Affordable mental health care, available now.

Sesame is the first-ever healthcare marketplace, connecting thousands of healthcare providers across all 50 states directly with American consumers who are seeking high-quality, convenient medical care at unbeatable cash prices - no long wait times, no hidden fees, and no insurance needed.

Find top doctors near you across 40+ specialties and pay them directly to save up to 60% on prescription refills, skin consults, imaging, dentistry, therapy, labs and more.

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.

Sesame uses Stripe, the most trusted, secure third-party payment platform in the world. Stripe is used by large technology platforms like Lyft, Etsy, and Open Table.

Stripe keeps your payment information for all future purchases on their secure servers and no one else receives access to your payment information.

Sesame’s cancellation policy makes booking, canceling, and rescheduling easy. Sesame will honor a full refund for any of our appointments when canceled within the following time constraints:

• Virtual appointments: cancel up to 3 hours before the scheduled appointment.
  
• In-person appointments: cancel up to 24 hours before the scheduled appointment.
  
• All other appointments (including labs, imaging, and appointments that do not have a specific day or time at purchase): cancel up to 10 days after the purchase date once Sesame confirms with the provider that the appointment did not take place.
  
• Memberships: You may cancel your subscription to Membership Services at any time up to forty-eight (48) hours before the applicable renewal processing date of your subscription, by emailing support@sesamecare.com directly requesting a cancellation, or by calling +1 (877) 947-6411 to cancel. If you cancel the Membership Services and your subscription term has not expired, you may continue to use the Membership Services until the end of your then-current subscription monthly or annual term and your subscription will not be renewed after your then-current term expires. However, you won't be eligible for a prorated refund of any portion of the recurring subscription fee paid for the then-current recurring subscription term.
  
  

We are unable to offer refunds for the following:

• No-shows.
  
• Requests within 24 hours of your appointment time for in-person appointments.
  
• Requests within 3 hours of your appointment time for virtual appointments.
  
• Requests to prescribe a particular medication or complete particular paperwork that is not accepted.
  
• Surgical procedures with confirmed scheduling.
  
• A lab must be completed within 7 days of purchase. Sesame cannot issue a refund after the 7-day window.
  
• Any refund request more than 10 days after the scheduled visit.
  

There are several ways to contact Sesame's Customer Support team:

Email: support@sesamecare.com

Chat: Open chat window

Call: 1 (877) 947-6411

During a mental health consult, a primary care provider can help start the conversation about mental health care and maintain prescribing and medication management for those who are in stable condition and do not need the expertise of a psychiatry specialist. It's ideal for individuals seeking basic mental health guidance within a primary care context.

Mental health care starts with reaching out for help. On Sesame, you can connect with mental health specialists online to get the quality care you need right away.

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.

Though both a psychiatrist and psychologist provide mental health services and promote mental health wellness, there are some differences to keep in mind when selecting a mental health care provider.

A psychologist is not a medical doctor, but a psychiatrist is. This means that a board-certified psychiatrist (certified by the American Board of Psychiatry and Neurology) has completed medical school along with a residency with a focus in psychiatry, and has the ability not only to diagnose and treat mental illness but to assist in any medication management that comes along with the treatment plan.

The American Psychiatric Association (APA) notes that "psychologists in some states can prescribe psychiatric medications with additional training, although this is not the case in most states," so you may keep that in mind when choosing a mental health care provider. Psychologists are highly trained mental health professionals that can help and assist a broad variety of mental health conditions that don't necessarily require medication or other medical treatments such as learning disabilities, phobias, or relationship issues.

While there is a lot of cross-over when it comes to licensed psychologists and therapists, the main difference to keep in mind is education. Most clinical psychologists have received a doctorate (Ph.D. or PsyD) from an accredited institution and all must possess a state license to practice. Certain therapists like marriage and family therapists usually require at least a master’s degree, while other therapists like mental health counselors require at least a bachelor’s degree. Neither a therapist nor a doctor of psychology is considered a medical doctor, but rather, a mental health professional.

No matter the difference, a mental health clinician whether it be a clinical psychologist or a clinical social worker, can work to create treatment plans for mental health disorders such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), or personality disorders, though these plans do not include medication as a part of treatment.

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.

Conversely, therapists work more with clients managing mental health, behavioral, or personality disorders. Therapists tend to work with clients on a deeper level, addressing psychological and emotional issues, mental health disorders, and facilitating personal growth. They often utilize various therapeutic modalities to help clients explore and process their thoughts, feelings, and behaviors. Therapists use a broader range of therapeutic techniques and interventions to delve into clients' underlying emotional and psychological issues. They might use psychoanalytic, cognitive-behavioral, humanistic, or other approaches.

In sum, counselors will work with clients to overcome a problem or concern. Therapists will work with clients to address why that concern is occurring in the first place while addressing the underlying causes of behavioral or emotional challenges.

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.

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.

With deep expertise in mental health, psychiatrists are able to effectively treat a range of conditions. You may consider consulting a psychiatrist if you are experiencing:

• Anxiety
  
• Long and lasting depression
  
• Delusions or hallucinations
  
• Uncontrollable substance abuse and addiction
  
• Personality disorders such as paranoia, schizophrenia, bipolar disorder, narcissism, and OCD
  
• Severe learning disabilities: When learning disabilities affect a wide range of academic subjects, you may require intense and specialized training and/or medication to overcome these difficulties
  

If you are experiencing suicidal thoughts, call the National Suicide Prevention Hotline at 800-273-8255 or dial 911.

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.

Because online psychiatrist appointments on Sesame use a video conferencing platform (like Zoom or Facetime), it is recommended that you have a stable internet connection and a private space to conduct the appointment. Even though it is taking place on a video call, you will be meeting with a mental health care provider in real-time. For your privacy, a quiet and secluded space in your home is the best place to have this video consultation.

It is generally recommended for all psychiatry consultations to jot down a few questions or concerns you may have prior to your appointment. Mental health care providers on Sesame are certified psychiatrists and therapists with the extensive experience needed to help walk you through the consultation, but it is still encouraged to come up with some questions or thoughts of your own to get the most out of your appointment.

If any other preparation is needed, your provider will reach out to discuss these specifics with you.

Telepsychiatry (online psychiatry care) appointments are a convenient option for those seeking mental health care, without requiring a trip to a clinic. This form of telemedicine can help those seeking to fit mental health services into a busy schedule, people who either cannot - or do not want to - commute to a psychiatrist's office, or those who just want an informal chat about mental health concerns.

Most video mental health appointments will start with an initial consultation about your mental health history, symptoms you may be experiencing, medication you are currently taking, and your history with psychiatric care. After this, your mental health provider can recommend the best treatment plan for you. This may include follow-up appointments, a referral to a specialist, or a prescription for medication.

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
  

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.

Every provider on Sesame treats patients differently - while maintaining the same level of quality care. Generally speaking, the first sessions are often quite similar - regardless of whether you’re seeing a couples therapist, psychotherapist, or family therapist, you are likely to experience a similar. First sessions are often used as “get to know you” sessions where you may share the history of your relationship, i.e. how you began, where you see yourselves now, and what you would like to achieve with therapy. This is a great opportunity to work through priorities and decide whether or not this therapist a good fit for you. The preliminary couples therapy session may involve separate meetings with the therapist and/or joint sessions that include both parties. In the case of family therapy, you are likely to include some/all family members.

Many therapists use a method called emotionally focused therapy (EFT) which is a short-term therapy with the goal of aiding the bond between partners. This method is based on the attachment theory, which suggests that patterns of attachment are developed early in life and stay with you as an adult.

If you are seeking couples therapy, Sesame makes it easy to find the right counselor with direct-to-patient care. No more insurance companies making decisions for you. Sesame sets fair, clear prices for every service- no mystery billing, no membership fees, no insurance mark-ups. It’s perfect for couples therapy, family counseling, and one-on-one sessions. Book a visit today and save up to 60% on counseling services.

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.

Online couples therapy and online marriage counseling is a form of telehealth psychotherapy that allows couples to have a counseling session with licensed therapists through video chat sessions on Sesame. During couples therapy sessions, couples work with a couples therapist to talk through their relationship, their challenges, their mental health, and more. Online couples therapy is particularly helpful when in-person sessions are:

1) Unsafe (e.g. social distancing guidelines during COVID-19 pandemic)

2) Inconvenient (e.g. based on work/ family schedules)

3) Impossible (e.g. long-distance relationships)

Start healing together today with a real licensed professional counselor (LPC), licensed clinical social worker (LCSW), or provider on Sesame.

Couples therapy can cover a wide range of issues and goals. Psychology Today offers some insight on common reasons why a couple may seek counseling:

Trust Issues

A breach of trust is one of the most common reasons why couples may seek counseling. Deception can show up in many forms, from physical and/or emotional affairs to money issues. Therapy can create a safe space in order to talk about and work through trust issues.

Communication issues

If you or your partner are finding it difficult to express how you’re feeling to one another, you may have communication issues. This is a very common conflict for a therapist to address.

An uptick in arguing

It is normal for couples to argue sometimes, but if you notice that they are becoming more frequent, it may be a sign that there are more problems under the surface of the relationship that need to be addressed.

Conflict management

Conflicts can arise from minor stressors to major impasses. Though some conflicts can be resolved after a session, some conflicts may involve innate personality traits or other unsolvable problems. Your therapist can provide tools to manage the emotional reaction around the stressors that cannot be resolved.

Sharing things that are hard to talk about

Fear can sometimes keep you or your partner from sharing openly. A therapy session can act as a safe space for couples to talk about things they might not otherwise share.

Major life events

The stress caused by traumatic events such as cancer, or the loss of a child, can cause partners to go their own ways. Relationship counseling might feel trivial when the trauma is taking the front seat, but it can help keep the bond strong and communication channels open for a couple when faced with life’s big challenges.

Intimacy issues

Intimacy issues, whether it’s emotional or physical in manner, can put stress on a couple. It is common for a couple to fall into a rut over time, and speaking with a therapist can help reenergize the union. Likewise, issues in the bedroom are common bases for couples to seek therapy. Physical intimacy may arise as a singular problem, or as a response to a larger problem. Therapists can provide activities, prompts, and other tools to help couples rekindle their connection.

Premarital counseling

Relationship counseling can help a couple work towards a strong and successful future together. American Association of Marriage and Family Therapy (AAMFT) notes that a satisfying marriage revolves around three factors: individual traits, couple traits, and personal and relationship contexts. Therapy may provide useful tools that strengthen the connection and help a couple prepare for the future.

Couples therapy is a normal, healthy part of every relationship. Couples and marriage counseling by a licensed counselor offers emotionally-focused therapy to address relationship problems including:

• Communication issues
  
• Sexual obstacles
  
• Anger management
  
• Infidelity
  
• Substance abuse
  
• Separation
  

In order to address any issues you may be facing in your relationship, a therapist, psychotherapist, or counselor may offer tools such as:

• Conflict resolution
  
• Marriage counseling
  
• Gottman Method
  
• Emotionally Focused Therapy (EFT)
  

Sesame offers video visits with licensed therapists/ licensed clinical social workers in Portland, OR. These live video sessions can help couples work through a wide range of issues including:

• Communication skills
  
• Sexual obstacles
  
• Financial strain
  
• Stress management
  
• Anger management
  
• Substance abuse
  
• Separation
  
• Infidelity/ communication to regain trust
  
• Family therapy
  
• Premarital counseling
  

You certainly don't need to be experiencing relationship issues to talk to a couples therapist/ marriage counselor. Relationship help can address problems in your relationship, or build a stronger relationship through communication in a safe and confidential space. All you need is an internet connection and a space where you feel comfortable together. If your partner isn't interested in participating, couples therapy can be beneficial for individuals as well.

Book a visit on Sesame with a licensed therapist/ clinical social worker today for convenient and affordable video couples therapy sessions. 60-minute visits start at just $132 - no insurance needed.

There are a number of benefits to online couples therapy/ counseling. Speaking with a licensed therapist/ clinician through video sessions lets you address relationship issues even if you are separated, or have barriers that make in-person therapy difficult (such as work or childcare scheduling). If you think you may have a difficult time working couples therapy into your schedule or life, you might consider online marriage counseling/ couples therapy as a way to work on your relationship without the hurdles of going to a clinician's office.

Couples therapy can help your relationship even if you aren't having relationship issues. Some couples use couples therapy as a way to strengthen a relationship or work through thoughts in a safe space. Some things that online couples therapy can help address include:

• Communication skills
  
• Sexual obstacles
  
• Financial strain
  
• Stress management
  
• Anger management
  
• Substance abuse
  
• Separation
  
• Infidelity/ communication to regain trust
  
• Family therapy
  
• Premarital counseling
  

Every couple is different - and your counselor should be able to help you determine whether you should attend alone or together. Consult with your couples therapist or marriage counselor about the issues you are hoping to address. In most cases, attending online couples therapy together is most beneficial, as it helps individuals talk through relationship issues together. That being said, in certain cases a counselor may want to meet with each partner individually, such as when domestic abuse is an issue.

Additionally, your partner may not want counseling services. If you are looking for help, but your partner isn't, you may consider booking a visit with a counselor yourself to talk through any issues you may be facing.

Talk to your counselor/ therapist about what form of online couples therapy/ online marriage counseling is right for you.

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.

Depression can be caused by any number of things, from genetic makeup to traumatic events or medical illnesses. Depression isn't always caused by just one thing; it often results from the interplay between multiple factors.

Your mood and the way you see reality are controlled by a complex system of chemicals. There could be as many chemical reactions in charge of regulating your mood as there are people on the planet. There is not just one chemical that is high or low when you have depression.

Though your chemical makeup is complex, there has been a lot of research to develop medications such as antidepressants and mood stabilizers to help regulate these chemicals.

Some causes linked to depression and chemical makeup include:

Hyperthyroidism: People who suffer from this have an overactive thyroid, which is a butterfly-shaped gland in your throat that helps release hormones. In the Journal of Thyroid Research, it is estimated that up to 69% of people who have hyperthyroidism also have clinical depression.

Hypothyroidism: This is a medical condition of having an underactive thyroid. When a thyroid isn’t as active as it should be, it does not produce the normal amount of thyroid hormones into your central nervous system, which can cause a person to gain weight and feel tired, which are both symptoms of depression.

Certain mental illnesses or mental health conditions: Among them, the National Institute of Mental Health or NIMH has listed psychosis as being linked with depression. The CDC, the United State’s national health protection agency, notes that those who suffer from mental disorders have a higher risk for developing depression due to the stresses from the pandemic.

Stressful Events: Death, divorce, a major move, even Covid-19, can all induce depressive episodes. In fact, during the pandemic, more than 1 in 3 adults have reported feeling depressed or anxious. In 2019, this number was closer to 1 in 10.

If you feel depressed and would like to speak to someone, Sesame can make finding a qualified therapist easier and more affordable than ever. Save 60% when you book an in-person or video doctor appointment today with Sesame. All care. No nonsense.

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.

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.

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.

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.

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.

For some people, anxiety is manifested in physical symptoms. These can include:

• Chest pains
  
• Heart palpitations
  
• Sweating
  
• Nausea
  
• Trembling
  
• Chills
  
• Feeling weak
  
• Gastrointestinal problems
  
• Increased heart rate
  
• Hyperventilation
  

Some of these symptoms including chest pains, heart palpitations, nausea, and sweating may also be signs of a heart attack. If you think you may be having a heart attack, you should call 911 immediately.

Connect on Sesame with a real, quality doctor in Portland, OR who can assess your condition, address your symptoms, and craft an anxiety treatment plan that's right for you. Sesame works directly with mental health care providers - not insurance companies - to get you the care you need for affordable, cash prices.

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.