What is depression, and how is it diagnosed?

Depression is more than just feeling sad—it’s a complex mental health condition that affects how you think, feel, and function. A diagnosis of depression doesn’t require feeling down all the time. Instead, symptoms must be present most of the day, nearly every day, for at least two weeks. Common symptoms of depression include:

• Persistent feelings of sadness, emptiness, or irritability.

• Loss of interest or pleasure in previously enjoyable activities.

• Excessive guilt, shame, or negative self-perceptions.

• Difficulty concentrating, paying attention, or making decisions.

• Changes in appetite, leading to significant weight loss or gain.

• Sleep disturbances, including insomnia or sleeping much more than usual.

• Physical symptoms like fatigue, restlessness, or feeling weighed down.

• Thoughts of death or suicidal ideation.

A psychiatrist evaluates depression by assessing these symptoms, taking a thorough history, and ruling out other potential causes. Screening tools and structured interviews may also be used to measure the severity of symptoms.

Can depression be tested for?

While there’s no single test for depression, psychiatrists consider a range of factors to make an accurate diagnosis. This includes reviewing your medical history, family history, current symptoms, and any past treatments. For some, taking a depression screening test can provide insight into their symptoms and help guide next steps in seeking professional care.

What are the treatment options for depression?

Treatment for depression is tailored to each person’s unique needs. Many patients benefit from a combination of antidepressant medications and psychotherapy. Some of the most commonly prescribed antidepressants include:

• SSRIs: Prozac, Zoloft, Lexapro, and others.

• SNRIs: Effexor, Cymbalta.

• Atypical Antidepressants: Wellbutrin, Remeron.

• Older Medications: Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).

Antidepressants are generally well-tolerated, but finding the right one may take time. Some patients respond quickly, while others require adjustments to the dosage or medication. As a psychiatrist specializing in depression and treatment-resistant depression, I work collaboratively with patients to create an effective, individualized treatment plan.

How long do I need to take antidepressants?

The duration of antidepressant treatment depends on your individual history and symptoms:

• For a first depressive episode, the general recommendation is to continue antidepressants for 6-12 months after feeling better.

• For those with recurrent depression, longer-term or even indefinite treatment may be advised to prevent relapses.

The decision to stop or continue antidepressants is always made in collaboration with a psychiatrist, based on your goals and progress.

What if antidepressants don’t work for me?

If traditional antidepressants aren’t effective, treatment-resistant depression can be addressed with alternative strategies, such as:

• Exploring other potential diagnoses.

• Trying different classes or combinations of medications.

• Newer treatments like ketamine, esketamine (Spravato), or transcranial magnetic stimulation (TMS).

• Evidence-based psychotherapies such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT).

Are non-medication treatments for depression effective?

Yes, non-medication treatments play a crucial role in managing depression. Antidepressants can help restore energy, focus, and sleep, but they are most effective when combined with lifestyle changes and psychotherapy. Therapy modalities such as CBT, interpersonal therapy, or psychodynamic therapy can help address underlying patterns and provide tools for coping and growth. Regular exercise, improved sleep hygiene, mindfulness practices, and healthy social connections also significantly contribute to recovery.

Seeking Help for Depression

As a board-certified psychiatrist based in Los Angeles, I specialize in treating depression and treatment-resistant depression. My approach is collaborative and personalized, combining advanced psychopharmacology with therapeutic interventions to help you achieve lasting growth. Whether you are exploring treatment for the first time or have struggled with inadequate responses in the past, I’m here to help. Contact my office to schedule a consultation and take the first step toward a more fulfilling life.