Online Depression Treatment in Pennsylvania and New York

What depression treatment can include

The National Institute of Mental Health (NIMH) says depression treatment typically involves psychotherapy, medication or both. If those do not reduce symptoms enough, brain stimulation therapy may be another option. NIMH also says most people with depression benefit from treatment.

The right plan depends on your needs, your preferences and your medical situation, and it is chosen with a professional. NIMH notes that finding what works may take some trial and error. Psychotherapy is often tried first for milder depression, while people with moderate or severe depression are usually prescribed medication as part of the first plan.

Therapy approaches, and where we offer them

Therapy with our team is online and is for clients physically located in Pennsylvania, West Virginia, Arizona, Colorado or Florida during each session. It is not available with us in New York, so a New York reader can see our psychiatrist here but would need a therapist elsewhere. Our depression therapy page has the details.

• Cognitive behavioral therapy (CBT). You learn to challenge and change unhelpful thoughts and behaviors. NIMH names it as an evidence-based therapy for depression, and members of our team use it.
• Mindfulness-based work. NIMH notes that recent advances in CBT add mindfulness principles. Members of our team use mindfulness-based approaches.

Medication groups, in plain words

NIMH says antidepressants work by changing how the brain produces or uses certain chemicals involved in mood or stress. Medication care here is with our psychiatrist, for people in Pennsylvania or New York during each visit. Our therapists do not prescribe. Each medicine has its own page in our medicine library, which separates FDA-approved uses from off-label uses.

• SSRIs and SNRIs. NIMH says these commonly prescribed groups are associated with fewer side effects than older antidepressants.
• NDRIs. Norepinephrine-dopamine reuptake inhibitors are the third commonly prescribed group NIMH lists.
• Atypical antidepressants. MedlinePlus describes these as newer medicines that do not fit the other groups.
• Tricyclics and tetracyclics. These are older types. MedlinePlus says a provider might suggest one if newer medicines do not help, and that they may cause more serious side effects.
• MAOIs. Monoamine oxidase inhibitors are also older. NIMH says they are associated with more side effects, though they may be the right fit for some people.
• Add-on medicines. NIMH says another option for treatment-resistant depression is to combine an antidepressant with a different type of medicine, such as an antipsychotic or anticonvulsant.
• Zuranolone. Its label approves it for postpartum depression in adults. It carries a boxed warning about impaired driving, and the label lists it as Schedule IV.

Treatments an online visit cannot provide

Esketamine (Spravato) is not something an online visit can provide. Its label approves this nasal spray for adults with treatment-resistant depression, on its own or with an oral antidepressant, and, with an oral antidepressant, for depressive symptoms in adults with major depression and acute suicidal thoughts or behavior. It is a Schedule III medicine under a restricted safety program. A certified healthcare setting gives it, under direct observation, with monitoring for at least two hours after each dose, because of risks that include sedation and breathing problems.

Brain stimulation therapy is not online either. NIMH describes it as activating or inhibiting the brain with electricity or magnetic waves, and says the most used types are electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). They are not something an online visit can provide. A doctor can tell you where they are offered.

For controlled medicines in general: as of November 2026, a temporary federal rule (Federal Register, Fourth Temporary Extension) allows DEA-registered practitioners to prescribe Schedule II to V medicines by audio-video telemedicine without a prior in-person evaluation, under set conditions, through December 31, 2026. Rules may change after that date. That rule does not change the esketamine safety program.

Getting started

If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services. Our crisis resources page has more. Antidepressant labels carry a boxed warning that these medicines increased the risk of suicidal thoughts and behaviors in children, teens and young adults. NIMH says this applies to people under 25 and that people of all ages taking antidepressants should be watched closely, especially in the first few weeks.

1. 1Reach outUse our medication care contact form and tell us what you are going through. Ask us about fees, insurance, ages seen and timing, because the answers depend on your situation.
2. 2Meet by videoYou see the psychiatrist from a private spot while physically located in Pennsylvania or New York. You can read more about online psychiatry in Pennsylvania or in New York.
3. 3Decide togetherWhether any medicine is an option for you is a decision for you and your prescriber, and a visit may not end in a prescription. Medication management explains the follow-up visits.