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.

Symptoms

Types

Treatment

When to Ask for Help

Depression in Adolescents

Depression Test

You know exactly what you're paying from day one

How much do the sessions cost?

€ 55

Price per session

Comprehensive Evaluation
Weekly sessions*
Online and In-Person Services **

€220

€ 199

Monthly

Comprehensive Evaluation
Weekly sessions*
20% discount**

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Why Choose Us

Why Choose MadridPsicoterapia?

✓

Licensed and Specialized Psychologists

Our Team consists of licensed health psychologists at the COP in Madrid, with specialized training and proven experience in treating depressive disorders. We work with professional rigor and stay up to date with the latest scientific developments to provide you with the best possible care.

✓

Evidence-Based Therapies

We use a variety of approaches, such as cognitive-behavioral therapy, ACT, exposure and emotional regulation techniques, and third-generation therapies, among others, because we believe you deserve treatment for depression that has proven its effectiveness in rigorous clinical research—not fads or empty promises.

✓

Personalized Treatment Plan

We don't follow rigid protocols. After a detailed initial evaluation, we design a treatment plan tailored to your specific situation, your goals, and your schedule. Because we understand that everyone experiences the depression in a unique way, and the approach must respect that uniqueness

✓

Central location in Chamberí

Our office is located at 141 Santa Engracia Street, in the Chamberí neighborhood, with excellent Metro and bus connections. We also offer treatment for depression in Chamberí, both in person and online for those who prefer the convenience of joining from home.

✓

Compassionate and non-judgmental support

We know that taking the step to ask for help isn’t always easy. That’s why at MadridPsicoterapia you’ll find a warm, confidential, and judgment-free space where you are our top priority. We’re committed to supporting you with honesty, empathy, and absolute respect for your journey.

Prices with no surprises and no pressure

Making decisions is also part of the process.

We offer you an initial session—either online or in person—so we can get to know each other.

From there, you should only continue if you feel you've established a connection with the professional you've met. The rest of the process is flexible, tWe explain how it works and the terms and conditions starting with the first session. No monthly fees, no long-term commitments, and fixed prices per session.

Individual Therapy

55 €

Couples Therapy

65 €

Individual Therapy

55 €

Therapy for couples

65 €

It's not how many, it's how

People who started individual therapy with us in Madrid

Juana, Carlos, Rocío, Almudena… We don't like to talk about numbers. We help real people with real names in real-life situations. It could be your neighbor, a friend, a mother, a coworker, your child… every name holds a different story. And every story deserves to be truly heard.

I came because my wife asked me to. I thought there was nothing wrong with me, but I was impossible to be around. Here, I've been able to talk about things I'd never talked about with anyone before. I've come to understand where all that anger was coming from. Things at home have improved a lot.

I started this after my partner suddenly broke up with me. The first few months were awful. Here, I've been able to let go of all that pain without feeling like I was burdening anyone. I've also worked on patterns I kept repeating in my relationships. It's helped me a lot.

I lost my mother years ago, and I was still having a really hard time. Here, I've learned that grief takes its own time. I still miss her every day, but it's different now.

I was on sick leave due to stress, headaches, insomnia, digestive problems… The usual stuff. Here, I’ve been working on setting boundaries at work. It’s not like I’m a completely different person now, but at least I’ve learned to say no every once in a while. To be honest, it’s still incredibly hard for me.

My kids and I were in a terrible place after the divorce. All we did was argue. I've worked on improving our communication, and well, now at least we can talk without ending up yelling at each other.

I started online therapy because my work schedule made it impossible to attend in-person sessions. At first, I thought it wouldn't be the same, but it's worked out really well for me—I do it from home after I get back from work, when everyone else is asleep.

My job requires me to travel constantly, and online therapy has been the only way I've been able to stay in therapy. It doesn't matter if I'm in Madrid, Barcelona, or anywhere else. I just log in, and that's it.

I felt trapped in a life that wasn't my own. I was doing what was expected of me, not what I wanted to do. I've been working on connecting with what I truly want. I'm making some major changes.

After becoming a mother, I felt invisible. I was just “the mother of.” I’ve worked on my identity beyond motherhood and have reclaimed parts of myself that I had lost.

I live in a small town where everyone knows each other. Online therapy has allowed me to find a professional outside of town without anyone seeing me go in or out of anywhere. I've worked through some very personal issues that I would never have talked about here. I highly recommend it.

I started online during the lockdown and just stuck with it. I like being able to do it from home, without wasting time commuting. I've been working on my social anxiety, and starting online actually took that pressure off me.

Online therapy seemed a little strange to me at first, but with my shift work, it was impossible to fit in in-person appointments. Being able to log in at 10 p.m. after work has been key. If it had been in person, I would have quit right away.

I used to have uncontrollable outbursts of anger. I'd fly off the handle over the slightest thing and say terrible things. I'd lost friends because of this. I've worked on identifying what triggers me. My relationships have improved a lot.

I tried online therapy because I was too embarrassed to go to an in-person session. I know it sounds silly, but that's just how it is. From my room, where no one can see me, I've found it easier to open up. So far, this is working for me, and I feel comfortable this way.

I've been doing online therapy ever since I moved abroad. I wanted to continue seeing my longtime therapist, and this has made that possible. We've been doing this for two years now. The screen can sometimes be a barrier, but being able to maintain that therapeutic connection despite the distance is priceless.

I have two young children, and getting out of the house is a nightmare. Online therapy has been a lifesaver. While they’re napping, I log on. No commuting, no having to find someone to watch the kids. It’s been the only way I’ve been able to take care of myself, too.

My father has Alzheimer's, and I take care of everything. I was completely overwhelmed, juggling my own life and taking care of him. Here, I've been able to let off some steam without feeling guilty for being tired. I've learned to ask for help. It was either that or end up completely worn out myself.

My partner and I hadn't had sex in over a year. We were too embarrassed to even talk about it. Working on this here has helped us communicate better in general. We've regained that connection.

Online therapy made me a little nervous at first. I thought it would be weird to talk about my personal stuff in front of a screen. But it’s actually even more comfortable. I’m in my safe space, on my couch, with my blanket.

After I was dumped, I felt terrible. A friend recommended that I come here. It helped me a lot during the first few months—I could cry and let it all out. Then I stopped coming because I was feeling better. A few months later, I started feeling bad again, so I came back.

I was diagnosed with a chronic illness and it really got me down. I've been in therapy for six months. Some days I leave the session thinking, "That was great—really helpful." Other days I leave thinking, "Why am I even coming here if this isn't going to cure me?" But I'm grateful to the team.

We went to couples therapy. After four months, we broke up anyway. I don't know if it helped at all or if it just delayed the inevitable. But hey, at least we broke up without killing each other—that's something, at least.

Total apathy. A friend told me to come. I've been coming for three months. I don't know if I've noticed any changes. I still wake up without any motivation. But hey, at least for one hour a week I'm doing something other than lying on the couch. My psychologist says that just coming here is already a step forward.

Some very dark thoughts brought me here two years ago. I've improved a lot—I won't deny it. My psychologist explained to me that it's not like that, that there can be relapses. It bothered me to hear that, to be honest. But anyway, I'm still working on it.

I've been dealing with depression for two years. I've tried medication, gone to therapy, exercised—I've tried everything. There are times when I feel better, and other times when I slip back into it. I'm grateful that I've been able to stick it out, and I recommend reaching out for help.

I worry about everything: work, anxiety—which causes me horrible physical symptoms. Dizziness, rapid heartbeat, sweating. I’ve gone to the emergency room about five times thinking I was dying. It’s always anxiety. I’m doing online therapy because I’m terrified of leaving the house.

I've tried everything—yoga, meditation, pills. Nothing works for me. I've been doing online therapy for six months now. The other day, I had a panic attack during the session. I felt ridiculous. My therapist told me it was okay, that it was a good time to work through it.

I have a really hard time socializing with people. Just the thought of meeting up with friends makes me anxious days in advance. I started therapy a year ago. I've improved in some ways: I can go shopping without feeling so bad, and I can talk on the phone.

My anxiety started a couple of years ago. At first, I thought it was just work-related stress. I started online therapy because, with my schedule, it's impossible to go to in-person sessions. Sometimes it helps me to log in from home; other times, having the computer in front of me distracts me.

I felt constantly overwhelmed by work, by life, by everything. I couldn't stop mulling things over. A friend recommended online therapy to me. At first I was skeptical; I thought talking through a screen wouldn't do any good.

I have pretty severe social anxiety. Online therapy was perfect for me because being able to start without having to physically go anywhere took a lot of the pressure off. I've improved quite a bit in some areas—thank you!

I was diagnosed with depression a year ago. The first thing I thought was, “But I’m not sad all the time.” I started online therapy because I didn’t even have the energy to leave the house. It’s been seven months, and I’m starting to notice some changes.

Depression caught me by surprise. I had always been an active, energetic person. Suddenly, I found myself not wanting to do any of the things I used to enjoy. Going to the gym, hanging out with friends—everything felt like too much trouble. I felt empty.

I started online therapy six months ago because, honestly, I didn't have the energy to leave the house. Progress has been slow. Some weeks I feel a little better; other weeks I'm back to square one. But I'm learning that depression isn't something you can just snap out of.

I've been dealing with depression for about two years. The hardest part is that it's invisible—people look at me and think I'm fine. But inside, I feel empty most of the time. Getting through the day feels like climbing a mountain. I started online.

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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