Quick answer
Everyone feels low sometimes. Depression is different: it lasts at least 2 weeks, shows up most of the day, nearly every day, and changes how you feel, think, sleep, eat and work. It's one of the most common mental health conditions in the United States, and it comes in several forms, from major depression to long-lasting, seasonal and hormone-related depression. It's treatable, usually with therapy, medication, or both. This guide explains what depression looks like, the main types, when it's worth getting evaluated, and what care with us looks like.
Key takeaways
- Depression is more than sadness: it lasts at least 2 weeks, is there most of the day, nearly every day, and gets in the way of daily life.
- It comes in several forms: major depression, persistent depression, seasonal depression, and depression tied to pregnancy, the menstrual cycle or perimenopause. Low periods can also be part of bipolar disorder, which is treated differently.
- Therapy and medication both help, and they're often used together. Antidepressants usually take 4 to 8 weeks to work.
- A careful evaluation sorts out which pattern fits, and checks for things that can look like depression, such as burnout or a thyroid problem.
What depression looks like day to day
Everyone feels sad or low sometimes, and those feelings usually pass. Depression lasts longer and runs deeper. It can affect how you feel, how you think, and how you handle everyday things like sleeping, eating or working.
It doesn't always look like sadness. It can show up as irritability or anger, feeling detached, drinking more, or physical problems such as aches, headaches or stomach trouble without a clear cause.
Common signs, in plain language
- A sad, anxious or "empty" mood that doesn't lift
- Losing interest or pleasure in things you used to enjoy
- Low energy, or feeling slowed down
- Trouble concentrating, remembering or making decisions
- Changes in sleep or appetite
- Feeling hopeless, guilty or worthless
- Thoughts of death or suicide
These signs are a general guide, not a checklist for diagnosis. Not everyone has all of them.
Read more: why depression isn't just feeling sad, signs of depression you might be missing, depression and anger, how depression affects concentration and memory.
If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline), any time, day or night. In an emergency, call 911 or go to the nearest emergency room.
Sadness, a rough patch, or depression?
Feeling sad after a loss, a disappointment or a hard stretch is part of life, and it usually eases with time, rest or support. Depression lasts longer and runs deeper: it's there most of the day, nearly every day, for at least 2 weeks, and it starts to get in the way of work, relationships and everyday tasks.
Read more: depression vs. sadness.
Is it this or that?
Depression, or ordinary sadness?
| Ordinary sadness or low mood | Major depression | |
|---|---|---|
| How long it lasts | Often gets better after a few days or weeks. | Symptoms most of the day, nearly every day, for at least 2 weeks. |
| What it involves | Feeling sad, frustrated, tired or low on confidence for a while. | A depressed mood or loss of interest, plus other changes in sleep, appetite, energy, concentration or self-worth. |
| Effect on daily life | Small changes, like resolving a problem or getting more sleep, often help. | Gets in the way of day-to-day functioning and causes real distress. |
| When to get help | If it lasts more than 2 weeks, or you're struggling to cope. | Talk with a health care provider. Depression is treatable. |
Ordinary sadness or low mood
- How long it lasts
- Often gets better after a few days or weeks.
- What it involves
- Feeling sad, frustrated, tired or low on confidence for a while.
- Effect on daily life
- Small changes, like resolving a problem or getting more sleep, often help.
- When to get help
- If it lasts more than 2 weeks, or you're struggling to cope.
Major depression
- How long it lasts
- Symptoms most of the day, nearly every day, for at least 2 weeks.
- What it involves
- A depressed mood or loss of interest, plus other changes in sleep, appetite, energy, concentration or self-worth.
- Effect on daily life
- Gets in the way of day-to-day functioning and causes real distress.
- When to get help
- Talk with a health care provider. Depression is treatable.
If your low periods alternate with stretches of unusually high energy and little need for sleep, it could be bipolar disorder, which is treated differently. This comparison is general information, not a diagnosis. Sources: NIMH: Depression · NHS: Low mood, sadness and depression
The main types, in plain words
Depression isn't one thing. The pattern matters, because it shapes the treatment. You don't need to know which type fits before you come in; sorting that out is part of the evaluation.
Major depression
Low mood or loss of interest, most of the time, for at least 2 weeks, getting in the way of daily life.
About major depressionPersistent depressive disorder
Milder symptoms that last much longer, usually at least 2 years. Also called dysthymia.
About persistent depressionSeasonal affective disorder
Depression that comes and goes with the seasons, most often starting in late fall or early winter.
About seasonal depressionPostpartum, PMDD and perimenopause
Depression linked to pregnancy and after birth, the weeks before a period (PMDD), or the transition to menopause.
About women's mental healthBipolar depression
Depressive episodes that alternate with periods of unusually high or irritable mood and energy.
About bipolar disordersBurnout or depression?
Burnout comes from long-term work stress. It isn't a medical condition, but it can look a lot like depression.
Burnout vs. depressionRead more: atypical depression, why bipolar disorder is often mistaken for depression, postpartum depression or the baby blues.
What causes depression?
There's rarely one cause. Research suggests a mix of genetic, biological, environmental and psychological factors plays a role. A few things that matter:
- Family history: depression can run in families.
- Life events: loss, stress, trauma and major changes can bring it on, though it can also appear without an obvious reason.
- Physical health: depression often comes with chronic illnesses such as diabetes, cancer, heart disease and chronic pain, and some medical conditions and medications can cause similar symptoms.
- Past depression: people who have had depression are more likely to have it again, which is one reason regular follow-ups matter.
Depression isn't a weakness or something you can simply snap out of. It's a recognized condition, and it responds to treatment.
Depression in different parts of life
- Work: exhaustion and feeling detached from your job can be burnout, depression or both. See burnout vs. depression.
- Men: depression in men often shows up as irritability, anger, working too much or drinking more, and it's often missed. Read why men underreport depression.
- Pregnancy and after birth: depression can start during pregnancy or after the baby arrives, and it's different from the short-lived baby blues. See our women's mental health page and read the postpartum presentations you might not expect.
- The seasons: for some people, low mood comes back each fall or winter. Read winter and your mood and see our seasonal affective disorder page.
- Alcohol: drinking can seem to help for a while, but it can deepen depression afterward and over time. Read how alcohol affects anxiety and depression.
- Sleep: depression can mean sleeping too little or too much. Read when you sleep too much and still feel tired.
When it's worth getting evaluated
It's worth reaching out if:
- Low mood, emptiness or loss of interest has lasted more than 2 weeks
- It's affecting your sleep, work, school or relationships
- Everyday tasks take far more effort than they used to
- You're relying on alcohol or other substances to get through
- You've tried to manage it on your own and it isn't enough
- Depression has come back after getting better before
You don't need to wait until things are at their worst. If you've been looking for a psychiatrist for depression treatment in New Jersey, our board-certified psychiatric nurse practitioners can evaluate what's going on and talk through your options.
If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline), any time, day or night. In an emergency, call 911 or go to the nearest emergency room.
What an evaluation at ANK looks like
There's no blood test for depression. A careful evaluation looks at the pattern, not just how you feel today, and we take the time to hear it:
- When your symptoms started, how long they've lasted and whether they've come back before
- Whether they follow the seasons, your menstrual cycle, pregnancy or perimenopause
- Any past periods of unusually high energy or little need for sleep, which can point to bipolar disorder
- How much of it is tied to work stress
- Your physical health and medications, since some medical conditions, such as thyroid problems, and some medications can cause similar symptoms. Sometimes that means checking in with your primary care provider.
- Conditions that often come with depression, such as anxiety, or alcohol and substance use
- Past treatment, and what did or didn't help
This is part of a comprehensive psychiatric evaluation. Your first evaluation is up to 90 minutes in length. Some people need more time, some less, and we take the time you need. Follow-up visits are typically 20 to 30 minutes, and extended follow-ups are available. You'll leave understanding what we think is going on, and why. Read the questions you'll be asked at a first psychiatric evaluation.
Treatment options
Depression is treatable. Treatment usually involves therapy, medication, or both, chosen around your needs, preferences and health. For milder depression, therapy is often tried first. For moderate or severe depression, medication is usually part of the plan from the start, and many people use both.
Therapy
Talk therapy, such as cognitive behavioral therapy (CBT), helps with depression by working on the thoughts, habits and routines that keep it going. Depending on your clinician, visits may draw on supportive, motivational interviewing, CBT-based, or DBT-based skills. We don't offer standalone weekly therapy, but we're happy to help you find a therapist and, with your permission, we'll coordinate with them.
Medication
Antidepressants are the medications most often used. They usually take 4 to 8 weeks to work. Because they can trigger mania or hypomania, we check for bipolar disorder before starting one. Finding the best option can take some trial and error, so we go step by step and explain the reasons behind each choice. The medication quick facts below list the FDA-approved options. Our major depressive disorder page explains how long treatment usually lasts, and what happens when the first medication isn't enough.
Everyday steps that help
We also talk through the basics that support recovery: a regular bedtime and wake-up time, physical activity, regular meals, and staying connected with people you trust. Regular follow-ups are how we keep your plan on track and adjust it as things change.
Insurance and cost
We're in network with Horizon BCBS NJ and most other BCBS plans, Aetna, Cigna, UHC, Optum, Oscar, Oxford and Curative. Coverage can vary by plan and by provider, so after you submit your intake packet, we'll verify your benefits and let you know what to expect before your first appointment. We don't accept Medicare or Medicaid (NJ FamilyCare). Because of Medicare and Medicaid rules, we also can't see patients with these plans on a private-pay basis.
Self-pay rates, superbills and the Good Faith Estimate are on our insurance and fees page.
Is it this or that?
Depression, persistent depression or burnout?
| Major depression | Persistent depressive disorder | Burnout | |
|---|---|---|---|
| What it is | A depressive episode: low mood or loss of interest most of the time for at least 2 weeks. | Less severe depression symptoms that last much longer, usually at least 2 years. | The result of long-term workplace stress that hasn't been successfully managed. Not classified as a medical condition. |
| Main signs | Low mood, loss of interest, low energy, changes in sleep or appetite, trouble concentrating. | Similar signs, usually milder, that go on for years. | Exhaustion, feeling distant from or cynical about your job, and feeling less effective at work. |
| Where it shows up | Across daily life: sleep, eating, work and relationships. | Across daily life, over a long stretch of time. | At work specifically, by definition. |
Major depression
- What it is
- A depressive episode: low mood or loss of interest most of the time for at least 2 weeks.
- Main signs
- Low mood, loss of interest, low energy, changes in sleep or appetite, trouble concentrating.
- Where it shows up
- Across daily life: sleep, eating, work and relationships.
Persistent depressive disorder
- What it is
- Less severe depression symptoms that last much longer, usually at least 2 years.
- Main signs
- Similar signs, usually milder, that go on for years.
- Where it shows up
- Across daily life, over a long stretch of time.
Burnout
- What it is
- The result of long-term workplace stress that hasn't been successfully managed. Not classified as a medical condition.
- Main signs
- Exhaustion, feeling distant from or cynical about your job, and feeling less effective at work.
- Where it shows up
- At work specifically, by definition.
These can overlap or look alike, which is why a careful evaluation matters. This comparison is general information, not a diagnosis. Sources: NIMH: Depression · WHO: Burn-out, an occupational phenomenon
Medication quick facts
FDA-approved medications for depression include
These are some of the medications FDA-approved for depression. Most are approved for major depressive disorder; bupropion extended-release is also approved to prevent seasonal depressive episodes. FDA approval reflects which uses a manufacturer chose to study and submit, not the only medications that help. For medications used off-label, see our pages on major depressive disorder and persistent depressive disorder. Our seasonal affective disorder page covers other antidepressants used for the seasonal pattern. Your provider will talk with you about what fits you. There are more than these cards can hold, so the rest are listed below the cards.
Browse by name. Your provider will talk with you about which options fit you.
Sertraline (Zoloft)
An SSRI antidepressant (selective serotonin reuptake inhibitor)
- FDA-approved for
- Major depressive disorder. Also OCD, panic disorder, PTSD, social anxiety disorder and PMDD.
- Common side effects
- Nausea, diarrhea, tremor, indigestion, less appetite, sweating and sexual side effects.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Zoloft
General information, not medical advice; talk with your provider.
Fluoxetine (Prozac)
An SSRI antidepressant (selective serotonin reuptake inhibitor)
- FDA-approved for
- Short-term and long-term (maintenance) treatment of major depressive disorder. Also OCD, bulimia nervosa and panic disorder.
- Good to know
- It stays in the body a long time, so dose changes take several weeks to fully show, and it lingers for weeks after the last dose.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Prozac
General information, not medical advice; talk with your provider.
Escitalopram (Lexapro)
An SSRI antidepressant (selective serotonin reuptake inhibitor)
- FDA-approved for
- Major depressive disorder in adults and teens 12 and older. Also generalized anxiety disorder.
- Common side effects
- Trouble sleeping, nausea, sweating, tiredness or sleepiness, and sexual side effects.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Lexapro
General information, not medical advice; talk with your provider.
Citalopram (Celexa)
An SSRI antidepressant (selective serotonin reuptake inhibitor)
- FDA-approved for
- Major depressive disorder in adults.
- Important
- It can affect heart rhythm (a change called QT prolongation) at higher doses, so the label sets a maximum dose, and a lower one for people over 60. Tell your provider about any heart rhythm problems.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Celexa
General information, not medical advice; talk with your provider.
Paroxetine (Paxil, Paxil CR)
An SSRI antidepressant (selective serotonin reuptake inhibitor)
- FDA-approved for
- Major depressive disorder in adults. Paxil is also approved for OCD, panic disorder, social anxiety disorder, generalized anxiety disorder and PTSD; Paxil CR also for PMDD.
- Pregnancy
- If you're planning a pregnancy or in the first trimester, the label advises considering other options first.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Paxil · FDA label (DailyMed): Paxil CR
General information, not medical advice; talk with your provider.
Venlafaxine extended-release (Effexor XR)
An SNRI antidepressant (serotonin and norepinephrine reuptake inhibitor)
- FDA-approved for
- Major depressive disorder in adults. Also generalized anxiety disorder, social anxiety disorder and panic disorder.
- Watch for
- It can raise blood pressure, so your blood pressure is checked regularly. Taken once a day with food.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Effexor XR
General information, not medical advice; talk with your provider.
Desvenlafaxine (Pristiq)
An SNRI antidepressant (serotonin and norepinephrine reuptake inhibitor)
- FDA-approved for
- Major depressive disorder in adults.
- Watch for
- It can raise blood pressure, so your blood pressure is checked regularly.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Pristiq
General information, not medical advice; talk with your provider.
Duloxetine (Cymbalta)
An SNRI antidepressant (serotonin and norepinephrine reuptake inhibitor)
- FDA-approved for
- Major depressive disorder. Also generalized anxiety disorder, diabetic nerve pain, fibromyalgia and ongoing muscle or bone pain.
- Important
- Serious liver problems have been reported. Tell your provider about heavy drinking or any liver disease.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: MedlinePlus: Duloxetine · FDA label (DailyMed): Cymbalta
General information, not medical advice; talk with your provider.
Levomilnacipran (Fetzima)
An SNRI antidepressant (serotonin and norepinephrine reuptake inhibitor)
- FDA-approved for
- Major depressive disorder in adults.
- Watch for
- It can raise blood pressure and heart rate, so these are checked regularly.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Fetzima
General information, not medical advice; talk with your provider.
Bupropion extended-release (Wellbutrin XL)
An antidepressant (aminoketone) that works differently from SSRIs and SNRIs
- FDA-approved for
- Major depressive disorder, and preventing seasonal depressive episodes in people with seasonal affective disorder (started in the autumn and continued through the winter).
- Important
- It can cause seizures, and the risk goes up with the dose. It isn't used in people with a seizure disorder or a current or past eating disorder such as bulimia or anorexia. It can also raise blood pressure.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Wellbutrin XL
General information, not medical advice; talk with your provider.
Mirtazapine (Remeron)
An antidepressant that works differently from SSRIs and SNRIs
- FDA-approved for
- Major depressive disorder in adults.
- Common side effects
- Sleepiness, increased appetite, weight gain and dizziness. Usually taken in the evening, before sleep.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Remeron
General information, not medical advice; talk with your provider.
Vortioxetine (Trintellix)
An antidepressant that acts on serotonin in more than one way
- FDA-approved for
- Major depressive disorder in adults.
- Common side effects
- Nausea, constipation and vomiting. Can be taken with or without food.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Trintellix
General information, not medical advice; talk with your provider.
Vilazodone (Viibryd)
An antidepressant that acts on serotonin in more than one way
- FDA-approved for
- Major depressive disorder in adults.
- How it's taken
- Once a day with food, starting low and raising the dose step by step.
- Common side effects
- Diarrhea, nausea, vomiting and trouble sleeping.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Viibryd
General information, not medical advice; talk with your provider.
Trazodone
An antidepressant (serotonin modulator)
- FDA-approved for
- Major depressive disorder in adults.
- Watch for
- Drowsiness, and dizziness or fainting when standing up. Rarely, a painful, long-lasting erection (priapism), which needs medical care right away. Take it shortly after a meal or snack.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Trazodone · MedlinePlus: Trazodone
General information, not medical advice; talk with your provider.
Dextromethorphan and bupropion (Auvelity)
A combination antidepressant
- FDA-approved for
- Major depressive disorder in adults.
- Important
- It contains bupropion, so it carries the same seizure cautions (not for people with a seizure disorder or an eating disorder such as bulimia or anorexia). It can raise blood pressure and cause dizziness. It may harm a developing baby, so it isn't used during pregnancy.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Auvelity
General information, not medical advice; talk with your provider.
Gepirone extended-release (Exxua)
An antidepressant that acts on serotonin receptors
- FDA-approved for
- Major depressive disorder in adults.
- Monitoring
- It can affect heart rhythm (QT prolongation), so the label calls for an ECG (heart tracing) before starting and during treatment.
- Good to know
- A newer medication, so there's less real-world experience with it.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Exxua
General information, not medical advice; talk with your provider.
Aripiprazole (Abilify)
An atypical antipsychotic, used as an add-on to an antidepressant
- FDA-approved for
- Adjunctive treatment of major depressive disorder, meaning it's added to an antidepressant. Also approved for other conditions, including bipolar I.
- Watch for
- In depression studies: restlessness or an inner urge to keep moving (akathisia), trouble sleeping, constipation, tiredness and blurred vision. It can raise blood sugar, cholesterol and weight, so your provider may check these.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Abilify
General information, not medical advice; talk with your provider.
Brexpiprazole (Rexulti)
An atypical antipsychotic, used as an add-on to an antidepressant
- FDA-approved for
- Adjunctive treatment of major depressive disorder in adults, added to an antidepressant.
- Watch for
- In depression studies: weight gain, sleepiness and restlessness (akathisia). It can raise blood sugar and cholesterol, so your provider may check these.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Rexulti
General information, not medical advice; talk with your provider.
Cariprazine (Vraylar)
An atypical antipsychotic, used as an add-on to an antidepressant
- FDA-approved for
- Adjunctive treatment of major depressive disorder in adults, added to an antidepressant. Also approved for bipolar I.
- Watch for
- In depression studies: restlessness (akathisia), tiredness, constipation, nausea, trouble sleeping, increased appetite and dizziness. It stays in the body a long time, so side effects can show up weeks after starting or changing the dose. Your provider may check blood sugar, cholesterol and weight.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Vraylar
General information, not medical advice; talk with your provider.
Quetiapine extended-release (Seroquel XR)
An atypical antipsychotic, used as an add-on to an antidepressant
- FDA-approved for
- Adjunctive treatment of major depressive disorder, added to an antidepressant. Also approved for bipolar disorder.
- Watch for
- Sleepiness, dry mouth, constipation, dizziness, increased appetite and weight gain. It can raise blood sugar and cholesterol, so your provider may check these.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Seroquel XR
General information, not medical advice; talk with your provider.
Lumateperone (Caplyta)
An atypical antipsychotic, used as an add-on to an antidepressant
- FDA-approved for
- Adjunctive treatment of major depressive disorder in adults, added to an antidepressant. Also approved for bipolar depression.
- Watch for
- In depression studies: dizziness, dry mouth, sleepiness, nausea, tiredness and diarrhea. Your provider may check blood sugar, cholesterol and weight.
- Antidepressant warning
- In short-term studies, antidepressants increased suicidal thoughts and behaviors in people up to age 24. Anyone taking one should be watched closely for worsening, especially during the first few months and at times of dosage changes. Don't stop suddenly; talk with your provider first.
Source: FDA label (DailyMed): Caplyta
General information, not medical advice; talk with your provider.
Also FDA-approved for depression: other forms of venlafaxine (immediate-release) and bupropion (Wellbutrin SR, Aplenzin, Forfivo XL); olanzapine and fluoxetine for depression that hasn't responded to two antidepressants; the older tricyclic antidepressants amitriptyline, nortriptyline, imipramine, desipramine, doxepin, protriptyline, trimipramine and amoxapine; the MAO inhibitors phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan) and the selegiline patch (Emsam); and nefazodone, which carries a warning about liver failure. These are used less often today, usually when newer medications haven't helped. Links go to each FDA label.
Esketamine (Spravato), a nasal spray, is also FDA-approved for treatment-resistant depression, on its own or with an oral antidepressant, and, alongside an oral antidepressant, for depression in adults with acute suicidal thoughts or actions. It's a controlled medication given only in certified treatment centers, with monitoring for at least 2 hours afterward, so it isn't prescribed for home use. We can talk about whether a referral makes sense. (FDA label)
Brand names are listed for recognition only. Antidepressant labels warn that they can trigger mania or hypomania, and ask providers to check for bipolar disorder first. Most can also cause serotonin syndrome when combined with other medications that raise serotonin, and many raise bleeding risk with aspirin, NSAIDs (such as ibuprofen) or blood thinners, so tell your provider everything you take. Antipsychotics carry a warning about older adults with dementia, which mainly concerns people older than the adults we see.
What to expect
What to expect
1Start your intake packet
Fill out our secure intake packet. Once it's submitted, we'll verify your insurance and call you to schedule your appointment.
2A careful evaluation
A longer video visit about your mood, sleep, energy, health, history and goals.
3Understanding the picture
We explain which pattern we think fits, whether that's a type of depression, bipolar disorder, burnout or something else, and why.
4Your plan
If medication could help, we talk through the options, side effects and what to expect, and decide together. If therapy would help, we can help you find it.
5Regular follow-ups
We check how you're doing and adjust carefully over time, one change at a time.
Bring this to your visit
Questions to ask your provider
Tick the ones you want to ask, then copy your list. Nothing is saved or sent.
Before your first visit
Information your provider will want to know
Tick what you have ready, then copy the list to fill in your notes. Nothing is saved or sent.
Frequently asked questions
Is depression the same as sadness?
No. Sadness usually passes. Depression lasts longer, most of the day, nearly every day, for at least 2 weeks, and it gets in the way of daily life.
Do I need to know which type of depression I have before my visit?
No. Many people come in unsure. We look at how long your symptoms have lasted, whether they follow a pattern such as the seasons or your cycle, and whether you've had high periods too. Sorting that out is part of the evaluation.
Will I need medication?
Not necessarily. Therapy, medication, or both can help, and the choice is yours. If medication could help, your provider will explain the options, side effects and what to expect so you can decide together.
How long do antidepressants take to work?
Usually 4 to 8 weeks. Sleep, appetite and concentration often improve before mood lifts, so it's worth giving a medication a fair chance.
Do I need therapy too?
It depends. For milder depression, therapy is often tried first. For moderate or severe depression, medication is usually part of the plan from the start, and many people use both. We don't offer standalone weekly therapy, but we're happy to help you find a therapist and, with your permission, we'll coordinate with them.
Can you help with postpartum, PMDD or perimenopausal depression?
Yes. These are part of our women's mental health care.
Does insurance cover depression treatment?
We're in network with Horizon BCBS NJ and most other BCBS plans, Aetna, Cigna, UHC, Optum, Oscar, Oxford and Curative. Coverage can vary by plan and by provider, so after you submit your intake packet, we'll verify your benefits and let you know what to expect before your first appointment. See our <a href="/financial-and-insurance/">insurance and fees page</a> for details.
Can you treat depression by video?
Yes. Most visits are by secure video, anywhere in New Jersey. Our office is in Mount Laurel, NJ, and in-person visits there are limited and by appointment only; ask our office.
What if I'm having thoughts of suicide?
Please reach out right away. If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline), any time, day or night. In an emergency, call 911 or go to the nearest emergency room.
Is a psychiatric nurse practitioner the same as a psychiatrist?
Both diagnose psychiatric conditions and prescribe psychiatric medication. Ours are board-certified psychiatric nurse practitioners (PMHNP-BC), focused on careful evaluation and medication management.
Check your understanding
Three quick questions
1For depression, how long do symptoms usually need to last?
Symptoms are there most of the day, nearly every day, for at least 2 weeks.
2How does the World Health Organization classify burnout?
Burnout comes from long-term work stress and isn't classified as a medical condition, though it can look like depression.
3When does seasonal affective disorder most often start?
Most often it starts in the late fall or early winter and eases in spring and summer.
Myth or fact? Depression
Choose an answer for each to see the explanation. Nothing is saved.
1Depression always looks like sadness.
Myth. It can show up as irritability or anger, feeling detached, or physical aches without a clear cause.
2Pregnancy, the menstrual cycle and menopause can bring on depression in some people.
Fact. Postpartum depression, PMDD and perimenopausal depression are recognized types.
3Burnout and depression are the same thing.
Myth. Burnout is tied to work stress and isn't classified as a medical condition. Depression affects daily life more broadly. They can look alike, so an evaluation helps.
4Depression is a sign of weakness.
Myth. Depression is a recognized condition with genetic, biological, environmental and psychological causes, and it responds to treatment.
The science: how we checked this
Sources
- NIMH: Depression
- NIMH: Seasonal affective disorder
- NHS: Low mood, sadness and depression
- NIMH: Depression (overview)
- WHO: Burn-out, an occupational phenomenon
- Merck Manual (consumer version): Depression
- NHS: Antidepressants
- FDA label (DailyMed): Zoloft (sertraline)
- FDA label (DailyMed): Prozac (fluoxetine)
- FDA label (DailyMed): Lexapro (escitalopram)
- FDA label (DailyMed): Celexa (citalopram)
- FDA label (DailyMed): Paxil (paroxetine)
- FDA label (DailyMed): Effexor XR (venlafaxine)
- FDA label (DailyMed): Pristiq (desvenlafaxine)
- MedlinePlus: Duloxetine
- FDA label (DailyMed): Fetzima (levomilnacipran)
- FDA label (DailyMed): Wellbutrin XL (bupropion)
- FDA label (DailyMed): Remeron (mirtazapine)
- FDA label (DailyMed): Trintellix (vortioxetine)
- FDA label (DailyMed): Viibryd (vilazodone)
- FDA label (DailyMed): Trazodone
- FDA label (DailyMed): Auvelity (dextromethorphan and bupropion)
- FDA label (DailyMed): Exxua (gepirone)
- FDA label (DailyMed): Abilify (aripiprazole)
- FDA label (DailyMed): Rexulti (brexpiprazole)
- FDA label (DailyMed): Vraylar (cariprazine)
- FDA label (DailyMed): Seroquel XR (quetiapine)
- FDA label (DailyMed): Caplyta (lumateperone)
How we checked this
- Written in our own words from the sources above, checked November 3, 2026.
- Signs are described in plain language and aren't a diagnostic checklist.
- Each medication card lists only what its FDA label approves it for; add-on antipsychotics are included only where the label approves them alongside an antidepressant for major depressive disorder.
