Have you recently felt down, blue, or have a lack of enthusiasm about life more often than not?
Have you lost your energy, your appetite, or have trouble sleeping? Or conversely, have you been fidgety, abnormally hungry, or unable to sleep enough? Maybe you cannot concentrate or make simple decisions. You may have lost interest in your favorite activities or feel sad much of the time. Or maybe you feel guilty, or like a failure. Perhaps you have been having dark, gloomy thoughts, or thoughts of hurting yourself. All of these can signal clinical depression.
Depression manifests in a variety of ways. You may find yourself having trouble getting out of bed because you’ve been lying awake, couldn’t get to sleep, or waking up very early. Or maybe you’ve been taking extra naps to get all of the sleep you need. You may feel so upset that you cry often or feel like you have done something terribly wrong. At times you may have trouble getting household chores done due to fatigue, or you may be moving at a turtle’s pace. You may also be jittery and unable to sit still. You may think about death, such as the death of a loved one or a pet. You may sometimes injure yourself or, at times, have thoughts of hurting or killing yourself, or recurrent suicidal thoughts without a plan.
Others may tell you that you seem depressed or that you’re not acting like yourself. You may be craving sugary foods or eating more than normal. Or you may have lost or gained weight; your clothes may not be fitting the same. Maybe you can’t focus on what others are saying. Perhaps you can’t make simple decisions such as what to wear in the morning or what to have for dinner. Or maybe your self-esteem seems to be low. These are all symptoms of depression that may need treatment.
Depression Strikes One in Five
It is important to know that depression in all its forms is a treatable psychological and medical condition caused by a combination of factors. Common causes of depression are trauma and grief, drug and alcohol use, genetic inheritance, health conditions, history of other mental health issues, and psychological characteristics. The everyday stressors of financial strain, relationship problems, and concerns related to work can cause depression for many people. In fact, many people have difficulty adequately expressing their feelings. We are not always taught how to describe our personal experiences or our internal world when needed. Many of us don’t have supportive people around us to share our burdens, or we’re reluctant to seek support.
Treatment for Depression offers Relief and Understanding
Depression is a shared human experience. One in five people have difficulty with depression, and that person directly experiencing it tends to feel utterly alone and that their experience is unique. Simply by working with a therapist, that loneliness can be greatly reduced. The process of sharing in a counseling relationship enables you to communicate with another and recognize rational ways of reframing your experience. This reduces isolation and aids in balancing emotional distress by increasing your ability to rationally question your thinking and take a more objective perspective on your experience. Research has shown this type therapy to be effective. Studies have demonstrated that counseling is at least as effective as medication alone, and a combination of counseling and medication is better than either one of them by themselves.
In therapy, you can expect to gain a heightened capacity to understand emotionally challenging experiences and decrease their overall impact. Therapy helps develop an understanding of the close connection between feelings, thoughts, and beliefs. It is a process of actively questioning the thoughts and beliefs that prolong sadness and depression. Therapy is also a process of learning distress tolerance and emotional regulation skills to reduce the depressive symptoms and feel better. Sometimes those thoughts and beliefs are rooted in past events, while other times they are based in current life experiences. Whatever their cause, relief is possible within the supportive, compassionate, and empathic environment established within your therapy. The focus will be finding solutions to problems of daily living and removing the obstacles to resolve the depression that you experience.
In more than 20 years of practice, working with depression has been incredibly gratifying. I know the pain and suffering of depression from personal experience. I also know that life can be bright and worth living again. We can schedule a free in-person or phone consultation to discuss your options for overcoming symptoms of depression.
1Hasin DS, Sarvet AL, Meyers JL, et al. Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States. JAMA Psychiatry. 2018 Apr 1;75(4):336-346.
Frequently Asked Questions (FAQs)
Are you going to prescribe me medication?
No. As a clinical psychologist, I do not have the ability to prescribe medications. Only a licensed medical professional such as a psychiatrist or a primary care physician can prescribe medications.
What is the difference between a psychologist and a psychiatrist?
A psychiatrist is a medical doctor with a rotation in mental health that prescribes medications related to mental health concerns. They typically do not do therapy with their clients. Rather, the heart of their practice lies in medication management. Their sessions are typically 15-20 minutes long and center around making a diagnosis and determining the best medication to treat the patient’s symptoms.
A psychologist is a behavioral health specialist who trains in two specialty areas. First, they are trained in making accurate diagnoses. This may be done, in part, with the aid of psychological testing. Psychologists are the only mental health profession certified in this form of assessment. Testing is sometimes used as an adjunct to the other area to expertise of a psychologist. Second, psychologists have specialty in treating mental health issues with a variety of therapeutic techniques. Unlike many other professional therapists, psychologists are trained in treating more severe, chronic mental health issues.
What is therapy all about? How does therapy work?
No two therapies are alike. All therapy is tailored to the specific goals of the individual. A treatment plan designed for your specific needs and goals drive our sessions’ focus. We will use empirically derived treatment methods to address your issues and concerns as we work through the treatment plan. It is common to schedule a series of weekly sessions. Sometimes sessions are scheduled less frequently to meet individual therapeutic, financial, and scheduling needs. The length of sessions also varies depending on your needs. Therapy can last a few weeks or months, or it can last a year or more depending on the depth of focus. We may focus on a specific issue, a series of issues, or deal with a more complex combination of issues. To be most effective, it is important to attempt to integrate session material into day-to-day life through active engagement, such as completing homework assignments. Whether it be building skills, working toward change, or creating greater self-understanding in your life, your commitment to the treatment process will increase the benefits you receive from your efforts.
Do I have to take medications to be in therapy?
While research has shown that medication and therapy is superior to medication or therapy alone, it is up to the client to make the decision about their own course of treatment. Medication is often seen as a “band-aid” while therapy provides lasting relief. The benefits of medication end with the termination of treatment, while the skills learned in therapy have a lasting effect. If you so choose, however, I will help you evaluate your options, and I can make a referral to a qualified doctor for medications and prescriptions. I believe it is each person’s choice to take or not take medications while in therapy.
Is my therapy going to be confidential?
Yes. The information that you share with your mental health provider is considered, by law, to be confidential. In most cases, information cannot be released to another party without your written consent. However, in certain circumstances, information can be shared legally without your permission. These circumstances include:
- Suicide: If information is conveyed suggesting a significant danger of suicide or an inability to guarantee against the intention of suicide, this information must, by law, be shared to protect an individual’s safety. Murdering oneself is murder under the law. Many clients are concerned that if they report thoughts of suicide that they will be hospitalized. It is important to know that hospitalization is always the option of last resort and only in cases when someone’s life is in danger. Passing thoughts of wanting to be dead do not create cause for hospitalization.
- Homicide: If, engaged in my professional duties, a threat to cause serious physical injury or death to a specific person I can identify is made with an indication that you can and will carry out these threats immediately or very soon, I am legally required to take steps to protect that person or persons.
- Abuse/Neglect: North Carolina law requires me to report to the local Department of Social Services or the appropriate authorities, any suspicion or evidence of child abuse or neglect. This applies to both children and the elderly.
- Court orders/Subpoenas: I can be required to turn over a copy of a client’s mental health record to the court when issued a subpoena or court order. I can also be subpoenaed to testify in court without a client’s consent in the case of a court action.
- Insurance Companies: Some clients choose to pay for their therapy privately rather than bill their insurance due to the policies of insurance companies. Insurance companies require mental health providers to provide a diagnosis for clients to pay for services. They also sometimes require mental health providers to give them with copies of treatment plans, progress notes, and other documents. This may provide them with information that some clients would consider confidential.
These limitations to confidentiality, which apply to all mental health professionals, are a concern for some clients. If you have concerns about any of these, you are free to discuss them with me and ask additional questions.