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Depression and Anxiety Treatment in Manhattan

Depression and Anxiety

manhattan-depression-therapistNot only do depression and anxiety often coexist, but the causes and treatment for depression and anxiety often overlap as well: from a biological predisposition; to unhealed wounds from childhood; to confusion around identity and direction, to present setbacks or losses; or to upcoming life changes and challenges.

The more painful the unhealed psychological injury or wound, the more distress you may feel in terms of anxiety and depression symptoms.Anxiety and Depression are wake-up calls that something profound internally is broken and needs to be fixed. Which is where I, as a psychologist and therapist, can help you.

Proven, successful treatment for depression and anxiety combines psychotherapy, particularly cognitive-behavioral therapy, and, where needed, anti-depressants and anxiety disorder medication.

Through an integrated treatment approach, in a manner that is caring, attuned, and engaging, I can help alleviate your symptoms of depression and anxiety, thereby enabling you, as Freud poignantly wrote, to find fulfillment in Love and Work… to which I’d add: and Play. For as depression and anxiety wane, invariably my clients’ career and relationship satisfaction improves, as does their avid pursuit of hobbies and passions above and beyond work and love.

Depression Unmasked

In depression, you become your own worst enemy, relentlessly preying on yourself: on your perceived deficiencies, missed opportunities, failed relationships, career mis-steps. Your shame in being depressed may be so extreme that you isolate yourself, concealing your hurt and sadness by physically and emotionally withdrawing from others.

Depression is like a living death, all life-support systems down: your appetite, your sleep, your energy, your libido, your memory, your capacity to derive pleasure from anything; your ability to engage others; your ability to make decisions; your ability to think (other than thoughts of relentless self-condemnation); and your ability to muster any faith that the dark, gray cloud hovering over you will ever lift.

If anything can level your humanity, depression is it!

Clinical depression is so profoundly painful, it is no wonder that depressed individuals often turn to drugs or alcohol or other forms of addiction — be it food, gambling, sex, web-surfing, etc. — anything to numb and escape the pain.The good news is: Depression is eminently treatable. Roughly 70% of individuals suffering from depression respond favorably to a combination of psychotherapy and antidepressants.

As a psychologist specializing in therapy for depression, I am experienced in working with the myriad forms of depression: unipolar depression, bipolar depression, anxiety depression, and dysthymic disorder, as well as depression comingled with other mental health disorders, like PTSD, OCD, ADHD, and Borderline Personality Disorder.

Anxiety Unmasked

The devil of anxiety has many faces.

In the form of panic attacks, anxiety can terrify you with fears of going mad, or of having a stroke or heart attack. With performance or publicspeaking phobia, anxiety may fill you with dread at the thought of blanking out and experiencing utter shame and humiliation. Or in the case of any specific phobia, say a phobia of snakes or elevators or flying, anxiety may torment you with visions of a painful death or injury if forced to confront the object that you fear. Lastly, if you suffer from social phobia or agoraphobia, your palpable anxiety may compel you to avoid social situations altogether.

Whether acute and discrete, in the form of a panic attack or a specific phobia, or chronic and diffuse, in the form of perpetual, generalized worry and unrest, anxiety feels like an assault by a faceless enemy, inflicting upon you a rash of anxiety symptoms that wreak havoc with your physiological and mental equilibrium: heart palpitations, sweaty palms, tingling and trembling, dizziness or lightheadedness, fear of losing control and fainting, chills or hot fl
flashes; shortness of breath, difficulty focusing, and a sense of impending doom.

These debilitating symptoms of anxiety owe their power to the excessive, irrational nature of your fear. It is as if your entire being has risen to a state of high alert, preparing itself for an imagined threat or disaster that rarely if ever comes to pass. To combat anxiety and depression, I use an integrated treatment model, incorporating primarily insight-oriented and cognitive-behavioral techniques.

Causes of Anxiety and Depression

In my clinical experience, I have found there to be four major causes of anxiety and depression that are separate but inter-related:

1) Cognitive – negative thoughts or “cognitions” are the cause of your anxiety. You feel anxious or afraid because you’re convincing yourself that something terrible is about to happen. Similarly, your negative thoughts cause depression. You feel depressed because you’re telling and convincing yourself of either something negative about yourself (“I’m a loser, failure, dimwit, etc.”) or something terrible about your situation (“I’ll never find someone to love me,”or “No matter how hard I try, I’ll never find a job”)

2) Avoidance – you ratchet up the anxiety by avoiding the thing you fear, thus strengthening the fear and magnifying your feelings of powerlessness in facing that which you fear. Likewise, you intensify your depression by avoiding doing that which will make you feel better or that which will address the situation you are depressed about.

3) Hidden Emotion – you feel anxious and/or depressed due to “hiding” or stuffing negative feelings, particularly anger, to avoid conflict and confrontation. In such cases, the negative feelings are stuffed because at one time, most often dating back to childhood, for you to express such feelings risked hurting, overwhelming, or enraging a parent, or caretaker, upon whom you were dependent and understandably fearful of alienating.

4) Biological – you feel anxious and/or depressed due to a chemical imbalance in the brain. In the case of anxiety and depression, a chemical imbalance, of some degree, is common among individuals seeking treatment for anxiety or depression.

Treatment of Anxiety and Depression

Utilizing this four-prong approach, I have had great success in helping my therapy clients overcome anxiety and depression and, in the process, bolster their self-esteem and self-confidence.

Cognitively, we will work actively at changing the way you think, in turn changing the way you feel.

To overcome avoidance, our therapy work will empower you to confront and overcome those things you fear the most, and to confront and actively change those things about yourself or your situation that depress you.

Regarding hidden emotions, through insight and increased selfawareness, you’ll first uncover hidden feelings, often hidden even from yourself, then come to understand and validate these feelings, and finally, be able to effectively express them, a process that ultimately puts anxiety and depression to rest.

Regarding the biological component, if, after exhausting the therapeutic, curative possibilities of the first three treatment approaches, your anxiety or depressive symptoms are still disabling, I can refer you to one of two highly qualified and skilled psychopharmacologists for a medication screening and evaluation. Understand that if, for whatever reason, you choose at any point in our therapy work, to be on antidepressants or anti-anxiety medication, I will wholeheartedly support this as well.

The clinical skills I use in implementing this four-prong treatment approach combine insight-oriented and cognitive-behavioral techniques, the two treatment methodologies proven to be the most effective in alleviating anxiety and depression.

Cognitive Behavioral Therapy (CBT)

In cognitive-behavioral therapy, you learn to change the negative thoughts or “cognitions” that cause depression and anxiety as well as the self-defeating behavior patterns that keep you stuck. Dozens of published studies have confirmed CBT’s efficacy in treating mood and anxiety disorders when administered by therapists. In fact, some studies confirm that CBT is, in the short term, as good as the best antidepressants and is often more effective in the long term, both effects due largely to the fact that CBT empowers you, the patient, with the tools needed to manage your own problems and emotions.

For cognitive-behavioral therapy to work, however, willpower is essential. For example, if you are clinically depressed, as difficult as it might be, you need to will yourself to do what you know is healthy, even if it feels futile and takes every ounce of energy to do.

You exercise because its good for you even if every step weighs a ton. You eat even if without appetite or when food repulses you. You force yourself to evaluate your situation objectively and realistically even in the face of your subjectively bleak and irrational perceptions of yourself and your situation. And when the raging sea of self-condemning thoughts floods your mind, you muster all your willpower to distract yourself or to affirm yourself.

However pat and contrived they may seem, these affirming “cognitive” thoughts and “behavioral” actions will in time, if not immediately, lift the veil of depression.

In addition to treating depression, Cognitive-Behavioral Therapy is effective in treating every conceivable type of anxiety, including public speaking anxiety, performance or test anxiety, phobias, panic attacks, and the chronic worrying, restlessness, irritability, and difficulty concentrating associated with generalized anxiety disorder.

Utilizing combined CBT and insight-oriented techniques, our work together will empower you with the tools necessary to recognize and control your symptoms of depression and anxiety, mitigating against prolonged dependence on therapy, hence reducing the overall length and cost of your therapy.