Treating Depression

Therapy & Medication for Depression

Although individuals suffering from depression often feel hopeless and despairing, at TMP we offer a broad range of evidence-based, effective therapies to bring sustained relief. Our treatments are divided into three categories: psychotherapy, psychopharmacology, and combination treatment. Psychotherapy, or talk therapy, involves speaking with a clinician about your history and mental life in order to feel less alone and get unstuck, discover new perspectives and develop new psychological skills, and build inner resilience.

Psychopharmacology is the use of medications to improve mood and bring relief to many symptoms of depression. Combination therapy is the simultaneous use of psychotherapy and pharmacology. While we often encourage combination therapy instead of a purely psychopharmacological treatment, we appreciate that some individuals are not interested in psychotherapy and choosing medication treatment alone works well for some. The choice of treatment that suits you best is one that we help you make in a collaborative process that is unique to every client. Just as the symptoms of depression might look different in each person, treatment must be customized and personal. At TMP our overarching goal is to provide enduring relief while helping our patients live their fullest lives, and since no two people are alike, all treatment approaches are tailored to your specific needs and goals. There is simply no one size fits all approach.

Antidepressants

Psychopharmacology is the use of medications to treat psychological disorders. A psychopharmacologist is a clinician, either a Psychiatrist or Psychiatric Nurse Practitioner, who is an expert in the use of medications to address psychiatric symptoms. Often, antidepressants are extremely effective at ameliorating symptoms of hopelessness, helplessness, poor appetite, insomnia, changes in energy level and poor concentration. Once these are eliminated, it is easier to develop new perspectives on the issues contributing to depression, which in turn facilitates more useful changes through your active participation in therapy.

Antidepressants may help to reduce symptoms, but often they take time to work, usually 2-4 weeks, although sometimes more and sometimes less time is needed to see progress. Our goal is to select a medication that balances symptom relief with as few side effects as possible. Although this might involve some trial and error, we are dedicated to helping you find maximum benefit and optimal relief with a minimum of side effects, ideally none. Finding what works best for you is the art of psychopharmacology. Common side effects include headaches, nausea, trouble sleeping, agitation and sexual problems. Over time, these side effects can diminish.

At TMP, we have the benefit of both psychopharmacology and psychotherapy under one roof.
Our clinicians are in constant communication with each other and working along with you, as a team, to optimize your care and recovery. If your medication doesn’t relieve your symptoms or causes unwanted side effects, your psychopharmacologist will work with you to find one that does. The idea is not for you to suffer, but to make sure you are moving constantly towards living a fuller life, whatever that looks like for you. After sustained symptoms relief, you and/or your clinician might decide it is time to terminate psychopharmacological therapy. After decades of research and clinical experience, we know that individuals are more likely to stay off mediation when we taper them slowly. Once again, we use a collaborative approach, constantly assessing how you are feeling as we reduce the dosage. We always keep the end in mind, working to make sure you achieve both relief and work towards building a life consistent with your personal goals and values.

Psychotherapy (Talk Therapy)

Psychotherapy is effective and long lasting. Our personal bias is that individuals often need support and new ways of examining familiar problems and thought patterns. As Albert Einstein once said “We cannot solve our problems with the same thinking we used when we created them.” Talk therapy can help you find a way not to let negative moods impact your life, all while teaching you coping skills and clarifying goals and values. The ultimate treatment goal is a more rewarding, meaningful, joy-filled life. With the help of a caring clinician, it is possible to identify negative beliefs and thinking patterns and replace them with positive thoughts and behaviors. Studies report that talk therapy is as effective as medication and provides a valuable approach to managing mild to moderate depression. Sometimes, even for milder depressions, the best treatment can be to combine psychotherapy and medication, and certainly for severe depressions we typically encourage considering a combination treatment. The choice of treatment modality is always yours.

Types of Psychotherapy Offered at the Midtown Practice

At TMP we offer evidence – based and cutting – edge treatments to help you achieve a richer and more rewarding life. Three common methods are cognitive behavior therapy, dialectical therapy, and psychodynamic therapy. We offer other evidence-based approaches to help you get unstuck and focus on what matters to you.

Cognitive Behavior Therapy (CBT)

The goal of CBT is to help clients identify unrealistic and unhelpful negative thoughts that affect mood and produce negative behaviors. Many of us have maladaptive “automatic thoughts” that shape the way we view ourselves and the world around us. These thoughts unknowingly reinforce negative emotions and lead to self-defeating behaviors. Our therapists work with you to change these unconscious thought patterns and replace them with more productive ones. Research has shown the effectiveness of CBT in the treatment of the symptoms of depression.

Dialectical Behavior Therapy (DBT)

DBT is sometimes considered a “third wave” descendent of CBT. It incorporates mindfulness skills with interpersonal effectiveness and achieving distress tolerance. The goal is to teach people how to live adaptively in the NOW, acquire healthy coping skills, improve relationships, and build the inner musculature to endure different types of distressing emotions. It is designed to help you understand the connection between your thoughts, feelings and behaviors. Understanding what we feel and why allows us to recognize and manage or prevent unwanted emotions. DBT involves individual therapy, group therapy and coaching. Research has shown proven effectiveness to treat depression.

Psychodynamic Therapy (PDT)

PDT is a form of psychoanalytic therapy that helps a patient to explore their early childhood and discover repressed and unconscious emotions that interfere with the ability to make healthy decisions to improve their quality of life. Through insight oriented work, you will be able to identify and change unconscious ways of acting that might sabotage feelings of fulfillment and personal and professional success.

Acceptance and Commitment Therapy (ACT)

ACT is an evidence-based therapy that helps you build greater psychological flexibility so that you can avoid getting emotionally stuck. Developing this psychological flexibility involves learning to be fully present in the moment, which in turn empowers you with the ability to adjust behavior to reflect your personal values. Building the capacity to accept things as they are and accept them, at least for the moment, without judgment or evaluation, is actually a fundamental skill which increase the long-term success of all treatments. In addition, your clinician will work diligently with you to discover or clarify what you value most in life, since that understanding enables you to use your increased psychological flexibility and resilience to move towards a more rewarding life.

Lifestyle Changes

Lifestyle modifications including exercise, healthy eating, meditation, and engaging in
pleasurable activities are effective interventions for depression and a good adjunct to treatment with antidepressants or psychotherapy. They can augment the effects of antidepressants, talk therapy, and help you to build a more productive and fuller life.

We are born with the natural ability to be resilient. Life can wear us down. We are all human, and vulnerable to life’s challenges. Whatever you are suffering with, you do not need to suffer alone. At TMP, our goal is to listen without judgment and with open minds. We are committed to giving you the best customized care to help you gain perspective, overcome obstacles, and accept life’s challenges while living a more fulfilling life. When you are down and suffering, contact TMP to schedule a consultation with one of our esteemed clinicians. We will provide you with a roadmap for recovery; partner with you to restore hope and inspire and support a move toward a better life.