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. I agree with Drs. Beck and Alford and others who acknowledge that depression is “multifactorial” – or can have many probable causes. And, depression manifests differently among different people. Because of this, I use different approaches.

If you sought treatment with me for depression, I might:

  • Work with you to obtain a very though history of the course of your depression and determine what external influences affected its course, positively or negatively, and whether you might have a family history of mood disorders or negative thinking.
  • Determine if early events such as maltreatment or significant loss may have contributed to the development of your depression. If this is the case I might suggest using trauma focused techniques, describe above.
  • Explore your relationship history to assess whether there are any aspects of your current or past patterns of relating, or actual relationships that may have contributed to your depression and whether our work would benefit from an interpersonal approach.
  • Use cognitive techniques to identify your negative thought process and assess their validity, and work with you to counter and reformulate those thoughts. I might suggest some self monitoring between sessions, to help you determine what kinds of interactions or problems trigger these thoughts.

I Use a Holistic Lens in Treating Depression

I will work with you to explore not only your symptoms but your current life context. I might suggest that we explore:

  • Your medical health – not as a physician, but to open a dialogue about the possibility of health problems that masquerade as depression or have depressive aspects.
  • Whether you are taking other medications (for medical conditions) that might cause depression.
  • Your exercise and activity level – given the proven positive effect of exercise on mood, I might inquire about your level of physical activity.
  • Your basic nutrition – nutrition can also impact mood, and I might inquire about your diet. If you are interested I might recommend a nutritional specialist.
  • Your alcohol and substance use, as many people with depression self-medicate with alcohol (which is a depressant), smoke (which is a stimulant), or use illicit substances to “not feel so badly”, which is understandable but can exacerbate the problem.
  • Any current life circumstances that might heighten depression, such as the health and safety of your living situation.

The rational for this holistic approach is explained here:

In sum, it is my experience and firm belief that although depression is complex and determined by many factors, psychotherapy can be helpful in alleviating symptoms and in helping my clients gain perspective and control over their mood states.