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, perimenopausal 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

Biology

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

Mind

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

Lifestyle

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

Relationships

Depression sometimes arises from circumstances that would depress anyone — a bad job, stuck relationship, isolation, financial stress. We name it when it's there.

Meaning

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

What treatment typically looks like

An Elevae depression evaluation begins with a 60–90 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.

When medication helps, and when it doesn't

Different antidepressants have different profiles. SSRIs like sertraline and escitalopram are first-line. SNRIs help when fatigue or pain are prominent. Bupropion helps when low energy and motivation are central. Mirtazapine helps when insomnia and appetite loss dominate. We don't hand out the same prescription to every person.

Lifestyle interventions that actually work

• Aerobic exercise. 3–5 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.

Pharmacogenomics and depression

Pharmacogenomic testing meaningfully shortens the trial-and-error process for clients who have tried multiple antidepressants without benefit.

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.

Do antidepressants change who I am?

Well-matched antidepressants don't usually flatten personality; they lift the weight off so you can feel more like yourself.

How long do I have to stay on an antidepressant?

For a first episode, typically 6–12 months after feeling better. Coming off is slow and collaborative; abrupt stopping is not safe.

What if I'm already on an antidepressant but still feel depressed?

Common and treatable. A careful review of dose, medication, augmentation, lifestyle, and pharmacogenomics often identifies what's missing.

Can depression be treated without medication?

Yes, especially mild-to-moderate depression. Therapy, exercise, sleep, and nutrition resolve it for many people.

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