Depression
Everything is getting done and none of it registers.
The version I see most often is not in bed at noon. It is meeting every deadline and feeling nothing about any of it. We work on flatness, irritability, and sleep that does not restore.
Overview
Flatness is a symptom, not a temperament.
You are still doing the job. The kids get where they need to be, the emails go out, the gym happens most weeks. What is gone is the response. Things that used to produce something in you produce a kind of static instead. Sunday afternoon has a particular flatness to it that you have stopped mentioning because it sounds ungrateful.
The symptom nobody names is irritability. Not sadness: a short fuse, a low tolerance for noise, an edge in your voice that you hear a half second after it lands. And the sleep, which you are technically getting, seven hours of it, and which returns you to the morning as though you had not slept at all. Depression in high-functioning adults hides behind output, and output is the last thing to go, which is why people arrive here having felt this way for two years.
At a Glance
- Adults and couples, in person in San Diego
- Telehealth Monday through Friday across California
- EMDR certified, Gottman and EFIT Level 1 trained
- Free 15-minute consultation
Individual sessions are $210, or $325 for 90 minutes. Couples sessions are $225, or $345 for 90 minutes.
Full fees and policiesDoes This Sound Familiar?
The specifics, not a symptom list
Open any line to see how I would think about it with you.
Open any line that feels familiar.
The Work
Behavior first, then meaning
Behavioral activation
Action reliably precedes motivation in depression, not the other way around. We schedule specific, small, non-negotiable activity and track your mood against it. It is unglamorous and it is the most evidence-backed thing I can offer.
CBT on the commentary
Depression runs a running interpretation of everything, usually about your worth and the future. We catch the specific sentences and test them against evidence, which is more effective than trying to think positively.
Attachment work when it is relational
Sometimes the flatness is about a relationship that stopped being reciprocal, or a loneliness inside a full life. When that is the driver, skills alone will not touch it and we go relational.
The Arc
A shape, not a protocol
Everyone moves differently. This is how this particular work usually unfolds here.
We establish what your days actually contain and check in directly about how low it has gotten. That conversation happens early and plainly, and we agree on what you do and who you contact if things drop.
Questions
Answered plainly
Anything not covered here is worth asking on the free 15-minute consult.
Related Work
Is what I have serious enough, given I am still functioning?
Functioning is not the threshold. If your days have gone flat and stayed that way, that is worth working on regardless of what you are still managing to deliver.
Do you work with all levels of depression?
I work with adults experiencing depressed mood, low motivation, and burnout. I do not treat severe mental illness, and if what you are dealing with needs a higher level of care I will tell you honestly in the consult and help you find the right referral rather than keeping you here.
What if I am having thoughts of not wanting to be here?
Please tell me, and we will talk about it directly and without alarm. If you are in immediate danger, call or text 988, which is the Suicide and Crisis Lifeline, or go to your nearest emergency room. This website is not a crisis service.
Should I be on medication?
That is a decision between you and a prescriber. I am an LMFT and I do not prescribe or advise on medication. Many clients do both, and I am glad to coordinate with your physician with your written permission.
How quickly will I feel different?
I do not make guarantees about timelines. What I will do is review progress out loud with you regularly, so you are never left guessing whether this is working.
Free 15-Minute Consult
Fifteen minutes to find out whether this is the right work.
Tell me what is actually going on. I will tell you honestly how I would approach it and what to expect.
In person in San Diego, and by telehealth across California.