Depression can quietly take over every part of life. Getting out of bed feels heavy. Work, relationships, and things you once enjoyed start to slip away. Some people stop functioning. Others keep going on the outside while carrying silent pain on the inside. And for many, the hardest part is trying treatment after treatment without feeling better.
At Psychiatric Pathways in Bloomington, Brenna Christie, FNP-C, PMHNP-BC, provides comprehensive depression treatment in Minnesota for adults across the Twin Cities. Whether you are seeking help for the first time, struggling after the birth of a baby, or have tried several antidepressants without relief, our clinic brings together psychiatric medication management, ketamine therapy, and FDA-approved Spravato under one roof, with a plan built around you.
If you are having thoughts of suicide or feel unsafe, call or text 988 (the Suicide & Crisis Lifeline) or go to the nearest emergency department. If there is immediate danger, call 911.
On This Page
- Understanding Depression
- Depression Treatment in Minnesota Led by Brenna Christie
- Treatment for Depression: Our Approach
- Treatment for Clinical Depression
- Treatment for Resistant Depression
- Treatment for Postpartum Depression
- When Depression Includes Thoughts of Suicide
- What to Expect at Your First Visit
- Frequently Asked Questions
Understanding Depression
Depression is a medical condition that affects how you think, feel, and function. It is not a weakness, a character flaw, or something you can simply push through. According to the National Institute of Mental Health, an estimated 21 million U.S. adults, or 8.3% of all adults, had at least one major depressive episode in 2021.
Depression usually develops from a combination of factors, including brain chemistry, genetics, chronic stress, hormonal changes, trauma, major life events, and physical health. The good news is that it is treatable, even when earlier treatments have not worked.
Common Symptoms of Depression
- Emotional: Persistent sadness, emptiness or numbness, hopelessness, irritability, guilt, and feelings of worthlessness.
- Loss of interest: Hobbies, relationships, and activities that once brought joy start to feel meaningless or draining.
- Physical: Fatigue, changes in sleep or appetite, headaches, body aches, and digestive problems.
- Cognitive: Brain fog, trouble concentrating, slowed thinking, and difficulty making decisions.
- Safety: In severe cases, thoughts of self-harm or suicide, which always deserve immediate support.
Types of Depression We Treat
- Clinical depression (major depressive disorder): Persistent, more severe symptoms lasting at least two weeks that interfere with daily life.
- Postpartum depression: Depression that begins during pregnancy or after childbirth.
- Treatment-resistant depression: Depression that has not improved enough after trying at least two antidepressants.
- Depression with other conditions: Depression that overlaps with anxiety, PTSD, OCD, or bipolar disorder, which can change the right treatment.
Depression Treatment in Minnesota Led by Brenna Christie
Brenna Christie is dual board certified as both a Family Nurse Practitioner and a Psychiatric-Mental Health Nurse Practitioner, with 13 years in practice. She trained at the University of Colorado and the Rocky Mountain University of Health Professions and is a member of the American Society of Ketamine Physicians, Psychotherapists and Practitioners (ASKP3).
Mood disorders and depression are her primary specialties, including pregnancy and postpartum mental health, and much of her practice focuses on adults whose depression has not improved with traditional treatment alone. Alongside medication and advanced treatments, she draws on approaches such as mindfulness-based CBT, motivational interviewing, and person-centered care. At Psychiatric Pathways, care is built on:
- Whole-person care: Her background in family medicine means physical health, sleep, hormones, and medical conditions are part of the picture.
- Shared decisions: Every treatment choice is made with you, so you stay in control of your care.
- Coordinated care: We work alongside your therapist, primary care provider, and OB/GYN so your plan stays aligned.
- A safe, respectful setting: We take time to listen, explain your options clearly, and move at a pace that feels right for you.
Treatment for Depression: Our Approach
There is no single right treatment for depression. The right plan depends on your symptoms, history, what you have already tried, and your life circumstances. At Psychiatric Pathways, we offer three main treatment paths, and many patients use more than one.
| Treatment | How It Helps | Often Used When |
| Psychiatric medication management | Accurate diagnosis plus carefully chosen, closely monitored medication | Starting treatment, or refining a plan that is not working well enough |
| Ketamine therapy | Works on glutamate pathways; some people feel relief within hours or days | Depression is severe or has not responded to standard medications |
| Spravato | FDA-approved esketamine nasal spray, often covered by insurance | Depression has not improved after at least two antidepressants |
Because we offer all three in one place, your care can evolve as your needs change without starting over with a new provider.
Treatment for Clinical Depression
Clinical depression, also called major depressive disorder, is different from sadness after a hard event. It involves persistent symptoms that last at least two weeks, often much longer, and interfere with work, relationships, and daily life. Treatment for clinical depression usually begins with a careful evaluation and medication management, with advanced options available when needed.
Psychiatric Treatment for Clinical Depression
Psychiatric treatment for clinical depression provides a medical foundation for recovery: an accurate diagnosis, carefully chosen medication, and close follow-up that adapts as you improve.
- Thorough evaluation: Anxiety, PTSD, OCD, bipolar disorder, thyroid problems, and sleep disorders can all overlap with depression. Some change which treatments are safe and effective, so we review your symptoms, medical history, family history, and past treatment responses in detail.
- Medication management: Common options include SSRIs, SNRIs, bupropion, and mirtazapine, and some people benefit from adding a second medication. Most antidepressants take about four to eight weeks to reach full effect, and we monitor progress, adjust doses, and manage side effects along the way.
- Therapy coordination: We encourage you to keep working with your therapist and are happy to coordinate so medication and therapy support each other.
Learn more about our psychiatry for depression services.
Ketamine Treatment for Clinical Depression
Ketamine has been used safely in medical settings for decades as an anesthetic. At much lower doses, it has shown meaningful promise for severe and treatment-resistant depression. Unlike traditional antidepressants, which mainly target serotonin and can take weeks to work, ketamine acts on the brain’s glutamate system. This is thought to help the brain form new connections that chronic stress and depression have weakened.
Some people notice improvement within hours or days. Patients often describe feeling lighter, more hopeful, more motivated, and less weighed down, and many find it easier to engage in therapy once the heaviness lifts. Results vary, and ketamine is not a cure, but it can be a powerful part of a broader plan.
Ketamine is not FDA-approved for depression, so its use is considered off-label. We recommend it only after a thorough evaluation confirms it is medically appropriate for you.
What to expect: Treatment begins with a complimentary consultation, which typically takes about an hour. IV ketamine infusions are given slowly over about 40 to 60 minutes in a calm, monitored setting, and each visit takes about two hours in total. You stay awake and may feel deep relaxation, a floating sensation, or mild dissociation. These effects are temporary and closely supervised. Most patients begin with a series of treatments over several weeks, and some benefit from maintenance sessions later. We also offer ketamine injection for depression as an alternative for some patients.
Cost: Ketamine infusions are $395 per session and are self-pay. We accept HSA and FSA, and we can provide a superbill that may allow partial reimbursement depending on your plan.
Safety: When administered in a professional medical setting, ketamine has a well-established safety profile. Some patients experience temporary nausea, dizziness, elevated blood pressure, or dissociation, and our team monitors you throughout. Certain medical conditions, active substance use, or psychiatric concerns may require additional evaluation.
Learn more about ketamine therapy for depression.
Spravato Treatment for Clinical Depression
Spravato (esketamine) is a nasal spray that works on the same glutamate pathways as ketamine. It is FDA-approved for adults with treatment-resistant depression, and, together with an oral antidepressant, for adults with major depression who are experiencing suicidal thoughts or actions.
Spravato is administered in our office under direct supervision, with monitoring for at least two hours after each dose, and you will need someone else to drive you home. Because it is FDA-approved, it is often covered by insurance, including Optum, UnitedHealthcare, Medica, UMR, Humana, and Aetna. Learn more about Spravato treatment for depression.
Treatment for Resistant Depression
Many people start an antidepressant expecting relief, only to see weeks turn into months with little change. They switch medications, deal with side effects, and slowly lose hope. If that sounds familiar, you are not alone, and you are not out of options.
What Is Treatment-Resistant Depression?
Depression is generally considered treatment-resistant when it has not improved enough after at least two adequate trials of antidepressants, meaning each medication was taken consistently at a therapeutic dose for about six to eight weeks. It is common. According to a review in Neuropsychiatric Disease and Treatment, approximately 30% of people with major depression do not respond to conventional treatments.
Treatment-resistant depression often shows up as ongoing emotional numbness or an inability to feel pleasure, persistent brain fog, sleep problems that do not improve, physical exhaustion, and a deep sense of burnout from treatments that have not worked.
Why Standard Antidepressants May Not Work
- Different brain pathways: Most antidepressants work on serotonin, norepinephrine, or dopamine. For some people, depression is driven more by other systems, such as glutamate, that standard medications do not directly target.
- An incomplete diagnosis: Bipolar depression, PTSD, OCD, or medical issues such as thyroid problems can look like major depression but need a different approach.
- Trials that were not adequate: A medication may have been stopped early, taken at too low a dose, or discontinued because of side effects before it had a real chance to work.
Psychiatric Re-Evaluation and Medication Strategy
When standard treatment falls short, simply trying another similar medication often leads to more disappointment. Our approach starts with a fresh look:
- Diagnostic verification: We check whether anxiety, trauma, bipolar spectrum symptoms, or medical factors are influencing your treatment response.
- Medication mapping: We review every medication you have tried, including doses, how long you took each one, side effects, and how much it helped, so we do not repeat what has already failed.
- Augmentation and switching: We may add a second medication with a complementary mechanism or move to a different class of antidepressant altogether.
Ketamine for Resistant Depression
Ketamine is one of the most studied options for resistant depression because it works through a completely different pathway than standard antidepressants. Some people who have tried many medications without success experience meaningful improvement, sometimes within hours or days. Treatment follows the same process described above, beginning with a complimentary consultation and a series of monitored infusions. Its use for depression is off-label.
Spravato for Resistant Depression
Treatment-resistant depression is exactly what Spravato is FDA-approved to treat. For adults who have not responded to at least two antidepressants, it offers an in-office, insurance-covered option that works on glutamate pathways. Many patients use Spravato alongside an oral antidepressant as part of a broader plan.
Treatment for Postpartum Depression
Bringing a baby home is supposed to feel joyful. For many mothers, it also brings sadness, anxiety, exhaustion, or numbness that does not lift. Many carry this quietly, afraid that struggling means they are failing. It does not. Postpartum depression is a real, common, and treatable medical condition.
Understanding Postpartum Depression
Postpartum depression can begin during pregnancy or at any point after childbirth, sometimes months later. According to the CDC, about 1 in 8 women with a recent live birth report symptoms of postpartum depression. It is different from the “baby blues,” which bring mood swings and tearfulness that usually fade within about two weeks. Postpartum depression lasts longer, feels more intense, and gets in the way of sleep, bonding, daily functioning, or safety.
Common symptoms include persistent sadness or numbness, crying spells, guilt, severe fatigue, trouble sleeping even when the baby sleeps, anxiety about the baby’s safety, difficulty bonding, and pulling away from loved ones. Some mothers experience intrusive thoughts: unwanted, frightening thoughts that do not match who they are. These are often a symptom of postpartum anxiety or OCD rather than a sign of intent, and they deserve prompt, supportive evaluation.
Get help right away if you feel unsafe, have thoughts of self-harm, go long periods unable to sleep, experience hallucinations or paranoia, or feel out of control. Call or text 988, or call 911 if there is immediate danger.
Psychiatric Treatment for Postpartum Depression
Postpartum depression can be hard to treat. Mothers are often told to “wait it out” or rest more when rest is not realistic. Sometimes anxiety or intrusive thoughts are the main problem, a past trauma is reactivated, or what looks like depression is actually part of a bipolar spectrum condition. Psychiatric treatment for postpartum depression brings clarity and a plan that fits the postpartum season of life:
- Comprehensive evaluation of your symptoms, postpartum timeline, sleep, medical recovery, and mental health history.
- Diagnostic clarification for postpartum anxiety, OCD-type intrusive thoughts, trauma responses, and bipolar spectrum symptoms.
- Medication management with clear explanations of benefits, risks, and how we will monitor your response.
- Coordinated care with your OB/GYN, primary care provider, and therapist, with your consent.
- Practical support planning for protecting sleep, getting through daily routines, and knowing what to do if symptoms spike.
Medication and breastfeeding: Many antidepressants can be used while breastfeeding, and the right choice depends on your symptoms, history, and your baby’s needs. We weigh the benefits and risks together, including the risks of leaving postpartum depression untreated, without pressure in any direction. Newer options designed specifically for postpartum depression, such as zuranolone (Zurzuvae), the first oral medication FDA-approved for postpartum depression, may also be discussed when appropriate.
Ketamine Treatment for Postpartum Depression
For mothers with severe symptoms, a history of hard-to-treat depression, or postpartum depression that has not responded to standard medications, ketamine treatment for postpartum depression offers a different option. Some mothers describe feeling lighter, calmer, more hopeful, and more present with their baby and family after treatment. Its use is off-label and not a cure, but it may be an important part of a broader plan. If you are breastfeeding, we will talk through your feeding plans around treatment before you begin.
Spravato Treatment for Postpartum Depression
Postpartum depression is a form of major depression, so Spravato may be an option for mothers whose postpartum depression has not improved after trying at least two antidepressants. It has not been studied specifically as a postpartum treatment, and breastfeeding is not recommended during Spravato treatment, so it is a decision we make together after a careful review.
Postpartum Depression Treatment in Minnesota
We know it is hard to get to appointments with a newborn. Many follow-up visits for medication management can be held via telehealth, and we welcome partners and family members who want to help. For partners, gathering medical history or arranging childcare for appointments is one of the most practical ways to support a mother with postpartum depression.
When Depression Includes Thoughts of Suicide
Severe depression can bring hopelessness and thoughts of suicide. If you are experiencing these thoughts, you are not alone, and help is available right now: call or text 988, or call 911 if you are in immediate danger. Once you are safe, our team can provide close psychiatric care and discuss treatments designed to work faster than standard antidepressants. Learn more about our psychiatric treatment for suicidal ideation.
Conditions That Often Occur Alongside Depression
Depression often overlaps with other conditions, including anxiety, PTSD, OCD, and bipolar disorder. Treating the full picture rather than isolated symptoms is often the key to lasting improvement.
What to Expect at Your First Visit
Your first visit focuses on getting the full story right: your symptoms, when they started, what you have tried, and what “better” would look like for you. That might mean sleeping through the night, less dread in the morning, or feeling present with the people you love again. Those goals guide your plan and help us track whether it is working.
You do not need perfect words or a tidy timeline. If you are able, it can help to:
- Write down your symptoms, including mood, sleep, appetite, energy, and any intrusive thoughts.
- List past treatments, including medications, doses, how long you took them, what helped, and any side effects.
- Bring your questions about treatment options, timelines, cost, and safety.
Clinical Depression Treatment in Minnesota: Serving the Twin Cities
Our clinic is located at 3601 Minnesota Dr #510 in Bloomington, serving adults throughout the Twin Cities, including Minneapolis, Edina, Richfield, Eden Prairie, and surrounding communities. Many follow-up visits for medication management can also be held via telehealth. We are in-network with several major insurance plans and accept HSA and FSA payments.
Frequently Asked Questions About Depression Treatment
What is the difference between depression and clinical depression?
Feeling down after a hard event is a normal response that usually eases with time. Clinical depression, or major depressive disorder, involves persistent, more severe symptoms lasting at least two weeks that interfere with daily life and usually need treatment.
How long do antidepressants take to work?
Most antidepressants take about four to eight weeks of daily use to reach their full effect.
What is treatment-resistant depression?
Depression is generally considered treatment-resistant when it has not improved enough after at least two adequate trials of antidepressants, typically six to eight weeks each. It does not mean your depression cannot be treated. It means a different approach is needed.
Could my original diagnosis be wrong?
Sometimes. Bipolar depression, PTSD, and medical issues such as thyroid problems can look like major depression but respond poorly to standard antidepressants. A careful re-evaluation is often the first step when treatment has not worked.
How is ketamine different from traditional antidepressants?
Most antidepressants target serotonin or norepinephrine and take weeks to work. Ketamine targets the glutamate system, and some people notice relief within hours or days. Its use for depression is off-label and recommended only after a careful evaluation.
What is the difference between ketamine and Spravato?
Spravato (esketamine) is a nasal spray derived from ketamine. It is FDA-approved for treatment-resistant depression and is often covered by insurance. IV ketamine is given by infusion, is used off-label, and is self-pay. We can help you decide which fits your needs.
Is Spravato covered by insurance?
Spravato is often covered by major plans, including Optum, UnitedHealthcare, Medica, UMR, Humana, and Aetna. Coverage varies by plan, and we can help you check your benefits.
How do I know if it is postpartum depression or the baby blues?
The baby blues usually improve within about two weeks. Postpartum depression lasts longer, feels more intense, and interferes with sleep, bonding, daily functioning, or safety. If symptoms are not improving or are getting worse, get evaluated.
Can I take antidepressants while breastfeeding?
Often, yes. The best option depends on your symptoms, history, and your baby’s needs. Breastfeeding is not recommended during Spravato treatment, and for ketamine we review your feeding plans with you before any treatment begins.
Do I need to stop seeing my current therapist?
No. We encourage you to continue therapy and stay connected with your other providers. We are happy to coordinate so your care stays aligned.
How do I get started?
Call our Bloomington office or book a complimentary 15-minute intro call online to talk through your symptoms and the best next step.
Take the First Step Toward Relief
Whether depression is new, came after the birth of your baby, or has not responded to treatment for years, you do not have to keep struggling alone. At Psychiatric Pathways, Brenna Christie and our team are here to help you find a path forward.
Call (952) 592-5421 or schedule your complimentary consultation today.