Have You Been…

  • Feeling sad or low most of the day, nearly every day?
  • Losing interest in things you used to enjoy, feeling increased lethargy, or losing motivation to do things?
  • Feeling like your attitude has changed toward your life, that it seems less meaningful?
  • Feeling unexplained physical changes, like insomnia, changes in appetite, or fatigue?
  • Experiencing increased sense of hopelessness about the future?
  • Feeling an increased sense of worthlessness or guilt that seems disproportionate?

Treatment for Depression

Depression is fairly common – artists, writers, musicians, scientists, and world leaders have suffered from depression or bipolar disorder throughout history. It can be severely debilitating, and still remains somewhat of a paradox. While a diagnosis of “major depressive disorder” may be given to a person experiencing specific symptoms by a mental health professional, there are less severe forms of depression.

Whether you have been feeling like this for a very long time, have felt this way intermittently, or have noticed these kinds of feelings only recently, you may be experiencing depression. Depression is a common term, one often used to describe a mood or state of mind. “I’m depressed” can range from slight to moderate feelings of “being down”, to severe withdrawal from the world.  Andrew Solomon, in a personal account entitled Noonday Demon, likened his depression to “falling away from the sunlight toward a place where shadows are black”.

My Approach to Treatment for Depression

My experiences working with patients at Columbia Presbyterian with severe depression, as well as in my practice with my clients who have a range of mood symptoms, have helped me formulate an eclectic approach to treating depression.

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Alternative Approaches to Treatment for Depression

There is considerable controversy though, over “what works best”. As can be seen from the symptoms above, depression can strike at three levels – thoughts, emotions, and physical changes.

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Current Debate/ Issues Around Depression and Treatment for Depression

One of the chief questions asked by mental health professionals and laypersons alike is, “is depression an exaggeration of a normal mood state, and therefore on a continuum, or is it qualitatively and quantitatively different from ‘normal’ moods?” Another continuing debate among those dedicated to the study and treatment of depression involves its cause. Is depression a reaction to an external event, or, is it an intrinsic illness that can strike for no apparent reason?

According to the eminent psychiatrist Aaron Beck and his colleague, the psychologist Dr. Brad Alford, depression may have psychological roots such as negative cognitive “constructs” or “schemas” that develop early in life in response to child physical, sexual or emotional abuse, or significant loss. It may have biological roots, in that people may be depression-prone due to genetic factors, or to the presence of medical illnesses like hypothyroidism that have mood symptoms. It may have environmental roots, from life stressors or events such as the end of a long term relationship, job loss, or death or a significant other. A person’s reaction to a stressor can be intensified by his or her cognitive schemas or biological vulnerabilities. In addition, early onset of depression and having numerous depressive episodes can also heighten risk for future depressive episodes.