Gail Appel, MS, LMHC, CASAC, CSAT New York, NY Dealing with Depression and Anxiety Dealing With Depression People often contact me because they are depressed. If you think you may be depressed, it is important to know that depression is not a sign of weakness. Depression in fact is an illness and there are actual symptoms. Here are some of them: Loss of interest in things that used to bring enjoyment Sleep difficulties: trouble going to sleep or staying asleep, excessive sleeping, difficulty getting up in the morning Experiencing frequent or random anger Feelings of guilt, shame or worthlessness Feelings of hopelessness Difficulty making decisions, procrastination Desire to isolate from others Thoughts of death Difficulty eating or excessive eating Physical symptoms of depression including: fatigue, frequent headaches, vague aches and pains, and significant weight changes. If you feel that some of these symptoms describe you or the struggles you might be having, you may be depressed. The first thing I can do to begin to help you deal with your depression is to create a safe and supportive space. As we begin to work together, hopefully you will begin to feel less alone. I will ask you a lot of questions about when the depression began, how it is manifesting itself in your life and what caused you to come for help right now. I will be trying to distinguish if your depression is coming from a particular situation you are dealing with or from internal thoughts and beliefs you have had about yourself for a long time. Some of your depression may be a reaction to childhood trauma, or frustrations you are having in your life today. Whatever the reason for the depression, my goal is to help you discover and deal with the causes of your depression so that you can access your true and authentic self. This involves beginning to get in touch with your feelings and sharing them. Depression often occurs when feelings, especially anger, hurt or fear, are held in. I begin working with you by exploring your issues and helping you to access and share your feelings. This may be done with just you and me. Sometimes meeting in a group with others helps you to realize you are not alone. It also gives you a place to see others expressing feelings and to learn how to express them yourself. Sometimes referring you for medication evaluation can be helpful. Whatever it is that you need, I welcome the opportunity to help you feel better. Please feel free to call or email me. Dealing with Anxiety Many people I see in therapy suffer from anxiety. We all experience anxiety at times in our lives. Some of the symptoms of mild anxiety, and the more extreme form of anxiety, called panic attacks, are: difficulty in breathing or shortness of breath, headaches, stomach pain, nausea, trembling, and excessive perspiration. Feelings of irritability, helplessness or hopelessness often go hand-in-hand with anxiety. Anxiety is the body's way of getting us to deal with a threat. It could be an imagined threat of something that may or may not happen in the future. In its milder form anxiety may mobilize us to deal with something in a positive way, such as when a student is preparing for an exam or a business person is designing a presentation at work. In its more extreme form however, anxiety is debilitating and interferes with our lives in a profound way. People often feel that there is something wrong with them because there is nothing "tangible" to justify all the anxiety they feel. If you are anxious it is important to know you do not have to deal with your anxiety alone. A good therapist can really help. If you would like to explore working together, I would begin by asking questions about what is making you anxious right now. You may be experiencing mild anxiety about an upcoming work or personal event, or you may be having extreme anxiety which can involve fears you have had since childhood. For example, when we are small children we learn to anticipate what will displease our parents and try to avoid punishment or withdrawal of their love. Often we carry the reality and fears of what we experienced as children into today, causing us to imagine we will be fired if our boss frowned, despite our good work reviews, or that our partner will leave us, even though he or she has reassured us of his or her love many times. In overcoming anxiety it is important that I understand what you are experiencing and for you to know that I appreciate how hopeless and fearful you may feel. As we work together in psychotherapy in dealing with anxiety, we can talk about and understand these fears better so that they have far less power in your life. We might not need to explore childhood issues. Behavioral techniques or, if appropriate, a referral for medication evaluation may be what will help you resolve the issues and the effects anxiety can bring to your life. Whatever is necessary, I would be happy to help you work toward feeling better. home | about me | couples counseling | group therapy individual psychotherapy | depression | anxiety addictions & codependency | faqs | resources & links location | contact Gail Appel, MS, LMHC, CASAC, CSAT 144 West 86th St., Suite 1A New York, NY 10024 212-787-1879 gail@gailappel.net

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