from the mind are some examples linked to OCD.

        Post-traumatic stress disorder (PTSD): This type of anxiety is brought about by a traumatic event in which a person was or could have been harmed, such as a natural disaster, a car accident, military combat, or domestic violence. Symptoms of PTSD may include flashbacks, severe anxiety, or obsessive thoughts regarding the event(s).

        Panic disorder: People suffering from a panic disorder may feel sudden bouts of intense fear, or panic attacks, that are often paired with physical symptoms including but not limited to a fast heart rate, heart palpitations, shortness of breath, sweating, or the general feeling of being out of control.

        Selective mutism: This is a complex anxiety disorder that affects children. A child who has selective mutism may have the ability to speak in safe, relaxed situations but may find themselves unable to talk in social situations. Though many kids will grow out of this type of disorder, in some cases if left untreated other anxiety disorders may develop and persist.

        Separation Anxiety Disorder: A childhood anxiety disorder in which a child has excessive anxiety from a parent or guardian leaving the child, even for a short amount of time.

        Substance-induced anxiety disorder: A person with a substance-induced anxiety disorder may have intense anxiety from overuse, use, exposure, or withdrawal from a particular substance or toxin.

        Anxiety disorder caused by a medical condition: This is caused by a physical health problem. Conditions such as heart disease, irritable bowel syndrome, diabetes, chronic pulmonary disease or COPD, thyroid issues such as hyperthyroidism, and chronic pain can be linked to anxiety. Many phobias also fall under the umbrella of anxiety. These include:

        Agoraphobia: People with agoraphobia have a fear of being in situations in which they cannot, or may not be able to escape. Places like shopping malls, subways, and crowded or open areas may cause those with agoraphobia to feel overwhelmed and anxious. Some people with agoraphobia may even find it hard to leave their homes.

        Social phobia, or social anxiety disorder: A person with social phobia may find themselves unable to be in social interactions. Anxiety and extreme self-consciousness are symptoms that are linked to this disorder. This anxiety can be triggered by acute circumstances like having to deliver a public presentation, for example. Social phobia can also be felt more chronically, applying to a wide range of social scenarios.

        Specific phobia: This is a phobia that is caused by a trigger that often poses little or no threat. This irrational fear can be of a specific object, situation, or activity. This category is wide-ranging and covers a host of topics such as acrophobia (fear of heights), agoraphobia (fear of crowded spaces), claustrophobia (fear of small or enclosed spaces), and ailurophobia (fear of cats).

        What are the different treatment options for anxiety?

        If you have symptoms of anxiety there are options that you may find useful. Treatment options include:

        - Psychotherapy counseling: Also known as talk therapy, psychotherapy is a means of speaking to a therapist or counselor to help reduce symptoms linked to anxiety disorders.

        - Cognitive-behavioral therapy (CBT): This is a form of psychotherapy known to be the best in helping with anxiety disorders.

        - Support groups: It may help to speak with others who have the same anxiety disorder. Support groups offer those with anxiety a way to heal with others and fill the void. The Substance Abuse and Mental Health Services Administration recommends calling 1-800-622-HELP (4357) to help find local treatment centers and support groups in your area.

        - Relaxation techniques: These techniques are useful when managing stress and other health problems such as pain and heart disease.

        Anti-anxiety Medicines

        Selective Serotonin Reuptake Inhibitors (SSRIs): When too much serotonin gets reabsorbed, it inhibits messaging between brain nerve cells or neurons. With the use of SSRIs, more serotonin is available for brain chemistry, which allows more messages to pass between brain nerve cells, thus helping your mood. There are some side effects to taking SSRIs, however. SSRIs often cause fewer side effects than tricyclic antidepressants and are useful in treating all types of anxiety disorders. It should be noted that those with obsessive-compulsive disorder (OCD) more often may need a higher dose of SSRIs.

        - Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): SNRIs have a dual-action: Like SSRIs, this type of medicine increases the serotonin in the brain, but unlike SSRIs, serotonin-norepinephrine reuptake inhibitors also increase norepinephrine. SNRIs have some common linked side effects including headache, upset stomach, gain in weight and/or blood pressure, as well as insomnia. SNRIs are just as effective as SSRIs, but not used for those with obsessive-compulsive disorder.

        - Benzodiazepines (beta-blockers): Though this type of medication should not be used for Post Traumatic Stress Disorder, benzodiazepines are used for anxiety management for those that are resistant to other forms of treatment. Benzodiazepines are useful in boosting relaxation while reducing physical symptoms linked to anxiety, like muscle tension by lowering your fight-or-flight reflex. Because the body builds a tolerance to this type of medicine it is more often prescribed for short-term use.

        - Tricyclic antidepressants: Tricyclic antidepressants are often prescribed when other treatments aren’t working. Unlike beta-blockers, this type of drug can be prescribed for long-term use. You should note, however, that there are serious side effects linked with this type of medicine. Dry mouth, constipation, blurred vision, and a drop in blood pressure when you stand are some of the side effects linked to tricyclic antidepressants.

        - Buspirone hydrochloride: This type of drug is often tried in the early stages of treatment. It works with the neurotransmitters in the brain. It is recommended to avoid eating grapefruit if you’re using buspirone hydrochloride as it can make it more likely to suffer from side effects linked with this drug.

        You may want to speak with a doctor about medical advice and treatment options if you have or think you have an anxiety disorder. Sesamecare.com can find you a high-quality doctor at a fraction of the price by connecting you right to the doctor with no hidden costs or surprise fees.

        Can intensive behavioral therapy be used to treat obesity?

        One common treatment option for obesity is intensive behavioral therapy (IBT). This type of therapy focuses on teaching patients how to change their eating and exercise habits to more sustainably manage their weight. IBT involves many components that may vary depending on the program you're enrolled in. In general, though, your IBT to include:

        - Making and celebrating small, realistic changes.

        - Screening for depression. Obesity often goes hand in hand with mental health issues, including depression.

        - Self-monitoring. This is a key part of the therapy in which you may be asked to keep a food and fitness journal for a few weeks, or even a few months, to get a clear picture of where you can improve.

        - Learning healthy habits. Learning about nutrition, stress reduction techniques, how to identify and overcome weight loss obstacles, and more.

        What are the major types of depression?

        There are many types of depression caused by a variety of triggers, sometimes chemical and sometimes the result of traumatic life events.

        These include:

        Major depression: People with major depression have depressed moods most of the day for most days of the week.

        Persistent Depressive Disorder: If a person has depression for 2 or more years, this is known as persistent depressive disorder. This type of depression has two subgroups called chronic major depression and dysthymia, or low-grade persistent depression.

        Bipolar Disorder: Also known as manic depression, a person with bipolar disorder has extremes, ranging from states of low energy and/or mood to periods of high energy and/or mood. Also known as manic depression, bipolar disorder can be treated with mood stabilizer medication, such as Latuda, Seroquel, and Olanzapine-fluoxetine combo.

        Seasonal Affective Disorder (SAD): A person who has seasonal affective disorder will often feel periods of major depression during winter. Because winter days are shorter than the rest of the year, a person receives less and less sunlight which can cause seasonal affective disorder. Antidepressants may be a great option for someone who has SAD.

        Psychotic Depression: If a person has paranoia, hallucinations, and/or delusions during periods of major depression, they may be suffering from psychotic depression. This type of depression can be treated with antipsychotic drugs along with antidepressants.

        Peripartum (Postpartum) Disorder: Postpartum depression affects new mothers, typically in the weeks and months post-childbirth.

        Premenstrual Dysphoric Disorder (PMDD): This type of depression affects people at the onset of their monthly period. Along with depression, you may feel tired, irritable, unfocused, anxious, overwhelmed, or have changes in your sleep patterns. PMDD can be treated with some birth controls and antidepressants.

        ‘Situational’ Depression (Stress response syndrome): This is caused by a traumatic or stressful event like moving, divorce, losing your job, or a death in the family, and can likely be treated with psychotherapy.

        Atypical Depression: Unlike typical depression, this depression follows more unusual patterns such as feeling overly sensitive to critique, finding you have increased your appetite, sleeping more than usual, or your arms and/or legs feeling heavy.

        Connect with real, quality mental health professionals on Sesame for affordable, cash-pay prices. Sesame works directly with doctors - not insurance companies - to get you the care you need, minus the copays and surprise medical bills. Save 60% on your next mental health consult when you book with Sesame.

        Is major depression genetic?

        It may be.

        Research suggests that major depression can be shared through genes and passed through families. If you have a member in your immediate family that has major depression, you may be at a higher risk of also developing major depression. It is estimated that genetics account for about 50 percent of major depression - while the other 50 percent is caused by other factors, such as those listed above. This means while you may inherit a higher risk of developing depression, it isn’t likely that genes are the sole cause.

        What are the symptoms of depression?

        Depressive episodes can sometimes be one-time events but are more often recurring experiences. If you have depression, you may experience one of the following:
        - Emotions like sadness, worthlessness, anguish, frustration, emptiness, anger, anxiety, restlessness, hopelessness, self-blame, guilt, irritability, anger, or low self-esteem.
        - Brain Fog, or fuzzy thinking, difficulty thinking, focusing, remembering, or making decisions.
        - Lethargy, sleeping too much, or insomnia.
        - Unexplained physical problems, such as back pain or headaches.
        - A lack of interest in performing normal tasks, including things you may normally enjoy doing like physical activities or hobbies.
        - Weight gain, weight loss, increased appetite, reduced or a loss of appetite.
        - Frequent or recurrent thoughts of death, suicidal thoughts, or suicide attempts.


        If you are worried about your safety or the safety of others, please dial 911.

        What are some effective treatments for depression?

        There are many effective treatments for depression, including medication, talk therapy, and more. Your doctor - whether a psychotherapist, psychiatrist, or psychologist - will craft a treatment plan that works for your needs. Treatment options for depression include:

        Therapy

        Psychotherapy: In-depth talk therapy that is used to examine unconscious or repressed thoughts and feelings and learn tools to address them. If you have experienced trauma, speaking with a mental health professional can be helpful. They can help you learn coping techniques, identify major triggers, and adjust to stressful situations.

        Electroconvulsive therapy (ECT): This is a therapy in which small electric pulses course through the brain causing an intentional seizure. This may be an option for someone who has found other therapies unsuccessful.

        Cognitive-behavioral therapy (CBT): Behavioral health issues like eating disorders and drug or alcohol abuse can be treated with the use of CBT. This treatment helps change thinking and behavioral patterns. CBT is used to treat a wide variety of conditions including depression, eating disorders, and substance abuse. It can even help with marital problems. CBT offers self-help as it trains you to be your own therapist, teaching you coping skills and how to shift your thinking or behaviors.

        Interpersonal therapy (IPT): A common treatment for depression among children, teens, and young adults, IPT is a short-term treatment focused on addressing interpersonal issues.

        Transcranial magnetic stimulation (TMS): Often used when other treatments prove ineffective, TMS is brain stimulation that uses magnetic fields to prompt nerve cells to improve depression symptoms. This is a noninvasive procedure.

        Medication

        After a consultation, your doctor of psychiatry may determine that your treatment plan should include medication. All prescriptions are at the sole discretion of your doctor. Common medications treating depression include:

        Selective serotonin reuptake inhibitors, or SSRIs: Celexa, Lexapro, Paxil or Pexeva, Prozac, Viibryd, and Zoloft are some examples of SSRIs. Serotonin-norepinephrine reuptake inhibitors, or SNRIs: Some examples include Cymbalta, Effexor XR, Fetzima, and Khedezla or Pristiq.

        Atypical antidepressants: These types of medicine don’t fall into either SSRI or SNRI categories. Atypical antidepressants include Aplenzin, Forfivo XL, Wellbutrin SR, and Wellbutrin XL which are all brands of bupropion, as well as Remeron, and Trintellix.

        Tricyclic antidepressants: If SSRIs aren’t as effective for your care, a doctor may prescribe tricyclic antidepressant medications, which can be very effective but can also have more side effects. Common medications include Norpramin, Pamelor, Surmontil, and Vivactil.

        There are many risk factors linked with taking these types of medicine. Speak with your doctor about which option is best for you. Connect directly with quality doctors through Sesame on your schedule. With Sesame, you get fair, clear prices on all kinds of care. See who you want, not who your insurance company lets you. Book an in-person or virtual visit near you today.

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