Therapy for Depression in DC

• Written by Dr. Collin Vernay •

“Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary.”

—Fred Rogers

Table of Contents

• What is depression?

• Common symptoms of depression

• Risk factors for depression

• Thoughts of suicide

• Treatment options

Depression (formally known as major depressive disorder) is a mood disorder characterized by persistent feelings of sadness and a loss of interest in activities that were previously enjoyable. According to the American Psychiatric Association, depression affects an estimated 1 in 15 adults in the United States each year, and 1 in 6 individuals will meet criteria for a diagnosis of depression at some point in their lifetimes.

People who are depressed are not “just feeling sad.” Depression is distinct from everyday sadness and grief, though both may be features of depression, contribute to its development, or exacerbate an existing depression. Depression is the result of a complex interplay of neurobiological, hormonal, environmental, and genetic factors, and its symptoms can seriously impair an individual’s day-to-day functioning leading to major issues in their work, schooling, or relationships. It is not a “weakness” or a moral failing any more than any other medical issue and deserves compassionate, expert care.

Depression is defined by a number of symptoms, most notable of which are a depressed mood or a loss of interest in pleasurable activities for most of the day, nearly every day, for at least two weeks. That said, the symptoms associated with depression can be understood as existing on a spectrum, and individuals who do not qualify for a diagnosis of major depressive disorder may still benefit from treatment to address distressing or distracting emotional, cognitive, physiological, and behavioral concerns. Click on the tabs below to learn more about common symptoms associated with depression, which fall into the following four broad categories:

It is worth noting that depression and its expression can be a highly individualized experience, and identity and cultural factors likely play a role in determining which symptoms of depression manifest and in what way. For example, some people, men in particular, may experience a “masked depression” characterized by feelings of apathy or disinterest rather than the more stereotypical presentation of feeling sad. Certain cultural groups may report greater physiological symptoms like digestive problems, headaches, or sleep disturbances, but report few emotional symptoms, leading them to seek medical attention rather than mental healthcare to address their concerns. Societal stigma, gender norms, cultural expectations regarding emotional expressivity, and other cultural factors may help to explain these differences among groups. It’s important to find a therapist who understands and is equipped to work with these cultural differences.

As with most mental health concerns, the exact cause of depression is uncertain and thought to be the result of a complex interplay of neurobiological, hormonal, environmental, and genetic factors. Depression is more common in individuals with a history of depression in their biological families, suggesting a hereditary component. However, studies have also documented environmental risk factors for depression, with poverty for example increasing the risk for depression among economically disadvantaged individuals by 1.5 to 3 times when compared to their wealthier counterparts. Depression is also more common among those diagnosed with an anxiety disorder, with as many as an estimated 60% meeting criteria for a diagnosis of major depressive disorder as well. It is therefore likely that a combination of factors best explains how people come to be depressed.

If you are worried you may hurt yourself or attempt suicide, please call 911 or ask a loved one to accompany you to your nearest emergency room immediately. The majority of individuals who have thoughts of suicide will not attempt or complete suicide; however, untreated thoughts of suicide (and any underlying concerns that contribute to them) can quickly escalate and for this reason should be taken seriously.

Many people who have thoughts of suicide may be frightened by them and for fear of stigma from their friends and family may choose to keep these thoughts to themselves, resulting in deeper isolation and pain. If you are having thoughts of suicide but feel you are not in any immediate danger, I would encourage you to:

• Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255)

• Speak with a mental health professional or your physician 

• Reach out to a close friend, loved one, or trusted community leader (e.g., a faith leader)

Depression significantly increases one’s risk for dying by suicide, though not all who are depressed will consider harming themselves in any way. If you are depressed, have thoughts of suicide, and are not already in mental health treatment, you should enter treatment as soon as possible while planning for your continued safety in the meantime. If you are already working with a provider, you should contact them and talk with them about your thoughts. They will be able to help you to determine the best course of action for planning for your continued safety while addressing these thoughts long-term.

Generally, treatment for depression involves some combination of talk therapy, medication management, and/or other complementary health practices (e.g., exercise, light therapy). Though significantly less common, brain stimulation therapies such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) may also be used if other methods like talk therapy and medication fail to relieve symptoms. Finding a qualified therapist in DC with whom to explore treatment options can be an important first step to getting started.

I often work with individuals struggling with depression in my own practice and have seen how therapy can help lift the veil of sadness. If you’re interested in working together, simply click the “Get Help Now” button below to contact me.