Depression Algorithm

Step One: Make sure the person meets DSM-5 criteria for depression. The research has been done on people who meet full criteria. People who partially meet criteria might respond similarly but the chances start to go down. 

Tip: If they are only one symptom away from meeting criteria, use your psychotherapy skills to try to make them feel excessively guilty about something! (If they did not already have excessive guilt.) That tips them over the edge and now they meet full criteria, and are statistically more likely to respond to the medications in the algorithm. 

Start with an antidepressant. SSRIs are popular but bupropion also works and does not cause loss of libido. So look at your patient and decide, is this someone who could use a little bit less libido? Do they seem like they are about to sexually assault someone? If yes, go with the SSRI. Do they seem like someone should really be at risk of reproducing? (Be honest.) If maybe no, go with the SSRI. Also, remember how overpopulated the planet is! Or, do they seem like they deserve a decent sex life? If yes, then prescribe the bupropion. 

If that first medication does not work, then evaluate your initial assessment (see previous paragraph) and prescribe something else.