Takeaway: Depression can impact every area of your life, making getting through the day a struggle. The good news is that depression is treatable, and reaching out for support can be the first step toward healing and recovery.

Depression Doesn’t Always Look Like Sadness

When people think of depression, they often picture someone who can’t stop crying or struggles to get out of bed. While that can certainly be true, depression doesn’t always present that way.

In my practice, I often meet people who continue to work, care for their families, and fulfill their responsibilities. From the outside, they are functioning, but internally, they feel exhausted, numb, overwhelmed, disconnected from the things they once enjoyed, or weighed down by constant self-criticism.

Depression affects everyone differently. For some, it looks like hopelessness or isolation. For others, it’s fatigue, irritability, difficulty concentrating, or feeling like you can barely get through the day.

Looking at the Bigger Picture

One of the first things I try to understand is why depression has developed.

For some people, depression emerges after a significant loss, trauma, or major life transition. For others, it may be connected to chronic stress from oppression, anxiety, perfectionism, burnout, ADHD, autism, or relationship difficulties. Sometimes depression develops without one obvious cause.

In therapy, we’ll work together to understand what’s contributing to your depression, and use that understanding to help personalize and guide treatment.

Is Depression Therapy Right For Me?

Therapy for depression may be a good fit for you if you experience any of the following symptoms:

• Persistent Sadness: Feeling sad, empty, or hopeless most of the day, nearly every day.
• Loss of Interest: Reducing or stopping once enjoyable activities.
• Fatigue: Experiencing constant tiredness and low energy levels, even after adequate rest.
• Sleep Disturbances: Having difficulty falling asleep, staying asleep, or experiencing oversleeping.
• Appetite Changes: Significant shift in your eating habits, leading to weight loss or gain.
• Irritability: Feeling easily irritated or agitated, even over minor issues.
• Difficulty Concentrating: Struggling to concentrate, make decisions, or remember things.
• Feelings of Worthlessness: A sense of worthlessness or excessive guilt over perceived failures.
• Social Withdrawal: Withdrawing from social interactions and isolating oneself from friends and family.
• Physical Aches and Pains: Experiencing unexplained physical symptoms like headaches, backaches, or stomachaches.
• Slowed Thinking or Reaction Time: Feeling physically and/or mentally sluggish.
• Negative Thoughts: Constantly having negative thoughts or a pessimistic outlook on life.
• Suicidal Thoughts: Experiencing thoughts of death or suicide.

How I Approach Depression Therapy

Depression can feel like you’re trapped in a cycle of hopelessness and isolation that affects how you see yourself, your relationships, and your future.

My approach combines evidence-based treatment with genuine curiosity about your life and your story. Depending on your needs, we may explore current stressors, patterns, questions of identity and meaning, or experiences that shape how you move through the world.

As a psychiatrist, I offer therapy, diagnostic assessment, and medication management. I can help you determine if medication would be a helpful part of treatment or if therapy alone is a good place to start. Together, we’ll develop an individualized treatment plan that reflects your goals and needs and can help you work towards:

• Developing and practicing healthier coping strategies
• Increasing emotional regulation
• Processing grief or trauma
• Setting and achieving goals
• Strengthening your relationships with yourself and others
• Improving your quality of life

What to Expect During Your First Appointment

Starting therapy can feel like a big step, especially when depression has made everything feel more difficult.

During our first session, we’ll spend time talking about what has been happening in your life, how your symptoms have been affecting you, and what you’re hoping will be different. I’ll ask about your emotional health, relationships, medical history, and any previous experiences with therapy or medication so I can understand the full picture.

You don’t need to have the right words or tell your entire life story during that first appointment. My goal is simply to get to know you, answer your questions, and work together to decide what treatment approach makes the most sense moving forward.

Meet Dr. David G. Zacharias | Seattle Depression Therapist

Living with depression can make it feel as though nothing will change, but depression is treatable. You don’t have to navigate it alone.

At Existential Psychiatry, I offer compassionate, individualized care that goes beyond symptom management. Whether you’re experiencing depression related to trauma, burnout, grief, life transitions, or you’re not sure why you’ve been struggling, therapy can provide a place to better understand your experience and move toward healing.

If you’re looking for depression therapy in Seattle or anywhere in Washington through telehealth, reach out to schedule a free consultation.

Frequently Asked Questions

How do I know if I’m depressed or just going through a difficult time?

Everyone experiences periods of sadness or stress. Depression is different because the symptoms persist, interfere with daily life, and affect areas like your sleep, energy, motivation, relationships, or ability to enjoy things. If you’re unsure, a professional evaluation can help clarify what’s going on.

Will I need medication for depression?

Not necessarily. Some people improve through therapy alone, while others benefit from combining therapy with medication. We’ll discuss your symptoms, history, and preferences to determine what approach makes the most sense for you.

What if I’ve tried therapy before and it didn’t help?

Not every therapist or therapeutic approach is the right fit for you. Sometimes, the relationship with your therapist, the type of therapy, or changes in your life circumstances can make a significant difference. A previous experience with a clinician doesn’t mean therapy won’t be helpful now.

How long does depression therapy usually take?

That depends on your goals and the nature of your depression. Some people seek short-term support during a difficult period, while others benefit from longer-term therapy to address deeper patterns and trauma. We’ll regularly revisit your goals together and adjust treatment as your needs change.

Can depression be related to trauma or ADHD?

Yes. Depression can occur alongside trauma, ADHD, anxiety, autism, grief, chronic stress, and many medical conditions. Part of treatment is understanding how these experiences may be connected, so your care addresses the underlying factors in addition to your symptoms.

What are the different types of depression?

There are several different kinds of depression, including:

Major Depressive Disorder (MDD), often referred to as clinical depression, is one of the most common and severe forms of depression. This is characterized by persistent sadness, loss of interest or pleasure in activities, changes in appetite and sleep patterns, fatigue, feelings of worthlessness, and trouble focusing. Treatment typically involves a combination of psychotherapy, medication, and lifestyle changes.

Persistent Depressive Disorder, also known as dysthymia, is a chronic form of depression lasting for at least two years. While the symptoms of PDD might be less severe than MDD, they can still significantly impact daily life and well-being. Therapy for PDD often focuses on long-term support and coping strategies.

Disruptive Mood Dysregulation Disorder (DMDD) is a type of depression that primarily affects children and adolescents. This involves severe and recurrent temper outbursts and consistent irritability. Treatment helps children and their families build emotional regulation and communication.

Premenstrual Dysphoric Disorder (PMDD) typically shows up as severe mood swings, irritability, and other depression symptoms in the days leading up to an individual’s menstrual period. Therapy may include hormonal treatments, lifestyle changes, and coping strategies to manage symptoms.

Depression may be related to other medical conditions (e.g., chronic pain, cancer, or neurological disorders). Effective therapy involves addressing the person’s physical and mental health. Bipolar disorder also involves periods of depression in addition to manic or hypomanic episodes.

Seasonal Affective Disorder (SAD) or Seasonal Depression occurs at specific times of the year. It typically impacts individuals during the fall and winter months when there is less natural sunlight. Treatment often includes light therapy to compensate for the lack of natural sunlight.

Prenatal Depression and Postpartum Depression affect pregnant individuals and new parents, respectively. Treatment may involve counseling, peer groups, building support networks, resource referrals, and medication.

Atypical Depression involves mood reactivity. The person’s mood temporarily improves in response to positive situations or events. Therapy may include a combination of psychotherapy and antidepressant medications.

Searching for relief from depression symptoms?

At Existential Psychiatry, we believe that effective treatment can help you heal and grow. Reach out today to schedule a free consultation with Dr. Zacharias to determine if his services are a good fit for you.

Sources

“Depression.” Cleveland Clinic, January 13, 2023. Accessed August 4, 2023.

“Mental Health Conditions: Depression and Anxiety.” Centers for Disease Control and Prevention, April 23, 2018. Accessed August 4, 2023.