Depression

Depression is one of the most common mental health conditions in the United States, and one of the most treatable. At Greater Boston Psychiatric Services, we provide psychiatric evaluation and ongoing medication management for adults experiencing depression, by telehealth or in person at our office in Medway.

What Is Depression?

Depression — clinically known as major depressive disorder — is a mood disorder characterized by persistent sadness, hopelessness, or loss of interest in activities that were once enjoyable, lasting most of the day, nearly every day, for at least two weeks. It's different from ordinary sadness or grief: depression affects how a person thinks, feels, and functions, often interfering with work, relationships, sleep, and appetite. Depression can occur as a single episode or recur throughout a person's life, and it ranges from mild to severe.

Types of Depression

• Major Depressive Disorder (MDD) — the classic form, involving a persistent depressed mood or loss of interest lasting two weeks or longer

• Persistent Depressive Disorder (Dysthymia) — a chronic, lower-grade depression lasting two years or more

• Seasonal Affective Disorder (SAD) — depressive episodes that follow a seasonal pattern, most often in fall and winter

• Postpartum Depression — depression occurring during pregnancy or in the weeks and months after childbirth

• Bipolar Depression — the depressive phase of bipolar disorder, which requires a different treatment approach than MDD alone — see our Bipolar Disorder page

Signs & Symptoms

• Persistent sad, empty, or anxious mood

• Loss of interest or pleasure in activities once enjoyed

• Significant changes in appetite or weight

• Sleeping too much or too little

• Fatigue or loss of energy nearly every day

• Difficulty concentrating, thinking, or making decisions

• Feelings of worthlessness or excessive guilt

• Physical symptoms such as headaches or digestive issues without a clear cause

• Thoughts of death or suicide

Causes & Risk Factors

• Neurotransmitter imbalances involving serotonin, norepinephrine, and dopamine

• Genetics and family history of depression or other mood disorders

• Significant life stress, loss, or trauma

• Chronic medical conditions or certain medications

• Hormonal changes, including postpartum and perimenopausal periods

How It's Diagnosed

Depression is diagnosed through a clinical evaluation — a structured conversation about your symptoms, how long they've lasted, and how they're affecting your daily life, combined with a review of your medical and psychiatric history. There's no blood test or scan that diagnoses depression on its own; the evaluation is what identifies it and rules out other explanations, such as a thyroid condition or medication side effect. Our psychiatric evaluation is built around exactly this process.

Treatment Options

Depression is most often treated with antidepressant medication, psychotherapy, or a combination of both. Our clinicians focus on medication management: identifying an appropriate antidepressant (commonly an SSRI or SNRI), starting at an appropriate dose, and adjusting based on how you respond over the following weeks. Most antidepressants take two to six weeks to show their full effect, so follow-up visits in the early weeks of treatment are important. We don't provide therapy directly, but many patients get the strongest results by combining medication management with psychotherapy from a separate licensed therapist, and we're glad to coordinate with a therapist you're already seeing.

When to Seek Help

If depressive symptoms have lasted two weeks or longer and are affecting your work, relationships, or ability to function day to day, it's worth scheduling an evaluation. You don't need to wait until symptoms are severe — earlier treatment is generally more effective. If you are having thoughts of suicide or self-harm, call or text 988 (the Suicide & Crisis Lifeline) or go to your nearest emergency room.

Insurance & Self-Pay

We're in-network with Blue Cross Blue Shield, Aetna, Harvard Pilgrim Healthcare, Optum, Tufts Health Plan, Wellpoint, United Healthcare, HPI, Mass General Brigham, Carelon, UMR, and UniCare. Self-pay options are available. We are unable to bill Medicare, Medicaid, or supplemental plans.

Frequently Asked Questions

Is depression treatable?

Yes. Depression is one of the most treatable mental health conditions. Most people see meaningful improvement with medication, therapy, or a combination of both.

How long does it take for antidepressants to work?

Most antidepressants take two to six weeks to produce their full effect, though some improvement in sleep or energy can appear sooner. Your clinician will schedule follow-up visits during this period to monitor your response and adjust your dose or medication if needed.

Can depression come back after treatment?

It can. Depression is often a recurring condition, which is part of why ongoing medication management — not just an initial prescription — matters. Many patients stay on treatment for an extended period even after symptoms improve, to reduce the risk of relapse.

Is depression genetic?

Family history is one risk factor among several. Having a close relative with depression increases your own risk, but depression also develops in people with no family history, and having a family history doesn't guarantee you'll experience it.

Do you treat postpartum depression?

Yes, postpartum depression is one of the conditions we treat through evaluation and medication management. If you're currently pregnant or breastfeeding, your clinician will discuss medication options appropriate for your situation.

What's the difference between sadness and clinical depression?

Sadness is a normal, temporary emotional response to a difficult event. Clinical depression is a persistent state — lasting two weeks or more — that affects sleep, appetite, energy, concentration, and daily functioning, often without a specific external cause.

Will I need medication forever?

Not necessarily. Treatment length depends on your history — whether this is a first episode or a recurrence, and how you respond to treatment. Your clinician will discuss an appropriate timeline with you as part of your ongoing care.

Related Conditions We Treat

Depression often overlaps with, or can be mistaken for, other conditions. We also provide evaluation and medication management for Bipolar Disorder, Anxiety & Panic Disorders, Sleep Disturbance.

Get Started

If you're experiencing symptoms of depression, the first step is a comprehensive psychiatric evaluation, available by telehealth or in person at our office in Medway. Schedule an appointment or view our full list of conditions we treat.