Depression, or major depressive disorder (MDD), is a serious and common mood disorder that affects how a person feels, thinks, and handles daily activities. It goes far beyond ordinary sadness or grief — it is a persistent condition that can significantly impair work, relationships, and physical health. According to the World Health Organization, depression is a leading cause of disability worldwide and affects approximately 280 million people globally. Depression involves dysregulation of brain chemistry, particularly neurotransmitters such as serotonin, norepinephrine, and dopamine. Neuroimaging studies have shown structural and functional changes in brain regions involved in mood regulation, including the prefrontal cortex, hippocampus, and amygdala. Risk factors include a personal or family history of depression, major life stressors, chronic illness, trauma or adverse childhood experiences, social isolation, certain medications, and substance misuse. Symptoms of depression include persistent sadness, emptiness, or hopelessness; loss of interest or pleasure in activities once enjoyed (anhedonia); significant changes in appetite or weight; sleep disturbances (insomnia or hypersomnia); fatigue; difficulty concentrating or making decisions; feelings of worthlessness or excessive guilt; and in severe cases, recurrent thoughts of death or suicide. Symptoms must persist for at least two weeks and represent a change from previous functioning to meet diagnostic criteria. Depression frequently co-occurs with anxiety disorders, chronic pain conditions, cardiovascular disease, diabetes, and substance use disorders. Treating depression in the context of these comorbidities requires an integrated, multidisciplinary approach. Postpartum depression, affecting up to 1 in 5 new mothers, is a particularly important subtype requiring prompt recognition and treatment. Evidence-based treatments include antidepressant medications (SSRIs, SNRIs, and others), psychotherapy (especially CBT and interpersonal therapy), and combined approaches. For treatment-resistant depression, options include electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and ketamine infusions. Our psychiatry team at Silvaris provides comprehensive assessment, individualized treatment planning, and ongoing support to help patients achieve remission and maintain mental wellness.
