Depression Treatment

Table of Contents

Expert Depression Treatment from a Board-Certified Psychologist

Dr. Ginny Estupinian is a board-certified clinical psychologist (ABPP)—a distinction held by only 4-5% of psychologists in the United States. With over a decade of experience treating depression, including complex cases and depression with co-occurring trauma, Dr. Estupinian provides evidence-based therapy tailored to your unique needs. [Learn more about Dr. Estupinian’s credentials and experience →]

Depression

Major depression is a treatable illness that affects the way a person thinks, feels, behaves, and functions. Research into this condition shows that 21 million people in the United States suffer from major depression, and the lifetime risk of suffering from depression can be as high as 17%.

This is why various governmental reports now show depression has surpassed HIV, AIDS, Malaria, Diabetes, and war as the leading cause of disability worldwide. Similarly, the CDC estimates that 1 in 4 of all American adults will suffer from mental illness every year.

Based on these findings, it is reasonable to assume that either you or someone in your family or even someone you know has experienced depression, although they may not talk about it.

Causes of Depression

There are many causes of depression, including environmental, genetic predisposition, and other things. Still, each individual’s uniqueness and circumstances make it almost impossible to isolate the root cause of the illness in general. Nonetheless, we know that in approximately 80% of cases, the initial trigger is a stress-related factor.

Many people suffer a series of losses, such as the loss of a job, followed by the death of a loved one, and even the end of a relationship. It is completely understandable that when a difficult chain of events such as these occurs, depression would set in.

Depression (mood) is much more than sadness

A Major Depressive Episode May Include These Symptoms:

Persistent sad, anxious, or “empty” mood
Feelings of hopelessness, pessimism
Feelings of guilt, worthlessness, helplessness
Loss of interest or pleasure in hobbies and activities, including sex
Decreased energy, fatigue, and feeling “slowed down.
Difficulty concentrating, remembering, making decisions
Thoughts of death or suicide, suicide attempts
Restlessness, irritability

Dysthymia -Persistent Depressive Disorder

Dysthymia, now officially known as Persistent Depressive Disorder (PDD), is like depression’s quieter but more persistent cousin.

Unlike major depression, which might come in intense episodes, PDD is a chronic condition that lingers for at least two years, like a constant gray cloud that never quite lifts.

While it might not knock you down completely like major depression can, it’s like carrying a heavy backpack everywhere you go – it makes everything more difficult, from maintaining relationships to performing at work.

People with PDD might experience a range of symptoms, including poor appetite or overeating, sleep problems, constant fatigue, low self-esteem, difficulty concentrating, and a pervasive feeling of hopelessness.

The tricky part about PDD is that, because it’s long-lasting, many people might mistake it for their personality or “just the way they are” rather than recognizing it as a treatable mental health condition.

Anhedonia

Anhedonia, though not widely discussed, is a significant mental health symptom that affects many individuals, often appearing as a core feature of depression and other mood disorders.

Imagine waking up one day and finding that everything that once brought you joy – your morning coffee, your favorite music, time with loved ones, even a warm shower – suddenly feels empty and meaningless.

This isn’t just a temporary loss of interest; it’s a profound inability to experience pleasure from activities that should typically bring satisfaction.

Some people might experience anticipatory anhedonia, where they can’t even get excited about future events, while others face consummatory anhedonia, where they can’t feel pleasure even while engaging in traditionally enjoyable activities.

Think of it as having a broken “pleasure sensor” in your brain, where the usual rewards of life’s experiences simply don’t register anymore.

Physical Symptoms of Depression

When an individual is depressed, it can result in that individual losing interest in almost everything in their life. Not wanting to do what they usually do regularly and not knowing why.

There is no vitality in life. Everything feels like too much work; even the simplest of things, like eating, can seem overwhelming. At times, individuals feeling depressed will lie frozen, feel numb, or be unable to seek support.

Several physical manifestations of depression may or may not be present. Not everyone will have all of these physical symptoms. Here are some of the common physical symptoms that have been noted:

Insomnia

Depression can have both physical and mental effects. It is not uncommon for people dealing with depression to have trouble falling or staying asleep. Also, in other cases, individuals may find that they are now sleeping too much when compared to their normal amount before the depression.

Chest Pain

Pain is a symptom of depression. However, when chest pain is present, it is very important to see your primary physician first to rule out any physical problems associated with your heart, lungs, or stomach. Nonetheless, persons who have experienced heart attacks are more likely to be depressed. Similarly, research is showing that depression can also raise your risk of heart disease.

Exhaustion and Fatigue

People suffering from depression will often report feeling so tired that they can’t find the energy to do basic everyday tasks. No amount of sleep or rest seems to help. Depression and fatigue occur together and tend to become worse over time.

Aching Muscles and Joints

Depression and pain share the same chemical messengers in the brain. This is why people who are depressed are three times as likely to experience regular pain. Likewise, a person living with ongoing pain has an increased risk of developing depression.

Digestive Problems

The brain-gut connection has been well documented. It is now understood that this is why we experience stomachaches or nausea when we’re stressed or worried. Depression can affect the gut, causing nausea, indigestion, diarrhea, or constipation.

Headaches

One study shows that people with major depression are three times more likely to have migraines, and people with migraines are five times more likely to get depressed.

Changes in Appetite or Weight

Some people who become depressed feel less hungry, while others can’t stop eating. The result can be weight gain or loss, along with a lack of energy. We now know that depression has been linked to eating disorders like bulimia, anorexia, or binge eating.

Back Pain

Research has shown that people who are depressed may be four times more likely to get intense, disabling neck or back pain. Nonetheless, it is important to have a physical examination to rule out any other medical issues regarding back pain.

Irritable, Agitated, and Restless

Sleep problems or other depression symptoms can make you feel this way. Men are more likely than women to be irritable when they’re depressed.

Sexual Problems

Individuals suffering from depression might lose interest in sex. A common side effect of some prescription drugs that treat depression is their effect on sexual drive and performance. This is why talking to your doctor about medication options is important.

Maybe, I will just push through it on my own

It is possible, but many times, you are going to lose that time in your life, and that is something that you can never get back. Also, shutting out the depression or trying to convince yourself that it is not a factor only strengthens the depression. Depression tends to fluctuate over time, making it difficult for the individual suffering from this condition to address the illness objectively.

How Is Depression Diagnosed?

Comprehensive Depression Assessment

Accurate diagnosis is the first step toward effective treatment. During your initial evaluation, Dr. Estupinian conducts a thorough assessment that includes:

Your Symptom Profile:

Type and severity of depressive symptoms you’re experiencing
Duration and pattern of symptoms
How depression affects your daily functioning

Complete Clinical History:

Medical history and current health conditions
Family history of depression or other mental health conditions
Previous treatment experiences (what has or hasn’t worked)
Life stressors and triggering events

Lifestyle and Behavioral Patterns:

Sleep quality and patterns
Eating habits and appetite changes
Energy levels and activity
Social connections and support systems

Psychological Assessment: When appropriate, standardized assessment tools help clarify your diagnosis and rule out other conditions, such as:

Bipolar disorder
Persistent Depressive Disorder (Dysthymia)
Anxiety disorders
Other forms of clinical depression

This comprehensive evaluation typically takes one to two sessions and ensures you receive an accurate diagnosis and the most effective treatment approach for your specific type of depression.

What Type of Therapy Works Best for Depression?

Evidence-Based Treatment Approaches

Dr. Estupinian uses proven, research-supported therapies to treat depression, with a primary focus on Cognitive Behavioral Therapy (CBT)—one of the most effective treatments for depression available.

How Cognitive Behavioral Therapy (CBT) Helps Depression:

CBT is based on the understanding that our thoughts, feelings, and behaviors are interconnected. When you’re depressed, negative thought patterns can trap you in a cycle that reinforces low mood and hopelessness. CBT helps you:

Identify negative thought patterns that maintain depression (“I’m worthless,” “Nothing will ever get better”)
Challenge and reframe distorted thinking with more balanced, realistic perspectives
Develop practical coping strategies for managing difficult emotions and situations
Change behaviors that keep you stuck (isolation, avoidance, inactivity)
Build skills for problem-solving and managing stress

What to Expect in CBT for Depression:

Sessions are structured and goal-focused. Together, we’ll work on specific problems and develop actionable strategies you can use between sessions. You’ll learn techniques you can apply throughout your life, providing lasting protection against future depressive episodes.

Integrated, Personalized Approach:

While CBT forms the foundation of treatment, Dr. Estupinian integrates other evidence-based approaches tailored to your specific needs, including:

Trauma-focused therapy (for depression with PTSD or past trauma)
Behavioral activation (to combat withdrawal and inactivity)
Mindfulness-based techniques
Interpersonal therapy approaches

Your treatment plan will be uniquely designed for your situation, symptoms, and goals.

Medication and Therapy: A Powerful Combination

Coordinated Care for Optimal Results

As a clinical psychologist, Dr. Estupinian does not prescribe medication but works collaboratively with your primary care physician and psychiatrist when medication is part of your treatment plan. This integrated approach ensures you receive comprehensive, coordinated care for depression.

If you don’t currently have a psychiatrist but are interested in exploring medication, Dr. Estupinian can refer you to trusted prescribers who will work as part of your treatment team.

Why Combined Treatment Often Works Best

Research consistently shows that the combination of medication and psychotherapy produces better outcomes for depression than medication alone, with higher response rates, lower relapse rates, and improved long-term functioning—especially for moderate to severe, chronic, or complex depression.

Why is Combined Treatment More Effective? The Science Behind It

Studies suggest several reasons for this synergistic effect:

1. Targeting Different Aspects of Depression

Medication works from the “bottom-up,” regulating neurotransmitters like serotonin and norepinephrine to reduce core biological symptoms:

Low energy and motivation
Sleep disturbances
Concentration problems
Physical symptoms of depression

Therapy works from the “top-down,” helping you reshape maladaptive thought patterns, beliefs, and behaviors that maintain depression:

Negative self-talk and cognitive distortions
Avoidance and withdrawal behaviors
Unhelpful coping strategies
Relationship patterns that contribute to distress

2. Enhancing Your Ability to Engage in Therapy

When medication reduces severe symptoms like intense anxiety, profound fatigue, or anhedonia (inability to feel pleasure), you’re better able to engage in and benefit from the demanding work of therapy. You have more mental and emotional energy to:

Practice new skills between sessions
Process difficult emotions
Make meaningful behavioral changes
Participate fully in the therapeutic process

3. Addressing Complex, Co-Occurring Issues

Many people with depression also experience other challenges—anxiety disorders, trauma history, chronic stress, or personality patterns that contribute to their struggles. Therapy addresses these underlying psychological vulnerabilities that medication alone cannot resolve, providing a more comprehensive treatment approach.

4. Reducing Long-Term Relapse

Psychotherapy provides you with lifelong coping skills and strategies that protect against relapse when medication is eventually discontinued or becomes less effective. These skills remain with you long after treatment ends:

Recognition of early warning signs
Strategies for managing triggers
Healthy thought and behavior patterns
Problem-solving skills for life’s challenges

The Bottom Line for Depression Treatment

The evidence is robust: combined treatment leads to higher response rates, lower relapse rates, and better functional outcomes than either treatment alone, particularly for those dealing with moderate to severe, chronic, or complex depression.

Whether you’re already taking antidepressants or considering medication, therapy provides essential tools that medication cannot help you not just feel better, but develop lasting skills for managing your mental health.

Psychologist vs. Psychiatrist: Understanding the Difference

Which Mental Health Professional Do You Need?

Many people are confused about the difference between psychologists and psychiatrists. Here’s what you need to know:

Clinical Psychologist (like Dr. Estupinian):

Doctoral degree (PhD or PsyD) in psychology
Specializes in psychotherapy and psychological assessment
Cannot prescribe medication
Focuses on changing thoughts, behaviors, and coping strategies
Provides talk therapy and evidence-based interventions

Psychiatrist:

Medical doctor (MD or DO) specializing in mental health
Can prescribe medication
Often focuses primarily on medication management
May or may not provide psychotherapy

Do You Need Both?

For moderate to severe depression, research shows the best outcomes often come from working with both:

A psychologist for regular therapy sessions
A psychiatrist or primary care physician for medication management

Dr. Estupinian coordinates closely with your prescribing doctor to ensure your treatments work together effectively. This collaborative care model provides the comprehensive support that leads to the best outcomes.

Can Therapy Alone Be Enough?

Yes. For many people with mild to moderate depression, therapy alone is highly effective. Research shows that CBT can be as effective as medication for treating depression, with longer-lasting benefits because you develop skills that protect against future episodes.

The decision about whether to include medication depends on factors like:

Severity of your symptoms
Previous treatment history
Your preferences and concerns
Presence of other conditions
How depression affects your daily functioning

Dr. Estupinian will discuss these options with you and help you make informed decisions about your treatment.

How Long Does Depression Treatment Take?

Every person’s experience with depression is unique, but the following offers a general outline of what to expect:

During your first session, Dr. Estupinian will review your concerns, develop a personalized treatment plan, and explain the options available to you. As therapy progresses, she may adjust the plan to ensure you receive the best possible results. Any changes will always be discussed with you in advance, so you remain informed and involved in every step of your care.

Specialized Expertise in Complex Depression

Treatment for Depression with Additional Challenges

Dr. Estupinian has specialized training and extensive experience treating complex presentations of depression, including:

Depression with Trauma or PTSD: Many people struggling with depression have also experienced trauma. Dr. Estupinian’s specialized training in trauma treatment allows her to address both conditions comprehensively.

Treatment-Resistant Depression: If you’ve tried other therapies or medications without success, Dr. Estupinian’s expertise in complex cases can help identify what’s been missing and develop new approaches.

Chronic Depression (Persistent Depressive Disorder): Long-standing depression requires specialized approaches. Treatment focuses on building sustainable coping strategies and addressing deeply ingrained patterns.

Depression in Older Adults: With specialized training in geriatric psychology, Dr. Estupinian understands the unique factors affecting older adults, including medical conditions, life transitions, and age-related concerns.

Depression with Co-Occurring Conditions: Many people experience depression alongside anxiety disorders, chronic pain, medical conditions, or other mental health challenges. Integrated treatment addresses all aspects of your well-being.

Online Depression Therapy Available

Convenient, Effective Teletherapy from Anywhere

Dr. Estupinian offers secure video therapy sessions for clients in California, Oregon, Florida, and Illinois—making expert depression treatment accessible no matter where you live in these states.

Is Online Therapy as Effective as In-Person?

Yes. Research shows that teletherapy is just as effective as in-person therapy for treating depression. Many people actually prefer virtual sessions because they:

Eliminate travel time and transportation barriers
Provide privacy and comfort of attending from home
Make it easier to fit therapy into busy schedules
Reduce childcare or time-off-work challenges

How Virtual Sessions Work:

Sessions are conducted via a secure, HIPAA-compliant video platform. All you need is:

A computer, tablet, or smartphone
Reliable internet connection
Private space where you can talk confidentially
Headphones (recommended for privacy)

In-Person Sessions Also Available:

For clients in the Bay Area, in-person sessions are available at Dr. Estupinian’s office, conveniently located in the South Bay and serving San Jose, Campbell, Saratoga, Los Gatos, and surrounding communities.

Whether you choose virtual or in-person sessions, you’ll receive the same high-quality, evidence-based treatment for depression.

Investment in Your Mental Health

Therapy Fees & Payment Options

Session Fee: $250 per session

Payment Methods Accepted:

All major credit cards (Visa, Mastercard, American Express, Discover)
Apple Pay
Google Pay
CareCredit (financing available)
HSA and FSA accounts

Payment is due at the time of service.

Insurance & Reimbursement:

Dr. Estupinian’s practice is private pay and does not accept insurance directly. However, depending on your insurance plan, you may be eligible for partial reimbursement for out-of-network mental health services.

How to Check Your Out-of-Network Benefits:

Call the customer service number on your insurance card
Ask about “out-of-network mental health benefits” or “out-of-network psychologist services”
Ask what percentage they reimburse for out-of-network providers
Ask if you have a deductible and if it’s been met
Ask how to submit claims for reimbursement

Dr. Estupinian will provide you with a detailed superbill (receipt) after each session that you can submit to your insurance company for potential reimbursement.

Payment Plans Available:

CareCredit offers flexible financing options that allow you to spread therapy costs over time with manageable monthly payments. Call my office to learn more about CareCredit.

Why Choose Private Pay Therapy?

Private pay allows for:

Complete confidentiality (no diagnosis sent to insurance)
Flexible treatment tailored to your needs, not insurance requirements
No session limits imposed by insurance companies
Freedom to determine the length and frequency of treatment together

Frequently Asked Questions (FAQs)

Q: Can depression be treated without medication?

A: Yes. For many people with mild to moderate depression, therapy alone is highly effective. Cognitive Behavioral Therapy (CBT) is as effective as medication for treating depression, with lasting benefits because you develop skills that continue protecting you after treatment ends. However, for moderate to severe depression, research shows that combining therapy with medication often produces the best results.

Q: What if I’m already on antidepressants? Can therapy still help?

A: Absolutely. Studies show that adding therapy to medication produces significantly better results than medication alone. Therapy helps you develop coping strategies, change negative thinking patterns, and address underlying issues that medication cannot resolve. Many people find that therapy helps them manage depression more effectively and may eventually reduce their reliance on medication.

Q: Do you prescribe medication for depression?

A: No. As a clinical psychologist, I do not prescribe medication—only physicians (including psychiatrists) can. However, I work closely with your prescribing doctor to ensure coordinated care. This collaborative approach combines the benefits of medication (which addresses brain chemistry) with therapy (which changes thought patterns and behaviors), providing the most comprehensive treatment for depression.

Q: Will I need to be on antidepressants forever?

A: Not necessarily. While some people benefit from long-term medication, therapy provides you with skills and strategies that remain effective even after treatment ends. This is one reason why combined treatment is so effective—therapy offers lasting tools that can protect you from relapse if you eventually discontinue medication. I work with your prescribing doctor to determine the best long-term plan for you.

Q: How do I know if I need therapy, medication, or both?

A: The most effective treatment depends on your individual situation. For mild to moderate depression, therapy alone is often sufficient. For moderate to severe depression, research shows that combining medication with therapy produces better outcomes than either treatment alone. During your evaluation, we’ll discuss your symptoms, preferences, and treatment history to determine the best approach for you.

About the Practice

Q: Do you accept insurance for depression treatment?

A: My practice is private pay and does not accept insurance directly. However, depending on your insurance plan, you may be eligible for partial reimbursement for out-of-network mental health services. I provide detailed superbills (receipts) after each session that you can submit to your insurance company. Many clients receive 50-80% reimbursement from their insurance.

Q: How much does depression therapy cost?

A: The session fee is $250 per session. Payment is due at the time of service.

Q: What payment methods do you accept?

A: I accept all major credit cards (Visa, Mastercard, American Express, Discover), Apple Pay, Google Pay, and CareCredit. HSA and FSA accounts can also be used.

Q: Do you offer payment plans for depression therapy?

A: Yes, I accept CareCredit, which allows you to finance your therapy sessions and pay over time with flexible monthly payment plans.

Q: How do I get reimbursed by my insurance for therapy?

A: To check your out-of-network benefits, call the customer service number on your insurance card and ask about “out-of-network mental health benefits” or “out-of-network psychologist services.” Ask what percentage they reimburse, whether you have a deductible, and how to submit claims. I’ll provide you with a detailed superbill containing all the information your insurance company needs for reimbursement.

Q: Do you offer online therapy for depression?

A: Yes, I offer secure video therapy sessions for clients in California, Oregon, Florida, and Illinois. Research shows that teletherapy is just as effective as in-person therapy for treating depression. Virtual sessions provide convenience and flexibility while maintaining the same quality of care.

Q: Where is your office located?

A: My office is located in Los Gatos, California, conveniently serving the South Bay area, including San Jose, Campbell, Saratoga, and surrounding communities. Virtual sessions are available for clients anywhere in California, Oregon, Florida, and Illinois.

Q: Are you accepting new clients?

A: Yes, I am currently accepting new clients for depression treatment. To schedule your first appointment, call (844) 802-6512 or [book online here].

About Credentials & Expertise

Q: What are your qualifications for treating depression?

A: I am a board-certified clinical psychologist through the American Board of Professional Psychology (ABPP). This is a distinction held by only 4-5% of psychologists in the United States. I earned my doctorate in Clinical Psychology from Palo Alto University and have over a decade of experience treating depression, including complex cases and depression with co-occurring trauma. I’m licensed in California, Oregon, Florida, and Illinois. [Learn more about my credentials →]

Q: What type of therapy do you use for depression?

A: I primarily use Cognitive Behavioral Therapy (CBT), one of the most effective, research-supported treatments for depression. I also integrate other evidence-based approaches tailored to your specific needs, including trauma-focused therapy, behavioral activation, and mindfulness-based techniques. Your treatment plan will be uniquely designed for your situation and goals.

Q: Do you specialize in any particular types of depression?

A: Yes, I have specialized expertise in complex presentations of depression, including depression with trauma or PTSD, treatment-resistant depression, chronic depression (Persistent Depressive Disorder), and depression in older adults. I also treat depression with co-occurring conditions like anxiety disorders.

Q: How is a board-certified psychologist different from other therapists?

A: Board certification (ABPP) represents the highest level of recognized competence in psychology. It requires extensive additional training, rigorous examination, and demonstrated expertise beyond licensure. Only 4-5% of licensed psychologists achieve board certification, ensuring you’re working with a provider who has met the highest standards in the field.

About Getting Started

Q: How do I schedule my first appointment?

A: Call my office at (844) 802-6512 or [book your appointment online here]. During your first contact, we can briefly discuss your concerns and schedule your initial evaluation.

Q: What should I bring to my first appointment?

A: Just bring yourself and be ready to talk openly about what you’re experiencing. If you’re taking any medications, it’s helpful to know the names and dosages. If you have records from previous mental health treatment, you’re welcome to bring them, but it’s not required.

Q: How do I prepare for my first therapy session?

A: There’s no special preparation needed. Think about what you’d like to share about your current struggles and what you hope to gain from therapy. It’s normal to feel nervous; many people do. Remember that the first session is about getting to know each other and understanding how I can help.

Q: What if I’m not sure therapy is right for me?

A: It’s completely normal to have uncertainty. The first session is partly about determining whether therapy is a good fit and whether we’re a good fit to work together. There’s no obligation after the initial evaluation. Many people find that just taking the step to come in provides clarity and relief.

Q: Is therapy confidential?

A: Yes, therapy is confidential with a few exceptions required by law (such as if you’re in imminent danger of harming yourself or others, or in cases of child or elder abuse). Because I don’t bill insurance directly, your privacy is further protected. No diagnosis or treatment information is shared with insurance companies unless you choose to submit claims for reimbursement.

Take the First Step

Is Therapy Right for Me? Depression Self-Assessment

Consider seeking professional help if you’re experiencing several of these signs:

✓ Persistent sadness, emptiness, or hopelessness lasting more than two weeks
✓ Loss of interest or pleasure in activities you used to enjoy
✓ Significant changes in sleep (sleeping too much or too little)
✓ Changes in appetite or weight
✓ Fatigue or loss of energy nearly every day
✓ Difficulty concentrating, making decisions, or remembering
✓ Feelings of worthlessness or excessive guilt
✓ Physical symptoms like headaches, digestive problems, or chronic pain
✓ Withdrawing from friends, family, or social activities
✓ Thoughts of death or suicide
✓ Difficulty functioning at work, school, or in relationships

If you’re experiencing thoughts of suicide, please call 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room immediately.

You Don’t Have to Face Depression Alone

Depression is treatable, and you deserve support. With the right help, you can:

Regain energy and motivation
Rediscover enjoyment in life
Develop effective coping strategies
Improve relationships
Function better at work and at home
Build resilience against future episodes

Ready to Begin Your Journey to Recovery?

Take the first step towards feeling better. Dr. Estupinian provides expert, compassionate care in a safe, non-judgmental environment where you’ll be truly heard and understood.

Call today (844) 802-6512

[Book Your Appointment Online →]

Evening and weekend appointments available. Virtual sessions are offered in California, Oregon, Florida, and Illinois.

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Have Questions?

Call our office, and our friendly and knowledgeable staff will help you get the answers you need

844-802-6512

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The Office of Ginny Estupinian Ph.D. ABPP

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