Approached with patience rather than urgency.

What It Looks Like

Not sadness. Expense.

People expect depression to feel like grief and are surprised when it feels like cost. Getting up costs something. Answering a message costs something. The things you used to want are still recognizably good and you cannot find the appetite for any of them.

It is often invisible from outside, because the competent part of you keeps operating. Work still gets done. Calls still get returned. What has gone quiet is the part that used to look forward to things, and its absence is difficult to explain to people who ask how you are.

Some of what gets called depression here is closer to a life that has stopped meaning anything, and some of it is not. That distinction matters, and we make it early rather than assuming it.

How We Work

Slow, and without a protocol.

I do not run people through a program. We begin where you actually are, in conversation, taking time to meet and hear from you, so the session does not start with you performing wellness for another hour of your week.

From there the work is a mix. Sometimes cognitive and practical: what you are telling yourself, what you have stopped doing, what a genuinely small next step would be. Sometimes psychodynamic: older material still setting the terms. Sometimes somatic, because a body that has been flat for a year has learned that flatness as a habit.

Patience is a method here, not a mood. Pushing a depressed person to move faster reliably produces one more piece of evidence that they are failing, and I have no interest in supplying that.

What Changes

Appetite returns before energy does.

Usually the first sign is small and specific. Wanting to hear a particular record. Noticing the light on a drive you have made a thousand times. People often dismiss these as irrelevant. They are not irrelevant, and part of my job is to say so.

We also work on what to do on the days that are still heavy, because those days will keep arriving for a while and the plan for them matters as much as the good ones.

I make no claim about how long this takes or how far it goes. Individual outcomes vary, and any counselor who tells you otherwise is selling something.

Practical

How the work runs.

Sessions are 60 minutes by secure video, anywhere in North Carolina, most often weekly to begin with. Adults 18 and over, most between 30 and 75. Availability is Monday, Tuesday, Thursday and Friday.

I work alongside prescribers when medication is part of your care, and I do not prescribe.

I am not a crisis service. If you are in immediate danger, call or text 988, call 911, or go to your nearest emergency room. I also do not treat addictions or eating disorders and will refer you out if either is the primary concern.

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