Depression Treatment at Baltimore Psychiatry
Learn About Depression Treatment in Maryland, Test Your Depression Symptoms, & Schedule a Diagnostic Evaluation Online Today!
Is depression preventing you from experiencing joy and happiness in your life or achieving your goals? Baltimore Psychiatry can diagnose a variety of depressive disorders and provide medication management anywhere in Maryland where it is convenient for you. We accept new patients quickly, work with all private insurance, and our cash pricing is transparent and affordable. Baltimore Psychiatry has been offering reliable medication management services for depression throughout Maryland since 2019. Do not let life pass you by, depression is treatable!
Disclaimer: The information provided here is intended to give the non-medical layman a simplistic overview of complex information and processes. This is not intended to be medical advice which can only be provided by a licensed healthcare provider who conducts a thorough evaluation and reviews the specific information in the individual case directly with their patient.
How Can I Test Myself For Depression Symptoms?
The Patient Health Questionnaire (PHQ-9) is a commonly used clinical screening scale that can be completed in as little as 2 minutes. It assesses for the presence of 9 depressive symptoms of Major Depressive Disorder (MDD) and also gauges the overall severity of depression experienced with a scoring system. The purpose of providing this scale is to help you determine if the symptoms you are experiencing may align with depression and warrant further evaluation. It is important to understand that scales are subjective, can be inaccurate, and symptoms of many disorders overlap which can create false positives. An official diagnosis and treatment recommendations can only be made by a licensed provider after conducting a thorough evaluation. Click here to view or download the Patient Health Questionnaire (PHQ9) depression assessment.
Depression Severity Scores*:
0-4 Minimal to none
5-9 Mild
10-14 Moderate
15-19 Moderately Severe
20-27 Severe
*Scores are determined by the individuals perception and thus subjective. They are intended to be a rough guide only and do not indicate the presence or absence of a depressive disorder on their own. If symptoms are impacting your life they should be assessed by a licensed healthcare professional regardless of your score.
PHQ-9 was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues. It is copyrighted by © Pfizer Inc and used with open permission.
Depression is a mood disorder that negatively influences the way we think, feel, and behave. It is a complex disorder, and the cause or contributing factors may be singular or numerous, varying widely on a case-by-case basis. These causes may include biological and hereditary, medical, and situational or psychological. A depressive episode may be caused or worsened by genetics, situational and/or temporary stressors, childhood experiences, current environment (including home, work and school), lack of support or meaningful interpersonal relationships, general lack of purpose in life, limited coping skills, drug or alcohol use, personality traits or disorders, sleeping patterns, dietary habits, activity level, and many others.
How Common is Depression?
If you are experiencing depression you are not alone. Depression is one of the most common mental health disorders in the United States among adults and is the leading cause of all disability worldwide.¹ Several large surveys have been conducted to estimate the lifetime prevalence of major depressive disorder for adults in the United States and most have arrived at relatively similar results. A couple of these studies estimate that 20.6% and 18.4% of adults in the United States have experienced at least one depressive episode in their lifetime.²˒³ In 2023, more than 1 out of 9 adults in the United States took medication for depression within the past year.⁴
What Are the Symptoms of Depression?
The core component or symptom of depression is a persistently depressed mood and/or a loss of interest in, or inability to derive joy or pleasure from, nearly all previously enjoyable activities and hobbies. In addition to experiencing at least one of these two core symptoms, several other symptoms of depression (and other criteria) must also be present to receive a formal diagnosis. The cluster of symptoms must be present for a minimum of 2 consecutive weeks for consideration of a Major Depressive Disorder (MDD) diagnosis. Symptoms must be present most of the day nearly every day during this 2 week period.
Common symptoms of depression:
- Fatigue or loss of energy
- Feelings of worthlessness
- Low self-esteem
- Excessive or inappropriate feelings of guilt
- Diminished ability to think, concentrate, or make decisions
- Significant changes in sleeping pattern. This can be insomnia or hypersomnia (excessive sleeping).
- Significant change in appetite. This can be increased or decreased.
- Significant change in body weight. Weight loss or weight gain of more than 5% of one's body weight in one month.
- Readily apparent "psychomotor agitation" (purposeless movement such as tapping, pacing, or fidgeting)
- Readily apparent "psychomotor retardation" (delayed thoughts or movements as if a person is operating in slow motion)
- Recurrent thoughts of death or suicide*
Symptoms must be a change from one's "baseline" or what is typical and normal for them. For example, if someone suddenly develops low self-esteem and poor appetite these would likely qualify as symptoms. On the other hand, if someone has had low self-esteem and poor appetite their entire life but these symptoms have remained stable, they likely would not qualify as diagnostic symptoms (unless perhaps someone has been clinically depressed their entire life).
*Notice: If you are experiencing suicidal thoughts, please seek professional help immediately. If you also have a suicide plan or intent to hurt yourself, please seek emergency medical help NOW by calling local emergency services at 911 or the Suicide and Crisis Lifeline at 988.
How is Depression Diagnosed or Evaluated at Baltimore Psychiatry?
A diagnosis can only be made by a licensed clinician who conducts a thorough history and evaluation. Fundamental to any good evaluation is starting with a broad overview to ensure important history is not missed before narrowing down the focus on bothersome symptoms. In other words, evaluations that focus primarily on current symptoms often miss important information. A diagnosis is made by collectively reviewing medical and psychiatric history, extensive interviewing of the patient, observation, and potential use of clinical screening tools. The symptoms you are experiencing, potential causes for those symptoms, timeline of symptoms, and many other factors will be assessed. Psychiatrists, psychiatric NP's, and other psychiatric specialists use the criteria in the Diagnostic and Statistical Manual of Mental Disorders to diagnose mental health disorders such as depression. In addition to assessing for depression, other potential related disorders are ruled out or considered in addition to the depression to ensure holistic treatment with optimal outcomes.
At Baltimore Psychiatry we believe the first step in determining how to best treat someones depression requires first identifying the primary underlying cause. So first we try to identify and breakdown the cause(s) of the depressive episode which then dictates the best treatment route. With that being said, it is important to understand that depression is often incredibly deep, layered, and complex. The cause of someone's depression will rarely have one single cause or fit neatly into any single category. Instead the cause(s) and/or contributing factor(s) will intertwine and overlap with significant nuance. Likewise, the same will be true of treatment recommendations. In addition to this complexity, depression often causes or co-exists with other disorders that may need evaluation and treatment as well. While there may be numerous potential causes for depression, they generally fall under one of three primary categories.
Biological Depression
Biological depression is depression that is believed to be of biological origin. In the case of depression the brain is not functioning optimally in one manner or another in relation to mood regulation. While there is no definitive way to be 100% certain that depression has a biological origin, there are several prominent cues. Depression is believed to be hereditary and run in families, so family history is an important consideration. Another cue that depression is likely to have a biological origin is when someone is unable to identify any reasons as to why they may be depressed or the severity of their depression does not make sense to them given the context of their case.
Psychological and/or Situational Depression
Sometimes depression will have a psychological and/or situational cause. If someone's reaction to situational depression is normal given the context of the situation then the depression itself may be normal and even healthy. It is when the reaction to the situation is not normal in severity or duration that treatment is needed. Treatment would also be necessary if someone's response to the situation is normal but the amount or seriousness of stressors exceeds their ability to cope without professional help.
Psychological and/or situational depression may be caused by external environmental factors or internal factors. Examples of situational and/or environmental causes of depression may include conflict or termination of a relationship, death of a family member or friend, conflict at work or loss of employment, stressors at home or an unsafe home environment, financial stressors and so forth. Internal factors include one's ability to emotionally regulate, coping skills, personality traits or disorders, general outlook and perspective, and so forth.
Depression Caused by Medication or a Medical Diagnosis
Occasionally, depression will have a medical (non psychiatric, non-psychological) origin. Some common examples of medical disorders that may cause depression include an underactive thyroid (hypothyroidism), iron-deficiency anemia, and vitamin D deficiency. Certain medications may also contribute to depressive symptoms and may need further evaluation, alternatives, or adjustments.
In the instances where it is actually a medical disorder or problem that is indirectly causing depression symptoms, identifying the specific medical disorder is a crucial (and often overlooked) first step. This is one of the many reasons that conducting a thorough evaluation and history is so important. Psychiatric medications and therapy are generally not appropriate for most medical disorders and the root underlying cause would be directly treated instead. When warranted by the information provided, a psychiatric provider may order labs to help rule-out some of these medical causes.
What Does Depression Treatment Consist of?
Treating Biological Depression
If someone is deemed to have biological depression, medication is usually the primary treatment recommendation. With that being said, Baltimore Psychiatry views all cases in a holistic manner and will often make multiple treatment recommendations intended to improve ones mental and physical health. In addition to medication, other lifestyle factors are assessed and recommendations are often made in relation to exercising, eating habits, sleeping patterns, finding hobbies or activities that provide meaning and purpose to an individual, and so on. If someone seems like they may benefit from therapy or have overlapping situational depression, therapy may also be recommended.
Treating Psychological or Situational Depression
The primary treatment for depression that is solely psychological or situational is likely going to be therapy and/or lifestyle changes. Cognitive Behavioral Therapy (CBT) is often a good option for depression, though other therapy modalities may be recommended based on one's overall presentation. Like most medication management practices, Baltimore Psychiatry currently offers limited to no therapy services directly but will refer one to connect with a therapist if therapy seems warranted.
Treating Depression Caused by a Medical Disorder
A psychiatric specialist may treat a limited number of medical disorders that cause depression, but they will often refer out to a specialist relevant in the field of the specific disorder. For example, if someone has vitamin D deficiency a psychiatric provider may be comfortable recommending vitamin D supplementation. However, if someone has hypothyroidism it would generally be inappropriate for a psychiatric provider to prescribe the necessary non-psychiatric medication because it is outside the scope of their practice specialty.
The actual treatment for medical disorders will be dependent on the specific type of medical disorder and its severity. Treatment options may include prescription medications, making changes to current medication regimens, supplementation, dietary changes, exercise recommendations, modifying sleeping habits, and so on. These recommendations would be made by the medical provider.
Real World Application for Depression Treatment
While categorizing the underlying cause of depression symptoms helps provide a broad starting point for developing a more comprehensive treatment plan, real world application is rarely so simple. In real world cases individuals often have multiple causes or factors that need to be considered and treated together. Additionally, other symptoms or disorders such as anxiety and insomnia may be caused by, worsened by, or co-exist with depression. Other disorders would also need to be evaluated and potentially treated for optimal outcomes. If you believe you are struggling with depression schedule an evaluation for depression diagnosis and treatment here.
References:
¹ Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization; 2017
² Hasin, D. S., Sarvet, A. L., Meyers, J. L., Saha, T. D., Ruan, W. J., Stohl, M., & Grant, B. F. (2018). Epidemiology of adult dsm-5 major depressive disorder and its specifiers in the United States. JAMA Psychiatry, 75(4), 336.
³ Lee, B., Wang, Y., Carlson, S. A., Greenlund, K. J., Lu, H., Liu, Y., Croft, J. B., Eke, P. I., Town, M., & Thomas, C. W. (2023). National, state-level, and county-level prevalence estimates of adults aged ≥18 years self-reporting a lifetime diagnosis of depression — United States, 2020. MMWR. Morbidity and Mortality Weekly Report, 72(24), 644–650.
⁴ Elgaddal N, Weeks JD, Mykyta L. Characteristics of adults age 18 and older who took prescription medication for depression: United States, 2023. NCHS Data Brief. 2025 Apr;(528):1.