What is Depression?

Depression is more than sadness—often showing up as irritability, emptiness, loss of interest, or exhaustion that won’t lift. At SHIELD Psychiatry, we clarify the emotional, cognitive, behavioral, and biological drivers and build a plan that fits your child, teen, or young adult.

Common Signs by Age

  • Ages 5–12: irritability, tummy aches, school refusal, tearfulness, loss of interest in play
  • Ages 13–18: withdrawal, sleep/appetite changes, drop in grades, hopeless statements, self-criticism
  • Ages 19–25: low motivation, burnout, isolation, difficulty with transitions, impaired concentration

Our Depression Treatment Approach

  • Comprehensive evaluation with DSM-5-TR formulation & safety planning
  • Evidence-based therapy: CBT, Behavioral Activation, emotion-regulation skills
  • Medication management when indicated, with careful titration & monitoring
  • Sleep optimization (CBT-I if needed), routine design, and school collaboration
  • Family partnership and values-/faith-integrated care upon request

Symptom Constellation (At a Glance)

Low mood / irritability Loss of interest Fatigue Sleep changes Appetite shifts Guilt / self-blame Slowed thinking Concentration issues Withdrawal Hopeless statements
Activity Re-engagement Goal ↑ weekly

Returning to valued activities supports mood via Behavioral Activation.

Sleep Regularity ±30–45 min

Consistent sleep/wake anchors energy, focus, and resilience.

Cognitive Flexibility CBT skills

Challenging unhelpful thoughts reduces hopelessness and rumination.

Daily Structure Routines

Small, repeatable routines build momentum and confidence.

What to Expect at SHIELD

  • Week 1: Comprehensive evaluation, safety plan, and first steps
  • Weeks 2–4: Skills training + Behavioral Activation; sleep plan starts
  • Weeks 5–8: Medication review (if indicated), school support, track progress
  • Ongoing: Relapse-prevention skills, schedule anchors, and family coaching

Superbill codes typically used: 99204/99205, 90834, 90838 (as clinically appropriate).

When to Seek Urgent Help

If there are concerns for safety (self-harm, suicidal thoughts, or inability to stay safe), call 911, go to the nearest emergency room, or dial 988 for the Suicide & Crisis Lifeline.

Frequently Asked Questions

  • Do you use therapy or medication? We start with evidence-based therapy and skills; medication is added only when it’s clearly indicated and desired.
  • Can you coordinate with school? Yes. We provide letters, recommendations for IEP/504, and collaborate with your team.
  • Is this concierge / private pay? Yes. You receive detailed documentation and superbills for out-of-network reimbursement.

Depression FAQ & Resources

  • Depression is a mental health disorder that causes persistent feelings of sadness, hopelessness, and loss of interest in activities. It affects how you think, feel, and function in daily life, often leading to fatigue, sleep disturbances, difficulty concentrating, and physical symptoms like body aches or appetite changes.

  • Major Depressive Disorder (MDD) – Persistent sadness, loss of interest, and difficulty functioning for at least two weeks
    Persistent Depressive Disorder (Dysthymia) – Chronic, lower-level depression lasting two years or more
    Bipolar Depression – Depression that occurs as part of bipolar disorder, alternating with manic episodes
    Seasonal Affective Disorder (SAD) – Depression that follows a seasonal pattern, usually worse in winter months
    Postpartum Depression – Depression that occurs after childbirth due to hormonal and emotional changes
    Situational Depression – Short-term depression triggered by stressful life events, grief, or major changes

  • Depression is a complex condition caused by a combination of:
    Brain Chemistry & Genetics – Imbalances in neurotransmitters (serotonin, dopamine) and family history of depression
    Chronic Stress & Trauma – Long-term stress, abuse, or unresolved trauma can contribute to depressive symptoms
    Medical Conditions & Medications – Thyroid disorders, chronic pain, or medications like beta-blockers can trigger depression
    Lifestyle & Environmental Factors – Poor diet, lack of exercise, and social isolation can worsen symptoms

  • Depression is diagnosed through a comprehensive psychiatric evaluation, including:
    A discussion of symptoms and how they impact daily life
    A review of medical and family history
    Standardized depression screening tools

    At SHIELD Psychiatry, we offer telehealth-based depression assessments to provide accurate diagnosis and personalized treatment plans.

  • Cognitive Behavioral Therapy (CBT) – A structured therapy that helps identify and change negative thought patterns
    Medication Management – Antidepressants such as SSRIs, SNRIs, or atypical antidepressants may help rebalance brain chemistry
    Lifestyle Adjustments – Regular exercise, healthy sleep habits, and nutrition can improve mood
    Mindfulness & Relaxation Techniques – Meditation, deep breathing, and stress-reduction exercises
    Support Groups & Psychotherapy – Connecting with others can provide emotional support and encouragement

  • Yes! Many people manage depression effectively without medication by using therapy, lifestyle modifications, and mindfulness techniques. However, for moderate to severe depression, a combination of therapy and medication is often the most effective treatment.

  • Encourage professional help – Therapy and treatment can provide relief and long-term improvement
    Stay connected – Isolation worsens depression, so maintain supportive relationships
    Create small, achievable goals – Accomplishing small tasks can build motivation
    Practice self-care – Prioritize sleep, nutrition, and physical activity
    Avoid alcohol & substance use – These can worsen depressive symptoms

  • You can schedule a depression evaluation or therapy session by filling out our online form or contacting us directly. Our telehealth services make it easy to receive expert mental health care from the comfort of your home.

Trusted ADHD & Mental Health Resources

Curated organizations, books, and apps families can rely on.

Trusted Mental Health Organizations

Books on Depression & Recovery

  • Feeling Good: The New Mood Therapy — David D. Burns, MD

    CBT-based self-help with actionable thought records and exercises.

    CBTAdult
  • The Upward Spiral — Alex Korb, PhD

    Neuroscience-informed micro-habits to nudge mood and motivation.

    NeuroHabits
  • Lost Connections — Johann Hari

    Explores social/contextual drivers; a discussion starter for care plans.

    ContextAdult

Top-Rated Mental Health Apps

  • Moodfit

    Mood tracking, goals, and coping tools to build routines.

    AdultTracking
  • Woebot

    Daily CBT micro-coaching via conversational check-ins.

    CBTAll
  • Happify

    Evidence-informed activities targeting resilience and positive affect.

    SkillsAdult
  • Calm

    Meditation, sleep stories, and stress reduction modules.

    SleepAll
An infographic illustrating signs and symptoms of depression, including sadness and irritability, loss of interest, fatigue, changes in sleep, and low self-esteem, with illustrations of sad, tired, and withdrawn children and a sleeping boy.