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Elevating Psychiatric care What We Treat


Depression is one of the most common mental disorders. It affects people of all ages, from young children to older adults. It is more common in women than in men. Almost 8.5% of the adult U.S. population suffers with depression. In 2020 depression tripled due to the pandemic, jumping from 8.5% to 27.8%. In 2021 the elevation persisted and climbed to 32.8% affecting one out of every 3 American adults. Depression can make it hard to do your job, take care of things at home, or enjoy activities you once enjoyed. It can even lead to suicide.

Major depression affects function in about 10.6% of American youth; and 60% of them do not receive treatment. Almost 27 million adults in America do not receive treatment for depression. It can happen at any age, can affect children, adolescents, teens, young adults, adults, and older adults. It is not a normal part of aging. If you are depressed, you can’t just “snap out of it.”

Depression is also called major depressive disorder or clinical depression. It is a mood disorder that causes persistent feelings of sadness and loss of interest. It affects how you feel, think, and behave and can lead to physical problems.  Depression interferes with daily life and can last weeks to months. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.

Depression is treatable, even in its most severe forms. Most people feel better with treatment, but it can take time to learn what works for you. There are many different types of treatments available for depression. The most important thing is to get the right kind of help.

  • Persistent depressive disorder also called dysthymia. A depressed mood that lasts for at least two years. People with this form may have episodes of major depression and periods of low mood. To be diagnosed with his disorder symptoms must last two years.
  • Postpartum depression, sometimes called the ‘baby blues” appears after birth and affects 1 in 9 post-partum people. Symptoms include feelings of sadness, anxiety, disconnection with the baby, and hopelessness. Postpartum depression is more intense and lasts longer than the baby blues.
  • Seasonal Affective Disorder (SAD) is depression that occurs in the winter when there is less natural light. Symptoms include increased sleep, weight gain, and withdrawal that occurs every winter.

People can experience just a few or many of these symptoms. How frequent and severe the symptoms are varies from person to person. Symptoms of depression that you may experience almost every day include:

  • Persistent sadness, anxiety, or a loss of interest in people and activities that you once enjoyed
  • Feeling hopeless or pessimistic
  • Angry outbursts, hostility, or aggression
  • Sleep disturbances, including insomnia, waking early morning, or sleeping too much
  • Tiredness and decreased energy
  • Reduced appetite and weight loss, or increased appetite and weight gain
  • Anxiety, agitation, irritability, restlessness
  • Slowed thinking, speaking, or body movements
  • Feelings of worthlessness, guilt, or helplessness
  • Difficulty thinking, concentrating, making decisions
  • Feeling stuck
  • Recurrent thoughts of death or suicide, or attempted suicide
  • Unexplained physical problems, such as back pain or headaches or feeling tired all the time

Depression is a brain disorder. It does not have a single cause. Rather, it is the result of a combination of factors including genetics, biology, environmental and psychological factors.

Biological factors: People with depression may have changes in their brain structure or function. These changes may be related to genetic vulnerabilities and hormones. A family history of depression increases the risk of developing depression.

Psychological factors: Depression often occurs along with other psychological disorders, such as anxiety, eating disorders, or substance abuse. It may also be triggered by a major life event, such as the death of a loved one, divorce, or job loss.

Environmental factors: Stressful life events, such as financial problems or relationship difficulties, can trigger depression. Some medications can trigger depression. Some chronic medical conditions, such as diabetes or cancer and trigger or worsen depression. People who grew up in homes where there was abuse, neglect, or mental illness are also at increased risk.

To be diagnosed with depression, the symptoms must include a low mood and persistent symptoms for at least two weeks. These symptoms must also interfere with your ability to work, sleep, eat, and enjoy activities you once enjoyed.

Dr. Poulakos will screen you for depression asking questions about your symptoms, how long you’ve been experiencing them, and how your symptoms are affecting your life. He may ask you to fill out a questionnaire.

Because depression can cause physical signs, Dr. Poulakos will ask about your pain, digestion issues, fatigue, appetite, and sleep problems. He will review your medical and family history and rule out physical causes and medications that can cause depression such as thyroid problems. If he is concerned about a certain condition, he may order blood tests to find out if a health problem is the cause of your depression.

With this information he will make a diagnosis or perform other testing and consider the best treatments for you. Dr. Poulakos offers evidence-based, individualized treatment using medication and psychotherapy, and state-of-the-art treatments. He is a caring and compassionate doctor who will work with you to find solutions that meet your unique needs. Contact him at his New York City office to schedule an appointment to receive the correct diagnosis and all your treatment options.

At a Glance

Dr. Paul Poulakos

  • Attending Psychiatrist at Mount Sinai Beth Israel Medical Center
  • Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai
  • Past Clinical Assistant Professor of NYU Langone Medical Center
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