Why Integrated Therapy Matters at Blue Umbrella Psychiatry

The Psychiatric Side of Anxiety: What Medication Can (and Can’t) Do

Is TMS Right for You? Understanding Transcranial Magnetic Stimulation for Depression 

Back-to-School Transitions: Mental Health Tips for Kids, Teens & Parents

When It’s More Than Stress: Understanding High-Functioning Anxiety August 14

When Traditional Treatments Don’t Work: A Guide to Treatment-Resistant Depression (TRD)

For those living with treatment-resistant depression, it’s common to feel like you’ve tried everything — multiple medications, therapy, lifestyle changes — and still, the cloud won’t lift. At Blue Umbrella Psychiatry, we offer Spravato® (esketamine) as a powerful, FDA-approved treatment option when standard antidepressants haven’t provided relief. Spravato isn’t a first-line treatment — it’s for patients who have tried at least two other antidepressants without success. But for the right individuals, it can be life-changing. What Is Spravato®? Spravato® is a nasal spray form of esketamine, a medication derived from ketamine. Unlike traditional antidepressants that target serotonin or norepinephrine, esketamine acts on glutamate — a different brain chemical involved in mood regulation and neuroplasticity (the brain's ability to form new connections). Because of this unique mechanism, many patients begin to feel improvement within hours to days — not weeks. Who Is It For? Spravato® is approved for adults with: Treatment-resistant depression Major depressive disorder with suicidal thoughts or behaviors It’s typically used in combination with an oral antidepressant for best results. What to Expect During Treatment Spravato® must be administered in-office under supervision due to its potential side effects. At Blue Umbrella Psychiatry, our Breakthrough Center offers a calm, private treatment space designed for your safety and comfort. Here’s how it works: You self-administer the nasal spray in our clinic. You remain under observation for two hours afterward. Our staff monitors your blood pressure, vital signs, and response. You’ll need a ride home after each session. Starting Strong: Twice a Week for Four Weeks To maximize effectiveness, patients begin Spravato® treatment with an induction phase — typically twice-weekly sessions for the first four weeks. This schedule is designed to give your brain the best chance to respond and stabilize. After that, treatment usually shifts to once weekly or every other week, based on your progress and your provider’s recommendation. Is Spravato® Safe? Spravato® is well-studied and FDA-approved, but it isn’t right for everyone. Common side effects can include dizziness, dissociation, nausea, or increased blood pressure. That’s why it’s administered in a structured, supervised setting. Before starting, you’ll undergo a comprehensive evaluation to ensure it’s a safe and appropriate fit for your needs. Real Relief, Backed by Science Many of our patients who have felt stuck or hopeless with other medications report that Spravato® finally offers a shift — a sense of lightness, clarity, or energy they haven’t felt in years. Some say it’s the first treatment that made a noticeable difference. It’s not a magic fix, but it’s a significant step forward when other paths have been exhausted. Spravato® + Therapy: A Healing Combination At Blue Umbrella Psychiatry, we believe Spravato® is most powerful when paired with therapy. Medication can lift the fog — therapy helps you rebuild once you can see the road again.  Our therapists work closely with psychiatric providers to support your healing, offering a whole-person approach to recovery. Is Spravato® Right for You? Let’s Talk If you’re feeling stuck and nothing else has helped, Spravato® may be worth exploring. You don’t have to go it alone — and you don’t have to keep trying the same things expecting different results.

When we think of depression, we often picture someone who can’t get out of bed, who cries constantly, or who’s visibly struggling. But depression doesn’t always look like what we expect. Many adults live with high-functioning depression — managing careers, parenting, and responsibilities on the outside, while quietly battling pain on the inside. At Blue Umbrella Psychiatry, we frequently see individuals who “have it all together” but feel empty, exhausted, or numb underneath. If this sounds like you or someone you love, you’re not alone — and there are ways to find balance, relief, and renewed purpose. What Is High-Functioning Depression? High-functioning depression isn’t a clinical diagnosis on its own — it often refers to Persistent Depressive Disorder (dysthymia) or Major Depressive Disorder that’s masked by productivity. People with high-functioning depression may keep up appearances, perform well at work, and fulfill social roles — all while feeling internally depleted. Common signs include: Constant low mood or emptiness Feeling tired or emotionally flat, even with enough sleep Difficulty enjoying things you used to love Irritability, guilt, or self-criticism Overworking or perfectionism to distract from inner distress Withdrawing emotionally, even while staying socially active “Everything is fine” on the outside, but “I’m not okay” inside This form of depression is especially tricky — because it can go unnoticed, even by the person experiencing it. Why It Often Gets Missed High-functioning adults are often praised for being dependable, driven, and strong. This can lead to pressure to hide vulnerability, push through symptoms, or dismiss your own suffering. You might tell yourself: "Other people have it worse." "I should be grateful." "I just need to work harder." But depression doesn’t care how successful you are or how busy your calendar is. If you’re feeling emotionally numb, disconnected, or constantly overwhelmed, it’s worth paying attention. The Impact of Ignoring High-Functioning Depression When untreated, high-functioning depression can gradually erode your quality of life. Over time, it can lead to: Burnout and chronic fatigue Relationship strain Poor concentration and memory Increased risk for anxiety or substance use Loss of meaning or joy Worse, people often delay seeking help because they don’t “look depressed.” That’s why compassionate, early support matters. How We Help at Blue Umbrella Psychiatry You don’t have to wait for a crisis to seek help. At Blue Umbrella Psychiatry, we provide psychiatric evaluations and personalized treatment plans for adults dealing with all types of depression — including the quiet kind. Our approach includes: Medication management, when appropriate, to restore mood stability Therapy to address emotional burnout, perfectionism, and core beliefs Lifestyle support, including sleep, nutrition, and stress reduction strategies Ongoing collaboration between psychiatry and therapy to ensure continuity of care We aim to create a space where you don’t have to pretend everything is fine — because healing starts with honesty and support. You're Not Broken — You're Human High-functioning depression is not a character flaw. It’s a real mental health condition that deserves real care. You’re allowed to have struggles, even if everything “looks fine.” You’re allowed to ask for help, even if others rely on you.  Therapy and psychiatric support can help you reconnect with your feelings, rediscover joy, and manage your mental health in sustainable ways. Let’s Talk — You Don’t Have to Do It Alone If you’ve been carrying quiet sadness, chronic fatigue, or emotional numbness, we see you — and we’re here to help. At Blue Umbrella Psychiatry, our team offers compassionate, integrated care that goes beyond the diagnosis. Together, we’ll explore what you’re going through and create a plan that fits your life — so you can feel more like yourself again.

Understanding ADHD in Adults: Symptoms, Struggles, and Support When we think of ADHD, we often imagine hyperactive kids bouncing around classrooms. But Attention-Deficit/Hyperactivity Disorder doesn’t disappear with age — in fact, many adults live with undiagnosed or misdiagnosed ADHD for years, impacting their relationships, work, and self-esteem. At Blue Umbrella Psychiatry, we work with adults at all stages of life who are just beginning to recognize the signs of ADHD. Whether you’ve long suspected it or are newly exploring a diagnosis, you’re not alone — and there are effective, compassionate ways to find clarity and relief. What Does Adult ADHD Look Like? ADHD in adults can look very different than it does in children. Hyperactivity may shift into restlessness or inner tension. Challenges with focus, organization, and follow-through are often the biggest struggles. Common signs of ADHD in adults include: Difficulty focusing or completing tasks Forgetfulness and frequent distractions Trouble organizing, prioritizing, or managing time Impulsivity — interrupting, overspending, or difficulty pausing Chronic lateness or missed deadlines Feeling overwhelmed by everyday responsibilities Emotional reactivity or mood swings It’s not laziness or lack of willpower — ADHD is rooted in how the brain regulates attention and executive functioning. The Emotional Toll of Undiagnosed ADHD Many adults with ADHD carry years of frustration or shame. You may have been labeled as “careless,” “disorganized,” or “too much.” You might blame yourself for things that are actually neurologically based. Untreated ADHD can lead to: Anxiety and depression Low self-esteem Relationship difficulties Career instability Chronic stress or burnout That’s why understanding the root cause — and getting proper support — can be life-changing. Getting Diagnosed and Treated At Blue Umbrella Psychiatry, we offer comprehensive ADHD evaluations tailored to adults. Diagnosis involves clinical interviews, symptom assessments, and a clear look at how your challenges impact daily life. If you’re diagnosed, we create a treatment plan that may include: Medication management (like stimulants or non-stimulants) Therapy focused on executive function, self-worth, and life skills Practical tools for time management, organization, and focus Coordination with therapists for ongoing behavioral support Treatment is about more than symptom relief — it’s about helping you thrive in work, relationships, and self-confidence. Yes, ADHD Affects All Ages We see adults of all ages seeking answers. Some are college students or young professionals, struggling to stay on track. Others are parents overwhelmed by juggling it all. Still others are approaching retirement, only now connecting the dots of a lifetime of distraction or underachievement. ADHD doesn’t expire. And it’s never too late to understand yourself more fully. How Therapy Helps with ADHD In addition to psychiatric care, therapy can make a big difference for adults with ADHD. At Blue Umbrella Psychiatry, our therapists help patients: Build routines and coping strategies Challenge internalized shame or self-doubt Improve relationships and communication Set boundaries and realistic goals Therapy and medication often work best as a team, offering support from multiple angles. You Deserve Support — Let’s Talk If you recognize yourself in any of these symptoms, we invite you to explore what might be going on — and what’s possible with the right support.  At Blue Umbrella Psychiatry, we provide both psychiatric treatment and therapy, working together to help you manage ADHD with clarity and compassion.