Major
Depression
From first episode to recurrent and chronic. Depression is not a character flaw — it is a neurobiological condition with highly effective treatments. Dr. Farkas's 30–60 minute evaluations ensure nothing is missed before treatment begins.
What is Major?
From first episode to recurrent and chronic. Depression is not a character flaw — it is a neurobiological condition with highly effective treatments. Dr. Farkas's 30–60 minute evaluations ensure nothing is missed before treatment begins.
Dr. Farkas brings a rare combination of MD/PhD neuroscience training, NIH research center experience, and clinical expertise to the evaluation and treatment of major depression. Her 30–60 minute new patient evaluations are designed to understand your full picture — medical history, prior treatments, contributing factors — before any treatment begins.
Effective treatment requires accurate diagnosis. Dr. Farkas's rigorous diagnostic approach ensures the right condition is identified and treated — not just the most common one that looks similar.
Common presentations
This page is educational and is not a diagnostic tool.
How Dr. Farkas treats Major Depression
Evidence-based, neurobiologically-informed care. The treatment plan is built around your specific situation — not a protocol template.
What to expect from your first appointment
A new patient evaluation with Dr. Farkas is 30–60 minutes — not a rushed intake. It covers your full psychiatric and medical history, prior diagnoses, all medications tried, and what has or hasn't worked. You'll leave with a clear diagnosis, a treatment plan you understand and agree with, and a follow-up already scheduled.
Telehealth is available throughout South Carolina and New York. In-person appointments are available at our Hilton Head Island, SC office.
Related Conditions
Call or text 988 (Suicide & Crisis Lifeline). Text HOME to 741741 for the Crisis Text Line. Call 911 or go to your nearest emergency room if you are in immediate danger.
Medical disclaimer: This page is for educational purposes and does not constitute medical advice. No doctor–patient relationship is established through website use. Individual results vary; no specific outcome is guaranteed. Telehealth visits are conducted on a HIPAA-compliant platform. Gabriella I. Farkas, MD PhD, is a board-certified psychiatrist licensed in South Carolina and New York.
Ready for a real evaluation
of Major?
30–60 minutes. Expert diagnosis. A treatment plan built around your specific situation.
Major depressive disorder (MDD) treatment starts with confirming the diagnosis — ruling out bipolar depression, medical contributors, and substance effects — then selecting an antidepressant matched to symptom profile and prior response. Dr. Farkas uses the PHQ-9 to measure objective change and adjusts systematically at weeks 4–6 rather than waiting through prolonged partial response.
Key Takeaways
- Major depression treatment starts by confirming the diagnosis and ruling out bipolar depression, medical causes, and substance effects.
- Diagnosis requires at least five depressive symptoms most days for two weeks or more, with real impairment.
- The PHQ-9 tracks progress at every visit. Remission, a score of 4 or below, is the goal.
- If the first antidepressant doesn't work, next steps include dose changes, switching, or adding another medication.
Frequently Asked Questions
What defines major depression?
DSM-5-TR requires at least five depressive symptoms — depressed mood or anhedonia plus additional criteria including sleep, appetite, energy, concentration, worthlessness, or suicidal ideation — present most days for at least two weeks and causing significant impairment.
How is antidepressant response measured?
The PHQ-9 (Patient Health Questionnaire-9) is administered at baseline and every visit. A 50% reduction from baseline indicates response; a score of 4 or below indicates remission — the goal of treatment.
What happens if the first antidepressant doesn't work?
STAR*D data show only about one-third of patients achieve remission on the first antidepressant. Systematic next steps — dose optimization, switch to a different class, augmentation with lithium, thyroid hormone, or an atypical antipsychotic — dramatically improve remission rates.