Are you having trouble sleeping, eating, or motivating yourself?
Do old sources of pleasure no longer inspire happiness?
Do you frequently experience feelings of hopelessness and thoughts of death?
Does everything feel effortful and do you feel slowed down?
These are some of the common symptoms of depression. In children and in some adults, depression often manifests as irritability and acting out behaviors. Regardless of the particulars, in nearly all instances depression is closely linking to poor self-worth and profound yet sometimes disguised sadness.
While some are hesitant to discuss it, depression is a very common problem for adults, adolescents and children. It occurs in approximately 2 percent of children and between 5 and 8 percent of adolescents. For adults, about 7 percent have had a major depressive episode within any given year. It is especially common in our senior population. The numbers of people with mild depression is significantly higher among all age groups.
Postpartum depression is a particular area of specialty of mine. Somewhere between 11%-20% of women in the US will develop symptoms of postpartum depression. Some doctors believe it is the single most under-reported and under-treated complication of childbirth. Postpartum depression is more than the baby blues and needs proper and effective treatment and the inclusion and education of new mothers' partner and or support network. In working with women struggling with postpartum depression, I validate their challenges, offer support and encouragement, and direct them to needed resources, including, if indicated, psychiatric care specialists who know which medication are safe for women who wish to breastfeed.
Depression is painful and isolating. Whether acute or chronic, severe or moderate, depression can be hard to overcome. Perhaps you, like many others who expect to push through these difficult moods and states of mind, have tried to ignore your feelings or have muscled through your experience. This “stiff upper lip” approach rarely works and can actually cause you to feel more discouraged.
Over time, depression, when untreated, takes its toll on many domains of your life. In addition to affecting the quality of your sleep, your appetite, your ability to concentrate and perform at work, depression challenges your relationships with colleagues, family and friends. People who are depressed tend to isolate themselves, thereby losing out on the many benefits of social engagement; this in turn can lead to a greater sense of unhappiness and loneliness.
Depression also has a negative impact on your physical health. It weakens the immune system, making you more susceptible to infectious diseases. For those who overeat to manage sad and painful feelings, depression increases the risk of obesity and Type II diabetes. According to a Harvard Medical School study, patients hospitalized for a heart condition who are also suffering from depression are two to five times likelier to have severe chest pain, heart attack, or stroke, within the next year. Finally, many people with depression experience more frequent headaches along with joint and muscular pain.
Psychotherapy is one of the most effective treatments for therapy. With the support of a caring and well-trained therapist, therapy can help you identify the roadblocks to well-being and strategies for removing them. We know so much now about the need for human connection as a primary source of wellness and healing. For depressed people who lock themselves away from others, the psychotherapeutic relationship may be the first place of social and interpersonal contact on the road to building or rediscovering a social support network.
Therapy can support you in developing greater compassion and respect for yourself, while encouraging you to pursue lifestyle changes that reduce symptoms of fatigue, heaviness and insomnia. It can increase your awareness of automatic negative thoughts and offer effective means to challenge these old and unhelpful patterns. For some for whom depression has been a lifelong battle, it may offer a place to explore early experiences of hurt or disappointment with caregivers and to come away with a new, more integrated and informed narrative.
Prolonged - or what psychologists call “complicated” grief - is a close cousin of depression. The loss of a loved one, a home, even a pet naturally results in a period of deep sadness, low energy, and frequent and sometimes intrusive thoughts about the loss. However, when these feelings and related symptoms such as insomnia, marked weight loss or weight gain, inability to concentrate, persist and cause moderate to significant impairment in daily living, then the bereaved individual is likely to benefit from psychotherapy or interventions.
Won’t discussing my feelings only make me feel worse?
Again, therapy is geared to your individual needs and your pace and is generally a gentle intervention. I will respect your concerns and tailor my responses accordingly. With some clients, we build up a lot of areas of strength and encouragement prior to tackling the more difficult feelings.
My first goal is to help you feel safe and understood, to understand the ways you have already attempted to tackle these heavy moods. I then work with you to reclaim your strengths by offering you guidance and support. I also provide tools (from cognitive tools to behavioral changes to mindfulness practice) that promote psychological wellbeing. In addition to focusing on challenging your automatic negative thoughts, I work in a holistic way, addressing healthy habits around sleep, exercise, diet and social supports.
Isn’t it easier to ask my doctor for medication?
Recent studies indicate that therapy is as effective as medication for treating depression. Some findings suggest that a combination of medication and psychotherapy has the greatest benefit for people with severe symptoms. As researchers are fine-tuning our understanding of depression and the brain, we may learn that certain people respond better to one approach depending on their unique profile but the science has not yet determined these distinctions. So, while psychotherapy may require more of a time and financial commitment up front, it is a viable alternative or addition to medication.
What are your skills in this area?
With more than 25 years of clinical experience, I have worked with a large number of depressed clients including children, adolescents and adults. My background and theoretical orientation enable me to combine some deeper, insight-oriented work with some very practical behavioral recommendations.
When clinically indicated, I collaborate with psychiatrists as medication as an adjunctive treatment can often prove highly effective. In such cases, should you have concerns about pharmaceuticals, we will first explore these together prior to the referral.
If you still have questions or are ready to give therapy a go, call me at (914) 764-5582 or email me. If I’m not available, I’ll get back to you promptly and we can discuss your particular concerns and questions about therapy and my practice. Following the first appointment, you are welcome to go online and schedule your appointment yourself.