Depression Therapy in Northern Virginia

For when You Feel Like a Ghost in Your Own Life

I offer depression therapy in person at my McLean office, serving clients throughout Northern Virginia, including Arlington, Alexandria, Reston, and Vienna. Telehealth available throughout Virginia, Maryland, and Washington, D.C.

Depression doesn't always look like staying in bed, letting the dishes pile up, and missing things you'd normally never miss. Don't get me wrong, sometimes it looks very much like that. But it can also look like getting up, going to work, answering the requisite emails, making dinner, and feeling... almost nothing. For some people, it's both, depending on the week, the month, or the time of year. The things that used to matter? They still do, at least technically. But man, they feel so hard to reach.

Yes, you might have heavy, aching sadness. But you may also have flatness. Food doesn't taste as good. The good news you were waiting for lands with a dull thud. You laugh at the right moments, but you don't really laugh. The trickiest part may be the weeks when you're functioning better, because it's easy to tell yourself it isn't so bad after all. You're still keeping it together. Other people have real problems. Keep the line moving.

Underneath all that are the harder questions that show up in the quiet hours, when you're tossing in bed: What happened to me? Where did I go?

What Depression Looks Like

The signs of depression aren't always obvious, even to the person living with it. You might notice:

Persistent sadness, emptiness, or numbness
Losing interest in things you used to enjoy, including sex and intimacy
Exhaustion that sleep doesn't fix
Changes in appetite or sleep
A harsh inner voice: worthless, guilty, a burden
Irritability or anger that seems to come out of nowhere (especially common in men)
Trouble concentrating or making decisions
Pulling away from people, even the ones you love
Thoughts of death or not wanting to be here

Depression lives in the body too: heaviness in your limbs, a hollow or tight chest, headaches, stomach trouble, moving and even talking more slowly than usual. Some days it feels like walking through wet cement.

*If you're in crisis or having thoughts of harming yourself, call or text 988 (Suicide & Crisis Lifeline), or go to your nearest emergency room.

How Depression Takes Hold

The protections of the past can become the prisons of today. Depression often shows up as a protective system run amok. It's a bit like an autoimmune condition, where the body's defense system thinks it's helping but ends up attacking the very thing it's supposed to protect. Our psychological defenses can work the same way. Biology plays a role, and some of us are genetically predisposed to depression, but predisposition doesn't equal depression. When depression takes root, there's usually an interplay of genetics, personal history, and psychological defenses that have gotten stuck. That can look like:

Disconnection. When feelings weren't welcomed growing up, or no one showed us what to do with them, many of us learned to just turn the volume down on all of them. That solved the problem for a while. But you can't mute the painful feelings without muting the good ones too. Eventually you're left cut off from your emotions, from the people around you, and from your own sense of being alive.

Self-attack. Anger has to go somewhere. Maybe it wasn't safe to be angry at the people you depended on. Maybe you saw what anger did in your house and swore you'd never be like that. Or maybe your own anger came out in ways that scared you. Whatever the reason, once you've learned to fear your own anger, it tends to turn inward instead. That's where the relentless inner critic comes from, the one that says you're at fault, you're failing, you should be over this by now. A lot of depression is anger with nowhere else to go.

Aerial view of a braided river splitting and rejoining across a valley floor

Shutdown. When your nervous system has been overwhelmed for long enough, it can drop into a kind of functional freeze. Think of a phone in low-power mode: everything nonessential switches off so it can keep running. You can still get through the day, but motivation, pleasure, and energy are among the first things to go.

Stuck beliefs. Let's say your early experiences left you believing you were never quite good enough. Today, that might show up as trouble getting started on things, or projects you can't seem to follow through on. From the outside it can look like procrastination. Underneath, an old belief is running on autopilot. It's tied to old memories, and it comes with its own body sensations and thought loops. And in its own way, it's trying to protect you: if you don't fully try, you can't get hurt by falling short again. A part of you stayed back in those original experiences and is still living them. So when something in the present brushes up against the old wound, that part takes over before you even realize it.

These paths often feed into each other. The belief that you're not good enough feeds the inner critic. The critic wears you down until your system shuts down. And shutdown cuts you off even further from the feelings and people that could help. Each one started as a way to protect you, an adaptation. And adaptations can change.

My Approach to Depression Therapy

I take an experiential, relational approach to depression treatment. We pay attention to what you're feeling, and to what you're not feeling, moment by moment in session. When a flicker of sadness or anger gets swallowed back down, or your voice goes flat while you're talking about something painful, we slow down right there, because that's where the work is. I draw on several models and tailor them to you:

ISTDP and AEDP. I'm certified in ISTDP (Intensive Short-Term Dynamic Psychotherapy), which is well suited to tracking how anger and grief get turned against yourself. My style leans toward AEDP (Accelerated Experiential Dynamic Psychotherapy), which focuses on repairing disconnection so you can feel your emotions again, with someone alongside you.
EMDR therapy. Eye Movement Desensitization and Reprocessing helps your brain finish digesting the experiences that got stuck, so beliefs like "I'm not good enough" lose their grip.
IFS-informed work. Depression often has parts: one that pushes you to keep going, one that has given up, one that criticizes you for both. We get to know each of them and what they're trying to do for you.

Types of Depression I Treat

I work with adults dealing with:

High-functioning depression
Chronic, low-grade depression that has been there for years
Depression after a loss or major life change
Depression with anxiety
Depression that hasn't responded to medication or past therapy

Many of the people I see have been "fine" for a long time. They've built careers and families and reputations for being the reliable one. And it might be worth asking what "fine" actually means to you, and whether it's what you want for yourself.

Common Questions About Depression Counseling

I don't feel sad. I mostly feel nothing. Is that still depression? Often, yes. Numbness and flatness are some of the most common ways depression shows up, especially in people who learned early to keep their feelings under wraps. Feeling nothing is frequently a sign that a lot is being held down.

I'm irritable and angry most of the time. Could that be depression? It can be, and it's one of the most commonly missed forms. For many people, especially men, depression shows up as a short fuse: snapping at the people you love, stewing in resentment, or drinking or working more to keep the feelings at bay. Anger usually has a job to do, and it's worth understanding what it's trying to help you with.

Do I need to be on medication? That's a decision for you and a prescriber. Medication helps many people, and research consistently shows that, especially for more severe depression, therapy and medication together work better than either one alone. Medication can ease symptoms, sometimes enough to make the deeper work possible. Therapy works on what's underneath: the feelings, beliefs, and patterns that keep depression going.