By Khrista Quevedo, LPC-A, LMFT-A, NCC Bilingual Licensed Professional Counselor Associate | Mental Health Counseling Group Publicado: 8 de junio, 2026 / Published: June 8, 2026

A lot of the depression I see in my Katy office doesn't look like the depression people expect. It's the parent who keeps showing up for everyone else while running on fumes. The new mom who feels guilty for not enjoying motherhood. The husband whose family is finally stable enough that he has space to feel how hard the last decade was. Depression doesn't always look like sadness. Sometimes it looks like irritability, or numbness, or a body that can't get out of bed even though the mind knows there's nowhere to hide.

This post is for people who have been wondering whether what they're feeling is depression, what treatment actually involves, and what to know about getting help in Spanish or English in Texas. Mucho de lo que sigue es para las familias latinas que vienen a terapia por primera vez.

What Counts as Depression?

Clinical depression is more than a low mood. It's a persistent change in mood, energy, and function that lasts at least two weeks and starts to interfere with daily life. The classic signs include sustained sadness or numbness, loss of interest in things that used to feel good, sleep changes (too much or too little), appetite changes, fatigue, difficulty concentrating, feelings of worthlessness or guilt, and in some cases thoughts of death or self-harm. The DSM-5-TR lists nine criteria; meeting five or more of them, for at least two weeks, generally meets the threshold for major depressive disorder (American Psychiatric Association, 2022).

It helps to know that depression is common. The National Institute of Mental Health estimates that about 21 million U.S. adults experienced at least one major depressive episode in the past year, around 8 percent of the adult population (NIMH, 2023). The World Health Organization names depression as one of the leading causes of disability worldwide (WHO, 2023). You are not alone, and the condition is treatable.

Why Is Depression Often Missed in Latinx Families?

This is a piece I think about often as a bilingual therapist. Latinx clients in my practice frequently come to therapy years later than they could have, and the reasons aren't usually about ignorance or denial. They're about stigma, language, and the cost of being the strong one.

In many Latinx households, mental health gets framed as a private family matter, not something you talk about with strangers. There's a cultural strength to that, and there's also a cost: when the suffering is invisible, it doesn't get addressed. Add to that the fact that many older family members grew up in countries where mental health care was either inaccessible or stigmatized as locura (madness), and you get a pattern where depression in a parent or a grandparent quietly shapes a whole family without ever being named.

Younger Latinx adults often come to therapy in the middle of that knot. They're processing their own depression, the depression they grew up around, and the guilt of seeking help that earlier generations couldn't. That work is real, and it's some of the most meaningful work I do.

I see clients in English and Spanish, depending on what feels most comfortable. Sometimes we switch between the two within a session, especially when the emotion lives in one language and the analytic part of the brain in the other.

What Does Depression Treatment Actually Look Like?

The two treatments with the strongest evidence for depression are psychotherapy and medication, often in combination. A 2014 meta-analysis published in the World Psychiatry journal pooled data from 122 trials and confirmed that psychotherapy, on its own, produces substantial improvement in depression, with effect sizes comparable to antidepressant medication (Cuijpers et al., 2014). Combination treatment (therapy plus medication) tends to outperform either alone for moderate-to-severe depression, while milder depression often responds well to therapy alone.

Within therapy, the modalities with the strongest evidence for depression are Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT). At Mental Health Counseling Group we draw from both, plus we layer in family or couples work when the depression is showing up inside a relationship system that needs attention. For trauma-driven depression, EMDR is another option, often pairing well with cognitive work.

What I tell clients in their first session is: we are going to find the smallest sustainable thing first. Depression robs energy. If the first homework I give you requires the energy of a person who is not depressed, the plan is broken. So we start with one workable change. Then another. Compound interest does the rest.

When Should I Seek Help for Depression?

A reasonable rule of thumb: if depression symptoms have been present for more than two weeks, are interfering with your sleep, work, parenting, or relationships, and aren't responding to the usual recovery strategies (sleep, exercise, time with loved ones), it's worth talking to a clinician. You don't need to be in crisis to qualify for therapy. Many of my clients come because they want to catch it early.

Reach out sooner, not later, if any of the following are happening:

You're having thoughts of suicide or self-harm. Texas has a free 24/7 988 Suicide and Crisis Lifeline that supports calls and texts in English and Spanish.

You can't function at work or with your family.

You've been depressed before and recognize the pattern returning.

You're a new parent and the heaviness has lasted more than a couple of weeks (postpartum depression is real and responsive to treatment).

You're using alcohol, food, or other substances to push the feelings down.

If you're not sure whether what you're feeling is "really" depression, that's a reasonable thing to bring to a first session. We can sort it out together.

What About Family Therapy When One Person Has Depression?

Depression doesn't live in isolation. When one member of a family is depressed, the rest of the family often unconsciously rearranges itself to compensate, and that rearrangement can become its own source of suffering. The non-depressed partner over-functions and starts to feel resentful. Kids worry. The depressed person feels increasingly like a burden, which deepens the depression.

Family therapy or couples therapy doesn't replace individual treatment for depression, but it adds something individual therapy can't. It gives the family a shared language, addresses the dynamics that may be making recovery harder, and lets everyone in the system get support, not just the person carrying the diagnosis.

This is one of the reasons I'm also trained as an LMFT-Associate. A lot of depression cases benefit from work at both the individual and family level.

Can Depression Treatment Be Done Over Telehealth?

Yes, and for many people it's a relief. Depression often makes the practical work of getting to an appointment harder, and removing the commute removes a real barrier. Research has consistently found that telehealth therapy for depression produces outcomes comparable to in-person therapy. At Mental Health Counseling Group we offer in-person sessions in Katy, Sugar Land, Fulshear, and Austin, and telehealth across Texas. For my bilingual clients, I can do telehealth sessions in Spanish or English, depending on what fits.

Frequently Asked Questions About Depression Treatment

Is what I'm feeling really depression, or just stress? A licensed clinician can help you sort this out in a first session. The general rule is that depression is more pervasive and longer-lasting than situational stress. Stress lifts when the stressor resolves; depression often doesn't.

Do I need medication to treat depression? Not necessarily. Mild and moderate depression often respond well to therapy alone. Moderate-to-severe depression often benefits from a combination of therapy and medication. The decision is between you and a prescriber.

Will my insurance cover therapy for depression? Mental Health Counseling Group is private-pay and provides detailed superbills you can submit to your insurance carrier for out-of-network reimbursement. Most PPO plans reimburse a portion after a deductible. Our insurance and fees page explains the details.

Can I get bilingual therapy in Katy? Yes. I see clients in English and Spanish in our Katy office and via telehealth across Texas.

¿Puedo hacer terapia en español? Sí. Ofrezco terapia individual, de pareja y familiar en español, en persona en Katy y por telehealth en todo Texas. La primera sesión es para conocernos y decidir juntos qué sería más útil para usted.

Talk With a Counselor

If you've been wondering whether to talk to someone about depression, you can book a consultation. I see clients in our Katy office and via telehealth across Texas in English and Spanish. Our FAQ covers logistics and what to expect.

About the Author

Khrista Quevedo, LPC-A, LMFT-A, NCC is a bilingual (English/Spanish) Licensed Professional Counselor Associate and Licensed Marriage and Family Therapist Associate at Mental Health Counseling Group in Katy, Texas. She works with individuals, couples, and families across cultural backgrounds.

Read more about Khrista → · Book a session

Sources

Photo by Vanburn Gonsalves on Unsplash.