What is depression?
Major depressive disorder is more than feeling sad. It's a persistent loss of interest, low energy, change in sleep and appetite, and often hopelessness that lasts at least 2 weeks and interferes with daily life. About 1 in 6 US adults experience it at some point.
Depression is highly treatable. Most people see significant improvement with medication, therapy, or both. The hardest part is reaching out — once treatment is underway, the trajectory usually bends in the right direction.
If you've been struggling for more than 2 weeks with low mood, loss of interest, sleep changes, or fatigue, telehealth is a reasonable place to start. A clinician can evaluate severity, screen for safety, and start an appropriate treatment plan.
Do I have depression? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Depression is multi-factorial: genetics, brain chemistry (serotonin, norepinephrine, dopamine), stressful life events, chronic medical illness, certain medications, hormonal changes (postpartum, perimenopause), thyroid problems, sleep apnea, and substance use can all contribute. Often there's no single cause.
Is it contagious?
No — depression is not contagious.
The decision to ask for help is often the hardest step. After that, most pathways lead somewhere better.
Can it be treated online?
Mild to moderate depression without active suicidal ideation is a good fit for telehealth. A clinician evaluates your symptoms, history, safety, and prescribes appropriate medication. Telehealth is NOT appropriate for severe depression with suicidal thoughts, psychotic features (hallucinations or delusions), bipolar features (manic episodes), or significant substance abuse — those need in-person psychiatric care immediately.
How depression is treated
SSRIs like sertraline, escitalopram, and fluoxetine are first-line for most adults. SNRIs like duloxetine and venlafaxine are alternatives. Bupropion (Wellbutrin) is helpful for people with low energy or who don't want sexual side effects. Mirtazapine helps with sleep and appetite issues. Full effect takes 4–6 weeks. Therapy (CBT, IPT, behavioral activation) works well alone or combined with medication.
Self-care while you wait
- Maintain a sleep schedule — depression worsens with irregular sleep
- Get outside daily — even 10 minutes of sunlight helps
- Aerobic exercise has direct antidepressant effect — start small
- Limit alcohol — it makes depression worse
- Stay connected — isolation feeds depression
- Eat regularly, even when appetite is gone
- Behavioral activation: schedule one pleasant or productive activity per day, even if you don’t feel like it
How long does it last?
Without treatment, depressive episodes typically last 6–12 months and tend to recur. With treatment, most people feel meaningfully better in 4–6 weeks. Standard practice is to continue medication for 6–12 months after symptoms resolve, with longer or indefinite treatment for people who've had multiple episodes.
Frequently asked questions
How do I know if it's depression vs just a rough patch?
Two weeks of persistent low mood, loss of interest, sleep/appetite/energy changes — especially when it's affecting work, relationships, or daily functioning — meets the threshold worth getting evaluated. Brief sadness after loss is normal grief, not depression.
Will antidepressants change who I am?
No. The goal is to lift the depression so you can feel more like yourself — not less. If you feel emotionally numb or 'flat,' that's a side effect to discuss with your clinician — different medications work differently.
How long do I have to take medication?
Standard course is 6–12 months past full symptom resolution. People with 2+ episodes often benefit from longer treatment. Stopping is done gradually with a clinician — never cold turkey.
What's the difference between SSRIs and SNRIs?
Both work on serotonin. SNRIs also affect norepinephrine and can be more activating — sometimes better for people with significant fatigue or pain symptoms. They have somewhat different side effect profiles.
Can I drink alcohol while taking antidepressants?
Alcohol is a depressant and can blunt the benefit of antidepressants — most clinicians recommend keeping intake low (1 drink occasionally), at least during the early treatment phase.
