Depression
Condition
What depression looks like
Depression frequently presents physically. Headaches, digestive symptoms, and unexplained pain are common, and some people describe fatigue or difficulty concentrating long before they describe low mood. In some patients, irritability rather than sadness is the most noticeable feature.
Depression is a medical condition that affects mood, thinking, sleep, appetite, energy, and the ability to take interest in ordinary activities. It is more than a period of sadness, and it does not resolve reliably on its own.
The common features include persistent low mood or a loss of interest and pleasure, along with changes in sleep, changes in appetite or weight, fatigue, difficulty concentrating or making decisions, restlessness or slowed movement, feelings of guilt or worthlessness, and thoughts of death or suicide. Not everyone has all of these, and the presentation varies a good deal from person to person.
Depression treatment in Dallas–Fort Worth begins the same way that treatment for any medical condition begins, with an evaluation.
Evaluation
How it is evaluated
The evaluation covers when the symptoms began, whether there have been previous episodes, what treatment has been tried, and how you responded to it.
We also evaluate the conditions that occur alongside depression or account for it. We ask about periods of elevated mood, decreased need for sleep, and unusual energy, because bipolar disorder is treated differently from unipolar depression and is often identified only when someone asks. We ask about anxiety, trauma, obsessive-compulsive symptoms, attention difficulties, and alcohol and substance use. We consider medical contributors, including thyroid disease, anemia, vitamin deficiency, sleep apnea, and the side effects of medications prescribed for other conditions, and we may order laboratory testing.
We will also ask about thoughts of suicide. This is a routine part of a psychiatric evaluation and it is asked of everyone.
The evaluation ends with a working diagnosis, a treatment plan, and a follow-up appointment, and the plan is adjusted as we see how you respond.
Treatment
How we treat it
Treatment for depression may include medication, therapy, or both, and the plan depends on the severity of symptoms, the history of prior treatment, and your preferences.
Antidepressant medications are effective for many patients. We will discuss the options, the expected timeline, and the side effects to watch for, and we will adjust the dose or change the medication based on your response. Antidepressants generally require several weeks at an adequate dose before their full effect can be assessed, and we will keep in contact with you during that period. Details are available on the Medication Management page.
Therapy is provided within our 50-minute medication-plus-therapy follow-up appointments, using evidence-based approaches. Where weekly standalone therapy is appropriate, we will refer you and coordinate care.
When depression has not improved with antidepressant medication, additional treatments are available in this practice. Transcranial magnetic stimulation (TMS) is FDA-cleared for major depressive disorder in patients who have not responded adequately to antidepressant medication. Esketamine (Spravato) is FDA-approved for treatment-resistant depression, taken together with an oral antidepressant. Information about depression that has not responded to treatment is available on the Treatment-Resistant Depression page.
Depression is treatable, and effective treatments are available.
Schedule
Getting started
Schedule an appointment today to meet with our care team and we will review your history, current symptoms, and goals of treatment. You may call 972-332-5922 or book online.