PHQ-9 Rating Scale

Depression Rating Scale

PHQ-9
Patient Name*

First NameLast Name
Date Completed*

MonthDayYear
Date
Date of Birth:*

MonthDayYear
Date
Depression Rating Scale-Over the last 2 weeks, how often have you been bothered by the following problems?
1. Little interest or pleasure in doing things*

Not at allSeveral DaysMore than half the daysNearly every day
2. Feeling down, depressed or hopeless*

Not at allSeveral DaysMore than half the daysNearly every day
3. Trouble falling or staying asleep, sleeping too much*

Not at allSeveral DaysMore than half the daysNearly every day
4. Feeling tired or having little energy*

Not at allSeveral DaysMore than half the daysNearly every day
5. Poor appetite or overeating*

Not at allSeveral DaysMore than half the daysNearly every day
6. Feeling bad about yourself-or that you are a failure or have let yourself or your family down*

Not at allSeveral DaysMore than half the daysNearly every day
7. Trouble concentrating on things, such as reading the newspaper or watching television*

Not at allSeveral DaysMore than half the daysNearly every day
8. Moving or speaking so slowly that other people could have noticed. Or the opposite-being so figety or restless that you have been moving around a lot more than usual*

Not at allSeveral DaysMore than half the daysNearly every day
9. Thoughts that you would be better off dead, or of hurting yourself*

Not at allSeveral DaysMore than half the daysNearly every day
PHQ-9 Calculation*
If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?

Not difficult at allSomewhat difficultVery difficultExtremely difficultNot Applicable
Have you been prescribed 3 or more anti-depressants in the past?

YesNo
Are you interested in learning about advanced mental health treatments such as TMS or Spravato?

Yes, i'd like to learn more.No I'm not interested
SPRAVATO (esketamine)

Spravato is the first FDA-approved nasal spray medication for Treatment Resistant Depression (TRD).

33% of people suffering from depression have treatment resistant depression.

Patients engaging in Esketamine therapy will not have to wait weeks or even months for the treatment to take effect. Patients will not have to suffer through months of side effects and depression before determining if the medicine works at all.

Am I a candidate for Spravato?

If you’ve tried two or more antidepressants without sufficient relief you may be a candidate for Spravato

Esketamine benefits often begin to appear within just hours and clinical trials with ketamine have shown peak mood elevation within 24-36 hours of treatment.

Esketamine offers patients a high success rate (50-70 percent) of reducing or eliminating severe depression symptoms opposed to traditional antidepressants boast a lower success rate (40-45 percent) and some do not work at all.

Esketamine therapy works fast and often!

Spravato therapy requires in office administration of intranasal medication. Weeks 1-4 visits occur twice per week. Weeks 5-8 visits occur once per week. After 8 weeks of treatment your healthcare provider will determine the dosing frequency based on how you feel.

What to expect on treatment days:

In a clinical setting, patient’s typically sit in a comfortable chair with an eye mask and dim lights. They listen to music or practice meditation and mindfulness techniques while the medication is administered. Before and after treatments patients are encouraged to briefly journal their experiences, creating an intention for their therapeutic journey.

Integration is also a vital part of working with esketamine. Integration is reflecting and acting upon the lessons learned during the treatment. It is a framework to process the journey. We can increase the impact of the medicine with somatic activities to help patients nourish their mind, body and spirit.

TMS (Transcranial Magnetic Stimulation)

Major Depression is a Brain Disease

Just as diabetes is a disorder of the pancreas, Depression is a brain based disorder which may improve with brain based solutions such as TMS

How it works:

Electronical currents flowing through a stimulating coil generate MRI-strength magnetic field pulses that affect electrochemical signaling between neurons in the brain:
- Cortical neurons depolarize and
- Neural networks are activated.
Through repetitive stimulation over time:
- Neuroplastic neurocircuit “strengthening”
- Subsequent relief of depressive symptoms.
TMS has fewer side effects than both medication and ECT.

Side effects o TMS are generally tolerable and most commonly consist of scalp discomfort and/or mild headaches.

There is a very rare risk of seizure that can occur.
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