Depression Counseling
When everything takes four times as long
The version people expect is sadness. Plenty of depression is not that.
It is the email that should take four minutes taking forty. It is the shower being a decision. It is looking at something you used to love and registering, with total accuracy and no feeling attached, that you used to love it.
And then the guilt about all of it, which is the part that keeps it running, because now the exhaustion has an explanation and the explanation is you.
It is not.
The first conversation is free and it lasts 55 minutes.
Open seven days a week.
Does your insurance cover this? Probably, and here is the list
We are in network with Kaiser, PacificSource, Cigna, Aetna, and United Healthcare and Optum, and with Medicare, both Open Card and in-network Advantage plans.
Regence Blue Cross Blue Shield is expected from 1 October 2026 and Moda from 15 October 2026, both for associates as well as licensed clinicians. For the Oregon Health Plan we can bill Open Card, but not the coordinated care organizations, and most OHP members are enrolled with a CCO rather than Open Card.
If you carry one of the plans above, you pay a copay rather than our full rate. If you do not, sessions are $205 an hour with a licensed clinician and $180 with a supervised associate, and we can give you a superbill to claim back whatever your out-of-network benefit allows.
We will tell you what your plan covers before your first session, not after it.
What people describe when they get here
No motivation to do anything, including the things that would obviously help. Knowing what would help and being unable to start is one of the most reliably misread symptoms there is. It reads as a character problem from the inside. It is not one.
Nothing is enjoyable, and nothing is unbearable either. Everything has gone the same temperature.
- Crying for no reason, or the reverse, which is not being able to cry about something that clearly warrants it.
- Sleep at one of two extremes. Too much and still tired, or awake at four with nothing to do about it.
- Irritability, which is what depression frequently looks like in people who were raised to keep going.
- Slowness. Thinking, deciding, moving, replying. Everything with a delay on it.
- Seasonal patterns, which matter here more than in most of the country. Oregon runs about eight months of low light, and for some people the shape of the year is the whole diagnosis.
- Postpartum depression, which has its own timeline and its own pressures and gets missed constantly because everybody is looking at the baby.
Am I burned out or depressed?
People ask this often enough that it deserves a straight answer.
Burnout usually lifts with real distance from the thing causing it. A month away, a genuine change at work, and it moves.
Depression usually does not. The holiday ends and it came with you.
They also overlap, and plenty of people have both. The reason it is worth telling apart is that the two need different responses, and treating burnout as depression means fixing a person instead of a situation.
If the pressure is coming from a career you cannot be open about, there is a page for that.
What we do about it
- Behavioral activation first, in most cases. Depression argues that you should wait until you feel like doing things. Waiting is how it stays. The work is finding the smallest possible thing that is actually available to you this week, which is a real clinical method and not a motivational poster.
- Acceptance and Commitment Therapy, our associates’ main approach, for getting your life pointed back at what you value while you still feel like this, rather than after.
- Cognitive Behavioral Therapy, for the thought patterns that respond to being seen and interrupted.
- Narrative Therapy, for the story that got built around the problem and the version of you that story requires.
- Internal Family Systems, for the part that wants to get up and the part that has stopped seeing the point.
- EMDR, when something underneath is driving it. We are trained in it.
We do not prescribe. Some people do better with medication, many do fine without it, and we will give you an honest read and work alongside your prescriber if you have one.
Who you would see
Every clinician here works with depression.
Licensed clinicians and registered associates, depending on fit and availability.
Our associates are credentialed with Aetna and Cigna. PacificSource stops taking associates on 1 October 2026. If you carry a different plan, our licensed clinicians are your in-network option.
Questions people ask
I do not think mine is bad enough to need this.
That thought is a symptom of the thing, and it keeps a lot of people out of a room that would help. The consultation costs nothing and 55 minutes is a reasonable way to find out.
Does therapy work for depression without medication?
Often, yes. It also works alongside it. What we will not do is tell you which one you need before we have met you.
How soon can I be seen?
Usually within days. We are open seven days a week, and inquiries are answered the same day.
How long does this take?
Depends on what you bring. We will give you an honest estimate after the consultation instead of selling you a package.
What if I start and it does not help?
Then we say so and change something. That conversation happens here rather than being avoided until you stop booking.
Book a free 55 minute consultation
An hour, at no cost, with a clinician rather than an intake screener.
Book online · In person in Tigard, by video anywhere in Oregon