Depression can make ordinary tasks feel impossible. At Cura Mind and Wellness, patients across the Houston metro receive comprehensive, individualized care directed by Vivian Emuobe, MSN, BSN, APRN, PMHNP-BC, a board certified psychiatric mental health nurse practitioner with experience in inpatient and outpatient settings. Our Richmond, TX location provides in person care, and secure telehealth brings treatment to patients throughout Houston and Fort Bend County.
We combine psychotherapy, medication management, and when appropriate, advanced treatment such as TMS therapy and IV ketamine, so patients have a clear path forward rather than trial and error that never ends.
A real world picture of depression
Patients often describe waking with heaviness, struggling to focus at work, avoiding plans with family, and feeling disconnected from activities that once brought joy. Sleep may be too much or too little, appetite can change, energy disappears, and the mind loops on self criticism or hopeless thoughts. These are not moral failings, they are symptoms of an illness that responds to care.
If you are noticing these patterns, the first step is an evaluation that clarifies what kind of depression is present and what will help.
Types of depression we evaluate and treat
- Major Depressive Disorder, episodes of low mood, loss of interest, changes in sleep or appetite, reduced energy,
- Persistent Depressive Disorder, longer lasting, lower grade symptoms that erode motivation and confidence,
- Postpartum and perinatal depression, mood changes during pregnancy or after delivery,
- Seasonal patterns, symptoms that worsen with reduced daylight,
- Premenstrual dysphoric disorder, cyclic mood, irritability, and sensitivity,
- Bipolar depression, depressive episodes within a bipolar spectrum, treated with mood stabilizing strategies.
Accurate diagnosis matters. Treatment for bipolar depression differs from treatment for unipolar depression, and the plan changes accordingly.
How we evaluate depression
- Comprehensive intake, we review history, symptoms, family risk, medical conditions, and medications,
- Validated measures, brief questionnaires track severity and guide adjustments,
- Differential diagnosis, we rule out overlapping issues such as ADHD, anxiety, thyroid concerns, sleep apnea, or substance use,
- Collaborative goal setting, we define outcomes that matter, improved sleep, returning to exercise, meeting work deadlines, reconnecting with family.
Clarity reduces uncertainty, and a shared plan turns motivation into momentum.
What progress looks like
Improvement is more than a number on a survey. Patients tell us they wake with less dread, complete tasks without stalling, answer messages again, eat regularly, and laugh with family. They return to workouts, contribute at work, and plan ahead rather than canceling. These everyday wins are the signals that treatment is working.
Depression and co occurring conditions
Depression often overlaps with anxiety, PTSD, ADHD, substance use, and sleep disorders. We screen for these concerns and treat them within the same plan, because addressing only half the picture slows recovery. When executive function makes follow through hard, we use checklists, reminders, and brief accountability touch points so progress sticks.
Care that fits Houston life
Patients travel from Houston, Sugar Land, Katy, Missouri City, and Fort Bend County for a plan that is structured and realistic. Many choose telehealth for evaluations and therapy, then come to Richmond for TMS or IV ketamine when indicated. This hybrid model keeps care accessible without sacrificing quality.
Treatment pathways that work
Psychotherapy that builds skills and resilience
We draw from Cognitive Behavioral Therapy, behavioral activation, trauma informed strategies, and supportive counseling. Therapy helps you understand thinking patterns, rebuild routines, and reengage with activities that restore mood. For many, therapy is the foundation that keeps gains after symptoms lift.
Medication management with precision
Antidepressants can be effective when selected and monitored carefully. We consider prior responses, side effect profiles, co-existing conditions, and lifestyle. Pharmacogenomic gene testing is available at the Richmond office to reduce guesswork when there is a history of side effects or non response. Follow ups are paced to support steady improvement.
Advanced options for treatment resistant depression
For patients who have tried two or more medications without lasting relief, we offer TMS therapy and IV ketamine.
- TMS is non-invasive, targets mood regulation circuits, and is completed in outpatient sessions at the Richmond site.
- IV ketamine provides monitored infusions that can relieve severe symptoms rapidly, followed by integration with therapy and routine supports.
Whole person supports that amplify results
Sleep, movement, nutrition, and structure all influence mood. We build practical routines, regular wake times, brief movement you enjoy, protein and fiber forward meals, and scheduling tools that fit Houston’s pace. Small changes, repeated often, lift mood and prevent relapse.
A typical timeline
- Weeks 1 to 2, evaluation, first therapy skills, medication plan if appropriate, sleep and schedule adjustments,
- Weeks 3 to 6, dose fine tuning, behavioral activation, measurable gains in energy and engagement,
- Weeks 6 to 12, consolidation, relapse prevention skills, consideration of TMS or IV ketamine if response is incomplete,
- Maintenance, less frequent visits, clear early warning signs, and a booster strategy for stressful seasons.
Every timeline is individualized, the structure simply keeps momentum visible.
Frequently asked questions, depression treatment in Houston and Richmond
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If low mood, loss of interest, fatigue, or negative thinking persist most days for two weeks or more, and interfere with work or relationships, an evaluation is appropriate.
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Many patients improve with therapy, especially when symptoms are mild to moderate. For moderate to severe episodes, combined therapy and medication often provides faster, more durable relief.
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Some people notice changes within two to four weeks, full effect can take six to eight weeks. We monitor closely, adjust doses, and support skills that enhance response.
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We review prior trials, side effects, and dosing, consider gene testing, and discuss TMS or IV ketamine if criteria are met. Many patients improve after years of frustration once the plan is personalized.
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Yes. Therapy and medication management are effective through secure video when sessions are consistent and private. Advanced treatments occur in person at the Richmond location.
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Yes. We provide evaluation and treatment that consider safety, lactation, and family supports, and we coordinate with obstetric or pediatric providers when helpful.
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Relapse prevention includes steady sleep and activity routines, therapy skills, maintenance visits, and early adjustment if warning signs appear.
Why patients in Houston choose Cura Mind and Wellness
- Board certified expertise, direct care from a psychiatric nurse practitioner with inpatient and outpatient experience,
- Integrated treatments, therapy, medication, gene testing, TMS, and IV ketamine available within one practice,
- Collaborative style, clear explanations, shared decisions, written plans after each visit,
- Whole person focus, attention to sleep, activity, nutrition, relationships, and work stress,
- Local access, in person services in Richmond with telehealth across Houston.
Take the next step
Depression is treatable, and you do not have to carry it alone. Cura Mind and Wellness provides structured, compassionate care for patients across Houston, with advanced options available in Richmond when needed. Whether you are starting treatment for the first time or returning after setbacks, we will help you build a plan that is clear, practical, and effective.