At Plume, we can provide medication for depression and/or anxiety (in eligible states). There are many options that can be helpful in the treatment of depression and/or anxiety, including both medications and therapy (counseling). Evidence shows that both medications or therapy alone can be helpful for the treatment of depression and/or anxiety, but both together have been proven most effective. 

If you think you have depression and/or anxiety and might need medication you can make an appointment to be evaluated by a Plume clinician, for assessment for a treatment plan. If you already have a diagnosis and have been on medications or are on medications and want to transition your treatment to Plume, you can meet with a clinician to discuss this as well.

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How does Plume treat anxiety and depression?

At Plume we can prescribe several different medications for depression and/or anxiety.  The most common choices are Selective Serotonin Reuptake Inhibitors (SSRIs) like Escitalopram (Lexapro), Fluoxetine (Prozac), and Sertraline (Zoloft), which have shown promise in alleviating symptoms and improving overall quality of life. Additionally, our clinicians may recommend other medications such as Duloxetine (Cymbalta), Venlafaxine (Effexor), Bupropion (Wellbutrin), Buspirone (Buspar), and Trazodone (Desyrel), ensuring personalized care that aligns with each individual's unique circumstances.

Your clinician will use a variety of screening tools to assess your mental health symptoms, and review your medical history.  They will determine if one of the medicines we offer is a good fit for you. We typically prescribe the generic forms of these medications because they have been proven to be just as effective and well-tolerated and often much cheaper than the brand name medications. You will then have regular check-in visits with your clinician to monitor your progress and adjust your medication as needed. 

Bipolar, schizophrenia, & schizoaffective disorders

Please note that we do not currently provide treatment for mood conditions such as bipolar, schizophrenia or schizoaffective disorder or prescribe medications such as Lamotrigine (Lamictal), Aripiprazole (Abilify), Divalproex (Depakote), Lithium, Olanzapine (Zyprexa), Quetiapine (Seroquel), or Risperidone (Risperdal). 

We recognize that depression and anxiety often co-occur with the above mood conditions. If you have been diagnosed with depression or anxiety and have one of these conditions, given the complexity and potential risks of the treatment involved, we recommend being seen by a psychiatrist or mental health center to ensure the best success of your treatment. We can help find local resources to provide treatment for you if we are unable to do so here at Plume. If you are unsure or there is a possibility of the above conditions, we highly recommend proper evaluation from a licensed mental health provider. We are here to help, but starting medication like an SSRI can be more hurtful than helpful if you have any of the above disorders. Safety is our priority!

What does Plume NOT prescribe?

We do not prescribe controlled substances like gabapentin or benzodiazepines, such as Alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan)) for anxiety or depression treatment.


When will I feel better? 

Typically with mental health medications, it can take 4 to 8 weeks so show improvement, sometimes longer. So, give yourself time, but let us know if you have increasing negative feelings and thoughts, or concerns with your regimen. It may be trial and error to find the right medications or dose.  Let us know immediately if you feel suicidal or feel you might hurt someone else.


Please note that we are not able to help with mental health emergencies. If you need to speak with someone urgently or are having a mental health emergency, please reach out using the following options:

Suicide Prevention Hotline: Call 9-8-8 

Trans Lifeline: Call 877-565-8860

Crisis Text Line: Text HOME to 741741 or Message on WhatsApp


What are the key characteristics of anxiety and depression? 

Anxiety involves persistent feelings of worry, fear, or unease, while depression entails persistent feelings of sadness, hopelessness, or loss of interest in activities. Both conditions can significantly impact various aspects of life, including relationships, work, and physical health.


How prevalent are anxiety and depression within the transgender and nonbinary community? 

Anxiety and depression affect approximately one-third of the transgender and nonbinary community, highlighting the critical need for accessible treatment options and support services.


What medications are used for anxiety and depression?

There are a variety of different medications that can be used to treat anxiety and depression. The two most common types of medications for anxiety and depression are SSRIs and SNRIs. SSRIs are more commonly used for anxiety, while SNRIs are more commonly used for depression. For anxiety, there are also anxiolytic medications that are often used as a short-term intervention, as well as benzodiazepines and beta-blockers that are used for more severe cases. For depression, there are also other types of antidepressants that can be used in addition to or instead of SNRIs and SSRIs, such as tricyclic antidepressants (TCAs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).


How do medications for anxiety and depression work?

The goal of any medication is to produce a desired effect by interacting with specific receptors in the body. We don’t fully understand how different medications work, but we have a general knowledge of how they are supposed to affect the body. 


Altering neurotransmitter levels: One of the most common theories about how medications for anxiety and depression work is that they affect neurotransmitters, which are chemicals that are important for brain function. Anxiety and depression can be linked to lower levels of certain neurotransmitters, such as serotonin and norepinephrine. Medications are thought to help increase those levels.


Regulating hormones: Another way that some medications may work is by regulating hormones. Many people who experience anxiety and depression have lower than normal hormone levels. Medications such as gender-affirming hormones like estrogen and testosterone can help bring those levels back up to normal.


Potential side effects of medications for mental health

Every medication has side effects and potential risks that need to be taken into account. While medications can provide effective treatment for mental health issues such as anxiety and depression, there is no one-size-fits-all approach. 


For many people, medications can help them to achieve better mental health and quality of life. However, there are a few potential side effects and risks to be aware of: 


Weight gain: Some medications for anxiety and depression cause weight gain. In some people, this may be a result of eating more due to an increase in appetite (a side effect of some medications). Others may experience weight gain as a side effect of the medication itself. Knowing about this potential side effect of medication can help you be prepared.

 

Nausea: Nausea may be a result of side effects such as weight gain or changes in appetite. It may also happen due to the specific medications used, such as SSRIs. If you feel nauseous while taking a certain medication, talk to your Care Team or mental health provider. They may have suggestions to help the nausea.


How medications for anxiety and depression can support you during your gender transition

Taking medications is one part of an overall treatment plan for anxiety and depression. You may also use other tools to improve your mental health, such as therapy and self-care. Medications alone don’t solve mental health issues. They are a tool that can help you to manage your symptoms and gain better control over your mental health. They can also help you to make progress on your treatment plan for gender transition. 


Depression and anxiety can make it difficult to make progress towards gender transition goals. It can also create a sense of low self-worth or make your gender dysphoria worse. Having a good mental health treatment plan can help you to overcome these obstacles and move forward with your transition. 


During your transition, you can always talk to your Care Team if you want to change the dose or type of medications that you are taking. (If you’re a Plume Member, you can easily schedule an appointment through our secure app.) Remember, don’t make any changes to your medications without talking with your Care Team first. A sudden change in medication dose can have serious side effects. Even a change that seems small can have an impact on your mental health.


Making the decision to take medications for mental health

If you decide that medication is right for you, you and your Care Team will determine which medication is best, in addition to the dosage. Finding the right medication and the right dose can take time. Some people feel better after a few weeks, while others may take a few months to see results. 


There is no one-size-fits-all approach for mental health issues such as anxiety and depression. What works for one person may not work for another. Finding the right treatment plan that works for you may mean trying a few medications until you find the one that works best for you. It is important to communicate with your Care Team about how you are feeling during this process. Your Care Team is here to help you find the right medication and dose for you.


Finding the right medications and doses

Finding the right medication can take time. You may have to try several medications until you find the one that works best for you. However, there are ways to make this process go a little more smoothly: 

  • Find a therapist, counselor, or mental health specialist who can collaborate with your Care Team or other gender-affirming care provider. Having a mental health provider who is willing to work with your other providers can help to make sure that both parts of your treatment plan are moving along smoothly. 

  • Be open and honest with your Care Team and mental health provider. If you are having side effects or you think a medication isn’t working, tell your Care Team. They can help you to find a better medication or a different dosage. 

  • Stay in touch with your Care Team. It can be easy to forget to follow up, especially when you are feeling anxious and overwhelmed. Let them know how you are doing and ask for help if you need it.


Combining medications with other treatments such as gender-affirming hormone therapy (GAHT)

Many trans and nonbinary people use medications in combination with other treatments. Medications can be used in conjunction with other mental health treatments such as therapy, self-help practices, or other medications. For example, antidepressants are often used in combination with CBT (cognitive behavioral therapy). Other medications may be used in combination with antidepressants, such as atypical antipsychotics or mood stabilizers. 


It is important to remember that each person is different, and what works for one person may not work for another. Your mental health provider and your Care Team can help you to decide what medications are best for you. You may also experience mental health issues along with the natural changes that accompany hormone therapy. It is important to talk with your mental health provider about how these changes may affect your treatment plan.


Managing long-term mental health with medications

Many people are able to manage their mental health effectively by taking medications for a certain amount of time. Some people may only need medication for a few months, while others may need medication long term. It is important to remember that medications are not a permanent solution. Taking medication is like taking care of a garden: you may need to do regular maintenance to keep it in good shape. You need to regularly monitor your mental health symptoms and side effects, along with any changes in your life (such as having a new baby, going to school, or losing a job). 


It is also important to remember that no two people react to medications in the same way. What works for one trans or nonbinary person may not work for another. This is why it is important to regularly check in with your Care Team. When you are taking medications, it is important to be mindful of possible side effects. With proper monitoring, medications can be used to help maintain long-term mental health. It is important to remember that mental health is a spectrum. Feeling your best is an important aspect of your gender-affirming health care.