Depression Therapy and Counseling in NYC
Depression is a frequent reason people seek counseling in New York City. Depression counseling in NYC is common as life here is stressful for a number of reasons. For many of my clients, life in New York can feel heavy and unhappy. First of all, the city itself has had a tough time coming back from the pandemic. People do not feel safe on the streets and on public transportation. Lack of safety in a city that felt safe for many years is depressing.
Another factor is that inflation has created financial difficulties and worries. New Yorkers always worked long hours and now is no exception. But now there are also financial worries. Many are struggling.
Everyday life feels hard. Personal loneliness and lack of connection which is worsened by work from home situation as well as preoccupation with social media and texting instead of face-to-face time is taking its toll. Loneliness in a big city like New York is a major factor in depression symptoms.
What is Depression? How is It Different from Sadness?
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, feeling of fatigue, self-blame, often times lack of appetite, sleep disturbance. A depressed person cannot experience any pleasure or joy.
There are different types of depression:
Major Depression or Clinical Depression is considered a mental health disorder, characterized by persistently depressed mood or loss of interest in activities, extreme sadness, low self-esteem, hopelessness, lack of energy. It is caused by a combination of biological, psychological and social sources of distress. It is now believed that prolonged sadness can cause depression due to changes in brain functioning. Treatment for Major Depression is usually a combination of medication and talk therapy. Sometimes, those suffering from Major Depression can have suicidal thoughts or plans in which case it may be necessary to seek psychiatric hospitalization.
Dysthymia is a long-term but mild depression. It is defined as low mood occurring for at least 2 years, along with at least 2-3 other symptoms of depression. The usual treatment is medication and psychotherapy.
What are The Symptoms of Depression?
The physical symptoms of depression may include:
- Persistent sadness and low mood
- Sleep disturbance
- Lack of appetite or overeating
- Lack of energy and motivation
- Diminished libido
- Inability to concentrate on tasks
- Isolation
- Withdrawal from friends and family,
- Diminished activity or loss of interest in activities that used to be enjoyable
- Restlessness or irritability
- Memory and thinking problems
- Increased feelings of shame, guilt and worthlessness
- Thoughts of death or suicide
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 many may happen later in life. Depression can have various 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.
How is Depression Diagnosed?
Typically a depressed person will come to a psychiatrist or a therapist to seek relief from symptoms. Sometimes a relative or a friend will bring him/her in for help. The professional will do a thorough assessment by getting history, including medical, family, social and substance abuse, through series of questions, as well as observation of the patient in the session, which usually makes it obvious.
A medical professional may use criteria for depression used in DSM-5 ( Diagnostic and Statistical Manual of Mental Disorders).A mental health professional may do a psychosocial evaluation.
Causes of Depression
Depression can manifest as a natural response to a difficult or frustrating situation, like 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 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 a person’s control and sometimes are a result of poor choices. Depression may occur regardless.
Treatment for Depression – How Depression Therapy in NYC Can Help
One of the biggest challenges that comes with treating depression in NYC 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 for depression, 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
The Benefits of Depression Counseling
There are many benefits to receiving counseling. Some include:
- You can improve your ability to cope with the issues you are experiencing much better with therapy as well as relieve symptoms.
- You can improve our overall sense of well-being and your physical health. The sooner treatment starts the better and quicker the prognosis. If untreated depression becomes chronic and harder to treat. Prolonged, unaddressed sadness following trauma or a painful situation can become a Major Depression or Dysthymia.
- You can lower the risk of experiencing Depression again.
- If depression is largely chemical or biological, medication can work well and lift depression. Counseling can help determine these needs.
- If depression is due to an event or situation, processing the event or situation and finding new understanding or better coping skills can heal the depression. Counseling can bring these issues to the surface so you can begin to mend.
- Depression that’s not treated can lead to suicide attempts. Treatment can and often does prevent that.
Are you battling against depression in NYC? If you feel depressed and think you need help, please contact me at: (212) 953-1388 or email irinafirstein@aol.com to make an appointment with the best individual therapist in NYC – Irina Firstein, LCSW.
What to Expect in Depression Therapy: The Treatment Process
Therapy treatment for depression starts with thorough history taking, then identifying psychological and or social causes of depression and addressing these causes. Sometimes if its trauma related, EMDR can be very helpful and sometimes different modalities will work better such as dynamic psychotherapy, cognitive-behavioral therapy or couples/family therapy.
A major concern is that the patient does not harm him/herself until depression lifts. Depressed patients need constant assessment for suicidal ideation. It is also helpful if the patient has support and is connected to other people in their lives. Depression usually causes increased isolation as depressed people feel shame, guilt, don’t want to be a burden, and don’t have the energy it takes to interact with others.
Client Testimonials
“I was referred to Irina after being terribly depressed over my divorce proceedings. I was afraid of losing my children, and petrified. I needed help. I cannot thank Irina enough for getting me through my tough situation. I will always think of you Irina as you helped me through this difficult time in my life.” – Emily R.
“Irina is a very confident and experienced therapist. She listens intently and helps you to sort your thoughts, but is not afraid to state her opinion and point you in the right direction. A book that she recommended I read was the best self-help book I have ever read (and I have read many) and helped me to change my energy and enjoy my life. I believe she helped me to attract and keep the right guys. When I went to her a couple years ago I was single and now I have been in a wonderful relationship for a year.” – Alena G.
“Irina Firstein is second to none. She is straight forward yet warm, and has the sharpest, most refined sense of perspective you know is coming from the best of places. She is the essence of compassion, honesty, and absolute trust.” – Diana V.
FAQs About Depression
Is depression a sign of weakness?
Depression is most definitely not a sign of weakness. Very strong and resilient people can become depressed in certain circumstances.
Is depression a mental illness?
If it is chronic and long term, depression can be an illness.
Can depression be cured?
The word I think is more accurate is recovery. People recover from depression all the time.
Can depression affect physical health?
Depression, as any extreme stress, can definitely affect physical health. People can lose or gain a lot of weight, which can have health consequences. Also sleep issues can be profound to health. Also with depression there is almost always a lack of self-care.
Can depression affect children?
Yes, most definitely.
What are the risks of untreated depression?
A major risk of untreated depression is suicide or chronic treatment resistant depression. Untreated depression can lead to divorce, the end of a significant relationship(s), job loss as well as substance abuse.
Will depression treatment involve medication?
Depression treatment will usually involve medication.
How long does it take to recover from depression?
There is no way to say how long it takes to recover. It depends on how long a person has been depressed, what are the underlying causes as well as how open the patient is to the process of treatment.
Is depression counseling confidential?
Depression counseling, as is any counseling, is confidential.
What can I do to support my recovery from depression outside of therapy?
It is important to take medication when appropriate as prescribed, self-educate about depression and talk to loved ones about how you feel and what is going on very regularly. Isolation, while it feels comfortable is not good as one of the common reasons or factors in depression is feeling alone.
How much does depression counseling cost?
Fees vary. I charge the same for depression counseling as all other kinds of therapy I do. My fees are as follows: $250 for 45 minutes and $310 for a full hour.
Additional Resources:
- National Institute of Mental Health (NIH) is a good resource.
- National Alliance on Mental Illness (NAMI), a great resource for patients and loved ones. They also have a Helpline.
- Anxiety and Depression Association of America offers support groups.
Interested in learning more? Read our Articles on Depression here.
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