Some people feel better the next morning. Patients often express ”I woke up and felt like doing things“ or “I woke up and felt like some of the weight of the world had fallen off of my shoulders“. Most people notice an improvement in their mood after three or four treatments. Some people that respond positively in the long run, don’t feel any improvement for the first three or four treatments. But most patients can tell whether the medicine is going to help or not within the first 30 days.  Sometimes increasing the dose is helpful, but this is only necessary for a percentage of patients. We will follow your improvement with standardized scales of anxiety. We will follow your improvement with standardize scales of anxiety, depression, suicidality and PTSD.  This will provide objective information to monitor and guide your treatment. It is very important that you fill out these surveys before each telemedicine visit.