Major Depressive Disorder: Symptoms, Diagnosis & Treatment

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AZZ Medical Associates offers professional evaluations and ongoing care in-clinic and by telehealth (video visits) throughout New Jersey.

Comprehensive Depression Care, Anywhere in NJ

Struggling with persistent sadness or fatigue? AZZ Medical Associates offers evidence-based treatments for Major Depressive Disorder, from medications to therapies like CBT, IPT, and supportive counseling.

Major Depressive Disorder Symptoms

Symptoms occur most of the day, almost every day for at least two weeks and represent a clear change from a person’s baseline:l;
  • Sad, empty, or hopeless mood; in youth, irritability may dominate
  • Marked loss of interest or pleasure
  • Sleep disturbance: insomnia or hypersomnia
  • Appetite/weight change (up or down)
  • Fatigue or loss of energy
  • Psychomotor agitation (restless, keyed up) or slowing of speech/thinking/movement
  • Feelings of worthlessness or excessive guilt
  • Difficulty concentrating, remembering, or making decisions
  • Thoughts of death, suicidal thinking, or attempts
  • Physical complaints without clear cause (e.g., headaches, back pain)
Children & teens: More aches, clinginess, school refusal, irritability, substance use, or self-harm.
Older adults: Memory complaints, personality change, reduced appetite/sex drive not explained by illness or meds, staying home more, higher suicide risk in older men.

Expert Insights

Medication addresses brain chemistry, while therapy rebuilds coping skills. The strongest results for major depressive disorder come when both are used together. AZZ Psychiatry Team

Why It Happens: Biology, Development, and Stress

MDD arises from interacting factors:
  • Brain circuits & chemistry: changes in neural networks involved in mood regulation can secondarily disrupt neurotransmitters (serotonin, norepinephrine, dopamine).
  • Genetics: first-degree relatives raise risk; you can still develop MDD without family history.
  • Hormones & medical issues: thyroid disease, postpartum changes, perimenopause; chronic illnesses (heart disease, stroke, COPD, diabetes) can worsen or be worsened by depression.
  • Adverse childhood experiences (ACEs) and stressful life events (loss, trauma, isolation) can trigger episodes in susceptible people.
On the other hand, if left untreated, an episode can last 6–12 months and complicate relationships, school/work, and health. Early treatment of AZZ Medical team in clinic or via telepsychiatry, shortens episodes and prevents relapse.

Get Same-Day Help for Major Depression

Don’t wait weeks to start care. With same-day appointments available across 21+ New Jersey locations and through secure telehealth, AZZ Medical Associates ensures you receive timely support for major depressive disorder symptoms, medication management, and follow-up care—all in one place.

How MDD Is Diagnosed (What to Expect)

Diagnosis blends and uses medical and mental-health expertise of certified psychiatrists and psychologists:
  • Physical exam & history: review sleep, pain, medical conditions, and medications; depression can co-occur with conditions like cancer, coronary disease, and chronic pain.
  • Lab tests (as indicated): thyroid panel, CBC, B-12/folate, or others to rule out contributors.
  • Psychiatric evaluation: timing, severity, impact, risk, and co-occurring disorders (anxiety, OCD, substance use). Brief self-report questionnaires may be used.
  • DSM-5 criteria for Major Depressive Disorder: ≥5 symptoms for ≥2 weeks, including either low mood or loss of interest, with functional impairment, and no history of mania/hypomania (otherwise considered bipolar disorder).
    ICD-10 coding (for documentation/insurance):
  • Single episode: F32.x (e.g., mild F32.0, moderate F32.1, severe F32.2/3, with psychotic features when present)
  • Recurrent: F33.x (e.g., major depressive disorder recurrent mild/moderate/severe; recurrent moderate is F33.1)
AZZ clinicians explain findings in plain language and differentiate persistent depressive disorder vs. major depressive disorder (dysthymia is longer-lasting, typically milder but more chronic).

Types & Specifiers That Shape Care

Your clinician may add specifiers to personalize treatment:
  • With anxious distress
  • With mixed features
  • Melancholic
  • Atypical (mood reactivity, increased sleep/appetite, rejection sensitivity)
  • With psychotic features (delusions/hallucinations)
  • With catatonia
  • Peripartum onset (prenatal/postpartum)
  • Seasonal pattern

These elements guide major depressive disorder treatments and medication choices. AZZ also screens for related diagnoses (bipolar I/II, cyclothymia, disruptive mood dysregulation in youth, premenstrual dysphoric disorder, substance-/medication-induced depression).

Treatment for Major Depressive Disorder

Most people do best with a combined plan, therapy + medication, adjusted over time.

Psychotherapies (Major Depressive Disorder Therapies)

  • Cognitive Behavioral Therapy (CBT): identifies and tests negative thoughts, rebuilds routine, and problem-solving.
  • Interpersonal Therapy (IPT): focuses on grief, role transitions, and relationship patterns.
  • Behavioral Activation: stepwise return to meaningful activities to counter withdrawal.
  • Problem-Solving & Brief Supportive Therapy: practical coping.
Therapy is available in person or via teletherapy/telehealth anywhere in New Jersey, easy to schedule around work, school, or caregiving.

Medications (Major Depressive Disorder Medication)

Your prescriber reviews benefits, side effects, and timelines (expect 2–6 weeks for a fair trial):
  • SSRIs: sertraline, escitalopram, fluoxetine, paroxetine, citalopram, vilazodone
  • SNRIs: venlafaxine, desvenlafaxine, duloxetine, levomilnacipran
  • Atypicals: bupropion, mirtazapine, vortioxetine, trazodone, nefazodone
  • TCAs and MAOIs: effective niche options with added monitoring/dietary rules
  • Augmentation: add a second antidepressant, lithium/mood stabilizer, or an atypical antipsychotic for major depressive disorder with psychotic features or partial response
  • Safety: don’t stop suddenly; discuss pregnancy/breastfeeding plans; close follow-up is standard at AZZ via HIPAA-compliant video or local visits.

Did You Know

  • Up to 90% of people with depression improve with proper treatment.
  • Telepsychiatry is proven as effective as in-person care for managing depression.

Advanced & Somatic Options

For severe or treatment-resistant episodes or when rapid relief is needed:
  • Transcranial Magnetic Stimulation (TMS): noninvasive outpatient neuromodulation
  • Electroconvulsive Therapy (ECT): most effective for psychotic, catatonic, or life-threatening depression
  • Esketamine/Ketamine: for resistant depression under strict protocols
  • Vagus Nerve Stimulation (VNS): for select, long-standing cases

Prognosis, Prevention & Relapse Planning

  • MDD is common (lifetime risk roughly 5–17%) and highly treatable; most patients respond to evidence-based care.
  • Untreated episodes can last 6–12 months and raise risks for anxiety disorders, substance use, and worsening of medical illnesses.
  • Relapse prevention: continue therapy skills, take medications as prescribed, schedule maintenance visits, know your early warning signs (sleep shift, isolation, rising guilt/hopelessness), and reconnect with your AZZ team quickly, by video or at a nearby clinic.

Self-Care That Supports Recovery

These steps support treatment (they don’t replace it):
  • Consistent sleep and wake times; limit alcohol and sedatives
  • Regular physical activity (even brief daily walks)
  • Balanced meals; address pain and medical conditions with your primary care clinician
  • Social connection; short, scheduled touchpoints help
  • Mind-body practices: relaxation training, yoga/tai chi, or brief meditation
  • Break tasks into small steps; delay major life decisions until mood improves

When to Seek Help & Emergency Resources

Reach out if low mood, loss of interest, sleep/appetite changes, fatigue, or cognitive fog persist beyond two weeks, or sooner if symptoms interfere with work, school, caregiving, or relationships. AZZ Medical Associates offers same-day and evening appointments in 21+ New Jersey locations, as well as via telehealth.

Take the First Step Toward Authentic Relief

Living with depression doesn’t have to be your normal. Call AZZ Medical Associates today or book online for a confidential, same-day appointment, available both in-person and through telehealth across New Jersey.

Final Words

Whether you prefer a near-me office visit or a private video session from home, AZZ Medical Associates provides comprehensive care for Major Depressive Disorder: DSM-5–aligned diagnosis, medication management, CBT/IPT/behavioral activation, and relapse prevention.
We coordinate closely with New Jersey primary care and specialty teams, offering flexible, patient-centered scheduling across 21+ locations and telepsychiatry services.

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David M Bresch, MD

Psychiatrist

Dr. David Bresch has expertise in neuropsychiatry and sleep medicine. His research includes work in autism, neurology/neuroscience, insomnia in prison, and neuropsychopharmacology. He is a member of the American Psychiatric Association and also certified by the United Council for Neurologic Subspecialties and the American Board of Sleep Medicine.

Abdulrahman Virk

Senior Content Editor

Abdulrahman Virk is a medical writer and editor with 7+ years of experience creating evidence-based healthcare content. He has collaborated with international Medical organizations, including GE Health, Teladoc Health, and more. Producing clear, accurate, and patient-focused materials.