The holidays can be a difficult time of year for many people, but not all seasonal sadness is the same. While the “holiday blues” are typically brief and situational, issues such as seasonal affective disorder (SAD) and major depressive disorder (MDD) are serious mental health conditions requiring professional care from a depression psychiatrist.
 
Whether it’s a temporary situation or something more serious, the symptoms are extremely unpleasant. Let’s take a look at each of these issues to gain a deeper understanding of how symptoms can be managed.
 
Before we dive in, though, if your symptoms include thoughts of death or suicide, please get help immediately. The national crisis hotline can be accessed by calling or texting 988, and help is available 24/7.
 
The Holiday Blues
While a myriad of songs tell us that the holiday season is the most wonderful time of the year, this is often simply not the case. The holidays bring with them a huge amount of stress and often high expectations of an idealized version of the season.
 
Additionally, for those with few family members or friends or those who have recently lost a loved one, this season can be extremely traumatic. Of course, family tension also can play a role in triggering the holiday blues, as it can be highly stressful and upsetting to navigate family get-togethers.
 
Of course, this “gift-giving” season also brings with it a financial burden that can cause huge amounts of stress, particularly if you are struggling financially. The season also brings with it disruptions in our daily routines, and while parties and special events can be enjoyable and meaningful, disrupted routines can alter our moods.
 
With all of that, it’s little wonder why some people experience unpleasant emotional symptoms at this time of year. Some common symptoms of the holiday blues include:

• Low mood
• Irritability
• Fatigue
• Mild Anxiety
• Feeling overwhelmed

 
The good news is that these feelings typically pass once the holidays are over and we return to our regular routine. There are also some steps we can take to minimize these unpleasant feelings during the holidays.
 
1. Keep Your Expectations Realistic
We are barraged by idealized versions of the holiday season on television and on social media, but these are not images that reflect reality. It is perfectly normal to feel stressed out or emotional during this time of year, and it’s also ok to scale back your celebrations to something manageable and comfortable.
 
2. Set Boundaries
Along these same lines, overcommitting can lead to burnout, and it is 100% acceptable to decline invitations to events that feel overwhelming. It’s also perfectly fine to limit time with stressful individuals.
 
3. Maintain Basic Routines
With the holidays, we tend to have our schedules disrupted, but, as much as possible, stick to a consistent routine. Keep consistent sleep and wake times, and keep mealtimes as regular as possible.
 
A bit of daily exercise can help as well, particularly going outside, especially if you live in an area with limited daylight during the winter months. Exposure to fresh air and sunlight can lift our mood.
 
4. Stay Connected
For many, many people, the holidays are a time of loneliness. It is important for people to stay connected with others, but this is not always easy. If family members are far away and cannot be seen in person during the holidays, set up time for a phone call or a FaceTime call. You can even schedule an online event with friends and family, if access in-person is difficult.
 
If you don’t have a strong network of friends or family, consider going to a house of worship to be around others or taking part in community activities. Volunteering is an excellent way to stay connected, and you will be brightening others' lives as well. Consider volunteering at a shelter, food bank, or perhaps a facility for the elderly.
 
4. Acknowledge Loss & Grief
For many of us, the holidays can exacerbate feelings of grief or loss. Whether the grief is due to a recent loss, strained family relationships, or just past losses, it’s ok to acknowledge that you feel grief. Suppressing these feelings can cause great emotional strain, so give yourself some space to grieve. As a depression doctor, I find that joining a support group can help provide you with a safe space to talk about these feelings of loss.
 
5. Plan Something for the Future
Whether you struggle to get through the holidays or tend to feel a huge letdown once the season ends, having something to look forward to can help improve your mood and maintain emotional balance.
 
This doesn’t have to be a huge event, just something manageable that you will enjoy. It could be as simple as a salon appointment for a new haircut, a lunch date with a friend (it’s often easier to schedule after the holidays), a scenic drive, a nature walk, trying out a new class, or even setting a few manageable goals for the new year.
 
Major Depressive Disorder
While the holiday blues typically pass fairly quickly after the holidays, Major Depressive Disorder (MDD) does not, and it tends to interfere much more intensely with our ability to manage our day-to-day life.
 
Common symptoms of MDD include:

• A depressed mood most of the day and nearly every day
• Loss of interest or pleasure in events you previously enjoyed
• Sleep and appetite changes (also significant weight loss or gain)
• Low energy
• Feelings of worthlessness or guilt
• Difficult concentrating
• Thoughts of death or suicide (Again, please call or text 988 if you are experiencing these thoughts now)

 
In general, with MDD, these symptoms persist for at least two weeks and often much longer, and these symptoms significantly impact daily functioning, including work and relationships with friends, family, and co-workers.
 
This is one of the main differences between holiday blues and MDD. With MMD, the symptoms greatly interfere with daily life. With holiday blues, we may experience unpleasant mood changes, but typically, we can still function and handle daily tasks.
 
MDD must be diagnosed by a professional, such as a depression psychiatrist. I recommend that you find a psychiatrist or ask your primary care physician to refer you to a local psychiatrist.
 
While a therapist and a psychologist can provide you with valuable therapy and tools to help manage symptoms, a psychiatrist is the only mental health professional who can prescribe medication for MDD, which may be needed.
 
Additionally, as we are also medical doctors, we can provide a more comprehensive diagnosis. In some cases, physical issues or other medications could be causing your symptoms, including drug or alcohol use. In other cases, you might suffer from multiple mental health conditions, and all of this must be treated properly.
 
Medication management can be an excellent tool, and we have many medications available that can reduce symptoms. There are also other options to consider, especially with treatment resistant depression, such as transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), and more.
 
Of course, as a psychiatrist for depression, I also strongly encourage all of my patients to find a good therapist or psychologist for talk therapy. Cognitive behavioral therapy (CBT) and other types of therapy can help you manage symptoms, and your psychiatrist can provide you with medication options or additional types of treatment, if needed.
 
Seasonal Affective Disorder
It’s not the holiday blues, and it typically doesn’t last beyond the winter months as MDD might, but Seasonal Affective Disorder (SAD) can be difficult to navigate all the same. Typically, SAD occurs during the fall and winter, and this disorder is classified as a type of depression with a seasonal pattern.
 
While many people feel a bit down during the winter months, often due to less sunlight and less accessibility to outdoor activities, people with SAD tend to suffer from symptoms that interfere with daily functioning, just as you would with any type of MDD. The symptoms can include:

• Low mood
• Low energy or fatigue
• Increased sleep
• Increased appetite
• Weight gain
• Social withdrawal
• Difficulty concentrating

 
Generally, with SAD, light therapy is one of the first treatments we try, and a depression psychiatrist can recommend some light box options as well as guidelines for use. Generally, people use these for about 30 minutes every morning and often see improvement within just a week or two.
 
Psychotherapy can be a great option, as well, and there is a type of cognitive behavioral therapy developed just for people with SAD (CBT-SAD). This can help an individual not only deal with symptoms but also help reduce the likelihood of depression returning in the future.
 
Medication may be prescribed by a depression psychiatrist, but often this is just for moderate to severe cases, especially when other treatments have not been effective. Sometimes, a patient will start medications a few weeks before the symptoms typically arrive to prevent SAD.
 
Struggling With Depression? I Can Help
If you need a psychiatrist for depression, I work as a psychiatrist in Thousand Oaks, as well as a psychiatrist in Westlake Village. In addition to treating depression, I also work as a psychiatrist for anxiety, a psychiatrist for bipolar disorder, and many other mental health conditions, including addiction, eating disorders, adult ADHD, and more.
 
Whether you are searching for a depression psychiatrist or a doctor to help with other mental health conditions, I encourage you to give me a call, and we will get you on a path to a happier life. 

Psilocybin, often known as “magic mushrooms,” is a naturally occurring psychedelic compound found in some types of mushroom species. It is classified as a hallucinogen and has been used for centuries in spiritual and therapeutic practices.
When consumed, psilocybin is metabolized into psilocin in the body, which then binds to serotonin receptors in the brain. This interaction results in changes to perception, mood, and consciousness, often leading to visual and auditory hallucinations.​

A study at Washington University in St. Louis tracked changes in the brain before and after the use of psilocybin. The researchers found that a microdose of psilocybin had a profound effect on what is known as functional connectivity. This refers to how different regions in our brains communicate and work together to perform tasks or process information.
Essentially, it is postulated that small doses of psilocybin, given in controlled circumstances, might act as a sort of “reset” for our brains. Research suggests that psilocybin may boost our brain’s ability to reorganize and form new and healthier patterns of thought and behavior. It may help patients improve emotional processing as well as emotional regulation.

Have you attempted several different treatments for depression yet still ask yourself why do I feel empty? These feelings of emptiness and despair can be overwhelming and confusing, and you may have what is known as treatment resistant depression, or TRD.
 
For those struggling with TRD, this emotional void can feel extremely isolating. Let's answer some common questions about TRD, explore why some people experience this persistent sense of emptiness, and discuss effective treatment options that may help restore hope and well-being.

First let’s talk about MDD, or Major Depressive Disorder, which typically is the first diagnosis you would receive. This serious mental health condition affects millions of people around the world.
 
Typically, the symptoms include persistent feelings of sadness, and/or hopelessness, and a loss of interest in previously-enjoyable activities  People with MDD often experience physical symptoms such as changes in sleep issues, loss of appetite (or increase), and a drop in energy levels.
 
To be diagnosed with MDD, these symptoms typically must last for at least two weeks and significantly impact a person’s daily life, relationships, or ability to function. MDD can vary in severity, with some individuals responding well to standard treatments like therapy and medication, while others may develop treatment-resistant depression (TRD).

To be honest, we don’t always know the specific reasons why depression occurs. Depression is a complex mental health condition with no single cause. Instead, it typically arises from a combination of biological, psychological, and environmental factors. Some common contributors include:

Biological Factors

• Brain Chemistry: Imbalances in neurotransmitters like serotonin, dopamine, and norepinephrine can affect mood regulation.
• Hormonal Changes: Hormone fluctuations, such as those occurring during pregnancy, menopause, or due to thyroid issues, can contribute to depression.
• Genetics: Individuals with a family history of depression may have a higher risk of developing the condition.

 
Psychological Factors

• Personality Traits: People with low self-esteem, perfectionism, or a tendency to ruminate may be more vulnerable.
• Unresolved Trauma: Past emotional or physical trauma can increase the risk of developing depression.

 
Environmental Factors

• Chronic Stress: Prolonged exposure to stressful situations, such as financial struggles, work pressure, or relationship conflicts, can trigger depression.
• Life Events: Major life changes — including the loss of a loved one, divorce, or job loss — are common triggers.
• Childhood Experiences: Adverse childhood experiences, such as neglect or abuse, can increase the risk.

 
Medical Conditions

• Chronic Illness: Conditions such as diabetes, heart disease, and chronic pain can contribute to depressive symptoms.
• Medication Side Effects: Certain drugs, including some blood pressure medications or hormonal treatments, may cause or worsen depression.

 
Lifestyle Factors

• Poor Sleep: Lack of restful sleep is closely linked to mood disorders.
• Substance Abuse: Alcohol, drugs, or certain medications can contribute to or exacerbate depressive symptoms. Of course, as an addiction psychiatrist, I often find that substance use disorders develop because a person is suffering from depression and drugs or alcohol are used to self-medicate.
• Nutritional Deficiencies: Deficiencies in key nutrients, such as vitamin D, omega-3 fatty acids, and B vitamins, have been linked to depression.

 
Social Isolation

• Limited social support or feelings of loneliness can increase the risk of developing depression.

 
Because depression can stem from multiple factors, effective treatment often requires a depression doctor to try a combination of therapies tailored to an individual's unique circumstances.

TRD is a form of major depressive disorder (MDD) that does not respond adequately to at least two different antidepressant treatments, taken at the appropriate dose and duration. Individuals with TRD may experience ongoing symptoms such as:

• Persistent sadness
• Fatigue
• Lack of motivation
• Emotional numbness

 These feelings persist despite trying multiple treatment approaches. Because TRD can be challenging to manage, it often requires a combination of therapies, specialized treatments, and expert care.

In this blog, the first in a series regarding TRD, we will briefly describe the various treatment resistant depression treatment options. As we dive further into the subject our next blogs will take a deeper dive into specific treatments, specifically some of the latest alternative treatments for people with TRD or depression in general.
 
But first, let’s take a quick look at the many different options psychiatrists can utilize to help patients with TRD. Keep in mind, that in many cases, it’s best to use a combination approach that includes multiple treatment options.

1. Switching Antidepressants
If one type of antidepressant doesn’t work, switching to another class of medications (e.g., from SSRIs to SNRIs) may be beneficial.
 
2. Combination Therapy
Using two different classes of antidepressants together can sometimes provide better results.

This entails adding non-antidepressant medications to enhance the effects of current treatment. Options may include:

• Atypical antipsychotics (e.g., aripiprazole, quetiapine)
• Mood stabilizers (e.g., lithium)
• Stimulants (e.g., methylphenidate)
• Thyroid hormones in some cases
• Ketamine or Esketamine (Spravato)
• Dopamine agonists (e.g. Pramipexole)

Ketamine for treatment resistant depression (often administered via IV infusion) and esketamine (a nasal spray) have shown rapid improvement in depressive symptoms, particularly in individuals with TRD. We will explore ketamine and specifically esketamine further on during our series about TRD. Pramipexole alone or in combination with other drugs, such as ketamine, is another subject we will explore more deeply in future blogs.

​1. Psychotherapy (Talk Therapy)
Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Acceptance and Commitment Therapy (ACT) may offer support when combined with other treatments. Again, as an experienced depression psychiatrist, I strongly recommend adding some type of talk therapy to any treatment plan.
 
2. Transcranial Magnetic Stimulation (TMS)
This is a non-invasive treatment where we use magnetic fields to stimulate the nerve cells in the brain. TMS has been found to be effective for some patients who haven’t responded to traditional medications.
 
3. Electroconvulsive Therapy (ECT)
ECT can be highly effective for severe TRD, particularly when other treatments have failed. Modern ECT is safer and involves controlled electrical currents under anesthesia.
 
4. Vagus Nerve Stimulation (VNS)
A device implanted in the chest sends electrical impulses to the vagus nerve, which can help regulate mood.
 
5. Deep Brain Stimulation (DBS)
Typically used for neurological conditions like Parkinson’s, DBS is now being explored for severe cases of TRD.

1. Exercise & Physical Activity
I know it can be tough for people with depression to get outside and get moving, but regular exercise has been shown to improve mood and overall mental well-being. I highly recommend trying to get outside and walking for at least 20 minutes per day. Sunshine, fresh air and a change of scene might not be a miracle cure, but they certainly can help improve your mood.
 
2. Mindfulness & Meditation
Practices such as mindfulness, meditation, yoga, or tai chi may reduce depressive symptoms.
 
3. Nutritional Support
Omega-3 fatty acids, vitamin D, and certain amino acids may provide additional support.
 
4. Light Therapy
This is especially effective for individuals with seasonal affective disorder (SAD) but can also benefit TRD patients.

1. Neurofeedback
This therapy trains individuals to regulate brainwave patterns.
 
2. Digital Therapeutics
App-based programs designed to support mental health may provide adjunctive benefits.
 
3. Biomarker Testing
Genetic testing may help identify which medications are most likely to be effective for an individual.

As a psychiatrist for depression, I understand how frustrating it can be to have treatment resistant depression. Many with TRD feel very hopeless, but generally, we can always find some type of treatment option that works, even if we need to veer away from some traditional therapies. If you are struggling with TRD and wondering “Why do I feel empty” despite several attempts at treatment, please contact me today and let’s find a new approach that can help you rebuild your life and mental health.
 
Whether you need a psychiatrist for TRD or perhaps a psychiatrist for bipolar disorder, anxiety, borderline personality disorder or another mental health condition, I work as a local psychiatrist for patients in Thousand Oaks, Westlake Village and surrounding areas. Don’t give up hope, together we can find a treatment plan that helps you live a better and happier life.

Humans are inherently social creatures, but if you’ve been feeling disconnected and lonely, this can impact your quality of life significantly. As a depression doctor, I believe it’s important for all of us to understand the impact of loneliness, but also to find ways to combat these feelings of isolation.

Loneliness can be a significant factor in the development of depression. While loneliness itself is a state of feeling disconnected, isolated, or separated from others, it can lead to various mental health issues, including depression. As a psychiatrist for depression, I’ve seen firsthand how loneliness impacts our lives. Here are just a few ways that feelings of loneliness can affect our psyche and lead to depression. ​

• Holiday & Seasonal Depression: For many people, the holidays and the winter season can be a difficult and problematic time, and this is especially true for those suffering from depression. The holidays are meant to be happy occasions, but they often make us feel sad, stressed out and alone.
  
  Additionally,  the lack of daylight during the winter months, and weather that often necessitates staying indoors, also can impact our well-being, leading to feelings of sadness and even full-blown depression. If depression haunts you seasonally, this is known as Seasonal Affective Disorder, and it’s very common. 
• Genetic Predisposition: A family history of depression can increase the risk, suggesting a genetic component to the disorder. 
• Brain Chemistry and Neurotransmitters: Imbalances in the brain's neurotransmitters, such as serotonin, norepinephrine, and dopamine, are believed to play a crucial role in depression. 
• Hormonal Changes: Changes in hormone levels, due to thyroid problems, menopause, childbirth (postpartum depression), or other health conditions, can trigger depression. 
• Life Events: Traumatic or stressful life events, including the loss of a loved one, financial problems, divorce, or significant life changes, can precipitate depression. 
• Chronic Illnesses: Living with chronic pain or a chronic illness, such as diabetes, heart disease, or cancer, can lead to feelings of hopelessness and depression. 
• Substance Abuse: Alcohol or drug abuse can both be a cause and a result of depression. Substance use can exacerbate or trigger depressive episodes. 
• Personality Traits: Individuals with certain personality traits, such as low self-esteem, being overly dependent, self-critical, or pessimistic, are at a higher risk of developing depression. 
• Trauma and Abuse: Experiencing trauma, abuse (whether physical, emotional, or sexual), or neglect, especially in early life, can significantly increase the likelihood of developing depression later in life.
• Social Factors: Poor social support, isolation, and conflict in relationships can contribute to the development of depression.

As a psychiatrist for depression, I work diligently to identify the root causes of a patient’s depression. In some cases, several of these factors can contribute to the development of depression. However, when we can identify the causes, this generally makes treatment more effective. 

If feelings of loneliness and isolation are at the root of your depression, there are some proactive steps you can take to connect with others, engage in meaningful activities and address underlying feelings of isolation. Here are several strategies to help alleviate loneliness:

1. Reach Out to Family and Friends: Make an effort to connect or reconnect with family and friends. Regular phone calls, messages, or video chats can help reduce feelings of isolation. Sometimes family members and friends are unaware of your level of loneliness, which is why you often have to be the person taking that first step. Once you connect, ask if you can schedule a regular phone call or video call or perhaps a weekly lunch or dinner.
2. Join Groups or Clubs: Participate in groups or clubs that align with your interests or hobbies. This can be a great way to meet new people who share similar passions.
3. Volunteer: Volunteering for causes you care about can connect you with others and provide a sense of purpose and community. 
4. Stay Active: Physical activity can boost mood and reduce feelings of loneliness. Joining exercise classes, yoga classes, dance classes or sports clubs can also introduce you to new friends. 
5. Explore New Interests: Taking classes or learning new skills can help you meet people, increase your self-confidence, and reduce feelings of loneliness. 
6. Attend Social Events: Make an effort to attend social gatherings, even if it feels daunting. Each event is an opportunity to connect with others. 
7. Consider a Pet: Pets can offer companionship, unconditional love, and a sense of responsibility. They also can be a way to meet other pet owners. 
8. Online Communities and Support Groups: Joining online forums or support groups related to your interests or experiences can offer a sense of belonging and connection. 
9. Practice Self-Compassion: Be kind to yourself and recognize that feeling lonely is a common human experience. Engage in self-care practices that nurture your well-being. 
10. Make Use of Technology: Use technology wisely to connect with others, but be mindful of screen time. Social media can be a tool for connection, but it's important to seek meaningful interactions. 
11. Create a Routine: Establishing a routine can provide structure and purpose, reducing feelings of aimlessness that can accompany loneliness. 
12. Seek Professional Help: If loneliness is persistent and affecting your mental health, consider talking to a mental health professional. Therapy can provide strategies to cope with loneliness and address any underlying issues.

​Combating loneliness is a process, and what works for one person might not work for another. It's important to try various strategies and find what best suits your personality and lifestyle. Remember, seeking connection and community is a fundamental human need, and taking steps to address loneliness is a brave and worthwhile endeavor. It’s not easy to reach out, but it’s also not easy to suffer from loneliness and depression.

Seeking treatment for depression or loneliness is an important step toward improving your mental health and overall well-being. Here are some signs and situations when it's advisable to seek professional help from a local psychiatrist:

​Whether you are dealing with persistent loneliness and/or depression, scheduling an appointment with a psychiatrist for depression is always a good idea. You also can talk with your primary care provider or a therapist.
 
As a psychiatrist for depression, I can provide you with a thorough diagnosis as well as create a treatment plan that addresses all of the issues you are facing. A depression psychiatrist also can provide you with medications, if needed.
 
Many different medications and combinations of medication can treat depression successfully. Talk therapy, dialectical behavior therapy and cognitive behavioral therapy can be helpful, as well. Even with medication, meeting with a depression therapist or psychologist is encouraged as a combination approach tends to yield the best results.
 
If you find that medications and therapy aren’t alleviating your symptoms, there are other options to consider, such as ketamine therapy and eye movement desensitization and reprocessing (EMDR). Other options, such as repetitive transcranial magnetic stimulation (rTMS), electroconvulsive therapy (ECT) or vagus nerve stimulation (VNS), also can be beneficial for those with treatment-resistant depression.
 
If you are struggling with deep feelings of loneliness and despair, it’s best to contact a psychiatrist for depression as quickly as possible. As a depression doctor, I have successfully treated many patients with depression and chronic loneliness, and there is always hope for a brighter future. I also work as a PTSD psychiatrist and anxiety psychiatrist, which often co-occur with depression. I also can treat bipolar disorder, eating disorders, borderline personality disorder or any other co-occurring disorder.
 
I offer both in-person services as a psychiatrist in Thousand Oaks, as well as telepsychiatry, which can be a very convenient option to consider. Don’t wait another day to seek help. Depression and these feelings of loneliness can be tackled, and while it can take time to find a treatment that works, you are worth it and all you have to do is take the first step and give our office a call. 

Depression is a complex and pervasive mental health condition that can significantly impact a person's emotional well-being and overall quality of life. While feeling down or sad occasionally is a normal part of the human experience, it becomes a cause for concern when these feelings persist, intensify, and interfere with daily functioning. If this is the case, it might be time to seek the services of a psychiatrist for depression.
​
Recognizing the signs of depression is crucial for early intervention and seeking appropriate help. In this article, we will explore five key indicators that may suggest it's time to consider consulting a psychiatrist for professional support and guidance on the journey to healing and emotional well-being. Understanding these signs can be the first step towards regaining control over your mental health and embarking on a path toward recovery.

​You've tried therapy, medication from your primary doctor, lifestyle changes, etc., but have not experienced relief from your depression symptoms. A psychiatrist for depression can evaluate other types of medication as well as alternative treatment options such as ketamine. 

​If you have been diagnosed or suspect you may have an additional mental illness such as an anxiety disorder, bipolar disorder, OCD, PTSD, etc., a psychiatrist can provide specialized treatment. Many people with depression also have a co-occurring disorder and while that can make it more difficult to find the best treatment options, an experienced depression psychiatrist can help.

Having recurring thoughts of suicide or feeling at risk of harming yourself are huge red flags, and you should consult a psychiatrist. (NOTE: If you are having suicidal thoughts, please call 911 or call the National Suicide & Crisis Lifeline by dialing 988. There is always support available for anyone experiencing suicidal thoughts or severe distress.)

​Genetics can play a role in depression, so a family history may mean you need more tailored psychiatric treatment. Your psychiatrist also can look at your medical history and that of your relatives to determine whether or not that has any impact on your mental health issues.
 
The right depression psychiatrist can help identify the roots of your depression through diagnosis and provide comprehensive treatment including therapy, medication, and lifestyle changes. 

Symptoms of Depression
When you think about depression, you might conjure up an image of a person curled up in their bed, crying or feeling sad. While that certainly can be one manifestation of depression, many other symptoms can indicate a person is depressed.
 
Physical Pain: Depression can be associated with unexplained physical pain, such as headaches, stomachaches, backaches, or muscle pains, without any apparent underlying medical cause.
 
Changes in Appetite: While a decrease or increase in appetite is common in depression, some individuals may experience specific food cravings or aversions, leading to unusual eating patterns.
 
Hypersomnia: While insomnia is a well-known symptom of depression, some individuals may experience hypersomnia, where they sleep excessively and have difficulty staying awake during the day.
 
Psychomotor Slowing: In some cases, depression can lead to psychomotor slowing, which involves slowed physical and mental activity. This can make everyday tasks feel arduous and lead to sluggish movements and speech.
 
Cognitive Impairment: Depression can affect cognitive functions, leading to difficulties with concentration, memory, and decision-making, often referred to as "brain fog."
 
Irritability or Anger: Instead of appearing sad, some people with depression may express their emotional distress through irritability, anger, or even aggression.
 
Loss of Emotional Expression: Known as "flat affect," some individuals with depression may exhibit a lack of emotional expression, appearing emotionally blank or indifferent.
 
Social Withdrawal: While some people with depression may isolate themselves, others may engage in social situations while feeling detached and emotionally distant from others.
 
Fixation on Death or Existential Themes: Unusual preoccupation with death, dying, or existential themes may be present in some individuals experiencing depression.
 
Physical Self-Neglect: Depressed individuals might neglect their physical appearance and personal hygiene due to a lack of motivation and self-care.
 
Self-Destructive Behavior: Some individuals may engage in self-destructive behaviors, such as substance abuse, reckless driving, or self-harm, as a way of coping with their emotional pain.
 
It is crucial to remember that depression affects individuals differently, and some people may experience a combination of these unusual symptoms alongside more common signs of depression. If you or someone you know is struggling with any of these symptoms or suspect depression, seeking help from a mental health professional is essential for proper assessment, diagnosis and treatment.
 
Mild Depression? What Should You Do?
Even if your symptoms aren’t impacting your ability to get work and personal tasks accomplished, mild depression reduces your quality of life, and seeking treatment can be a great option. In some cases, mild depression is common after an illness, a trauma or a life-changing event or perhaps due to changes in seasons. Many people experience some level of depression during the winter months when sunlight is at a minimum.
 
Talking with a therapist or a depression psychiatrist can be a great option to consider. Additionally, regular exercise and going outdoors can be helpful. Meditation and mindfulness exercises can help, as well. It also is recommended that you eat healthy foods and avoid alcohol and drugs, as these can worsen depression.
 
Do You Need A Depression Psychiatrist or Psychologist?
Psychiatrists are medical doctors that can prescribe medication and diagnose mental health disorders as well as other health issues but typically don’t provide talk therapy or cognitive behavioral therapy. A psychologist can diagnose mental health issues, but not physical health issues and these mental health professionals cannot prescribe medication. However, a psychologist can provide you with talk therapy and other types of therapy.
 
In many cases, I recommend that you enlist the services of both a psychiatrist and a psychologist or therapist. Multi-faceted treatment plans with therapy and possibly medication tend to yield the best results when it comes to many mental health issues, including depression and anxiety.
 
Treatment Options
There are many treatment methods available for people with depression. Some medications can help reduce symptoms, although it is important to note that it does take time to find the best medication for each patient as well as the best dosage.
 
In some cases, if medication doesn’t work, we can look into alternative treatments for depression such as transcranial magnetic stimulation (TMS), ketamine treatments or eye movement desensitization and reprocessing (EMDR).
 
If you do opt for medication, I also recommend finding a psychologist for talk therapy and also making some lifestyle choices to ensure that your physical and mental health is as strong as possible. This might include anything taking up a new hobby, art therapy, dance therapy, charity work, etc. Daily exercise, creating a daily schedule, minimizing stress and creating a soothing night/sleep schedule all can help reduce symptoms of depression.
 
How To Find A Psychiatrist For Depression
Finding a depression psychiatrist can seem like a huge challenge, but with telepsychiatry, you can expand your search field beyond setting for a “psychiatrist near me.” A virtual psychiatrist not only allows you to find the best possible match for your needs, but you can meet from the comfort of your own home or meet with your doctor when you are on vacation or on a work trip with ease.
 
When searching for a psychiatrist for depression, you can ask for recommendations from your primary care physician or friends or family members, as well as looking at patient reviews. Read over the website of each doctor carefully to see gauge whether or not their treatment philosophy feels comfortable to you. It can take time to find the right psychiatrist for your unique needs, but, in the end, finding the best care providers can ensure that treatment will be as successful as possible.
 
As an experienced psychiatrist for depression as well as many other mental health disorders, I strongly encourage anyone battling depression to seek treatment. My philosophy is that psychiatric disorders are not a weakness, they are a biological disease that is often treatable.
 
I offer both in-person psychiatric treatment and I also work as a virtual psychiatrist. In addition to serving as a depression psychiatrist, I also am a PTSD psychiatrist, bipolar psychiatrist, anxiety psychiatrist, addiction psychiatrist and an adult ADHD psychiatrist. Feel free to contact my office at any time to schedule a consultation and let’s get you on a path toward a happier, healthier future.

Millions of Americans suffer from some level of depression and while some depressive episodes are brief, for those that suffer from long-term depression, the effects can be devastating on one’s day-to-day life. Fortunately, an experienced depression psychiatrist can help, even with treatment-resistant depression. Let’s take a look at types of depression, symptoms and the many treatment options available.
 
It’s not uncommon for anyone to feel low or blue once in a while, even for a few days or a week or more. This is quite common after the loss of a loved one or perhaps in the aftermath of a divorce or another traumatic event, such as losing your job. Of course, many physical factors can contribute to depression, such as suffering from chronic pain, managing life with a disease such as cancer or even having a baby.
 
Reaching out to a trusted friend, a therapist or even a religious adviser can help during these times. However, when depression is constant and chronic and lasts for an extended period of time, it’s time to think about contacting a depression psychiatrist and finding treatment options that help you alleviate symptoms of depression or eliminate them altogether.
 
It is often hard for people to seek help for depression, but just like with physical pain, mental pain is a sign that something is wrong. As a depression psychiatrist, my philosophy is that psychiatric disorders are not a weakness, they are simply a biological disease that is often treatable.
 
Symptoms Of Depression
Again, most people have moments of sadness, loneliness and depression, but when depression lasts for several weeks or months, it is time to seek help. Here are a few symptoms you might notice that indicate you are clinically depressed:

• Fatigue
• Insomnia
• Irritability
• Feelings of hopelessness & pessimism
• Loss of interest in hobbies, work, relationships, etc.
• Chronic aches and pains (often headaches, as well)
• Persistent feelings of sadness and anxiety
• Feelings of guilt and helplessness
• Feelings of worthlessness
• Trouble concentrating & forgetfulness
• Suicidal thoughts (or attempting suicide)

 
If you are having suicidal thoughts, please call the National Suicide Prevention Lifeline at (800) 273-8255. While not everyone with depression will attempt suicide or have suicidal thoughts, please know that if you are feeling suicidal, help is available at any time of day or night.
 
What Causes Depression?
Many factors can cause depression, and in some cases, a combination of factors occurs. For instance, there is thought to be a genetic component with depression, so if your parent, grandparent or other relatives are prone to depression, this could be one of the causes of your depression.
 
For others, issues with brain chemistry might be an issue, such as lowered serotonin activity. Medical issues also can cause depression, and this can include conditions that cause chronic pain as well as diseases such as cancer, diabetes, Alzheimer’s disease, Parkinson’s disease and others. Of course, many women experience postpartum depression after giving birth. 
 
In some cases, drug or alcohol abuse can cause depression, but there are also some types of prescribed medications that can cause depression. A life-altering event also can trigger depression, and this can be anything from a death in the family to a car accident or some other type of traumatic event or just simply suffering from loneliness and feelings of isolation can cause depression.
 
Types Of Depression
There are several types of depression, and a depression psychiatrist will do a thorough evaluation to determine which type of depression is occurring, as treatment plans can vary based upon the type of depression.
 
Major Depressive Disorder (MDD) – With MDD, a person will experience a combination of the depression symptoms listed above for at least two weeks that mark a change from the person’s previous or usual mood.
 
The DSM-V, which is the classification system for mental disorders designed by the American Psychiatric Association, also states that for this diagnosis, these symptoms must be causing a significant amount of stress or reducing your ability to function. Perhaps your work suffers, or you have difficulty keeping your house clean or taking care of daily hygiene tasks.
 
These symptoms also must be independent of other disorders, such as schizophrenia or bipolar disorder. Additionally, the depression symptoms cannot be attributed to a medical condition or to drug or alcohol use.
 
Persistent Depressive Disorder (PDD) – While MDD is a type of depression lasting at least two weeks (or more), those with PDD have chronic depression lasting at least two years for adults and one year for children and teens. The symptoms of PDD often are milder than MDD, but the chronic nature of this depression obviously lessens one’s quality of life substantially. Again, the depression symptoms must be independent of disorders such as schizophrenia, bipolar disorder, medical conditions, etc.  
 
Postpartum Depression – While having a baby can be a wonderful event, a woman’s body goes through immense changes during pregnancy not to mention the huge changes that parenthood brings. Children are a blessing, but life does change signifcantly once they arrive, and it’s very common for women to experience depression and anxiety.
 
In fact, most women (as many as 70%) will experience what is known as the “baby blues.” This is a short-term issue that often causes women to feel anxious, irritable and perhaps very emotional, including bouts of crying for no specific reason. The good news is that the baby blues typically doesn’t interfere with daily life tasks and tends to resolve fairly quickly.
 
However, postpartum depression, also known as peripartum depression, is in a class by itself, so to speak. If you notice persistent feelings of depression, extreme sadness, anxiety or even feelings of indifference that last more than two weeks and prevent you from handling any normal activities, it’s important to seek help.
 
It’s also important to note that fathers also can suffer from this form of depression. While they don’t go through the same physical changes as mothers, the extreme changes and financial obligations of fatherhood can be daunting.
 
Premenstrual Dysphoric Disorder (PMDD) – While it’s not uncommon for women to experience mood changes as well as issues such as cramping, bloating, acne, headaches, etc. While this is certainly frustrating and uncomfortable, these issues rarely interfere with normal functioning at home, work or school.
 
For those with PMDD, the changes tend to occur about a week prior to menstruation and can last the duration of your period and the symptoms are severe enough to disrupt daily functioning. Symptoms of PMDD include severe fatigue and depression, anxiety, confusion, anger, crying spells, severe moodiness and sometimes even paranoia.
 
Many women with PMDD will experience headaches, dizziness, muscle spasms and heart palpitations.  Nausea and vomiting are other common symptoms as well as swelling of the ankles, feet and hands. In some cases, those with PMDD might experience vision changes and frequent eye infections. These are just a few of the severe symptoms a person with PMDD might encounter.
 
Seasonal Affective Disorder (SAD) – If you’ve ever had the winter blues for a few days, you are not alone. Many people tend to feel a bit down now and then during the winter, as there is less sunshine in our hemisphere. However, if you notice feelings of sadness, loss of energy, difficulty concentrating, oversleeping and the loss of interest in activities you previously enjoyed for a period of several weeks, this could be SAD, especially if these symptoms interfere with daily functioning.
 
With SAD, we might use some of the medications that are listed in the section below, but also light therapy and talk therapy, such as cognitive-behavioral therapy, have been shown to help lessen symptoms. With light therapy, the patient sits in front of a special light therapy box for about 20-30 minutes each day throughout the winter months.
 
Co-Occurring Disorders
As a depression psychiatrist, my job is not to simply diagnose depression, but also to look at the whole patient and determine all of the issues that you might be facing. For instance, it is not uncommon for people with depression to also suffer from anxiety. You might also suffer from addiction, OCD, PTSD or another mental health issue. Additionally, your depression could be caused by bipolar disorder or another mood disorder.
 
A depression psychiatrist must consider all of the possible diagnoses before setting on a course of treatment. We also must consider your general physical health. Is your body vitamin-deficient? Do you have diabetes? Are you suffering from chronic pain? Simply treating depression is often not enough, we need to treat all of the issues you are facing to improve your quality of life.
 
Depression Treatment Options
Many people with depression are hesitant to ask for help, but this is simply a biological disease, and it can be treated. Seeking help for depression is no different than seeking medical help for any other condition such as asthma or a broken bone.  It can, however, take some time to find the best treatment plan to fit your needs. Medications and therapy take time to work, so it’s important to have patience and keep taking medications and attending therapy as directed by your physician.
 
There are many treatment options to consider, including:
 
Selective Serotonin Reuptake Inhibitors (SSRIs) – This is often the first line of treatment for many types of depression, including MDD, PDD, postpartum depression, etc. These drugs tend to have fewer side effects and work for many people to lessen or eliminate symptoms of depression by boosting serotonin in your brain.
 
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) – These are similar to SSRIs, but they increase norepinephrine in the brain as well as serotonin. If you don’t respond well to SSRIs, your depression psychiatrist might try an SNRI instead.
 
Ketamine – Some patients will suffer from what is known as treatment-resistant depression. While this obviously can be frustrating and discouraging, ketamine is a medication that has shown some success with treatment-resistant depression as well as anxiety and PTSD.
 
Ketamine initially was used as an anesthetic, but interestingly, many EMTs and ER doctors would use it to calm agitated patients, especially those who had attempted suicide. While it did calm them initially, many of these patients would come back months later and state that they hadn’t felt suicidal or depressed since the ketamine treatment. Eventually, after much study, the FDA approved two types of ketamine as a treatment for depression, anxiety and PTSD.
 
Ketamine can be given either intravenously or as a nasal spray. After receiving the treatment, you need to wait at least two hours before heading home, and you will need to have someone drive you home as you might be drowsy.
 
Transcranial Magnetic Stimulation (TMS) – This is a non-invasive treatment that typically is used for people with treatment-resistant depression. For TMS, we place an electromagnetic coil by your forehead, and a magnetic pulse is delivered to nerve cells in your brain. This process is entirely painless for the patient and has been shown to stimulate the areas of the brain that control our mood. Often if TMS is unsuccessful, we will consider ketamine as our next approach.
 
Therapy – While medications certainly can be helpful, it is also wise to add some type of therapy to your treatment plan. Talking with a therapist or psychologist can help you work through problems and learn some tools to help you manage depression and anxiety. Some type of cognitive-behavioral therapy is usually always recommended in addition to medication.
 
Keep in mind, that if you have a co-occurring disorder, we may need to consider additional medications and treatments for those specific disorders. For instance, if your depression is caused by bipolar disorder, we might need to try more than one medication or perhaps other types of medications than those discussed above.
 
If you have depression caused by a physical medical condition, treating that condition can alleviate depression symptoms, so we might approach your depression treatment differently than for someone with MDD or PDD.
 
In addition, it is always recommended that you eat a healthy diet, and you consider daily exercise as these steps can help lessen symptoms and improve your overall health. Some patients, such as those with low levels of vitamin B12, iron and other vitamins or minerals also might need to consider taking vitamin supplements.
 
Contact A Depression Psychiatrist Today
As a depression psychiatrist, I can provide you with a thorough diagnosis as well as helping you find a medication or treatment plan that helps alleviate your symptoms. This thorough diagnosis is a crucial first step and it can take more than one session to determine the diagnosis and create a treatment plan, but it’s best to find ways to address all of the issues you are facing to achieve long-term success.
 
In addition to treating depression (including treatment-resistant depression), I also work as a bipolar disorder psychiatrist, ADHD psychiatrist, anxiety psychiatrist and can provide treatment for drug and alcohol addiction. While I have offices in Thousand Oaks, I also offer telepsychiatry services. Whether you live near my office or elsewhere in Southern California and beyond, I can provide you with quality virtual psychiatrist services.
 
If you need a depression psychiatrist, don’t wait another day to give me a call. No one should have to suffer from depression and there is hope. We have many treatment options that can help you live a healthier, happier life and you deserve to live your life to the fullest.