How our psychiatrists treat different types of depression

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What is depression?

If you or anyone you know has suffered from depression, you understand how disruptive and all-consuming it can be. So much more than everyday “sadness,” depression is a diagnosable mental health condition that's very common, and most importantly, treatable. It can be easy to dismiss the symptoms of depression, or to feel like they represent a kind of personal failure. But depression can affect anyone of any age or background, and if you’re suffering, help is available. The first step in treating depression is getting a clinical diagnosis from a qualified mental healthcare professional, like a psychiatrist. Many treatment options exist to help you start feeling better.
Depression vs. sadness
Depression is a mental health condition that causes persistent feelings of sadness and a lack of interest in activities you once enjoyed. While it's normal to feel upset and sad from time to time, especially after a major life event like the death of a loved one or the end of a relationship, these feelings normally pass or lessen in time.
The symptoms of depression, however:
  • Are severe enough to interfere with your everyday life, including how you sleep, eat, work, and interact with others
  • Last at least two weeks and aren’t something you can “snap out of”
  • May be accompanied by feelings of worthlessness or self-loathing
If you’ve been struggling with sadness or low mood in this way, it may be time to seek out professional help. It’s estimated that 1 in 6 people will experience clinical depression in their lifetime. The quickest way to feel better is to seek help from a qualified mental healthcare professional. Studies show that even the most severe cases of depression can be treated.
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What are the symptoms of depression?

The symptoms of depression can vary in intensity but are usually persistent—meaning they may last all day, oftentimes for weeks or months. They include:
  • Feelings of sadness or hopelessness
  • Loss of interest in most everyday activities, including those you once enjoyed
  • Feelings of worthlessness or self-loathing
  • Feelings of irritability or angry outbursts, including over small things
  • Changes in appetite
  • Changes in sleep habits, including insomnia or sleeping too much
  • Low energy or fatigue
  • Slow movements or slowed speech
  • Difficulty focusing or concentrating
  • Persistent thoughts of death or suicidal thoughts
Depending on your symptoms and how you're feeling, your clinician will create a treatment plan designed to help you feel better. In some cases, depression can be treated online. In some cases, it's safer to treat in-person or in a hybrid setting. During your first visit, your psychiatrist will listen to what you're going through and make sure virtual care at Talkiatry is the best option for you.
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What causes depression?

Depression can affect anyone, of any background. Millions of people around the world will be affected by depression in their lifetimes, including those with seemingly happy lives.
That said, there are certain factors that can increase your risk for depression:
  • Genetics: Having a close blood relative with depression increases your risk of having it in your lifetime.
  • Physical health: Having certain medical conditions, such as diabetes, cancer, or heart disease, can make you more likely to have depression. Head injuries can also increase the risk for depression.
  • Environment: Being continuously exposed to violence, neglect, abuse, or poverty makes you more likely to suffer from depression.
  • Substance abuse: Abuse of drugs and alcohol increases your risk for depression.
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What are the different types of depression?

There are many different types of depression. These include:
  • Major depressive disorder (also known as major depression) is characterized by depressed mood and loss of interest in activities. These symptoms last at least 2 weeks and are persistent enough to interfere with daily life.
  • Atypical depressive disorder (also known as atypical depression) is a type of major depressive disorder where you may experience a temporary boost in mood in response to positive events. Other symptoms include increased appetite and excessive sleepiness.
  • Persistent depressive disorder (also called dysthymia or dysthymic disorder) is defined by low-level depressive symptoms that may not be as severe but will last much longer than those of major depressive disorder. This “chronic low mood” can last at least 2 years.
  • Perinatal/postpartum depression is depression that starts during (perinatal) or after (postpartum) pregnancy and childbirth. Unlike the “baby blues,” postpartum depression involves more severe, persistent symptoms.
  • Seasonal affective disorder involves depressive periods that come and go with the seasons. Typically, depressive symptoms start in the fall and last through the winter, then go away during the spring and summer.
  • Disruptive mood dysregulation disorder (DMDD) is a type of depression in children and adolescents that involves persistent symptoms of irritability and anger, including frequent outbursts.
  • Depression with psychosis (also known as psychotic depression) is a form of severe depression that includes symptoms of psychosis, including hallucinations or delusions.
There are also other physical and mental health conditions that cause depressive symptoms, although they’re not considered to be forms of depression. These include:
  • Premenstrual dysphoric disorder (PMDD) is a severe form of PMS (premenstrual syndrome). Women typically experience mood swings, including depressive symptoms, irritability, increased sensitivity, anxiety, dysphoria, bloating, headache, and  cramping about 1-2 weeks before their period that significantly improves 1-3 days post-period.
  • Bipolar disorder is a mood disorder that includes mood swings between depressive episodes and episodes of mania or hypomania.
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How does Talkiatry treat depression?

The first step in treating depression is getting a clinical diagnosis from a qualified mental healthcare professional. Your psychiatrist may ask you questions or recommend additional testing to rule out other causes of your symptoms, like other medical or mental health conditions. While a range of treatment options exist, most forms of depression are best managed with a combination of medication and supportive therapy.
With Talkiatry, you can see a psychiatrist from the comfort of home and you can schedule your first appointment in a matter of days.
Here’s what to expect in your first visit:
Evaluation: During your first visit with a Talkiatry psychiatrist, you’ll get to meet each other and answer questions about your current symptoms, personal history, medical history, and mental health goals. They'll also make sure that virtual treatment at Talkiatry is the best fit for you and what you're feeling.
Diagnosis: Based on the information you’ve shared, your psychiatrist will be able to provide a diagnosis of your condition, if you have one. Getting a diagnosis can feel scary, but it can also feel validating to finally put a name to what you've been experiencing. Your psychiatrist will help you navigate any emotions that come up and work with you on a path to move forward.
Treatment plan: You’ll collaborate with your psychiatrist on the best way to manage your symptoms. If medication is appropriate, you’ll discuss your options, including the benefits and potential side effects of each medication. Your psychiatrist will provide supportive therapy throughout your session, and may also recommend working with one of our therapists. Our therapists partner with our psychiatrists to provide collaborative care.
To get started, take our free online assessment, to see if Talkiatry is right for you and get matched with a psychiatrist.  
Medication management
Many people with clinical depression will respond to medication as part of their treatment plan. The most common type of medications prescribed for depression are antidepressant medications, which fall into several different categories:
  • SSRIs (selective serotonin reuptake inhibitors): including Prozac, Lexapro, Paxil, Zoloft, and Celexa work to increase the level of serotonin in the brain, a chemical messenger (neurotransmitter) which helps regulate mood, emotion, and sleep.
  • SNRIs (serotonin-norepinephrine reuptake inhibitors): including Cymbalta, Effexor, Pristiq, and Savella increase the level of both serotonin and another neurotransmitter, norepinephrine, in the brain.
  • TCAs (tricyclic antidepressants): including Elavil, Norpramin, Asendin, Silenor, and Tofranil also increase the levels of serotonin and norepinephrine in the brain, but have the potential to affect more body systems than newer SSRIs or SNRIs. These drugs may be an effective option for people whose depression is resistant to other medications, but they come with more side effects.
  • Atypical antidepressants: including Wellbutrin, Remeron, and Trintellix work differently than other types of antidepressants, usually with multiple mechanisms of action. They can be effective on their own or in combination with other medications at treating the symptoms of depression.
  • MAOIs (monoamine oxidase inhibitors): including Marplan, Nardil, Emsam and Parnate work to prevent the breakdown of serotonin, dopamine, and norepinephrine (natural mood-altering chemicals in your brain).
Most of these medications take several weeks to reach full effectiveness, and not all are appropriate for everyone with depression. That’s why it’s so important to work with a qualified healthcare provider who can respond to the specifics of your condition as well as your body’s response to different treatment options.
Therapy
Your psychiatrist may additionally recommend supportive therapy (also called “talk therapy") to treat your depression. If your psychiatrist thinks this could be effective for you, we have therapists on staff to work with patients who are seeing our psychiatrists. Talk therapy may help you challenge destructive thought patterns and develop healthy coping skills to manage your depression symptoms.
Cognitive behavioral therapy (CBT) is a therapy technique that’s been shown to successfully help treat the symptoms of depression. This short-term, goal-oriented type of talk therapy can help people with depression cultivate in-the-moment problem-solving skills to change thoughts and behaviors.
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How to get started

If you think you might have depression, Talkiatry can help. The best way to start is to take our free assessment, and see if Talkiatry is the right fit for you. Based on your needs, you’ll be matched with one of our expert psychiatrists and you’ll be ready to schedule your first appointment in just a few days.
In patients with depression, a treatment plan at Talkiatry may look like this:
Expect to hear a bit about your psychiatrist’s background and availability, and then to share exactly what brought you in. You may be asked about your medical history, day-to-day life, and goals and expectations for treatment. If you’re nervous about a particular element of treatment—say, taking medication—we want to hear about that, too! Your Talkiatry psychiatrist knows that the best treatment plan is the one you’ll stick to, so they’ll work with you to make sure Talkiatry is the best fit for you and come up with a plan you're comfortable with.
Tip #3
Receive your personalized treatment plan, which may include a combination of medication and supportive therapy.
Tip #4
Continuous care will include adjusting your treatment plan as needed.
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About Talkiatry

Talkiatry is a national psychiatry practice that provides in-network, virtual care. Co-founded by a patient and a triple-board-certified psychiatrist, Talkiatry has over 300 doctors, 100 insurance partners, and first visits available in days. We treat patients with a range of mental health conditions, including depression. Get started with a short online assessment.
The information in this article is for educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.
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