- Difficulty falling asleep or waking in the middle of the night
- Waking too early and not getting back to sleep
- Eating more or less than usual
- Having lower sex drive than usual
- Loss of pleasure in things that normally are pleasurable
- Feelings of helplessness and hopelessness
- Poor concentration
We treat your depression by starting with a full evaluation to determine its nature. There are different kinds of depression. One type is Reactive Depression, and it occurs as a normal reaction to a loss or a frustration that you can’t do anything about. If someone you care about dies, if there is a reversal of fortune, if any difficult life experience occurs, you might get depressed. Although this is a normal reaction, the depression is still very unpleasant and difficult with symptoms of great distress, hopelessness, helplessness, a profound lack of energy, such that you might just want to stay in bed. Your sleep patterns and eating can change drastically. You lose interest in things that you normally enjoy.
Another type of depression has more of a history, and often has been there in one form or another since teenage or young adult years. This form often has a physiological base. Similar patterns of depression can be seen in parents or grandparents.
The good news is that Depression is treatable You can substantially reduce the amount of time you feel bad. We use Cognitive Therapy to treat it.
Cognitive Therapy is an Evidence Based Treatment which means that its validity and efficacy have been verified experimentally. It is goal directed and symptom focused, and is founded on the premise that feelings are based on perceptions and thoughts. The way you feel is determined by how you perceive a situation. If you are anxious, depressed or have some other mood fluctuation, the symptoms you have color your perception, and you don’t get a realistic view of things. As a result you often feel worse than reality would dictate. You also have “schemas” or core beliefs formed from your earlier childhood experiences that affect your perceptions, but do not match who you are today.
The concept of Cognitive Therapy is to teach a set of skills to identify thoughts and evaluate whether or not they are realistic. When they are not, you learn to replace them with ones that are. The therapist is not a quiet observer of your contemplations about the past, but rather is an active teacher of proficiency and adaptation. A goal is set. You are taught the ways to achieve it. The therapist functions more as a coach, in the spirit of a tennis or golf coach, than as the arbiter of you childhood traumas and frustrations.
The result is that you feel better in quite a short time.
Cognitive Therapy was developed by Dr. Aaron Beck, the psychiatrist who has made as great an impact on the field of psychiatry and psychology as Freud did in the early 1900’s. Dr. Beck was working with a group of very depressed people at the University of Pennsylvania in the late 60’s. These people had been in the hospital for months (in those days insurance companies did not dictate medical procedure) and had not responded to any treatment including medication. Dr. Beck saw that these people did not view things realistically. Rather, they saw events through the lenses of their symptoms. When there was something to do in the future, the patient would be hopeless and helpless. Those were his symptoms, not a realistic assessment of what was required for the task to come.
Dr. Beck found that if he helped the person identify the thought underlying the belief, and if he could help the patient assess how realistic it was, the thought could be replaced with a more realistic one. These very depressed people started getting better. When he saw how powerful this technique was, Dr. Beck began a number studies to prove its effectiveness. He then trained a group of psychiatrists and psychologists, who also designed studies. Now, forty years later, the powerful effect of Cognitive Therapy has been indisputedly proven to be superior to every other therapy.
Psychopharmacology With depression that has a physiological basis, it is important to treat the underlying psychobiology with medicine. When anti-depressants are indicated we work in conjunction with a number of the best doctors in New York who specialize in the use of psychotropic medicine.