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Depression and Anxiety Therapy in Greenwich, CT, White Plains and NYC

What is depression?

Female Depression Male Depression

It is common to feel occasional sadness and even grief in certain situations. Clinical Depression, however, is a prolonged feeling of sadness with lack of enjoyment or interest in the world around you.

Clinical depression is a psychological condition that can be treated so it doesn't negatively affect your emotional and physical well-being, your professional functioning and your personal and family relationships.

Depression is not just "feeling down in the dumps." People who are clinically depressed cannot simply will themselves to feel better. They are not able to just "snap out of it." Symptoms can last for weeks, months or years. Depression causes suffering for those who are depressed as well as for family and friends who want to help but don't know how. It can also drive loved ones away since it is painful to see your loved one suffer and not be able to help.

Acute or Reactive Depression can be linked to an external event that has or will occur, such as loss of a loved one or job, for example.

However, Chronic Depression can occur for reasons that have nothing to do with an external event. You may think/feel that your life is good and have no real complaints, and yet you cannot shake the chronic feeling of sadness, as if something is profoundly wrong.

Some symptoms of depression may include:

  • Low mood, sadness or feeling "empty"
  • Mental and physical fatigue (chronic); feeling "slowed down"
  • Loss of interest or pleasure in activities that were once enjoyable, including sex
  • Promiscuous and/or risky sex or dangerous behavior
  • Sleep disturbances: problems falling asleep or staying asleep or sleeping too much
  • Chronic irritability/readiness to anger, rage or engaging in ruminative resentment, picking fights
  • Eating disorders such as overeating, eating to avoid feelings, anorexia, bulimia, etc.
  • Persistent negativity, feelings of helplessness, hopelessness, pessimism, dread
  • Heightened suspiciousness of other's motives or intentions
  • Thoughts of death; suicidal thoughts, intentions or actions
  • Sudden crying spells or mood changes
  • Persistently interpreting situations in a negative light, "catastrophizing"
  • Self-cutting or engaging in other destructive, risky behaviors
  • Lack/loss of motivation or mental focus
  • Difficulty concentrating, taking in, processing or retrieving new information
  • Heightened sensitivity and reactivity, often to light, noise, smells and other sensory information
  • Low self-esteem, self-worth and confidence
  • Heightened anxiety or panic, obsessive preoccupations
  • Vague, multiple or ever-changing physical complaints
  • Isolation, social and emotional withdrawal
  • Turning to alcohol, drugs, food or compulsive activities for comfort or to avoid feelings or thoughts

Depression is often left untreated because the person may think or want to believe that their negativity and irritability are normal, or he/she does not recognize that they can get help. They may be in denial or don't want to admit to having a problem. In men, depression tends to manifest itself most commonly in withdrawal.

Clinical depression feeds upon itself. It is an illness that should be treated by a mental health professional.

Treatment of depression

Depressive Disorders include:

  • Major Depressive Disorder
  • Dysthymic Disorder (Reactive Depression)
  • Bipolar Disorder
  • Depressive Mood Disorder due to a general medical condition
  • Substance Induced Mood Disorder
  • Seasonal Affective Disorder
  • Postpartum Depression
  • Premenstrual Disorder

Recovery from depression is a step-by-step process. It often entails rebuilding one's self-concept and self-worth, setting positive goals, re-engaging with others and the world in a more positive, active and emotionally rewarding way. We also focus on enhancing personal meaning and positive values, addressing real-world problems realistically, and by recognizing and distinguishing between what we can and cannot control. By living a healthier lifestyle, including exercising and developing meaningful connections and engaging in gratifying pursuits, the depression is met with an active, positive perspective.

Cognitive Behavioral Therapy (CBT) is especially helpful in challenging negative thoughts and assumptions that lead to depression. CBT builds positive thinking and rewarding habits.

What is anxiety?

AnxietyThe feelings of fear and anxiety are natural reactions to danger, risk or uncertainty. Fear is the instinctive, adaptive way the body motivates and helps you remove yourself from perceived risk or threat.

Once the dangerous situation has been resolved, the feeling of fear is supposed to end since it is no longer useful. We were meant to feel fear only occasionally and only for brief periods of time.

Persistent, pervasive anxiety is not beneficial. Mild anxiety can help us to the extent that it can serve as a motivator, but it can also become a problem. It is problematic if it so great that it results in action paralysis (not being able to make a decision), or if it remains present for sustained periods of time or the person is unable to move past it.

The presence of persistently high levels of cortisol released into the bloodstream occurs when we feel anxiety/fear. The presence of sustained, high levels of cortisol is extremely unhealthy.

Anxiety Disorders I Treat Include Panic Disorder, Obsessive-Compulsive Disorder, Specific Phobias, and Post-Traumatic Stress Disorder.

Anxiety or fear triggers

  • Marriage, Separation or Divorce
  • Major life transitions (relationship loss, job loss, career change, retirement)
  • A child leaving home
  • Moving to a new geographic area or job
  • Menopause
  • Serious medical diagnosis
  • Chemical changes due to pregnancy
  • Drugs/Alcohol
  • Illness
  • Emerging or persistent memories of childhood neglect or abuse (physical, sexual, emotional)
  • Aftermath of a traumatic event, such as abandonment, betrayal, nearly fatal accident, war, sudden and unexpected loss or injury
  • Shame, regret, feelings of failure, humiliation or other negative repetitive thoughts that can't be controlled and won't go away
  • Difficult life circumstances: difficult partner, child, parent, financial stress, illness, sudden job loss, etc.

Anxiety can create physical or psychological symptoms which can create more anxiety, panic obsessive compulsive behaviors, self-worth issues or depression.

Panic disorder

Panic attacks are extreme anxiety attacks. They usually start suddenly, with little warning. They may occur frequently or only occasionally. The symptoms typically peak within minutes and you may feel exhausted after a panic attack subsides.

Panic Attack Symptoms

  • Rapid, pounding heartbeat
  • Sweating
  • Trembling or shaking
  • Shortness of breath or tightness in throat
  • Chills
  • Nausea
  • Tingling or numbing
  • Chest pain
  • Hot flashes
  • Headache
  • Dizziness or lightheadedness
  • Feeling of unreality or detachment
  • Impending sense of doom, fear of losing control

Because panic attack symptoms can also resemble other serious health problems, such as a heart attack, it is important to be evaluated by a medical doctor if you are not sure what is causing the symptoms. If the doctor tells you that you are having a panic attack, it is important to seek psychotherapy to help figure out what is triggering the feeling of panic (this may or may not be obvious).

One of the worst aspects of Panic Disorder is the anxious dread that you will have another one, since they are quite frightening. You may develop so much anxiety about having another panic attack that you start to avoid all situations that might trigger it. The anxiety may start interfering with and restricting your life. Untreated, Panic Disorder gets worse.

Personalized psychotherapy and counseling can help you determine what is triggering your depression, anxiety, or panic, or any other disturbing feelings or situations that are bothering you. We will work together to understand the basis of your upset, its causes and how to deal with your emotions, behaviors or other matters, constructively. The goal of therapy is for you to fully engage in and enjoy your life and not feel controlled by these disturbing feelings that interfere with this aim.


Joyce Nathan, Ph.D.

2 Benedict Place
Greenwich, CT 06830
(203) 661-5009Call Greenwich, CT Psychologist Dr. Joyce Nathan

499 North Broadway
Professional Offices
White Plains, NY 10603
(914) 806-6877Call Westchester, NY Psychotherapist Dr. Joyce Nathan

71 Park Avenue
Between 38th&39th St.
New York, NY 10016
(914) 806-6877Call New York, NY Psychotherapist Dr. Joyce Nathan

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