Major Depressive Disorder Treatment
Evidence-based depression care with direct physician access
What Is Major Depressive Disorder (MDD)?
Major Depressive Disorder (MDD) is a mood disorder characterized by persistent feelings of sadness, emptiness, or hopelessness that last at least two weeks and significantly interfere with daily functioning. It is one of the most common psychiatric conditions and is highly treatable with the right approach.
Signs & Symptoms
- Depressed mood most of the day, nearly every day
- Markedly diminished interest or pleasure
- Significant weight change or appetite disturbance
- Insomnia or hypersomnia
- Fatigue or loss of energy
- Feelings of worthlessness or guilt
- Difficulty concentrating or making decisions
- Recurrent thoughts of death or suicidal ideation
Treatment Approaches
MDD responds well to antidepressant medications (SSRIs, SNRIs, atypicals) combined with psychotherapy. For treatment-resistant cases, Dr. Agresti offers advanced options including Spravato (esketamine nasal spray), ketamine-assisted therapy, and complex psychopharmacology. Same-day prescription refills and direct physician texting ensure continuity of care.
Why Concierge Psychiatry?
With Dr. Agresti's concierge model, you get his direct cell number, same-day prescription refills, and 24-hour appointment availability — with no membership fee. Experience the difference that direct-access care makes.
Learn About Concierge CareFrequently Asked Questions
Sadness is a normal emotional response that passes with time. Major depressive disorder involves persistent depressed mood or loss of interest lasting at least two weeks, accompanied by changes in sleep, appetite, energy, concentration, and sometimes suicidal thoughts. MDD significantly impairs daily functioning and requires professional treatment.
Treatment-resistant depression affects roughly one-third of MDD patients. Options include augmentation strategies (adding lithium, atypical antipsychotics, or thyroid hormone), switching medication classes, Spravato (esketamine nasal spray), and ketamine-assisted therapy. Dr. Agresti specializes in complex psychopharmacology for patients who haven't responded to standard treatments.
Yes, and combined treatment is often more effective than either alone. Dr. Agresti is both a board-certified psychiatrist and psychotherapist, meaning you see one doctor for both medication management and psychotherapy rather than coordinating between separate providers. This integrated approach leads to better outcomes and more efficient care.
Spravato (esketamine) works on the glutamate system rather than serotonin, producing rapid antidepressant effects — often within hours to days rather than the 4-6 weeks typical of SSRIs. It is FDA-approved specifically for treatment-resistant depression and is administered as a nasal spray in a certified medical office under supervision.
This requires careful individual risk-benefit analysis. Some SSRIs have established safety profiles during pregnancy, while others carry higher risks. Untreated severe depression also poses risks to both mother and baby. Dr. Agresti's extended consultation sessions allow thorough discussion of all options, including medication adjustments and therapy intensification during pregnancy planning.