Integrative treatment for depression.

What this actually is

Depression is more than sadness. It involves persistent low mood, loss of interest or pleasure, disrupted sleep, changes in appetite or energy, difficulty concentrating, and feelings of worthlessness. It can be mild, moderate, or severe; a one time episode, recurrent, or chronic. It often coexists with anxiety, trauma, ADHD, or a medical condition nobody has looked at yet.

Why the standard approach often falls short

The standard approach is a short visit, an SSRI, and a recommendation to exercise more. That works for some people. It fails others for reasons the short visit never uncovers: undiagnosed thyroid disease, hormonal shifts, sleep apnea, chronic inflammation, a trauma history, or a medication that was prescribed before anyone knew how that person metabolizes SSRIs.

The Elevae approach

Mind

A careful evaluation including past treatments, trauma history, and coexisting conditions like ADHD or anxiety that frequently hide under a depression label.

Biology

Labs that matter for mood: thyroid, vitamin D, B12, folate, iron, fasting glucose, inflammation markers. Hormonal review for women. Sleep apnea screening.

Lifestyle

Sleep, movement, nutrition, alcohol, sunlight, and social contact. Each has a direct line to mood.

Relationships

Sometimes depression reflects what's happening around you, work, relationships, isolation, or financial stress. When that's the case, we address those realities as part of care.

Meaning

For some clients, depression is a grief response to a life that looks right on paper but isn't.

Therapies with the strongest evidence for depression

Depression responds well to several evidence based psychotherapies. The right approach depends on severity, prior treatment history, and individual preference.

Cognitive Behavioral Therapy (CBT)

A first line treatment for depression. CBT identifies and modifies the thought patterns that maintain low mood, and pairs cognitive work with behavioral changes. Most patients see meaningful change within 12 to 20 sessions.

Behavioral Activation (BA)

Often delivered alongside CBT or as a standalone treatment. Focuses on increasing engagement with valued and rewarding activities to interrupt the cycle of depression and inertia. Particularly effective for severe depression.

Interpersonal Therapy (IPT)

A brief, structured therapy focused on relationships, role transitions, and grief. Strong evidence, especially when depression is linked to a recent life change, loss, or interpersonal difficulty. Typically 12 to 16 sessions.

Acceptance and Commitment Therapy (ACT)

Focuses on values based action and changing the relationship with depressive thoughts. Strong evidence for chronic depression and depression that has not responded to standard treatment.

Mindfulness Based Cognitive Therapy (MBCT)

Specifically designed to prevent depression relapse. Strong evidence for people with recurrent episodes.

Psychodynamic and insight oriented therapy

Useful when depression has developmental, relational, or identity roots that more structured approaches do not fully reach. Often paired with CBT or ACT for layered treatment.

What treatment typically looks like

An Elevae depression evaluation begins with a 60 to 90 minute intake and a targeted lab panel. Within two weeks, you'll have a written plan that typically includes therapy, a decision about medication, nutritional recommendations, and a sleep protocol.

Lifestyle interventions that actually work

• Aerobic exercise. 3 to 5 times a week. Meta analyses show effect size on depression rivals many medications.
• Light. Morning light exposure within an hour of waking.
• Sleep. Regular and sufficient.
• Omega-3s. Modest but real evidence.
• Social contact. Isolation worsens depression; connection buffers it.
• Alcohol. A depressant masquerading as a mood lift.

Frequently asked questions

How do I know if this is depression or just a hard time?

Depression persists for weeks or months and affects sleep, energy, concentration, and the ability to enjoy things. If low mood has lasted more than two weeks and is changing how you function, it's worth evaluating.

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