Depression

People who experience acute and ongoing states of depression often seek psychotherapy at some point in their struggle with these conditions. The experience of depression is diverse and complex: episodes may be acute or chronic; feature singular or repetitive (with ongoing remissions and resurgences of symptoms) symptomatic profiles; vary in severity; result from neurochemical and/or situationally-based causal pathways; and may exist with or without other psychiatric conditions.

Patients with a chronic history of depression often have attempted psychopharmacological intervention, as well as previous stints of therapy, with uneven results. In the most severe cases, prolonged severe depression can be debilitating, negatively impacting all aspects of one’s life and compromising the fundamental ability to find pleasure or meaning in previously fulfilling activities.

For psychotherapy to be an effective intervention for depression, treatment must be tailored to the unique needs and circumstances of the patient, as well as the patient’s preparedness for and investment in certain therapeutic aims vs. others.

For examples, some depressed patients primarily benefit from a supportive psychotherapeutic approach characterized by the therapist’s empathizing with the patient’s subjective emotional experience, aiding in problem-solving, and bolstering strategies of coping and general resilience. Other depressed patients, conversely, may be eager to explore historical antecedents of their depressive symptoms through more exploratory, insight-oriented therapeutic approaches.

In my practice, I remain flexible and collaborative with the depressed patient, orienting therapeutic efforts in a targeted strategy so that supportive and insight-oriented techniques are utilized optimally.

Over the years, I have made the surprising realization in working with hundreds of depressed patients that, when psychotherapy is effective, the reduction (in severity, duration and range of symptoms) in depression often co-occurs with an increased ability on the part of the patient to experience, tolerate, and utilize sadnessas it emerges in daily life.

Some theorists view depression as a psychological defense employed when normal expectable feelings of sadness cannot be tolerated, and for many of my own patients this has been the case.

Moreover, when therapy is successful, the interdependent components of the depressive experience become identified and understood. For example, it is usually the case that depression arises in the context of external scenarios in which the other party or situation failed the patient in a significant way (i.e., death of a loved one; being betrayed by a romantic partner; being laid off or fired) that register internalfeelings of vulnerability and unresolved emotional experience (i.e., being laid off triggers long-held feelings and belief systems of never being good enough). Addressing the dualistic nature of internal and external constituents of the patient’s depression is often the most salient factor in breaking the episodic return of symptoms.

Visit Dr. Tobin's Office

15615 Alton Parkway
Suite 450
Irvine, CA 92618

Hours
Monday: 8am - 8pm
Tuesday: 8am - 8pm
Wednesday: 8am - 8pm
Thursday: 8am - 8pm
Friday: 8am - 8pm
Saturday: Closed
Sunday: Closed