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» Provider Directory » Find a Therapist » New York » Katonah Therapists » Therapist Profile


Laura Baldwin O'Keefe, LCSW

Understanding Depression

Depression is a disturbance in mood characterized by varying degrees of sadness, disappointment, loneliness, hopelessness, self-doubt, and guilt. Most people tend to feel depressed at one time or another, but some people may experience these feelings more frequently or with deeper, more lasting, effects. In some cases, depression can last for months or even years. The most common type of depression is what is referred to as "feeling blue” or "being in a bad mood.” These feelings are usually brief in duration and have minimal or slight effects on normal everyday activities. In the next level of depression, symptoms become more intense and last for a longer period of time. Daily activities may become more difficult…but the individual is still able to cope with them. It is at this level, however, that feelings of hopelessness can become so intense that suicide may seem the only solution. A person experiencing severe depression may experience extreme fluctuations in moods or even a desire for complete withdrawal from daily routine and/or the outside world.

Symptoms of Depression

Depression may affect one’s life in any of the following ways; Crying spells or, at the other extreme, lack of emotional responsiveness.

Changes in Feelings and/or Perceptions

  • Inability to find pleasure in anything.
  • Feelings of hopelessness and/or worthlessness.
  • Exaggerated sense of guilt or self-blame.
  • Loss of sexual desire.
  • Loss of warm feelings toward family or friends.

Changes in Behavior and Attitudes

  • Lack of interest in prior activities and withdrawal from others.
  • Neglect of responsibilities and appearance.
  • Irritability, complaints about matters previously taken in stride.
  • Dissatisfaction about life in general.
  • Impaired memory, inability to concentrate, indecisiveness, and confusion.
  • Reduced ability to cope on a daily basis.

Physical Complaints

  • Chronic fatigue and lack of energy.
  • Complete loss of appetite, or at the other extreme, compulsive eating.
  • Insomnia, early morning wakefulness, or excessive sleeping.
  • Unexplained headaches, backaches, and similar complaints.
  • Digestive problems including stomach pain, nausea, indigestion, and/or change in bowel habits.

Causes of Depression

Depression is often the result of an unhappy event such as the death of a loved one. When the source of depression is readily apparent and the person is fully aware of it, the individual can expect the reaction to moderate and then fade away within a reasonable amount of time. In cases where feelings of depression exist with no apparent source or the source is unclear, the depression may get worse because the person is unable to understand it. This sense of loss of control may add to the actual feelings of depression.

Any number of stressors may be involved in depression. These can include personality, environmental, or biomedical factors. Shortages or chemical imbalances in the brain may play a significant role in some cases of depression. Such imbalances may be created by illness, infections, certain drugs (including alcohol and even prescribed medications) and improper diet and nutrition. In general, depression may be viewed as a withdrawal from physical or psychological stress. Identifying and understanding the underlying causes of such stress is a necessary step in learning to cope with depression.

Helping Yourself

Being honest with yourself about changes in mood or the intensity of negative feelings as they occur will help you identify possible sources of depression or stress. You should examine your feelings and try to determine what is troubling you — relationships with family or friends, financial responsibilities, and so forth. Discussing problems with the people involved or with an understanding friend can sometimes bring about a resolution before a critical stage of stress is reached. Even mild depression should be dealt with if it interferes with your effectiveness. You might also try to:

  • Change your normal routine by taking a break for a favorite activity or something new — even if you don’t feel like it;
  • Exercise to work off tension, improve digestion, help you relax, and perhaps improve your ability to sleep;
  • Avoid known stressors;
  • Avoid making long-term commitments, decisions, or changes that make you feel trapped or confined — it is better to put them off until you feel you are better able to cope; and
  • See a physician, especially if physical complaints persist.

Helping a Depressed Friend

Since severely depressed individuals can be very withdrawn, lethargic, self-ruminating, and possibly suicidal, a concerned friend can provide a valuable and possibly life-saving service. Talking candidly with the individual regarding your concern for his or her well being will often bring the problems out into the open.

As you talk with your friend, the American College Health Association advises the following:

  • Do not try to "cheer up” the individual.
  • Do not criticize or shame, as feelings of depression cannot be helped.
  • Do not sympathize and claim that you feel the same way as he or she does.
  • Try not to get angry with the depressed individual.

Your primary objective is to let the person know you are concerned and willing to help.

If feelings of depression appear to turn to thoughts of suicide, urge the individual to seek professional help. If the person resists such a suggestion and you feel that suicide is likely — seek professional help yourself, so you will know how to best handle the situation.

Depression Questionnaire:  

When Professional Help is Necessary:

Depression is treatable and needless suffering of those who experience it can be alleviated. A mental health professional should be consulted when an individual experiences any of the following circumstances:

  • When pain or problems outweigh pleasures much of the time;
  • When symptoms are so severe and persistent that day-to-day functioning is impaired; and/or
  • When stress seems so overwhelming that suicidal thoughts are present.


Laura Baldwin O'Keefe, LCSW, Katonah

 Practice Locations
Katonah, NY 10536
Mount Kisco, NY 10549
Bedford, NY 10506

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Understanding Depression

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Last Modified: 4/1/2020  

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