What to expect when you get help for anxiety or depression:
a step-by-step guide

If you have decided to get help for anxiety or depression, not knowing what happens next can itself be a barrier. Will you be handed a prescription in five minutes? Will anyone actually listen to your story? Will you be locked into medication forever?

Good psychiatric care for anxiety and depression is a process, not a single event. It unfolds over a few structured visits, and you are a partner in every decision. Below is exactly what that process looks like at Alice Tran Psychiatric Care, so you can walk in knowing what to expect.

A reassuring note up front: supportive therapy is part of every visit, starting with the very first one. You are never simply waiting for a medication to work without support.

Step 1: The first visit, understanding your full story

The first appointment is a comprehensive conversation, not a checklist. The goal is to understand you: your current struggles, your history, and what you want to feel like again. It is up to 60 minutes, in person in Fairfax or by secure video anywhere in Virginia.

What we do together at the first visit:

• A thorough history. We talk in depth about your current symptoms, how long they have been present, how they affect your work, home, and relationships, and what may have triggered or worsened them. Mood, worry, sleep, energy, and safety are all part of this conversation.
• Supportive therapy from minute one. This visit is therapeutic in itself. You will receive validation, psychoeducation about what anxiety and depression actually are, and practical coping strategies you can start using right away.
• Screening measures. Standardized, validated questionnaires, such as the GAD-7 for anxiety and the PHQ-9 for depression, help pinpoint your diagnosis and give us a baseline number to track your progress over time. You will typically complete or be sent additional forms at the end of the visit.
• Ruling out look-alikes. Anxiety and depression can be mimicked by other medical conditions. To make sure we are treating the right thing, I typically order lab work, including thyroid testing, and request your prior medical records. Thyroid disease, certain substances, and other conditions can all produce symptoms that look like anxiety or depression.

About medication at the first visit: sometimes it makes sense to begin a medication at this visit; often it is better to review your labs and history first and start at the next visit. Either way, this is a shared decision. Nothing is rushed.

Step 2: The second visit, confirming the plan and usually starting medication

By the second visit, we have your screening scores, your lab results, and your records. This lets us confirm the diagnosis with confidence and finalize a plan.

What the second visit usually involves:

• Reviewing your results. We go over your labs and questionnaires together and confirm whether we are treating anxiety, depression, or both. The two very frequently overlap.
• Starting medication, typically now. For most people, this is the visit where we begin a medication if one is indicated. First-line options for both anxiety and depression are usually SSRIs or SNRIs, which are effective and generally well tolerated.
• What to realistically expect from medication. These medicines are started at a low dose and adjusted gradually. Some early side effects, such as nausea or feeling more keyed up, can appear first and usually settle within one to two weeks. Meaningful improvement often begins around two weeks, and full benefit can take up to about three months at the right dose. This is normal and expected, not a sign of failure.
• An important safety point. All antidepressants carry a warning that, rarely, they can prompt new or worsening thoughts of self-harm, most often in people under 25, and typically within the first few weeks or after a dose change. If this happens, contact the office right away. This is exactly why early follow-up matters.
• Supportive therapy, again. As at every visit, this appointment includes therapeutic support and coaching, not just a prescription.

Step 3: Follow-up, close at first, then spaced out as you improve

Getting better is monitored actively. The follow-up schedule is intentionally frequent early on, when doses are being adjusted and side effects are most likely, and then spaces out as you stabilize. Follow-up visits are 30 minutes.

A typical follow-up rhythm:

• Every 1 to 2 weeks at first. These early check-ins let us watch for side effects, monitor safety, encourage you through the "it takes a few weeks" phase, and fine-tune the dose.
• Monthly once you are tolerating the medication well and beginning to respond.
• Every 3 months once you are stable and doing well, for ongoing maintenance.

At each visit we re-check your GAD-7 or PHQ-9 so progress is measured, not guessed. If a medication is not helping enough after an adequate trial at an adequate dose, we have clear next steps: adjusting the dose, switching, or adding to it.

When is therapy added?

Supportive therapy is built into every one of your visits from the start. You are receiving therapeutic support throughout.

Beyond that, formal, structured psychotherapy such as CBT is strongly encouraged in many cases, because combining medication with therapy tends to work better than either one alone, especially for moderate to severe or more persistent symptoms. Depending on your needs and preferences, we may recommend adding a dedicated therapist to your care team, and we can coordinate that referral.

For milder symptoms, therapy or self-management strategies alone may be enough, and medication may not be necessary at all. This, too, is a decision we make together.

Frequently Asked Questions

How many visits does it take to start treatment for anxiety or depression?

Usually two. The first visit is a comprehensive 60-minute evaluation with screening questionnaires and, typically, lab work ordered. The second visit reviews results, confirms the diagnosis, and is usually when medication is started if it is indicated. Sometimes medication begins at the first visit; that is a shared decision.

How often are follow-up visits?

Every one to two weeks at first, while the dose is being adjusted and side effects are most likely. Monthly once you are tolerating the medication and beginning to respond. Every three months once you are stable. Follow-up visits are 30 minutes.

Is therapy part of treatment?

Supportive therapy is built into every visit from the first one. Formal, structured psychotherapy such as CBT is strongly encouraged in many cases, because combining it with medication tends to work better than either alone, and a referral to a dedicated therapist can be coordinated.

Why do I need lab work for anxiety or depression?

Thyroid disease, certain substances, and other medical conditions can produce symptoms that look like anxiety or depression. Lab work, including thyroid testing, and prior records help make sure the right thing is being treated.

See also: Anxiety Treatment · Depression Treatment · Your First Visit · Medication or Therapy for Anxiety? · What Your GAD-7 or PHQ-9 Score Means · Rates & Insurance