Roughly 10% of all people are feeling depressed at any given time (NIMH). But depression is different from person to person, and depression can be so commonplace that we don't even notice it. All of us experience depression in some form, but usually attribute it to "being blue" or say "I'm just a little tired." We sometimes even attribute depression to personality: "She's always irritable like that...it's just who she is."

The good news is that depression is highly treatable.

We know that depression correlates with certain brain chemical patterns and a person's predisposition toward it may even be genetic. We also know the we can change our brain's chemical patterns by changing behavior and beliefs. If you don't want to feel depressed, this means that it is possible to get the help you need.

Depression that routinely interferes with your responsibilities or relationships certainly warrants your attention. But you don't have to have severe clinical depression to want to make changes.

Some of the signs of depression are:

• Feelings of sadness, despair, loneliness or emptiness which seem never ending
• Feelings of guilt, hopelessness or worthlessness which don't go away
• Loss of interest or pleasure in former hobbies or other activities, including sex
• Loss of energy, feelings of fatigue
• Loss of sleep, or over-sleeping
• Appetite/weight loss, or overeating and weight gain
• Difficulty concentrating, remembering things or making decisions
• Anger or irritability
• Thinking or talking about death or suicide, or suicide attempts (seek professional help immediately if this is the case, see below)

Treating Depression: Anti-depressant Medication

If you watch any amount of primetime television you are likely to see ads promoting any number of popular anti-depressant medications. Anti-depressant medications have been a helpful form of treatment for depression for years and are useful for many people. Most research about depression suggests that treatment outcomes for depression are greatly improved when anti-depression medication is combined with talk therapy. You should know that anti-depressants are not for everyone and many kinds of depression are quite treatable without taking any medication. It is a personal decision to make with your doctor and I am glad to support you as you make that decision.

Treating Depression with Psychotherapy

When I worked for Washington DC's largest outpatient mental health clinic I learned how untreated depression can unravel a person's life. Yet on a daily basis I am now pleased to help people change how they relate to their depression and open up new possibilities in their life.    

In my practice, talk therapy isn't a one-size-fits-all endeavor. I approach psychotherapy for depression using several general components which, among others, include:

• Focus on Strengths: When we're depressed it's as if the part of us that might otherwise feel confident and strong is shut off or greatly diminished. Quite frequently, this part of us hasn't disappeared entirely but is being blocked or feels prohibited. We can work together to understand these blocks and gradually re-integrate strengths back into your thinking. Like many cognitive-behavioral approaches, this isn't a simple matter of doing an exercise once and feeling cured. It is normal for some parts of you to resist doing the exercises so we'll work with those parts to understand them and integrate them into the change process.
     
  
• Depression as Relational: Your depression affects the people around you whether you know it or not. In the same way, the people around you affect your depression. Small changes in how you express your needs to others or how you respond to the requests of others' needs can sometimes have a huge impact on your feelings of depression.
  
  
• Accepting Your Depression: Admitting you feel depressed is an important first step. Accepting your depression is a more challenging but very imporant next step. Accepting your depression means it's an invited member of your family at the dinner table. When you can get to the place where depressed feelings are just like any other feelings then you'll be less likely to have a freeze or panic response to them which often makes them more intense and potentially scary. You'll be more able to respond to your depressed feelings flexibly and then they won't take up permanent residence. This isn't easy but it works. Befriending the parts of you that you don't like is often more effective than trying to exile or manage our feelings which is never a permanant solution; humans are wired to experience a whole range of feelings, so depressed feelings are bound to return some other time and it's best to learn how to accept this when it happens.

Treating depression with talk psychotherapy can sometimes be done in brief therapy (6-10 sessions) and sometimes takes much longer. We will talk about what your goals are and I encourage you to assess our work together so that I can make adjustments and provide the best support for you.

Important note: If you or someone you know has thoughts of suicide, seek professional help immediately through your healthcare professional, or call one of the national suicide hotlines below.

National Suicide Hotlines USA 
Toll-Free / 24 hours a day / 7 days a week

 1-800-SUICIDE
1-800-784-2433

1-800-273-TALK
1-800-273-8255

 Read my article, Depression 101