What is Depression?

Depression––or Major Depressive Disorder (MDD)––is a medical condition that causes extreme feelings of sadness and emptiness. People who suffer from depression may lose interest in activities they once enjoyed and experience a near-constant feeling of hopelessness. Depression may be triggered by events or occur alongside other illnesses. Depression can interfere with your ability to work, sleep, eat, interact with others, and generally enjoy life; however, depression can become a manageable condition with proper treatment.

For a deeper dive into the causes of depression, different types of depression, and my approach to treating depression, be sure to check out my commentaries on depression.

What causes Depression?

While the exact cause of depression is unknown, experts theorize that it has multiple origins, which vary from person to person. Based on decades of research, experts suspect that chemical imbalances (i.e., affecting serotonin, norepinephrine, and dopamine) and changes in the brain (i.e., affecting its structure and function) play a significant role in depression. From an emotional and behavioral perspective, underlying personality traits as well as unaddressed, self-directed anger may be centralizing causes of depressive symptoms. In a commentary on depression, I have also written about how a masochistic personality disorder and/or a narcissistic crisis may lead to the development of depression.

What are the symptoms of Depression?

The criteria for depression are determined by mental health experts across the globe and validated in clinical research. They are published in two clinical manuals, which are made in conjunction with one another: the Diagnostic and Statistical Manual (DSM) and the International Classification of Disease (ICD) of the World Health Organization (WHO).

According to these manuals, depression is characterized by 1) sadness and/or 2) loss of interest or pleasure that occur alongside a number of the following most of the day over a period of weeks:

  • weight loss or gain;
  • difficulties sleeping (e.g., too much or too little);
  • physical agitation or slowing;
  • fatigue or loss of energy;
  • feelings of worthlessness or guilt;
  • difficulties concentrating;
  • and thoughts of death or suicide.

Depression is a serious condition that can severely affect individuals and their families. Notably, it is often an episodic illness that can worsen with each episode. Left untreated, depression can steadily worsen, leading to anxiety, social isolation, difficulties at work or school, substance abuse, and suicide.

How is Depression different from sadness?

Depression differs from sadness in a few meaningful ways. Foundationally, depression impacts most, if not all, of a person’s life (i.e., work, school, family). When experiencing a traumatic event or a difficult time period, those without depression may exhibit some––or all––of the symptoms listed above. The key differentiator is that those with depression experience them nearly all the time and cannot bounce back to their previous level of functioning. Those suffering from depression may be more profoundly impacted by relatively small life stressors compared to those without the disorder. Over time, depression can worsen and evolve into an absence of feeling and emotion. Patients use words like “hollow” and “empty” to describe this experience.

How is Depression generally treated?

Depression can be treated using psychotherapy and medications. Studies have repeatedly shown that both can be effective, especially when undertaken together. When both are used, treatment consists of a team-based approach with both a physician and a therapist.

How do I treat Depression?

In my practice, I treat depression through either psychodynamic psychotherapy or psychoanalysis. These sessions can occur one or more times per week over a period of months to years. I have utilized these techniques over the last twenty plus years with great, lasting results.

An important piece of the work I do with patients is addressing how they think. I guide patients to distinguish between thoughts and the act of thinking, developing a capacity to think with intention rather than be subjugated by painful thoughts. The premise is that this new thinking can lead to new ways of behaving. Ultimately, the positive impacts of these changes to thinking and behavior enhance self-esteem and reduce symptoms of depression. I find that long-term relief requires a longitudinal psychotherapeutic relationship with particular focus on targeting the root mental causes of depression.

What is Psychodynamic Psychotherapy?

Psychodynamic psychotherapy is a specific type of psychotherapy treatment that examines the connection between thinking and behavior. Most often, these treatments deal with day-to-day experiences, helping you process and adapt to life’s challenges in healthy ways. Its focus is usually on the more immediate past and present with direct ways of managing experiences and generating new skills (e.g., improving communication, recovering from grief, generating coping skills). Psychodynamic psychotherapy usually occurs 1-2 times per week. If you would like to learn more about psychodynamic psychotherapy or the different treatment modalities I use in my practice please click here.

How does Psychodynamic Psychotherapy treat Depression?

Psychodynamic psychotherapy enables us to explore and examine your thoughts and behaviors in a supportive environment. In this way, you can safely discuss your full range of emotions, likely uncovering unconscious feelings that contribute to your depressive symptoms. Hidden thoughts, feelings, and patterns in your life that you could not see on your own slowly come to light. Once revealed, you and I work together to create plans to address these patterns and create new ones, oftentimes directly treating the root causes of your depression. Research has shown that the results of psychodynamic psychotherapy are long lasting; the skills and habits you develop in treatment work to alleviate your current depressive symptoms and prepare you to confront future triggers.

In summary, psychodynamic psychotherapy enables you to heal from longstanding symptoms while generating skills to ward off future symptoms.

For a deeper look at how I think psychodynamic psychotherapy works, please click here to read one of my recent articles entitled “How Does Psychotherapy Work and What Leads to Lasting Change?”.

Read what our patients are saying!

"Dr. Mazzella gave great advice and insight! Thankful to be able to talk with him and have him share his knowledge with me."

- Krystal Reinosa

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What do I do if I would like to be evaluated and treated?

If you or someone you know are experiencing symptoms of depression and would like an evaluation and/or treatment, please call my office today at 212-591-0152 or fill out the form at this contact page. From there, I can review your case and offer you a treatment plan to meet your needs.

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I regret to inform you that I do not accept insurance and I am not participating with any insurance companies at this time. Payment for services rendered will be the responsibility of the patient directly. I apologize for any inconvenience this may cause. More information about financing can be found on this page.

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