Depression treatment for Delray Beach — measurement-based, 0 minutes away.

RECO Health's main campus sits at 140 NE 4th Avenue in Delray Beach — inside walking distance of Pineapple Grove and Osceola Park, and a five-minute drive from Lake Ida and Tropic Isle. Depression treatment is run by an in-house psychiatry team, tracked on PHQ-9 rather than clinical impression, and escalated on a written schedule to rTMS, IV ketamine, or Spravato when two adequate antidepressant trials fail. Treatment doesn't require leaving the neighborhoods that anchor recovery.

The RECO Health campus at 140 NE 4th Avenue sits one block off Atlantic Avenue and a five-minute walk from the ocean. For residents of Pineapple Grove, Lake Ida, Tropic Isle, the Beach District, and Osceola Park, treatment for major depressive disorder happens inside the same square mile where they already live and work — a geographic continuity that matters clinically, because depressed patients relapse when treatment disrupts the routines, relationships, and roles that anchor recovery. RECO Health delivers depression care as PHP or IOP, with in-house psychiatry, protocol-driven psychotherapy, and interventional options — rTMS, IV ketamine, and Spravato — when standard trials fail.

Diagnostic formulation and severity staging

The initial evaluation is a DSM-5-TR-based diagnostic formulation, not a checklist. Clinicians distinguish major depressive disorder from persistent depressive disorder, bipolar II depression, adjustment disorder with depressed mood, and depression secondary to hypothyroidism, B12 deficiency, or substance use. A Mood Disorder Questionnaire and a careful history of hypomanic episodes protect against misdiagnosing bipolar depression as unipolar — a common error that turns antidepressant monotherapy into a mood destabilizer.

Severity is anchored to PHQ-9 at intake, with GAD-7 to quantify comorbid anxiety, C-SSRS to stratify suicide risk, and PCL-5 when trauma history is present. Every patient receives a metabolic and endocrine screen — TSH, free T4, B12, folate, vitamin D, and a comprehensive metabolic panel — because untreated hypothyroidism or B12 deficiency will blunt response to any antidepressant.

Level of care is assigned to the presentation. PHP (six hours per day, five days per week) is indicated for PHQ-9 above 20, active suicidal ideation with plan, or functional collapse. IOP (three hours per day, three days per week) fits moderate depression that hasn’t derailed employment or caregiving. Outpatient step-down follows, with the same psychiatrist and therapist maintained across levels of care whenever the schedule allows.

Pharmacology sequenced by evidence, not habit

Pharmacology follows STAR*D-informed sequencing, not prescriber habit. First-line is an SSRI — sertraline titrated to 100-200 mg or escitalopram to 10-20 mg — or an SNRI (venlafaxine XR 150-225 mg, duloxetine 60 mg) when pain, fatigue, or amotivation dominate. An adequate trial means the therapeutic dose is held for four to six weeks; partial response at week four is not a reason to switch.

Partial responders are augmented before switching. Aripiprazole 2-15 mg, quetiapine XR 150-300 mg, or lithium 600-900 mg targeted to a serum level of 0.6-0.8 are all evidence-supported second-line augmentations. Bupropion is added when sexual side effects, weight gain, or anhedonia are prominent; mirtazapine when insomnia and appetite loss dominate. Every augmentation decision is documented against a PHQ-9 trajectory, not clinical impression.

Treatment-resistant depression — two failed adequate trials — triggers the interventional pathway rather than a third or fourth antidepressant swap. Prescribers coordinate with the interventional psychiatry team the same day the second failed trial is called. Measurement-based care runs throughout: PHQ-9 every two weeks, side-effect burden logged, and a written plan for the next decision point.

Behavioral therapy modalities with evidence for depression

Therapy at RECO Health is delivered to protocol, not as a loose menu of techniques. Cognitive Behavioral Therapy for depression, on Beck’s manual, targets cognitive distortions — catastrophizing, personalization, all-or-nothing thinking — and pairs cognitive restructuring with behavioral experiments. Behavioral Activation is run as a standalone modality for patients whose depression is dominated by withdrawal, anhedonia, and inertia; activity monitoring, values clarification, and graded assignments rebuild reward and mastery contact.

Interpersonal Therapy is chosen when depression is tethered to grief, role transition (divorce, retirement, empty nest), interpersonal disputes, or interpersonal deficits. Acceptance and Commitment Therapy is layered in for patients whose depression is fused with rumination and experiential avoidance. Motivational Interviewing frames every conversation about medication adherence and behavior change.

For patients with a trauma driver — and a substantial minority of adult depression has one — Cognitive Processing Therapy or EMDR runs concurrently once the patient is medication-stable. DBT skills training (distress tolerance, emotion regulation, interpersonal effectiveness) is added when chronic suicidality, self-harm, or emotion dysregulation is present. Group and individual work are integrated, not parallel.

Escalation pathway when medication and therapy aren’t enough

Roughly one-third of patients with major depression won’t remit on two adequate antidepressant trials. RECO Health’s depression treatment program defines the escalation pathway in advance so patients aren’t cycled through a fifth SSRI while their functional life comes apart.

rTMS is delivered on the standard FDA-cleared protocol: 10 Hz stimulation of the left dorsolateral prefrontal cortex, 3000 pulses per session at 120% of resting motor threshold, five days a week for six weeks, with tapered sessions through week nine — 36 sessions total. Insurance eligibility (two failed adequate antidepressant trials plus documented functional impairment) is confirmed before initiation. Response is scored on PHQ-9 at sessions 10, 20, and 30.

IV ketamine (0.5 mg/kg over 40 minutes, six-infusion induction across two to three weeks) is used when suicidality or occupational collapse doesn’t allow six weeks to see an rTMS response. Blood pressure, dissociation, and re-emergence phenomena are monitored throughout. Esketamine (Spravato) is available when a REMS-monitored intranasal protocol is clinically or logistically preferred; the two-hour post-dose observation window is built into the day. Escalation happens on a written schedule, not after months of drift.

What to expect on your first visit

The first visit is a 90-minute psychiatric intake plus a therapy assessment. The psychiatrist takes a full mood history — first depressive episode, prior antidepressant trials with doses and durations, response and side-effect profile, hypomanic or manic symptoms, family history of mood disorders and suicide, medical comorbidities, and current medications with the interaction profile mapped. PHQ-9, GAD-7, C-SSRS, and the Mood Disorder Questionnaire are administered at intake and re-administered at every checkpoint.

Labs are drawn the same day: TSH, free T4, CBC, comprehensive metabolic panel, B12, folate, vitamin D, and a urine drug screen. If the clinical picture suggests it, an EKG is added before any QT-prolonging medication (citalopram, quetiapine, hydroxyzine) is prescribed.

The initial treatment plan — level of care, first-line medication decision, therapy modality, and the next PHQ-9 checkpoint — is written and shared with the patient before they leave the intake. There is no waiting three weeks to hear back.

Insurance and admissions from Delray Beach

RECO Health is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and most Blue Cross Blue Shield commercial plans. Verification of benefits is completed within two business hours; the intake team quotes the deductible, coinsurance, and out-of-pocket maximum in writing before admission so financial decisions aren’t made on hallway estimates.

For Delray Beach residents, the campus is a one- to five-minute drive from Pineapple Grove, Osceola Park, and the Atlantic Avenue corridor, and a five- to ten-minute drive from Lake Ida, Tropic Isle, and the Beach District. On-site parking is available. PHP and IOP schedules preserve evenings for family, caregiving, and step-down work; same-day intakes are routine when a patient presents with acute suicidality or a recent hospitalization discharge.

Serving residents of: Pineapple Grove, Lake Ida, Tropic Isle, Beach District, Osceola Park.