Excel Psychiatry

Personalized Treatment Approaches for Major Depressive Disorder

Major Depressive Disorder (MDD), also known as clinical depression, is a complex and debilitating mental health condition affecting millions of people worldwide. While moments of sadness or melancholy are a part of the human experience, MDD goes beyond typical emotions, significantly impacting an individual’s thoughts, feelings, and daily functioning. Let’s delve into the depths of MDD, exploring its characteristics, causes, and available treatment options

Defining Major Depressive Disorder

Major Depressive Disorder is a mood disorder characterized by persistent feelings of sadness, hopelessness, and a loss of interest in activities once enjoyed. Unlike passing sadness or grief, MDD lasts for an extended period, with symptoms affecting everyday life and impairing overall well-being. It is essential to differentiate MDD from occasional sadness, as the latter is a normal emotional response to life’s challenges, while MDD is a clinical condition requiring professional intervention.

Defining Major Depressive Disorder

The symptoms of Major Depressive Disorder can vary in number, severity, and duration. Feelings of sadness or depression, or loss of interest or pleasure in activities must be present most of the day, nearly every day for at least 2 weeks. In addition, four other symptoms must be present for a total of at least five symptoms during this time period. To assess symptoms, the mnemonic SIGECAPS is often used.

S – Sleep disturbances: Insomnia (difficulty falling asleep or staying asleep) or hypersomnia (excessive sleepiness).

I – Loss of interest: A marked decline in interest or pleasure in previously enjoyed activities, hobbies, or social interactions.

G – Feelings of worthlessness and excessive guilt: Persistent feelings of guilt, self-blame, or worthlessness, often unrelated to the actual situation.

E – Fatigue or loss of energy: Feeling tired, sluggish, or lacking in energy, even after adequate rest.

C – Difficulty concentrating or making decisions: Trouble focusing, remembering information, or making even simple decisions.

A – Significant changes in appetite or weight: Unintentional weight loss or gain, or a noticeable change in appetite.

P – Psychomotor retardation or excitation: moving, talking, or thinking so slowly (or rapidly) you or others have taken notice.

S – Recurring thoughts of death or suicide: Persistent thoughts of death, suicidal ideation, or suicide attempts.

Causes and Risk Factors

The origins of Major Depressive Disorder are multi-faceted, involving a combination of genetic, biological, psychological, and environmental factors. Some common causes and risk factors include.

a) Genetics: Having a family history of MDD or other mood disorders increases the likelihood of developing the condition.

b) Brain chemistry: An imbalance in certain neurotransmitters (such as serotonin, norepinephrine, and dopamine) is believed to contribute to MDD.

c) Life events: Traumatic experiences, loss of a loved one, relationship difficulties, or significant life transitions can trigger or exacerbate MDD.

d) Personality traits: Certain personality traits, such as low self-esteem, pessimism, high levels of anxiety, or being overly self-critical, may increase the vulnerability to MDD.

e) Chronic illnesses: Those with chronic medical conditions, such as diabetes, cancer, or cardiovascular disease, are at a higher risk of developing MDD.

Causes and Risk Factors Infographic

Seeking Help and Treatment Options

Recovery from Major Depressive Disorder is possible with the appropriate treatment and support. It is crucial to encourage individuals experiencing symptoms of MDD to seek professional help. Common treatment options include:

a) Psychotherapy: Cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), or other forms of therapy can help individuals identify and modify negative thought patterns, develop healthy coping mechanisms, and improve overall well-being.

b) Medication: Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed to restore a chemical balance in the brain.

c) Lifestyle changes: Engaging in regular exercise, maintaining a balanced diet, ensuring adequate sleep, and practicing stress management techniques can significantly enhance mood and overall mental well-being.

d) Support systems: Building a strong support network, reaching out to loved ones, and joining support groups can provide a sense of understanding, connection, and validation.

e) Transcranial Magnetic Stimulation (TMS): may also be recommended for individuals whose symptoms are not improving with medication and therapy.  TMS is a non-invasive, FDA approved treatment for depression.  For more information, see our page on Neurostar TMS treatment offered at Excel Psychiatry.

f) Spravato is intranasal esketamine proven to reduce depression symptoms in those who have not responded to medications.  Excel Psychiatry is an approved Spravato treatment center.  For more information, see our page on Spravato treatment offered at Excel Psyciatry.

Destigmatizing MDD: Spreading Awareness and Compassion

To create a compassionate society, it is crucial to destigmatize Major Depressive Disorder. By spreading awareness, understanding, and empathy, we can provide a safe environment that encourages open communication about mental health. Education and discussions regarding mental health can help break down barriers and ensure that individuals with MDD receive the support and understanding they deserve.


Major Depressive Disorder is a prevalent and complex mental health condition that can have a significant impact on an individual’s life. By recognizing the signs, causes, and available treatment options for MDD, we can offer support, understanding, and hope to those affected. Together, let us strive to create a world where mental health is a priority, and individuals with Major Depressive Disorder can embark on their journey towards healing and recovery.

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