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Depression Counseling NYC

What is Depression?

There is a difference between being depressed and feeling occasional sadness. Anyone who has experienced depression can attest to the difference between the two. Those who are suffering from depression will experience feelings of extreme sadness, helplessness and hopelessness and self-blame.

The physical symptoms of depression may include sleep disturbance, lack of appetite or overeating, lack of energy, diminished libido, inability to concentrate on tasks, isolation, withdrawal from friends and family, diminished activity. Many people who suffer from depression are plagued with negative thoughts and in some cases they may have thoughts and plans of suicide.

The patterns of depression typically begin to present themselves in late teenage or early adult years. Although may happen later in life. Depression can have different levels of severity from a mild form where you may experience low energy levels, inability to enjoy normal enjoyable activities, to severe forms where you may find it difficult to get out of bed.

Causes of Depression

Depression can manifest as a natural response to a difficult or frustrating situation, like the low self-esteem, disappointment, rejection, loss, perceived failure, relationship stress, illness, chronic pain, illness, and medications. It can also be a function of a biological predisposition like genetics or a chemical imbalance. When an individual comes in for therapy for depression, it is important to begin with an evaluation so the therapist can understand whether it is genetic / biological or caused by circumstances.

The root cause of the depression will greatly impact the approach to therapy, so it is necessary that both the individual and counselor unearth the cause. Sometimes circumstances that lead to depression are outside of person’s control and sometimes are a result of poor choices. Depression may occur regardless.

Treatment for Depression

One of the biggest challenges that comes with treating depression is that it produces symptoms that are counterintuitive to wanting to get help, largely due to feelings of hopelessness and lack of energy. However, depression can be successfully treated through psychotherapy alone or by antidepressant medications in conjunction with individual psychotherapy. I work with a number of psychopharmacologists, and when appropriate, can make referrals for medication evaluation.

There is overwhelming evidence that therapy alone can be effective for treating depression and relieving symptoms. Therapy can often prevent a mild or situational depression from becoming more severe and even prevent future depressions.

In sessions with depressed clients, I work together with my clients to identify causes and deal with behavioral, interpersonal and situational contributors. I work with them to pinpoint the issues that contribute to their depression and we explore different aspects of these issues. We talk about options, choices, how to identify negative thoughts, develop coping skills and self-care practices, insights that lead to changes. Depending on the history of the patient, I will often use EMDR therapy once the depression has been stabilized. This is because depression sometimes is caused by past traumatic experiences.

When appropriate, we discuss the possibility of medication management and I am able make a referral to a psychiatrist.

When To Seek Treatment?

Knowing when to seek treatment, is very important. If you are experiencing any of these symptoms, it is important to seek help immediately before your symptoms worsen:

  • Persistent, extreme sadness
  • Hopelessness and Helplessness
  • Feeling fatigue, disinterest in any normal life activities
  • Withdrawal from family and friends
  • Inability to focus or concentrate
  • Self blame and self hate
  • Difficulties with sleep
  • Sudden and significant weight loss / gain
  • Negative thoughts and / or thoughts of suicide

If you feel depressed and think you need help, please contact me at: (212) 953-1388 or email to make an appointment with the best individual therapist in NYC – Irina Firstein, LCSW.

Interested in learning more? Read our Articles on Depression here.

Sessions available in person, by phone or on Skype.