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Depression Treatment


A Personalized Approach to Your Well-being

While neither depression nor feeling blue is a sign of weakness, the two are dramatically different and at times confusing. Moving through a blue mood or having a rough patch can be as simple as making a decision to change your thinking, your choice of friends or the activities you participate in. Many people think that they can eliminate depressed feelings from their lives by deciding that they have had enough. While your level of determination is important, this alone is insufficient. Each of us is characterized by patterns of repetition that bring us virtually to the same emotional and interpersonal challenges. Same dynamics, but different time, place and people! Does this sound familiar to you? There is a good chance it does.

The symptoms of depression can persist for weeks, months, or years. Left unaddressed they can become debilitating, serious, life-compromising psychological and/or medical conditions. However, under the care of a mental health professional you can be helped and learn how to live your best life. While you may feel hopeless, the situation is not, it just feels that way! Despite the fact that we often think that particular feelings will last forever, they do not. Depression does not have to keep your life on a looped track of a one-way train!  

Depression, which is related to changes in brain chemistry, is neither a myth nor a confabulation of false or fantastical information.  It is the leading cause of disability in the world (World Health Organization, 2020) and the top cause of disability of adults in America.  More than 264 million people suffer from depression worldwide. (World Health Organization, 2020) In the United States depression impacts one in six people at some points in their lives. This equates to approximately 1.3 percent of US adults.  There is an estimated 17.3 million adults in the United States that experienced at least one major depressive episode. WebMD reports than over six million men in the United States have depression each year.  It is estimated that approximately twelve million women in the United States experience clinical depression each year.  This number translates into one in every eight women can expect to deal with this.

Women, who are more likely to talk about their feelings, often struggle with depression during their late teens and early twenties.  In contrast men are less likely to discuss their feelings or to present themselves in a sad way.  More often men snap at others in anger or exhibit reckless behavior, drinking or drug involvement.  Unlike women who are more likely to express their sad or despondent feelings, men do not visibly express their feelings.  More often men will look blank, while feeling worthless or useless.  Is this something that feels familiar to you?  Have you noticed this surfacing in your spouse or partner?  This is not a dead end, but rather an opportunity to learn how to identify your feelings, process them constructively and respond to difficult situations in a productive way.  There is hope, even if it feels like you are at a dead end!

The National Institute of Mental Health (NIMH) reports that depression is a common condition affecting 25-30 million Americans. Generally the signs and symptoms of depression include feelings of worthlessness, malaise, hopelessness and body aches and pains. Abrupt changes in your life circumstances can result in depression. Divorce, death of a loved one, expected or unexpected career changes or financial difficulties can leave you feeling immobilized and helpless. Chronic illnesses across diagnoses often lead to depression as they effect ones sense of self, of independence and of future plans. While the similarities exist, no two people with depression have the exact same emotional experience.


People often want to know what the number one cause of depression is. The answer is complicated since there are multiple causes of major depression. Your brain chemistry, as reflected in the balance of neurotransmitters in your brain, can play a role in the onset of depression. Factors including genetic vulnerability; severe life stressors; some substances one may take including medications, drugs and alcohol; and serious medical conditions can effect the way your brain regulates your moods.

However, there are a number of variables that appear to contribute to depression.  Brain chemistry, as reflected in the balance of neurotransmitters in the brain, can play a role in the onset of depression.  Research into genetics indicate that genes may play a role in the symptoms of depression surfacing in an individual.  However, many affected people have no family history of depression, while others with a family history of depression will not exhibit symptoms of depression.  In addition environmental factors, such as protracted stress, can alter these brain chemicals.  Environmental factors including prolonged stress, the loss of a loved one, grief and major life changes can also cause depression. 

Research indicates that a variety of experiences leading to depression include protracted difficulties such as long-term unemployment; living in an abusive relationship or one that is devoid of caring; long-term isolation or loneliness; prolonged work stress. The existence of protracted long-term adverse circumstances have a greater likelihood of causing depression than more recent life events. However, a combination of recent life events, such as the loss of a job or death of a loved one, or a combination of events can set off depression if one is already at risk related to personal factors.

Family dynamics also have a significant impact both positively and negatively on the health and well-being of its members. A well-functioning family environment that is supportive, loving, caring and close-knit can offer the emotional support that is the bedrock of a child’s sense of well-being. This increases and strengthens his overall health. When each member of the family feels important, valued, respected and esteemed all benefit.

There is a growing body of research that indicates that negative family relationships can and often do cause stress, which impacts on the mental health of its members and ultimately can cause depression and physical symptoms. Research has shown that non-supportive families can compromise a member’s mental health and cause a mental illness to worsen. The role of family members patterns of interactions and the emotional climate a person grows up in has a significant impacting on whether or not depression surfaces in a person.

Risk Factors For Depression

A risk factor for depression is something that increases the probability of your developing this condition. Although it is possible to develop depression with or without the risk factors, the more risk factors you have, the greater is your likelihood of developing depression. A person’s risk of depression is generally related to a combination of genetic, physical, psychological, and environmental variables. These variables increase the risk of depression: a family history of mental illness, including multiple depressions exhibited by various family members; chronic physical or mental disorders; a stressful or abrupt change in life patterns including serious loss of a loved one, trauma, financial problems; psychological factors, such as low self-esteem; little or no social support; female gender-premenstrual changes; pregnancy, miscarriage, postpartum stage, peri-menopause and menopause; age-the elderly are at high risk; insomnia and sleep disorders; certain medications.

Nervous Breakdown

When one has a mental or emotional breakdown it is often referred to in the vernacular or everyday parlance as a nervous breakdown. This term is used to describe someone who is unable to function normally because of unmanageable or overwhelming stress. It had been used as an umbrella term to cover a variety of mental illnesses, including anxiety, and depression. However, today medical professionals no longer use it. This experience can be so debilitating that one may feel unable to meet his commitments in life, which can exacerbate an already challenging time. Oftentimes this can cause people to act in uncharacteristic ways, causing hurt and pain to those around them.

For many people who experience unmanageable stress the accompanying depression may result in feelings of hopelessness and thoughts of suicide or self-harm.

Dysthymia or Persistent Depressive Disorder

Dysthymia, now called persistent depressive disorder or PDD, is a mood disorder which can last years and is characterized by a chronic experience of feeling mildly depressed or “down in the dumps.”  It is typically defined as a chronic, but less severe, form of major depression, which can last at least two years for adults and one year for children and teens.  As is the case with other forms of depression, the exact cause of persistent depressive disorder (PDD) is unknown. However, there are a number of variables that appear to contribute to persistent depressive disorder.

It has many similar symptoms to other forms of clinical depression including poor self-esteem, guilt, lack of energy or chronic fatigue, sleeping too much, thoughts of death and increases or decreases in appetite. Dysthymia can cause people to have trouble making decisions, to become socially withdrawn and to lose interest and pleasure in daily activities. This results in their experiencing an overall sense of inadequacy, feelings of hopelessness, and a loss of interest in and difficulties with being productive in daily living activities, as well as in career responsibilities. This depressive, chronic, low-level illness can undermine your career, as well as your relationships.

However, since the depressive symptoms can wax and wane over time, people with dysthymia can live meaningful, happy lives. Does this sound like the lens through which you experience your life?  Could this description aptly relate to you and the themes characterizing your life’s challenges?  By establishing a solid system of supports including professional help you can facilitate your journey to recovery through treatment.  Studies suggest “talk therapy,” also known as treatment, is as effective as drugs for mild to moderate depression.

Depression Or Major Depressive Disorder

Depression, also known as a major depressive disorder or MDD, is also a common medical condition which negatively impacts on the way you perceive the world, how you think about it, feel about it and act in response to the triggers.  It often is precipitated by the diagnosis of a medical condition, such as cancer, heart disease or diabetes. Depression can result in emotional and physical problems that can compromise your ability to function in your personal and professional lives.

Signs And Symptoms Of Depression

The signs and symptoms of dysthymia and major depression are the same.  However those of dysthymia are fewer in number and less intense than those of major depression.

People with depression have experienced a number of the symptoms described below. However, it is important to remember that depression can present different symptoms in different people. Depression may have brought you to the experience one or more of these symptoms . Have you found yourself or a loved one experiencing any of these symptoms of depression?

  • Are you feeling anxious, down, tearful or often irritable? Do these symptoms leave you feeling as though you are living in the body of someone else?
  • Have you experienced a loss of interest in activities that were once enjoyable? Are you unable to get pleasure or fulfillment from activities or pursuits that generally gave you joy or satisfaction? Is there a loss of interest in sex? Are you experiencing menstrual changes? Are these symptoms leaving you indifferent or depressed?
  • Are you having a hard time getting along with family members and friends? Have you become intolerant of others? Have you begun to socially withdraw from people? Have you lost interest in others? Are these symptoms leaving you feeling lost in space?
  • Are you experiencing major weight gain or loss of more than 5% in a month? Have your eating and hygiene habits deteriorated? Have you lost motivation to eat or be clean? Have these symptoms left you feeling anxious since you have always been careful about your physical health and your appearance?
  • Are you feeling atypically fatigued, physically exhausted and emotionally drained without cause? Do you experience low energy levels almost daily? Are you moving or speaking more slowly than is typical for you? Are these symptoms leaving your worried about your functioning on the job, when it was never a concern in the past?
  • Do you find yourself feeling emotionally blank or with flat affect? Are you devoid of emotional expression no matter how hard you search for it? Did your self-esteem plummet? Are these symptoms leaving you feeling hollow inside?
  • Are you continually feeling sad, anxious, or empty most of the day or almost every day? Do you experience these symptoms as frightening?
  • Are you suffering from excessive feelings of hopeless, pessimism, guilt, or worthlessness almost daily? Are these symptoms pulling you into the unfamiliar territory of emotional doldrums?
  • Are you drained from sleep problems including interrupted sleep, insomnia or sleeping too much with difficulty arising? Do you find that you are unable to get a grip on your day? Does time seem to slip through your fingers? Do these symptoms leave you feeling disoriented?
  • Have you become unable to concentrate, remember, or make decisions almost daily? Are you having difficulty focusing and remembering the events of the day? Are these symptoms leading to think you need someone to manage your life?
  • Are you calling in sick for several days in a row? Are you missing important appointments or overlooking important projects? Are these symptoms causing you to feel worried about the security of your job?
  • Are you experiencing restlessness or rundown in a way that is noticeable to others? Do these symptoms make you feel as though this is not your body?
  • Are you preoccupied with persistent physical problems such as headaches, digestive disorders, or chronic pain that are unexplained and unresponsive to treatment? Are these symptoms leaving you confused since you recently went to your medical doctor?
  • Are you haunted by thoughts of death or suicide, suicide plan, or or suicide attempts? Do you have thoughts of harming yourself? Are these symptoms leaving you feeling terrified for your welfare?
  • Are you experiencing frightening flashbacks, violent or severe nightmares, and fight-or-flight symptoms, such as a racing heartbeat, dry mouth when there is no threat or danger? Are these symptoms leaving you terrified about your emotional stability?


Have you responded “Yes” to one or more of the above questions? Have you found yourself surprised at how many symptoms of depression seem to be describing you? Are you uncomfortable that “depression” may apply to you?

Have you found yourself wondering whether or not to seek the assistance of a mental health professional? If this is the case, it is time to stop the torment and commence the process of taking better care of yourself by committing to mental health treatment!

Hopefully you have already seen your primary care practitioner to eliminate any physical, medical conditions that may be triggering these feelings. If this is not the case, please be sure to make that call today. Many feel a sense of relief and report that they feel better knowing there is nothing physically problematic. They comfort in this regard. However, there are many who experience anxiety over not knowing what they don’t know. Either reaction is just fine; each of us is unique and different from the other. Remember, your symptoms may or may not resemble those of someone else.

The next step is to call a mental health practitioner so that you can begin the treatment process. Through this process you will become aware of your feelings, including those that are part of your depression, as well as those that more currently brought you to a therapist. You will learn how to respond to life from an objectively appropriate emotional and behavioral place, rather than react from your history.

Every one of us has a conscious mind, which for our purposes, I will describe as all of the facts and information that are retained there . In addition, there is the sub-conscious mind, which for our purposes, I will describe as what we know and have forgotten about, but with a little bit of reflection, we can recall. Lastly is the unconscious mind, which for our purposes, I will describe as a repository of all of our emotional memories that have accumulated over the course of our lives. In this unconscious repository is a lifetime’s accumulation of emotional memories– the happy feelings, sad feelings, angry feelings, depressed feelings, feelings of low self worth, frightened feelings. Herein lies the complex multitude of emotional feelings that you have experienced throughout your life and which help to form the unique tapestry of what makes you who you are.

Treatment will show you how these feelings are neither good nor bad in and of themselves. They just are; they exist in your emotional memory and have no intrinsic value. However, what you do with them can be good or bad, growth-producing or destructive. Through the therapeutic treatment process you will learn to survive when necessary and ultimately to thrive in your life. This treatment essentially will help you to develop an emotional “tool-box” that is with you so that wherever you find yourself you are better equipped to stay on course. This form of treatment will help you learn how to respond to potentially problematic situations, rather than to react; the treatment will help you to gain greater mastery over your impulse to react; and this treatment will guide you to make choices that help you feel better and live your life more in harmony with your values and goals, rather than as a slave to your repetition of depression. Treatment is not just about talking, treatment is about changing the trajectory of your life!

If you have identified with any of the above questions it is time to learn how to take better care of yourself, even if you do not necessarily want to. I will keep my sights on the light at the end of the tunnel for the two of us until you can see it also! Within the therapeutic treatment relationship you will experience emotional relearning, cognitive re-framing and behavioral modifications. You will learn how to experience your feelings, while moving beyond the undertow of depression and toward a healthier place in your life. While the challenges are real, the potential for growth and a healthy future are significant!

I am a Long Island therapist, call me at (516) 627-1145 for a complimentary consultation to discuss any of these or related topics.

Dr. Maryann B Schaefer

Ph.D. – Counseling, Concentration in Psychology
NYS Licensed Mental Health Counselor
Fellow of American Psychotherapy Association

Phone: (516) 627-1145


5 Travers Street  Manhasset, NY 11030

Office Hours: By appointment only.

american psychotherapy association