What is Depression?

by Daniel

Depression is more than just feeling sad or going through a rough patch; it’s a persistent condition that can impact daily life and overall well-being. Typically, depression is used as an umbrella term to refer to Major Depressive Disorder (MDD), clinical depression, or postpartum depression. 

More than just feeling down, depression is not a weakness or something to be dismissed. Depression may require long-term treatment as it is not a mood you can simply “snap out of” or ignore. But there is reason to be hopeful: depression is often successfully treated with medication, psychotherapy, interventional psychiatry or both. 

Symptoms of Depression 

Depression can manifest in various ways, and symptoms can vary from person to person. But some common symptoms include: 

  • Persistent sad, anxious, or “empty” mood 
  • Feelings of hopelessness or pessimism 
  • Irritability 
  • Feelings of guilt, worthlessness, or helplessness 
  • Loss of interest or pleasure in hobbies and activities 
  • Decreased energy or fatigue 
  • Difficulty concentrating, remembering, or making decisions 
  • Insomnia or sleeping too much 
  • Appetite changes, weight loss or gain 
  • Thoughts of death or suicide, suicide attempts 
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause 

It’s important to note that experiencing one or more of these symptoms does not necessarily mean you have depression. Seeking counsel from a mental health professional can help you diagnose depression.  

What Causes Depression? 

The exact cause of depression is not fully understood, as it is a complex interplay of genetic, biological, environmental, and psychological factors. Some common factors that may contribute to the development of depression include: 

Genetic factors

Depression can run in families, suggesting that there may be a genetic component to the disorder. 

Brain chemistry and function

Imbalances in certain chemicals in the brain, such as serotonin, dopamine, and norepinephrine, may play a role in depression. Additionally, changes in the function of neural circuits involved in mood regulation can contribute to the development of depression. 

Hormonal factors

Changes in hormone levels, such as those experienced during puberty, menstruation, pregnancy, childbirth, and menopause, as well as thyroid problems, can impact mood and contribute to depression. 

Life events

Stressful life events, such as the loss of a loved one, financial difficulties, relationship problems, or trauma, can trigger depression in susceptible individuals.

Environmental factors

Certain times of years may affect you in different ways. Seasonal affective disorder is most commonly associated with the fall and winter, but can sometimes occur in the summer as well.

Personality traits

Certain personality traits, such as low self-esteem, pessimism, or being overly dependent, can increase the risk of developing depression. 

Other medical conditions

Certain medical conditions, such as chronic illness, chronic pain, or a history of substance abuse, can increase the risk of depression. 

It’s important to note that not everyone with these risk factors will develop depression – and depression can occur without any obvious external triggers. 

woman struggling with depression

Treatment Options for Depression 

Effective depression treatment often involves a combination of therapeutic approaches tailored to your unique needs. At Aster Mental Health, your treatment team will create a personalized treatment plan that may involve medications, psychotherapy, lifestyle changes, and interventional psychiatry elements. Our holistic treatment plans are all evidence-based and are administered together with you. 

Aster Mental Health is in-network with a wide range of commercial insurance companies and treatments for depression are typically covered by these insurance plans. 

Medication Management

For some individuals, medication may be a valuable component of their treatment plan. Antidepressant, or Selective Serotonin Reuptake Inhibitors (SSRIs) or Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), medications can help regulate neurotransmitters in the brain, alleviating symptoms and supporting a more stable mood. Our experienced physicians, physician assistants, and nurse practitioners will work closely with you to determine the most suitable medication and dosage, monitoring progress and adjusting treatment as needed. Initially, you may see your clinician frequently, up to once every one to two weeks, so they can monitor the medications they have prescribed to ensure they are working. Once you feel more stable, the frequency of your appointments may decrease, down to once every one to three months. 

Therapy

Also known as psychotherapy, therapy is a fundamental aspect of depression treatment, providing individuals with a supportive environment to explore their thoughts and emotions. Our team of licensed mental health counselors and social workers employ various therapeutic modalities, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), Internal Family Systems (IFS), and psychodynamic therapy. These approaches empower clients with coping mechanisms and tools to navigate challenges effectively as well as can provide a supportive structure to make lifestyle changes. Therapy appointments will occur weekly or biweekly. 

Interventional Psychiatry

Interventional psychiatry is a collective noun for a group of outpatient procedures that are conducted in the office aimed at directly modulating brain activity to effectively treat depression. At Aster Mental Health, we offer Transcranial Magnetic Stimulation (TMS) and Esketamine (Spravato), two FDA-approved interventional psychiatry services.


Both treatment options have proven highly effective at treating Treatment-Resistant Depression (TRD) and depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions. For example, a study of TMS reported an 83% response rate. This means that 83% of patients that completed their NeuroStar treatment cycle saw measurable improvement in their depression symptoms. 

Transcranial Magnetic Stimulation (TMS or rTMS) 

A non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain, particularly in areas associated with mood regulation. TMS has shown effectiveness in treating depression when other interventions, especially medications, have not provided adequate relief. Each treatment course lasts 36 sessions that are administered Monday through Friday and each session lasts 19 minutes. 

Aster Mental Health uses the leading TMS device from NeuroStar to administer TMS treatments and the most common side effect is a slight headache at the treatment site for the first 2-3 days which is easily treated with over-the-counter pain medication. 

Esketamine (Spravato)

Esketamine, marketed under the brand Spravato brand name, is made from a drug called ketamine, an anesthetic that has also been used for many years to treat depression. Spravato is a nasal spray and is administered under the supervision of a physician in Aster Mental Health’s offices. Each treatment session lasts approximately 2 hours and treatments occur twice a week for the four weeks, once a week for the next four weeks, and as prescribed thereafter. Esketamine is FDA approved. 

When considering your interventional psychiatry options, it is important you meet with one of our physicians so that they can discuss the most appropriate intervention based on your unique needs and treatment history. 

When to See Your Doctor 

If you or someone you know is experiencing several of these symptoms for an extended period, make an appointment to see your doctor or mental health professional as soon as you can. If you’re reluctant to seek treatment, talk to a friend or loved one, your PCP or any health care professional, a faith leader, or someone else you trust. 

Can I Prevent Depression? 

Preventing depression involves a combination of lifestyle changes, developing healthy coping mechanisms, and addressing risk factors. While it may not be possible to prevent depression entirely, these strategies may help reduce the risk or lessen the severity of symptoms: 

  • Maintain a healthy lifestyle: Eating a balanced diet, getting regular exercise, and ensuring an adequate amount of sleep can help improve overall well-being and may reduce the risk of depression. 
  • Educate yourself and others: Awareness of depression is crucial. Having conversations about mental health with friends and loved ones can have a major positive impact. When there’s less stigma surrounding depression, it’s easier for people to seek care. And it’s always helpful to remind others – and yourself – that you’re not alone.
  • Develop coping skills: Learning healthy ways to cope with stress, such as relaxation techniques, mindfulness, or talking to a therapist, can help reduce the likelihood of developing depression. 
  • Build a strong support system: Cultivating relationships with friends, family, or support groups can provide a sense of belonging and emotional support, which can be protective against depression. 
  • Address underlying health issues: Managing chronic health conditions, such as diabetes or hypertension, and seeking treatment for substance abuse or other mental health disorders can help reduce the risk of depression. 
  • Identify and manage triggers: Recognizing and addressing factors that contribute to stress or negative emotions can help prevent these from escalating into depression. 
  • Seek professional help: If you have a history of depression or other mental health disorders, or if you are experiencing symptoms of depression, seeking help from a mental health professional can be beneficial. Therapy, medication, or a combination of both can effectively treat depression and reduce the risk of recurrence. 

Why Choose Aster Mental Health for Depression Treatment? 

At Aster Mental Health, we prioritize the well-being of our clients and are dedicated to providing personalized, evidence-based care. Our multidisciplinary team is completely available to you under one roof, meaning your treatment team can easily collaborate to create comprehensive treatment plans, addressing not only the symptoms but also the underlying factors contributing to your depression. 

We are in-network with the majority of commercial insurance companies in Massachusetts and offer in-person as well as telehealth appointments. 

When to Seek Emergency Help 

If you think you may hurt yourself, someone else, or attempt suicide, call 911 in the U.S. or your local emergency number immediately. 

Also consider these options if you’re having suicidal thoughts: 

  • Visit the nearest emergency room or urgent care facility. 
  • Contact a suicide hotline. 
  • In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential. 
  • U.S. veterans or service members who are in crisis can call 988 and then press “1” for the Veterans Crisis Line. Or text 838255. Or chat online. 
  • The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free). 
  • Reach out to a close friend or loved one. 
  • Contact a minister, spiritual leader or someone else in your faith community. 

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room. 

If you or a loved one is struggling with depression, we invite you to explore our services and discover the compassionate care and innovative treatments available at Aster Mental Health.  Contact us today to schedule a consultation and take the first step towards a brighter, more fulfilling future.