Depression is one of the most common mental-health conditions among adults, and one of the most treatable. We provide evidence-based treatment for major depressive disorder, persistent depressive disorder, seasonal affective disorder, postpartum and perinatal depression, perimenopausal depression, bipolar spectrum, and treatment-resistant depression, including when depression co-occurs with anxiety, ADHD, hormonal change, or chronic medical illness.
Our founder, Kim Wohlwend, MSN, APRN, is a dual ANCC board-certified Family Nurse Practitioner and Psychiatric-Mental Health Nurse Practitioner. Depression rarely exists in isolation: thyroid function, vitamin B12 and D levels, iron, sleep, perimenopausal change, and medication interactions all affect how depression presents and how it responds to treatment. As part of every evaluation we screen for those medical contributors, order labs when indicated, and interpret the results in the same visit that is addressing your mood — rather than handing the workup back to primary care and waiting weeks for the loop to close.
Treatment centers on evidence-based antidepressant medication management — SSRIs, SNRIs, atypicals, mood stabilizers, and augmentation strategies when first-line options stall — paired with CBT-informed supportive work and attention to the lifestyle variables (sleep, movement, light, alcohol, social connection) that have meaningful effect sizes in depression. For treatment-resistant depression, we prepare the step-therapy documentation and refer for TMS or ketamine at Omaha-area programs.
The first visit is a full 60 minutes, long enough to build a plan you agree with. Follow-ups are focused and practical, with direct access to a clinician through the patient portal between visits. Appointments are available in person at our Papillion office, about 15 to 25 minutes from most Omaha neighborhoods, or by secure telehealth anywhere in Nebraska.
Depression Presentations We Treat
Depression rarely looks the same twice.
We treat the full range of depressive and related mood disorders in adults 18 and over. You do not need a formal diagnosis to book. If your mood, energy, motivation, sleep, or ability to enjoy life has changed, that is reason enough.
Major Depressive Disorder (MDD)
Two or more weeks of persistent low mood, anhedonia, sleep and appetite change, fatigue, impaired concentration, and often guilt or hopelessness. Includes the "high-functioning" version — showing up to work and meeting obligations while quietly coming apart.
Persistent Depressive Disorder
Chronic, lower-intensity depression lasting two years or more. Patients often describe it as "I've felt this way since college" or "my baseline has always been heavy." Responds well to treatment once it is actually named and treated rather than accepted as personality.
Seasonal Affective Disorder (SAD)
Recurrent depression tied to fall and winter. Treatment combines bright-light therapy started in October, vitamin D replacement when indicated, seasonal adjustment of antidepressant dosing, and behavioral strategies for the dark months.
Postpartum & Perinatal Depression
Depression in pregnancy or the year after delivery, distinct from baby blues. We use pregnancy- and breastfeeding-aware medication choices and coordinate with your delivering OB. See our perinatal mood page.
Perimenopausal Depression
Mood change that arrives or worsens in the 40s alongside cycle change, hot flashes, sleep disruption, and brain fog. Our family-NP training means we address both the mood and the hormonal picture in the same visit rather than sending you to two places.
Bipolar Spectrum
Bipolar I, bipolar II, and cyclothymic disorder with mood stabilizers and atypical antipsychotics. We screen carefully at intake, because starting an SSRI in undetected bipolar II can precipitate mania. Complex or rapid-cycling cases are referred for subspecialty management.
Depression with Anxiety
The most common pattern we see. Most patients with depression also have GAD, social anxiety, or panic features. Many first-line antidepressants treat both. See our anxiety treatment page.
Treatment-Resistant Depression
Two or more failed adequate antidepressant trials. We review prior trials for true adequacy, consider augmentation strategies (aripiprazole, quetiapine, lithium, thyroid augmentation), and prepare the step-therapy documentation for TMS or ketamine referral when appropriate.
Our Approach
How depression treatment works here.
Comprehensive evaluation
60-minute first visit covering symptom history, medical and psychiatric history, current medications, sleep, substance use, and life context. Labs ordered when indicated to rule out medical contributors — thyroid, B12, vitamin D, iron, CMP — before adjusting or starting medication.
Individualized plan
Treatment typically combines evidence-based antidepressant medication (when appropriate), CBT-informed strategies, and attention to sleep, light, movement, alcohol, and social connection. For bipolar spectrum we screen carefully and use mood stabilizers or atypicals rather than SSRI monotherapy.
Close follow-up
We follow up 2 to 4 weeks after starting or changing medication to monitor response and side effects, then at the cadence you and your clinician decide. Direct access to your clinician between visits through the secure patient portal.
Medication Options
Evidence-based antidepressant management.
Medication is one tool among several. When it is the right tool, we use it carefully: starting dose, rate of titration, and choice of agent are matched to your history, your other medications, and the side-effect profile you can actually live with. Most antidepressants show partial response on sleep and appetite within 2 to 4 weeks and full response by 6 to 8. We explain our reasoning in plain language and decide together.
First-line agents we commonly prescribe:
- SSRIs. Sertraline (Zoloft), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa).
- SNRIs. Venlafaxine XR (Effexor XR), duloxetine (Cymbalta), desvenlafaxine (Pristiq), levomilnacipran (Fetzima). Useful when depression comes with chronic pain, fatigue, or neuropathic symptoms.
- Atypicals. Bupropion (Wellbutrin) for patients who want to protect sexual function or whose depression presents with low energy. Mirtazapine (Remeron) for depression with severe insomnia or appetite loss. Trazodone adjunctively for sleep.
When first-line options don't fully work:
- Switching. Moving to a different class often succeeds where one agent stalled.
- Augmentation. Adding a second agent (low-dose aripiprazole, quetiapine, lithium, T3, or buspirone) to an existing antidepressant.
- Advanced therapies. For true treatment-resistant depression, referral for TMS or ketamine / esketamine. We prepare the step-therapy and prior-authorization paperwork so the referral moves.
Bipolar-spectrum management:
- Mood stabilizers. Lithium, lamotrigine, valproate, carbamazepine.
- Atypical antipsychotics. Quetiapine, lurasidone, cariprazine, aripiprazole.
- Subspecialty referral. For complex or rapid-cycling bipolar we coordinate with academic-center psychiatry.
Medication is not the only conversation. We work through sleep, light exposure, movement, alcohol use, and social connection because those interventions have meaningful effect sizes in depression independent of medication. For ongoing talk therapy we refer to trusted therapy partners in our Omaha-area care network.
Pricing & Insurance
Transparent pricing. Major Omaha insurance accepted.
In-network plans
- Blue Cross Blue Shield of Nebraska
- UnitedHealthcare (including UMR)
- Aetna
- Midlands Choice
- Nebraska Total Care (Medicaid)
Self-pay
- Flat, transparent pricing.
- Good-faith estimate on request.
- Currently out of network with Medicare, Cigna, and Tricare.
Copay and deductible vary by plan. We recommend verifying your mental-health benefits with your carrier before the first visit.
Local Context
Depression care for the Omaha metro.
Access. The Omaha academic and health-system clinics — Nebraska Medicine / UNMC, CHI Health Behavioral Care, and Methodist — absorb most outpatient psychiatric demand, and new-patient waits for depression evaluations routinely quote 3 to 6 months. We typically see new Omaha patients within 1 to 2 weeks, in-network with most of the same major plans. We are not a replacement for the academic centers on tertiary or inpatient care; we fill the outpatient-access gap.
Who we see from the metro. A substantial share of our Omaha patient base is healthcare workers from the major hospital systems who prefer care outside their own employer, the professional workforce across downtown and West Omaha, spouses and dependents of Offutt AFB service members navigating deployment-related mood change, and students from Creighton, UNO, UNMC, and area graduate programs. Telehealth makes continuity possible when schedules and geography do not cooperate.
TMS & advanced-therapy referrals. For treatment-resistant depression meeting criteria (typically two or more failed adequate antidepressant trials), we prepare step-therapy documentation and refer to TMS programs in the Omaha metro, including Nebraska Medicine and independent clinics, and to ketamine / esketamine providers in the area.
Seasonal affective disorder. At roughly 41° N latitude with a long, gray Midwest winter, seasonal depression is genuinely common in the metro. Light therapy starting in October, vitamin D replacement when indicated, and seasonal antidepressant adjustment are part of routine care for affected patients.
Coordination with primary care. With your consent we send visit notes and medication updates to your PCP at Nebraska Medicine, Methodist, CHI, OneWorld, Charles Drew, or your private-practice primary care. Because our founder is also a board-certified Family NP, we can order and interpret the overlapping labs without duplicating primary care.
Serving Omaha and the surrounding metro.
Our physical office is in Papillion, a 15 to 25 minute drive from most Omaha neighborhoods. Telehealth is available anywhere in Nebraska. Mental-health services are licensed in Nebraska only.
FAQ
Omaha-specific questions about depression care.
How long are depression treatment waits at Nebraska Medicine or UNMC?
New-patient outpatient psychiatric waits at the Omaha academic centers (Nebraska Medicine, UNMC, CHI Behavioral Health) routinely run 3 to 6 months for depression, sometimes longer for specific subspecialty clinics. Our practice typically schedules new Omaha patients within 1 to 2 weeks with the same insurance acceptance for most major plans. We do not replace the academic centers for tertiary or inpatient care — we fill the outpatient-access gap.
What if my depression hasn't responded to SSRIs tried by my primary care doctor in Omaha?
This is one of the most common reasons Omaha patients transfer in. If you have had one or two SSRI trials through primary care without an adequate response, we review what was tried, at what dose, for how long, and whether the trial was truly adequate. Options from there include switching to a different class (SNRI, bupropion, mirtazapine), augmenting with a second agent, or, if you meet treatment-resistant criteria, referring for TMS or ketamine at an Omaha provider.
Do you coordinate with Omaha primary care providers?
Yes. With your consent we send visit notes and medication updates to your PCP at Nebraska Medicine, Methodist, CHI, OneWorld, Charles Drew, or your private-practice primary care. Because our founder is also a board-certified Family NP, we can order and interpret labs (thyroid, B12, vitamin D, CMP, iron studies) without duplicating primary care.
What is the referral path for TMS in Omaha?
For treatment-resistant depression that meets TMS criteria — typically two or more failed antidepressant trials at adequate dose and duration — we prepare documentation for TMS programs in the Omaha metro, including Nebraska Medicine and independent clinics. Most insurance plans require specific step-therapy documentation; we put that paperwork together so the referral moves quickly instead of bouncing.
Can I see you if my partner is deployed at Offutt?
Yes, provided you are physically located in Nebraska for the visit. Spouses, dependents, and household members of Offutt AFB service members are welcome. We are currently out of network with Tricare, but self-pay ($300 initial, $150 follow-up) is available, and some Tricare plans reimburse out-of-network mental-health claims. We regularly see patients working through deployment-related stress, anticipatory anxiety, and depression.
Do you accept BCBS of Nebraska, UnitedHealthcare, Aetna, Midlands Choice, or Nebraska Total Care?
Yes — we are in-network for mental-health services with all five. Most Omaha patients pay only their copay. Currently out of network with Medicare, Cigna, and Tricare.
Can I switch my antidepressant from another Omaha provider to you?
Yes, and this is routine. Bring your current prescriptions, prior records if available, and a list of what has been tried. We can often continue your existing regimen at the first visit and make changes deliberately from there rather than disrupting a stable medication on day one.
How does telehealth work if I live in West Omaha or Elkhorn?
Secure video through our patient portal. You need to be physically located in Nebraska at the time of the visit, with a private space and a device with camera and microphone. Many West Omaha, Elkhorn, Millard, and Aksarben patients do the initial evaluation in person at our Papillion office and move all follow-ups to telehealth, or use telehealth throughout and skip the commute entirely.
Do you offer postpartum depression treatment for Methodist or Nebraska Medicine OB patients?
Yes. We treat postpartum and perinatal depression with pregnancy- and breastfeeding-aware medication choices, coordinating with your delivering OB at Methodist Women's Hospital, Nebraska Medicine, or CHI Bergan Mercy. See our perinatal mood page.
What about depression with trauma, sleep problems, or burnout?
Depression rarely arrives alone. When trauma, insomnia, or professional burnout are the dominant features, see our companion trauma, sleep, and burnout page for how we approach that picture. Also see our sister Papillion depression page for patients closer to Sarpy County.
Three to six months is too long to wait.
Depression care for Omaha adults from a dual ANCC board-certified nurse practitioner. Most new patients seen within 1 to 2 weeks. BCBS, UHC, Aetna, Midlands Choice, and Nebraska Total Care accepted. In-person in Papillion or Nebraska telehealth.
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