What is Depression?
Depression is more than just feeling sad or having a bad day. Clinical depression, also known as Major Depressive Disorder (MDD), is a serious mental health condition that affects how you feel, think, and handle daily activities. It’s one of the most common mental health disorders in the United States, affecting over 21 million adults each year.
Depression doesn’t discriminate—it can affect anyone regardless of age, gender, race, or socioeconomic status. However, with proper treatment and support, most people with depression can achieve significant improvement in their symptoms and quality of life.
Recognizing the Signs of Depression
Depression shows up differently for everyone, but there are common symptoms that mental health professionals look for when making a diagnosis.
Emotional Symptoms
- Persistent sadness or emptiness most of the day, nearly every day
- Loss of interest or pleasure in activities you used to enjoy
- Feelings of hopelessness or “nothing will ever get better”
- Excessive guilt or worthlessness
- Irritability or feeling easily frustrated
- Anxiety, worry, or restlessness
Physical Symptoms
- Changes in sleep (insomnia or sleeping too much)
- Low energy or persistent fatigue
- Changes in appetite or weight
- Unexplained headaches, digestive issues, or body pain
- Noticeable slowing down or agitation in movements
Cognitive Symptoms
- Difficulty concentrating or making decisions
- Memory problems or “mental fog”
- Persistent negative or pessimistic thinking
- Thoughts of death, self-harm, or suicide
Important: If you’re experiencing thoughts of suicide or self-harm, seek immediate help by calling 988 (Suicide & Crisis Lifeline) or going to your nearest emergency room.
What Causes Depression?
Depression is a complex condition that usually involves a combination of biological, psychological, and environmental factors.
Biological Factors
- Imbalances in brain chemicals such as serotonin, norepinephrine, and dopamine
- Family history of depression or other mood disorders
- Hormonal changes (for example, pregnancy, postpartum, menopause, thyroid problems)
- Chronic medical conditions, chronic pain, or certain medications
Psychological Factors
- Past or recent trauma, including abuse, neglect, or major loss
- Ongoing high stress from work, school, finances, or relationships
- Longstanding negative thinking patterns and self-criticism
- Low self-esteem or chronic feelings of inadequacy
Environmental Factors
- Social isolation or lack of supportive relationships
- Financial hardship or job insecurity
- Seasonal changes with reduced sunlight (Seasonal Affective Disorder)
- Alcohol or drug use that can trigger or worsen depression
Professional Treatment Options
Effective treatment for depression often combines several approaches tailored to your specific needs.
Medication Management
As a Psychiatric Mental Health Nurse Practitioner (PMHNP), I specialize in prescribing and managing psychiatric medications when appropriate.
Common types of antidepressants include:
- SSRIs (Selective Serotonin Reuptake Inhibitors): Often first-line options such as sertraline, escitalopram, and fluoxetine
- SNRIs (Serotonin–Norepinephrine Reuptake Inhibitors): Such as duloxetine and venlafaxine, helpful when pain or anxiety are also present
- Atypical antidepressants: Such as bupropion, which may be useful for low energy, low motivation, or focus issues
- Other options: Tricyclics and MAOIs for more complex or treatment-resistant cases
What to expect with medications:
- Antidepressants typically take 4–6 weeks to show their full benefit
- Finding the best medication and dose can take some adjustment
- Regular follow-up visits are important to monitor effectiveness and side effects
- Many people experience significant symptom relief with proper medication management
Psychotherapy (Talk Therapy)
Medication is often most effective when combined with therapy. I collaborate closely with therapists who provide:
- Cognitive Behavioral Therapy (CBT): Helps identify and change unhelpful thoughts and behaviors
- Interpersonal Therapy (IPT): Focuses on relationships, communication, and life role changes
- Mindfulness-based therapies: Build present-moment awareness and emotional regulation
- Psychodynamic therapy: Explores deeper emotional patterns and past experiences
Combined Treatment Approach
Research shows that combining medication and therapy usually leads to the best outcomes for moderate to severe depression. Medication supports your brain chemistry, while therapy helps you build coping skills, process experiences, and change patterns that keep you feeling stuck.
When Should You Seek Professional Help?
Consider reaching out to a mental health professional if:
- Symptoms last longer than two weeks
- Depression interferes with work, school, relationships, or daily responsibilities
- You’ve lost interest in activities you used to enjoy
- You’re having thoughts of self-harm or suicide
- Your usual coping strategies aren’t working
- You’re using alcohol or drugs to manage your mood
- Physical symptoms (like pain, fatigue, or sleep problems) aren’t improving despite medical care
Seeking help is a sign of strength, not weakness. Early treatment often leads to better and faster recovery.
The Treatment Process: What to Expect
Initial Psychiatric Evaluation
During your first appointment with me, we’ll complete a thorough assessment that may include:
- Detailed history: Your current symptoms, how long they’ve been present, and how they affect your life
- Medical review: Current medications, medical conditions, and any substance use
- Mental health history: Previous diagnoses, treatments, hospitalizations, and family history
- Risk assessment: Screening for suicidal thoughts, self-harm, or safety concerns
- Collaborative treatment plan: We’ll discuss options and create a plan that fits your goals and preferences
Ongoing Care
- Regular follow-ups: Often every 2–4 weeks at first, then monthly or as needed
- Medication adjustments: Fine-tuning dose or changing medications based on how you’re doing
- Progress monitoring: Using rating scales and your own feedback to track improvements
- Care coordination: Communicating with your therapist and primary care provider (with your consent)
- Crisis planning: Clear steps for what to do if symptoms suddenly worsen
Living with Depression: Self-Care Strategies
Professional treatment is essential, but daily habits also play a big role in recovery.
Daily Habits
- Keep a regular sleep schedule and wind-down routine
- Aim for some physical activity most days, even a 10–15 minute walk
- Stay connected with supportive friends, family, or community
- Limit or avoid alcohol and drugs, which can worsen depression
- Spend a little time outdoors or in sunlight when possible
Stress Management
- Practice mindfulness or short guided meditations
- Use deep breathing during moments of distress
- Try journaling to process thoughts and emotions
- Explore creative outlets like art, music, or crafts
Building Support
- Share how you’re feeling with people you trust
- Consider support groups (online or in person)
- Set realistic boundaries and say no to overwhelming commitments
- Ask for help when you need it—emotionally, practically, or both
Depression Treatment in Delaware and Hawaii
At Aegis Behavioral Health Group, I provide comprehensive psychiatric care for depression through secure telehealth appointments.
Whether you’re in Delaware or Hawaii, you can access expert treatment from the comfort of your home.
Why Choose Telehealth for Depression Treatment?
- No commute or waiting rooms
- Easier to keep consistent appointments
- Comfortable, familiar environment for discussing sensitive topics
- Private and discreet access to mental health care
- Research supports telehealth as just as effective as in-person treatment for many people
Insurance and Access to Care
I accept many major insurance plans in Delaware and Hawaii, including:
- HMSA (Hawaii)
- UHA (Hawaii)
- UnitedHealthcare
- Medicare
- Medicaid/QUEST (Hawaii)
- Highmark Blue Cross Blue Shield (Delaware)
- And several other plans
We can discuss coverage and options during your initial consultation so cost doesn’t become a barrier to getting help.
Take the First Step Today
If you’re struggling with depression, you do not have to face it alone. Professional help can make a real difference in how you feel and function.
Contact Aegis Behavioral Health Group:
- Delaware Office: (302) 592-3780
- Hawaii Office: (808) 746-3664
- Email: admin@aegisbhg.com
Evening and weekend appointments are available to better fit your schedule.
Final Thoughts
Depression is a treatable medical condition, not a personal failure. With the right combination of support, therapy, and when appropriate, medication, most people begin to feel better within weeks to months.
Reaching out for help can feel like the hardest step—but it’s also the most important one. You deserve to feel better, and effective treatment is available.
About the Author
Jason Eala, DNP, APRN, PMHNP-BC is a board-certified Psychiatric Mental Health Nurse Practitioner with specialized training in treating depression, anxiety, ADHD, and other mental health conditions. He provides compassionate, evidence-based care through telehealth services in Delaware and Hawaii.
Disclaimer: This article is for informational purposes only and does not replace personalized medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment of depression or any other mental health condition.
If you’re in crisis, call 988 (Suicide & Crisis Lifeline) or text “HELLO” to 741741 (Crisis Text Line) for immediate support.
