Depression Treatment

When someone exhibits at least five of the symptoms listed below for a two-week period or longer, it is considered a major depressive episode. They can happen spontaneously, or after a painful life event like the death of a loved one, a romantic breakup, or a medical illness.

There are some exclusions to this. For example, if any of the below symptoms are caused by a medical condition, by another psychiatric condition, or by substance use, they not be attributable to depression.

• Persistent sad mood, most of the day, nearly every day 

• Loss of interest or pleasure in hobbies and activities, including sex 

• Feelings of guilt, worthlessness, helplessness 

• Decreased energy, fatigue, feeling “slowed down” 

• Restlessness or irritability 

• Difficulty concentrating, remembering, making decisions 

• Insomnia, early-morning awakening, or excessive sleeping 

• Low appetite and weight loss or overeating and weight gain 

• Thoughts of death or suicide, suicide attempts

Persistent Depressive Disorder is similar to Major Depressive Disorder except that symptoms are typically milder, persist for at least two years, and are consistently present with no more than two consecutive months of non-depressed mood. It is possible for someone to have a major depressive episode while also qualifying for persistent depressive disorder.

This can vary widely by therapist. Below are some different approaches to treating depression that you can expect when working with us.

Cognitive Behavioral Therapy (CBT)

• Focus: Identifying and changing negative or unhelpful thought patterns and behaviors that contribute to depression.

• What to expect:

  • Structured sessions: CBT is typically structured with clear goals and agendas.

  • Identifying negative thoughts: You'll learn to recognize automatic negative thoughts and how they affect your mood.

  • Challenging thoughts: You'll learn to challenge these thoughts and replace them with more balanced and realistic ones.

  • Behavioral activation: You'll work on increasing engagement in enjoyable activities to improve mood.

  • Homework: You may be given assignments to practice skills learned in sessions.

Acceptance and Commitment Therapy (ACT)

• Focus: Accepting difficult thoughts and feelings rather than struggling against them, and committing to actions aligned with your values.

• What to expect:

  • Mindfulness exercises: You'll learn mindfulness techniques to observe thoughts and feelings without judgment.

  • Values clarification: You'll explore what is truly important to you and set goals based on those values.

  • Psychological flexibility: You'll develop skills to be more present, open up to difficult experiences, and act in ways that are meaningful to you.

  • Less focus on changing thoughts directly: Unlike CBT, ACT doesn't aim to change the content of thoughts but rather your relationship to them.

Internal Family Systems (IFS) Therapy

• Focus: Understanding the different "parts" within you that contribute to depression. IFS proposes that we all have various sub-personalities (e.g., an inner critic, a wounded child) that interact with each other.

• What to expect:

  • Identifying "parts": You'll work on identifying and understanding the different parts of your inner system.

  • Developing self-compassion: You'll learn to approach these parts with curiosity and compassion, even the ones that seem negative.

  • Unburdening "parts": You'll work on healing wounded parts and helping them release their burdens (e.g., sadness, shame).

  • Strengthening the "Self": IFS emphasizes the core "Self," which is a source of wisdom, compassion, and healing within each person.

Somatic Therapy

• Focus: Addressing depression by focusing on the connection between the mind and body. It recognizes that trauma and emotional distress can be stored in the body.

• What to expect:

  • Focus on bodily sensations: You'll be guided to pay attention to physical sensations associated with emotions.

  • Movement and body-based techniques: Techniques like gentle movement, breathing exercises, and grounding practices may be used to release tension and promote emotional regulation.

  • Trauma-informed approach: Somatic therapy is often used to address trauma that may be contributing to depression.

  • Emphasis on present moment experience: The focus is on what you're experiencing in your body in the present moment.

High-functioning depression isn't a formal diagnosis, but it's a very real experience for many people. People described as having high-functioning depression often maintain their daily routines and responsibilities, appearing to be coping well. However, they experience internal symptoms of depression, such as low mood, loss of interest, fatigue, and self-criticism.

Because they are still functioning, their struggles may be minimized by themselves and others, delaying them from seeking help. Some experts suggest that many people described as having high-functioning depression might meet the criteria for PDD which is a chronic form of depression with less severe but long-lasting symptoms.