Course Overview
Concise, practical depression management for the real world. This course helps busy primary care and outpatient clinicians differentiate MDD and PDD from burnout, grief and overwhelm with confidence, integrate PHQ-2/PHQ-9 into measurement-based care, choose and titrate first-line antidepressants, and make clear decisions about when to switch vs augment. We also map out the non-pharmacologic landscape (psychotherapy, exercise) and advanced treatment options (ECT, TMS, ketamine) so you can situate office-based care within the broader treatment ecosystem. Communication tips throughout emphasize hope, self-efficacy, and adherence.
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Listen on-the-go
Course owners can access the course through a private podcast feed for listening on-the-go. If you are a Full-Access CME Member or purchased this course as a one-off, check you inbox for an email from Castos, our podcast hosting service, for instructions on how to set up the private podcast feed for this course. For more detailed instructions, check out our Private Podcast page.
Learning Objectives
After participating in this activity, learners will be able to:
- Distinguish between Major Depressive Disorder and Persistent Depressive Disorder using DSM-5 criteria.
- Apply validated screening tools such as the PHQ-9 to aid in diagnosis while integrating clinical judgment.
- Select and titrate first-line antidepressants based on patient-specific factors and side-effect profiles.
- Implement strategies for switching antidepressants or adding augmentation agents in partial or non-responders.
- Identify and refer for non-pharmacologic treatment options including psychotherapy, ECT, TMS, exercise, and ketamine.
- Communicate treatment expectations and reinforce patient self-efficacy and adherence using evidence-informed counseling strategies.
Course Content
Listen
Course Available to Members or Individual Purchasers
Get full access to the Managing Depression in Primary Care audio course, streamable here or on a private podcast feed, plus downloadable resources and CME credit.
Join our Full Access Membership to unlock this course and all current and future QuickTakes & audio courses — or purchase this course individually below.
Course Chapters
- 00:00 — Introduction: How to access the associated PDF clinical resources, patient handouts and CME for this course.
- 01:50 — Course Overview: Overview of course goals, structure, and what participants will gain.
- 03:23 — The State of Depression: Cultural and clinical context; differentiating sadness vs. depression.
- 07:05 — Diagnostic Foundation: Core principles for diagnosing depressive disorders in primary care.
- 08:18 — Major Depressive Disorder (MDD): Key DSM-5 criteria, symptom clusters, and functional impact.
- 13:52 — Persistent Depressive Disorder (PDD): Chronic low mood, overlapping presentations, and differentiators from MDD.
- 16:59 — Differential Diagnosis: Grief, burnout, medical causes, and how to distinguish clinical depression.
- 20:24 — Screening Tools in Practice: Effective use of PHQ-2, PHQ-9, and population-specific screeners.
- 23:32 — Antidepressant Classes and First-Line Med Selection: SSRIs, SNRIs, bupropion, mirtazapine, and older agents, as well as pharmacogenetic testing and expectation setting.
- 33:41 — Dose Titration and Monitoring: Starting doses, timing of dose increases, and monitoring response.
- 38:45 — Antidepressant Augmentation: Framework for partial responders, second-line trials, and augmentation basics.
- 46:53 — Duration of Antidepressant Therapy: Time frame depending on presentation, tachyphylaxis.
- 52:07 — Antidepressants in Special Populations: Pregnancy, Bipolar Disorder.
- 58:18 — Beyond Medications: Psychotherapy, behavioral activation, exercise, and other non-pharmacologic strategies.
- 1:03:40 — Neuromodulation and Ketamine: Overview of ECT, TMS, and ketamine/esketamine use in treatment-resistant depression.
- 1:16:51 — Understanding Depression: Monoamine, inflammatory, and neuroplasticity models; how these inform treatment perspectives.
- 1:23:55 — Talking about Depression With Patients: How to discuss diagnosis and treatment to build hope and self-efficacy.
- 1:28:35 — Wrap-up and Review: Summary of key points.
- 1:30:27 — Outro: CME instructions, review of PDF resources available on website
Clinic Resources and Patient Handouts
Diagnosis and Medication Guides (diagnosis, differential, side effects, discontinuation)
Frameworks & Flowcharts (selection, titration, augmentation)
Patient Handouts (behavioral activation, expectations, relapse prevention, exercise, sleep, and more)
References and Tables (PHQ-9 interpretation, med effect and side-effect comparisons)
Diagnostic foundation
- Focus on duration and functional impact: What’s changed from baseline?
- Use PHQ-2 → PHQ-9 as data points — not final answers.
- Always screen for:
- Bipolar disorder
- Grief and bereavement
- Burnout or situational distress
- Medical, medication, or substance contributors
Major Depressive Disorder (MDD)
- SIGECAPS: ≥5 symptoms for ≥2 weeks; one must be depressed mood or loss of interest.
- Episodic: symptoms remit between episodes.
- Specific symptoms like guilt, anhedonia, and suicidality are more diagnostically helpful.
- Refer or escalate for suicidality, psychosis, catatonia, or major functional collapse.
Persistent Depressive Disorder (PDD)
- Chronic low mood for ≥2 years, plus ≥2 other symptoms (hopelessness, low energy, appetite or sleep change, etc.).
- Symptom-free intervals are brief — <2 months.
- Often harder to treat, so normalize slower progress from the start.