When the weight doesn't lift on its own.

Depression affects roughly 21 million U.S. adults each year and is recognized by the World Health Organization as the leading cause of disability globally. It shows up as persistent low mood, loss of interest, fatigue, changes in sleep and appetite, difficulty concentrating, and feelings of worthlessness or hopelessness that persist across weeks rather than days.

What clinical experience consistently reveals — and what medication management alone often does not address — is that depression is rarely only a neurochemical event. For many adults it is a response: to loss, to chronic stress, to unresolved grief, to the accumulated cost of unaddressed trauma, to burnout that has crossed into something more pervasive. Understanding what a particular person's depression is responding to changes treatment significantly.

Depression therapy works differently depending on what's driving it. For situational or recent-loss presentations, structured approaches can produce meaningful relief relatively quickly. For depression that's chronic, recurrent, or connected to early attachment experiences and trauma, the work is longer and more layered — addressing the psychological and relational conditions that sustain the depressive state rather than only the mood itself.

Early sessions focus on understanding the history and context of the depression: when it began, what conditions have maintained it, and what has and hasn't helped. Many of my clients have already tried medication, CBT, or both, with partial or no relief. That history is clinical information, not a failure, and it shapes the approach. Depression that hasn't responded to standard short-term approaches typically requires depth-oriented treatment reaching relational patterns, internal belief structures, and somatic dimensions that shorter models don't.

For depression, I draw primarily from psychodynamic and attachment-informed therapy, Internal Family Systems (IFS), Somatic Experiencing, and ACT, with CBT incorporated when it serves the clinical moment. Psychodynamic and attachment-informed work addresses the relational and historical dimensions of depression: the losses, disappointments, and internalized beliefs that sustain a chronically diminished experience of life — particularly relevant for depression that has persisted across circumstances and hasn't shifted in response to external change.

IFS approaches depression through the lens of internal parts: the part that withdraws, the part that criticizes, the part that gave up, and the parts carrying grief, shame, or loss that haven't been processed. Working with those parts directly often reaches what cognitive restructuring alone cannot. Somatic Experiencing addresses the physiological dimension — the collapse, heaviness, and disconnection the body holds, which respond to body-based intervention in ways talk therapy alone doesn't always reach. I'm a second-year student at Somatic Experiencing International.

I work across the depression spectrum, with particular depth in several patterns. The first is high-functioning depression: adults meeting their obligations and maintaining outward function while privately experiencing pervasive flatness, loss of meaning, and an exhaustion they can't fully account for. Because it isn't visibly impairing, it often goes unrecognized or minimized for years.

The second is recurrent or treatment-resistant depression: adults who've tried medication, CBT, or both with partial or temporary relief, and who are ready for an approach that addresses the level at which the depression is actually organized. The third is depression intertwined with other concerns — complex trauma, burnout, grief, identity stress, or substance use. Depression rarely exists in isolation, and treatment that addresses only the mood while ignoring the context that produced it rarely holds.

Alchemy Psychotherapy is a private-pay, out-of-network practice. A reduced fee is available in limited circumstances based on financial need and current caseload. I do not bill insurance directly, but I provide a Superbill on the first of each month for clients with out-of-network mental health benefits, and HSA and FSA cards are accepted. Under the No Surprises Act, you have the right to a Good Faith Estimate of expected charges before treatment begins.