Depression

Depression is one of the most common and most treatable mental health conditions in the world. The term covers a family of related diagnoses: major depressive disorder (MDD), persistent depressive disorder (PDD), seasonal affective disorder (SAD), premenstrual dysphoric disorder (PMDD), and perinatal depression. What unifies them is a sustained disruption in mood, energy, and functioning—not simply sadness, but a whole-body shift that affects how you think, sleep, eat, and experience meaning.

A clinician evaluates depression through a structured clinical interview alongside a review of your history, timeline, and functioning. To meet criteria for major depressive disorder, symptoms must represent a change from previous functioning, cause meaningful distress, and include at least five core symptoms (e.g., depressed mood, loss of interest) over a two-week period. Clinicians also assess for thyroid dysfunction, vitamin deficiency, substance use, and bipolar-spectrum condition indicators.

Psychotherapy is a first-line treatment for depression, either alone or in combination with medication. Evidence supports Cognitive Behavioral Therapy (CBT), Behavioral Activation, Mindfulness-Based Cognitive Therapy (MBCT), and Interpersonal Therapy (IPT). Beyond formal therapy, evidence supports aerobic exercise, consistent sleep-wake schedules, and social connection.

When medication is appropriate, SSRIs (e.g., sertraline, escitalopram) or SNRIs (e.g., venlafaxine, duloxetine) are typically first-line options. For incomplete responses, clinicians may adjust the dose, switch agents, or add augmenting medications. A complete mood history is always part of an accurate evaluation to avoid triggering past hypomanic or manic episodes.