Depression treatment begins with diagnosis. If you've been treated before, you will probably recognize the process. Your doctor will talk to you or administer a short diagnostic test to compare your symptoms with those that define depression.

Main Symptoms of Depression

A common source for diagnostic information is the fourth edition of The Diagnostic and Statistical Manual of Mental Disorders (usually called the DSM-IV^® by psychiatrists) and the symptoms listed in it.

Your doctor may diagnose you with major depressive disorder (MDD) if you have at least five of the nine symptoms listed below during the same 2-week period — and those symptoms include either a depressed mood or a loss of interest or pleasure in your normal activities.

Review the list of symptoms:

1. Depressed mood most of the day, nearly every day
2. Lack of interest or pleasure in activities
3. Change in weight or appetite
4. Sleeping more or trouble sleeping
5. Agitation
6. Loss of energy
7. Feeling worthless or guilty for no reason
8. Difficulty concentrating
9. Thoughts of death or suicide

Three Phases of Treatment

After diagnosis, a person with depression may undergo the three phases of treatment outlined by the American Psychiatric Association. Each phase has a goal.

1. Phase 1 (acute phase): In the first phase of treatment, the goal is to relieve your symptoms. Your health care professional will work with you to try different treatment approaches to get you to remission. The time frame is generally 6 to 8 weeks from the start of treatment. By the end of this phase, you should have no more lingering symptoms and should be getting back to yourself again. This is achieving remission.
2. Phase 2 (continuation phase): The goal of the second phase of treatment is to sustain the remission achieved in the acute phase over enough time that the episode of depression is resolved. Your doctor will likely maintain and monitor your treatment regimen. The time frame for this phase is approximately 4 to 5 months without a return of symptoms. If symptoms return at this stage, it's called a relapse.
3. Phase 3 (maintenance phase): Once this episode of depression has been resolved, you and your health care professional may decide to begin long-term maintenance therapy. The goal of this phase of treatment is to prevent a new episode — a recurrence — of depression. Maintenance therapy may be particularly helpful for people who have been depressed before or whose symptoms do not resolve fully during the acute phase. These people have a higher risk for a recurrence of their depression.

• The Recurrent Nature of Depression
• Phases of Depression Treatment
• Depression Symptoms?
• Antidepressants and Other Treatments
• 10 Tips to Support Treatment