Mood disorders, in particularly Major Depressive Disorder are perhaps the most common psychiatric disorders encountered in a family practice setting. In milder cases psychological interventions may be all that is needed to manage the depression. Medication may be needed if the depression is more severe. Once an assessment including suicide assessment has been done, the primary care physician establishes a therapeutic relationship with the patient. He has 4 treatment options: watchful waiting, psychological interventions, pharmacotherapy, and referral to a psychiatrist. A combined approach of establishing a therapeutic relationship, psycho-education, and appropriate use of psychotropic medications give the best results. The primary care physician needs to know the indications for referral to a psychiatrist.