Depression

Depression Treatment in Los Angeles

What Dr. Willison Treats

Depression is more than a bad week or a low mood. It is a serious medical condition that affects how you think, feel, and function every single day. Without proper treatment, it tends to get worse over time, not better.

Dr. L. David Willison IV, MD, PhD, is a Board-certified Adult and Child/Adolescent psychiatrist in Los Angeles who provides compassionate, evidence-based depression treatment for adolescents and adults. Whether you are experiencing depression for the first time or have been struggling for years, Dr. Willison offers personalized care and clinical expertise to help you move forward. Call today to schedule your evaluation.

Types of Depression

Depression is not a single condition. There are several distinct types, each with its own features, duration, and treatment considerations. An accurate diagnosis is the first step toward effective care.

Major Depressive Disorder (MDD)

Major Depressive Disorder is the most common form of clinical depression. It involves persistent feelings of sadness, emptiness, or hopelessness that last for at least two weeks and significantly interfere with daily life. Episodes may occur once or recur throughout a person’s lifetime. MDD can range from mild to severe and often co-occurs with anxiety or other mental health conditions.

Persistent Depressive Disorder (Dysthymia)

Persistent Depressive Disorder, formerly known as dysthymia, is a chronic, lower-grade form of depression that lasts for two years or more. Because the symptoms are less intense than those of MDD, many people with this condition go undiagnosed for years, mistakenly believing that feeling consistently low is just part of their personality. Over time, dysthymia can be just as disabling as major depression.

Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder is a pattern of depression that follows the seasons, most commonly beginning in late fall or winter and lifting in spring. It is closely linked to reduced sunlight exposure and disruptions in the body’s internal clock. Light therapy is a common first-line treatment, often used alongside medication and therapy.

Postpartum Depression

Postpartum depression affects many new mothers and, less commonly, new fathers and adoptive parents. It goes well beyond the normal adjustment period after birth and involves significant depressive symptoms that impair a parent’s ability to care for themselves or their newborn. Postpartum depression is a medical condition that responds well to treatment, and seeking help is an act of strength, not weakness.

Other Depressive Conditions

Dr. Willison also treats related forms of depression including premenstrual dysphoric disorder (PMDD), depression related to medical illness, and substance-induced depressive disorder. A thorough evaluation helps identify the specific type of depression present so that treatment can be targeted accordingly.

Types of Depression

Depression affects people differently. Some people feel profoundly sad. Others feel empty, irritable, or completely numb. Recognizing the full range of symptoms is important because many people with depression do not realize that what they are experiencing has a name and a treatment.

Common Symptoms of Depression

Persistent sadness, emptiness, or feelings of hopelessness
Loss of interest or pleasure in activities you once enjoyed
Changes in appetite or weight, either loss or gain
Sleep disturbances, including insomnia or sleeping too much
Fatigue or loss of energy, even after rest
Difficulty concentrating, remembering details, or making decisions
Feelings of worthlessness or excessive guilt
Slowed thinking, speech, or physical movement
Withdrawing from family, friends, and social activities
Recurring thoughts of death or suicide

A diagnosis of major depression requires that five or more of these symptoms be present for at least two weeks, with at least one being depressed mood or loss of interest. However, even fewer or milder symptoms that disrupt daily functioning deserve clinical attention.

How Dr. Willison Diagnoses Depression

Dr. Willison conducts a comprehensive psychiatric evaluation that covers your current symptoms, personal and family mental health history, medical background, and how depression is affecting your relationships, work, and daily life. He also screens for co-occurring conditions such as anxiety, ADHD, and bipolar disorder, because depression rarely appears on its own. A correct diagnosis from the start leads to more effective treatment and fewer setbacks along the way.

Treatment Options for Depression

Depression is one of the most treatable mental health conditions. The majority of people who receive appropriate care experience meaningful improvement. Dr. Willison uses an individualized, evidence-based approach that may combine medication, therapy, and lifestyle strategies depending on the severity and type of depression.

Antidepressant Medications

Medication is often recommended for moderate to severe depression, and for milder cases where therapy alone has not provided sufficient relief. Dr. Willison carefully selects the right medication based on your specific symptoms, medical history, other medications you may be taking, and personal preferences.

Selective serotonin reuptake inhibitors (SSRIs) such as sertraline, escitalopram, and fluoxetine are typically the first-line choice due to their effectiveness and tolerability
Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine and duloxetine are particularly helpful when depression occurs alongside anxiety or chronic pain
Bupropion is a commonly used option that also addresses fatigue and low motivation and has a favorable side effect profile
Mirtazapine is often considered when sleep disturbance and appetite loss are prominent features of depression
Tricyclic antidepressants and MAOIs are older classes occasionally used when newer medications have not worked

Finding the right medication sometimes takes time. Dr. Willison monitors your response closely and makes adjustments as needed to help you achieve the best possible outcome with the fewest side effects.

Cognitive Behavioral Therapy for Depression

Cognitive Behavioral Therapy, or CBT, is one of the most extensively researched and effective treatments for depression. It is a structured, goal-oriented form of talk therapy that focuses on the connection between thoughts, feelings, and behaviors.

People with depression often develop patterns of thinking that reinforce low mood, such as seeing themselves, the world, and the future in a consistently negative light. CBT helps patients identify these unhelpful thought patterns and replace them with more balanced, realistic perspectives. Over time, this process changes how the brain responds to difficult situations.

CBT also addresses the behavioral side of depression. When people feel depressed, they often stop doing the things that used to bring them joy or meaning. This withdrawal makes depression worse. CBT uses a technique called behavioral activation to gradually re-engage patients with life in a way that builds momentum and improves mood.

Research consistently shows that CBT is as effective as medication for mild to moderate depression and that the combination of both produces the best outcomes for more severe cases. The skills learned in CBT also continue to protect against future episodes long after treatment ends.

Treatment-Resistant Depression

Treatment-resistant depression is typically defined as depression that has not adequately responded to at least two different antidepressant treatments taken at appropriate doses for a sufficient period of time. It is more common than many people realize and can be discouraging for patients who have already tried to get better without success.

Dr. Willison has experience evaluating and treating patients with complex or treatment-resistant depression. When standard approaches have not worked, he takes a thorough look at possible reasons, including whether the original diagnosis is accurate, whether there are untreated co-occurring conditions, whether medication dosing has been optimized, and whether contributing lifestyle or medical factors need to be addressed.

Options for Treatment-Resistant Depression

Augmentation strategies: adding a second medication such as lithium, an atypical antipsychotic, or thyroid hormone to enhance the effect of an antidepressant
Switching to a different class of antidepressant or trying a medication with a different mechanism of action
Esketamine (Spravato): an FDA-approved nasal spray for treatment-resistant depression that works through the glutamate system rather than serotonin
Referral for transcranial magnetic stimulation (TMS): a non-invasive brain stimulation procedure that has demonstrated effectiveness for treatment-resistant depression
Referral for electroconvulsive therapy (ECT): one of the most effective treatments available for severe, treatment-resistant depression when other approaches have been exhausted

If you have tried multiple treatments without adequate relief, there are still meaningful options available. Dr. Willison will work with you to find a path forward.

Lifestyle Interventions That Support Depression Treatment

Medication and therapy are the cornerstones of depression treatment, but lifestyle factors play a meaningful supporting role. Small, consistent changes in daily habits can significantly influence mood, energy, and the brain’s ability to respond to treatment.

Physical Activity

Exercise is one of the most well-documented lifestyle interventions for depression. Regular physical activity increases levels of serotonin, dopamine, and endorphins, the same brain chemicals that antidepressants target. Even moderate exercise, such as a 30-minute walk most days of the week, has been shown to reduce depressive symptoms in clinical studies. Dr. Willison may incorporate physical activity recommendations into your overall treatment plan.

Sleep

Depression and sleep are closely connected. Poor sleep worsens depression, and depression disrupts sleep, creating a cycle that can be difficult to break. Improving sleep hygiene, establishing a consistent schedule, and in some cases addressing underlying sleep disorders are all important components of depression care.

Nutrition

Emerging research supports a connection between diet and mental health. Diets high in ultra-processed foods and low in fruits, vegetables, and whole grains have been associated with higher rates of depression. While dietary changes alone are not a treatment for clinical depression, they can support overall brain health and complement other treatments.

Social Connection

Depression thrives in isolation. Staying connected to supportive people, even when it feels difficult, is one of the most protective factors against worsening depression. Dr. Willison may discuss ways to rebuild or maintain social connections as part of your care plan.

Stress Management

Chronic stress is both a trigger and a maintaining factor for depression. Learning to identify and manage sources of stress, whether through therapy, mindfulness, or practical life changes, reduces the burden on the nervous system and supports long-term recovery.

What Dr. Willison Treats

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Frequently Asked Questions

What is depression?

Depression is a serious mood disorder that affects how a person thinks, feels, and functions in daily life. It is not a personal weakness or a choice, and it cannot simply be willed away. Depression involves changes in brain chemistry, structure, and function that require proper clinical treatment. With the right care, the vast majority of people with depression experience meaningful improvement.

What are symptoms of depression?

The most recognized symptoms of depression are persistent sadness and loss of interest in things you once enjoyed. But depression also commonly causes changes in sleep and appetite, low energy, difficulty concentrating, feelings of worthlessness, physical slowing, withdrawal from others, and in some cases, thoughts of death or suicide. Symptoms vary from person to person, and not everyone with depression feels sad in the way most people expect.

How is depression treated?

Depression is most effectively treated through a combination of medication and psychotherapy. Antidepressants help correct chemical imbalances in the brain, while therapies like CBT help change the thought and behavior patterns that maintain depression. The right treatment plan depends on the type and severity of depression, any co-occurring conditions, and your personal goals and preferences. Dr. Willison works with each patient to develop an individualized approach.

How long does it take for antidepressants to work?

Most antidepressants take two to four weeks to begin showing noticeable effects, and up to six to eight weeks to reach their full benefit. This is one of the most important things to understand about depression medication. Stopping early because you do not feel better within the first week is one of the most common reasons treatment does not work. Dr. Willison will guide you through the process and monitor your progress closely.

Is depression a lifelong condition?

For some people, depression is a single episode that responds well to treatment and does not return. For others, it is a recurring condition that requires ongoing management. Having one episode of major depression increases the risk of future episodes, which is why Dr. Willison focuses not just on treating your current symptoms but on building a long-term plan that reduces the likelihood of relapse.

Can depression occur alongside other mental health conditions?

Yes, very commonly. Depression frequently co-occurs with anxiety disorders, ADHD, PTSD, substance use disorders, and chronic medical conditions such as diabetes and heart disease. When other conditions are present, they must be identified and treated alongside depression for care to be fully effective. This is one reason why a comprehensive psychiatric evaluation at the start of treatment is so important.

What is the difference between depression and grief?

Grief is a natural response to loss, and it can look very similar to depression on the surface. The key differences lie in how persistent the symptoms are, whether the person retains any capacity for positive moments, and whether functioning continues to deteriorate over time. Grief typically eases gradually, even if it takes months. Depression tends to persist and worsen without treatment. In some cases, grief can trigger a depressive episode, which does warrant clinical attention.

Does depression affect children and teenagers?

Yes. Depression can occur at any age, including in young children, though it sometimes presents differently in younger patients. Children and adolescents with depression may appear more irritable than sad, have more behavioral problems, refuse school, complain of physical symptoms like stomachaches, or withdraw from friends and family. Dr. Willison treats adolescents with depression and takes a family-informed approach to their care.

What should I do if I or someone I know is having thoughts of suicide?

Thoughts of suicide are a serious symptom that requires immediate attention. If you or someone you care about is in crisis, please call or text 988 to reach the Suicide and Crisis Lifeline, available 24 hours a day, seven days a week. If there is immediate danger, call 911. For patients of Dr. Willison who are experiencing worsening symptoms between appointments, please contact the office as soon as possible. You do not have to wait.

How do I know if I need a psychiatrist rather than a therapist for depression?

A psychiatrist is a medical doctor who can prescribe medication, which makes psychiatric care the right choice when depression is moderate to severe, when therapy alone has not been sufficient, or when there may be an underlying medical or neurological component to your symptoms. Dr. Willison provides both medication management and therapeutic support, and he can coordinate care with your existing therapist if you have one. The two approaches work best together.

Schedule Your Depression Evaluation in Los Angeles

You do not have to keep guessing about whether ADHD is behind the challenges you or your child are facing. A proper evaluation with Dr. Willison can give you real answers and a clear path forward.

Dr. L. David Willison IV, MD, PhD, is an experienced ADHD psychiatrist in Los Angeles who provides personalized care for children, adolescents, and adults. From diagnosis to medication management to therapy, his private practice offers the comprehensive support you need in one place.

Call 415-412-4613 or visit ldavidwillisonmdphd.com to request an appointment today.