Comprehensive Depression Care, Anywhere in NJ
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.
Expert Insights
Why It Happens: Biology, Development, and Stress
- 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.
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)
- 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)
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
Treatment for Major Depressive Disorder
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.
Medications (Major Depressive Disorder Medication)
- 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
- 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
- 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
Take the First Step Toward Authentic Relief
Final Words
How we reviewed this article:
- https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5709536/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9742046/
- https://phoenixhouseca.org/2020/12/08/teen-talk-talking-about-depression/
- https://www.cdc.gov/vitalsigns/aces/index.html#:~:text=Overview,one%20generation%20to%20the%20next.
- https://healthy.kaiserpermanente.org/health-wellness/depression-care/assessment
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How we reviewed this article:
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