Depression can change everything — how we think, what we do, and how we feel. It can even make us too pessimistic or downhearted to ask for help. But depression help is out there, with therapy right here in NYC.
Last updated: May 15, 2021
Symptoms of Depression
Depression can occur for many reasons and can range from mild to debilitating. Take depression seriously; it can be life-threatening at times. Symptoms include:
- frequent feelings of sadness or hopelessness
- change in one’s weight or appetite
- thoughts of death or suicide
- low self-worth or excessive guilt
- trouble concentrating,
- lessening of enjoyment of things less that used to be fun
- having less energy — even small things seem like huge tasks
- slower physical movement or thinking than usual.
Major Depressive Disorder
Major Depressive Disorder (MDD) is a condition characterized by most or all of the above-listed symptoms. The symptoms need to last for at least two weeks in order for major depressive disorder to be the problem.
Persistent Depressive Disorder
Not everyone who suffers from depression has most or all of the symptoms described above. Some people will have one or two, but they will be impactful. Others have a few symptoms that last for years, even though they are not debilitating. People with these issues may have a condition called “persistent depressive disorder,” also known as dysthymia. Some of the more common symptoms of this condition include low mood, low self-worth, and low interest in enjoyable activities lasting for at least two years and sometimes for decades.
Other Mental Health and Medical Conditions
There are many conditions that can cause depression. These include hypothyroidism, post-traumatic stress disorder, obsessive-compulsive disorder, brain injuries, personality disorders, certain neurological conditions, and several others. For this reason alone, if you are suffering from depression it is important to be evaluated by a medical or mental health professional. The problem may be different than what you think, and treatment may be more helpful than you imagine.
Finding Help for Depression
The first step in getting treatment for depression is getting an evaluation with a mental health professional. This is necessary for several reasons. (For one, depression can be caused by many factors, including other mental health problems.) Depression can be treated with or without medication in most cases.
To determine what your treatment should include, get a professional consultation. If you’re interested in addressing depression without medication, cognitive-behavioral therapy for depression is a good option.
Cognitive-Behavioral Therapy (CBT) for Depression
Cognitive-behavioral therapy (CBT) for depression can involve efforts to increase certain behaviors that improve mood and decrease behaviors that worsen mood. CBT may also focus on the relationship between one’s thoughts and behaviors. Some people experience low mood that is at least partially fueled by specific thought patterns — for example, negative thoughts about one’s competence or self-worth. None of us has total control over which thoughts come into our minds. However, we can exert some control over what we tell ourselves. CBT can help change this mental dialogue in ways that improve mood.
Cognitive-behavioral therapy is different from traditional counseling in that you are typically given specific exercises to do between sessions. These exercises are what help you change your mental and behavioral habits and improve your mood. For example, one common exercise in CBT is called a “thought record.” Using a thought record helps people to better understand how their interpretation of events affects their mood. It can then be used to help alter unhelpful patterns of thinking, providing a lasting natural tool against depression.
You might also be asked to make changes to your schedule. Changing what you do during the day or in specific situations can be surprisingly helpful in overcoming depression. However, it’s often challenging to determine which changes are important to make without some help. CBT for depression helps you identify helpful changes to make, and to overcome obstacles to making those changes.
Is CBT for Depression Effective?
Yes. Controlled clinical research studies show CBT to be an effective treatment for depression. It has generally been found to be a “somewhat superior” treatment to antidpressant medication, especially for mild and moderate depression. As such, it is currently considered the gold standard of psychotherapy options for depression.
Behavioral Activation for Depression
Research has shown behavioral activation, a version of CBT, to be particularly effective in the treatment of depressive disorders. Behavioral activation is partially based on the fact that clinically depressed people have often ceased to do specific things that previously improved their mood. They may not be aware of this change, but by re-engaging with those activities and behaviors, mood often improves. Working with a CBT therapist can help people determine if and how such behavior change might be helpful in their efforts to address depression.
Medication can be an important part of the treatment for depression but is not always necessary. The most commonly prescribed antidepressant medications are selective serotonin reuptake inhibitors, or SSRIs. SSRIs have been shown to be helpful, primarily for people with moderate to severe depression. They do have side effects for some people. Consult with your mental healthcare provider about whether medication might be helpful for you.
Steps to Take Without Therapy or Medication
If you’re interested in trying to improve depression on your own, some of the smartest strategies can be seen on our ABC PLEASE skills page. These skills are simple and straightforward to use. They’re often cheap or free, too! Cognitive-behavioral therapy for depression will often use some of the approaches described there, but you don’t need to be in therapy to try them.
Does mindfulness help with depression?
Mindfulness is a type of awareness we all have, to some extent, that comes from calmly and nonjudgmentally focusing on what we’re doing. (Read more on our main mindfulness page.) Mindfulness can be an effective part of recovery from many difficulties, including anxiety, substance abuse, emotion regulation problems, and angry outbursts. However, for most people, practicing mindfulness by itself is typically not sufficient to resolve major depressive disorder
Some therapies, such as mindfulness-based cognitive therapy, combine CBT with mindfulness practice. This combination can be quite effective, particularly in preventing relapse among those who’ve recovered from depression. Mindfulness helps us create a healthier relationship with our thoughts; this is likely to be at least somewhat helpful for everyone. However, without changing other aspects of one’s life, mindfulness can often fall short of helping one achieve full recovery from depression.
How to Find Help in New York (City or State)
Please contact us for help in your efforts to find therapy for depression here in New York City. Our CBT therapists are doctoral-level psychologists. We also have student therapists who offer reduced fee services. Our offices are in midtown Manhattan. We also offer teletherapy services to people elsewhere in New York State, New Jersey, and Florida. If you’re looking for therapy for depression in another part of the country or world, please contact us — we are happy to help!
Yes! Exercising, getting support from loved ones, and improving sleep hygiene are all good initial steps.
Research shows that effective treatments for depression include medications and psychotherapy. At present, only one natural supplement has been shown to sometimes be an effective tool against depression — St. John’s wort. However, its effects have been inconsistent in research trials. It is not a substitute for psychotherapy or medication.
It’s complicated. The functioning of neurotransmitters in the brain is different in people who are depressed than those who are not. However, it is not at all clear whether these neurochemical differences are caused by depression, are the cause of depression, or neither.