Anxiety & depression guide

Anxiety and depression treatment online in Virginia and West Virginia

This guide is for adults 18-64 with mild-to-moderate anxiety or depression who want to start a non-controlled SSRI (sertraline or escitalopram), or continue one they're already stable on. Care starts with the full standard depression and anxiety questionnaires. Severe symptoms, and any thoughts of self-harm, are always directed to 988 and in-person care, not treated online.

Start online

Start a $59 online review for Anxiety & depression.

Reaching out for help with anxiety or depression is a real step, and you deserve support without stigma. For adults 18-64 with mild-to-moderate symptoms, an online visit can start an evidence-based, non-controlled SSRI (sertraline or escitalopram) or continue one you're already stable on. Your visit begins with the full standard depression and anxiety questionnaires, the same ones used in clinics, so treatment matches how you're actually doing. This visit is built with clear limits for your safety: if your answers show any thoughts of being better off dead or of self-harm, we don't prescribe online. Instead we connect you right away with crisis support (call or text 988, or text HOME to 741741) and in-person care. Severe depression or anxiety, possible bipolar disorder, or psychosis are referred to psychiatry. And this visit never prescribes benzodiazepines (like Xanax or Ativan) or any controlled medication. Those aren't offered here.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

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Quick facts

You must be physically located in Virginia or West Virginia at the time of request.
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response times apply 24/7, every day

Common symptoms

Ongoing worry, tension, nervousness, or feeling on edge (anxiety)
Low mood, loss of interest or pleasure, or feeling hopeless (depression)
Trouble sleeping, low energy, or difficulty concentrating
Symptoms that are affecting your day-to-day life but you can still function

May fit online care

Adults 18 to 64
An adult aged 18-64 with mild-to-moderate anxiety or depression
Wanting to start sertraline or escitalopram, or continue an SSRI you're already stable on
No thoughts of being better off dead or of hurting yourself
No history of bipolar disorder, mania, or psychosis, and not currently managed by a psychiatrist who prescribes for you

Look for another care setting

Any thoughts of being better off dead or of self-harm (this needs crisis support and in-person care: call or text 988, or text HOME to 741741, or call 911/go to the ER)
Severe depression or anxiety with your daily life falling apart (needs in-person psychiatry)
A history of mania/hypomania, a mood stabilizer, or psychiatric hospitalization, or any psychosis (needs psychiatry: SSRIs can trigger mania)
Pregnant or breastfeeding (OB-coordinated care), an active substance-use disorder (in-person care), or age 65 or older
A request for a benzodiazepine or any controlled medication (never prescribed here)

What to have ready

About 10 minutes to complete the full standard depression and anxiety questionnaires honestly
Whether you're starting an SSRI for the first time or continuing one you already take
Any history of mania, bipolar disorder, mood stabilizers, or psychiatric hospitalization
A list of your current medications (especially triptans, tramadol, an MAOI, linezolid, or St. John's wort)

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.

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What if I'm having thoughts of harming myself?

Please reach out for help right now. You are not alone and support is available 24/7. Call or text 988 (the Suicide & Crisis Lifeline), or text HOME to 741741 (the Crisis Text Line). If you are in immediate danger, call 911 or go to the nearest emergency room. This visit does not prescribe when these thoughts are present; instead it connects you with crisis support and in-person care, which is the safest step.

How long until an SSRI works, and what side effects should I expect?

SSRIs usually take 2-6 weeks to reach their full effect, so it's important not to stop early. In the first week or two, some people feel a little more anxious, jittery, or have trouble sleeping. This is common and usually passes. SSRIs can also cause sexual side effects (lower desire or delayed orgasm), which are common and reversible; we'll counsel you honestly and can discuss options. Never stop an SSRI abruptly, since that can cause discontinuation symptoms. We taper if you ever stop.

Do you prescribe Xanax or other benzodiazepines for anxiety?

No. This visit and this entire platform never prescribe benzodiazepines (such as Xanax, Ativan, or Klonopin) or any controlled medication. For anxiety and depression, we use non-controlled SSRIs (sertraline or escitalopram) alongside the standard depression and anxiety assessments, which are effective and much safer for online care.

Why does the questionnaire ask about mania and past hospitalizations?

SSRIs can trigger a manic episode in people with bipolar disorder, so we screen for any past manic or hypomanic episode, any prior mood stabilizer, and any psychiatric hospitalization. If that screen is positive, the safest step is an evaluation with a psychiatrist rather than starting an SSRI online.

Other conditions we treat

Not quite what you have? Here are other conditions we treat.

Adult ADHD (non-stimulant)Grief and adjustment support Insomnia (trouble sleeping)Panic attacks Performance anxiety Postpartum mood support