Depressive Episode: Symptoms, Types, and Treatment in Madrid

A depressive episode doesn't warn. One day you realize that for weeks now you've been feeling empty, drained of energy, and uninterested in anything that used to matter to you. You might think it's just fatigue, stress, or a rough patch. But when that feeling lasts more than two weeks and starts to affect Your work, your relationships, and your ability to function—this isn't just a rough patch anymore: it could be a depressive episode. It is one of the most common diagnoses in clinical psychology. At MadridPsicoterapia, with an office in Chamberí and online services, we have psychologists who specialize in the diagnosis and treatment of depressive episodes using evidence-based therapy.

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Depressive episode

What is a depressive episode?

A depressive episode It is defined as a period of at least two weeks during which the person experiences a depressed mood, loss of interest or inability to experience pleasure (anhedonia), and increased fatigue. These three symptoms are the core symptoms, and at least two must be present for the diagnosis to be considered.

In addition, the following symptoms may accompany the episode: difficulty concentrating and making decisions, feelings of guilt or worthlessness, a pessimistic view of the future, sleep disturbances (early awakening, insomnia, or hypersomnia), changes in appetite and weight, and, in the most severe cases, suicidal thoughts or acts.

The difference between a mild episode and a severe one is not merely quantitative: in a severe episode, the symptoms are more intense, more numerous, and the functional impact is severe.

An important clinical fact: the prevalence of depressive episode Lifetime prevalence in Spain is around 15–20% of the population, with a higher incidence among women (a 2:1 ratio). At MadridPsicoterapia, in Chamberí, we conduct a comprehensive psychological evaluation to determine the severity of the episode and develop the most appropriate treatment plan. Cognitive-behavioral therapy is the first-line treatment for mild and moderate episodes according to all current clinical guidelines.

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Frequently Asked Questions

Frequently Asked Questions About Depressive Episodes

We know that many questions may arise before starting therapy. Here, we answer the most common questions we receive from people who contact our clinic.

What are the early symptoms of a depressive episode?

The early symptoms of a depressive episode are often subtle: difficulty enjoying activities that were once pleasurable, a persistent feeling of fatigue with no clear physical cause, trouble concentrating, irritability, or an underlying sadness with no specific cause. Often, a person realizes that something is wrong when they start avoiding social engagements, notice a decline in their work performance, or when close family members comment that they seem different. If you’ve been experiencing any of these symptoms for more than two weeks, it’s advisable to consult a psychologist for a comprehensive evaluation.

Does a depressive episode go away on its own without treatment?

A depressive episode may resolve spontaneously in some cases, but studies show that without treatment, the average duration of an episode is 6 to 9 months, and there is a high risk that it will become chronic or that new episodes will occur. Furthermore, during that time, the impact on quality of life, relationships, and work can be very significant. Psychological treatment shortens the duration of the episode, reduces the intensity of symptoms, and—most importantly—addresses vulnerability factors to prevent future relapses. Don’t wait for it to go away on its own.

What is the difference between a mild depressive episode and a severe one?

The distinction is based on the number of symptoms, their intensity, and the degree of functional impairment. A mild episode (F32.0) involves two of the three core symptoms plus at least two additional symptoms, with some ability to continue functioning in daily life. A severe episode (F32.2 or F32.3) involves all three core symptoms plus at least four additional symptoms of considerable intensity, with marked functional impairment that prevents work and social activities. In severe cases, there may also be a risk of suicide. Differential diagnosis requires clinical evaluation by a psychologist or psychiatrist.

Can a depressive episode develop into a recurrent depressive disorder?

Yes. A first depressive episode may remain an isolated event, but statistics indicate that approximately 50% of people who have had a first episode will experience at least one more throughout their lives. When two or more episodes occur, separated by a period of several months without significant symptoms, the diagnosis changes to recurrent depressive disorder (F33). For this reason, psychotherapy does not end when the episode remits: an essential part of treatment is preventing relapses and strengthening personal resources.

When should I see a psychologist for a depressive episode, and when should I see a psychiatrist?

Both psychologists and psychiatrists can assess and treat depression, but their roles are complementary. Psychologists provide psychotherapy (cognitive-behavioral therapy, behavioral activation therapy, etc.), which is the first-line treatment for mild and moderate episodes. The psychiatrist specializes in pharmacological treatment and is the appropriate choice when symptoms are very severe, there is a risk of suicide, or the episode does not respond to psychotherapy. At MadridPsicoterapia, we conduct an initial evaluation to determine the most appropriate referral and work in coordination with psychiatry when the case requires it.

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Depressive Episode: Symptoms, Types, and Treatment in Madrid

What is a depressive episode?

Frequently Asked Questions About Depressive Episodes

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