There are many levels at which people experience depression and there are many different diagnoses for depression. It is critical that you understand your particular diagnosis of depression in order that we can insure your safety and follow the correct course of treatment. Suicide is linked to depression and therefore treating someone with depression carries with it additional considerations.  I work with clients to trace the history of their experience with depression from their earliest memories to present so that we both have a clear and accurate picture of how long they have been living with this condition.  A history of self harm and suicidal ideation or suicide attempts are included in all client intakes.  Clients with a history of depression are more likely to have experienced these symptoms.  If you currently have suicidal thoughts even if they do not seem harmful to you such as "everyone would be ok if I died" or "it would be easier not to be here" we will create a Safety Plan that will include steps you can take on your own and people in your life you can turn to when you have these thoughts and feelings.

If we work together for treatment of depression I will monitor the level of the depressive state you are in through a weekly, biweekly or monthly PHQ-9 assessment. Depending on the level of your depression and your history with depression I may ask you to meet with a prescriber even if you choose not to take medication for the condition. I believe in behavioral activation as the front line of treatment for depression. This means you will hear me say "Don't think! Do!" Thinking (rumination) does not help depression. Getting out into the world and building up our lives and investing in relationships does. Our sessions will be highly structured and dynamic. Therapy will not just be a place you go to be honest about how badly you are feeling.  We will use our time together to help find the best way to create a reduction in those feelings. Our sessions will be grounded in CBT (Cognitive Behavioral Therapy) and ACT (Acceptance and Commitment Theory) so there will be "homework" which just means you will agree to try something new each week to see if it helps you feel better.