Therapy for

Coping with Depression

in San Francisco and California

Struggling with persistent sadness, lack of motivation, or feeling empty even when everything looks fine? You're not alone. As a California psychologist specializing in depression therapy, I help women throughout California manage depression, low mood, and the exhaustion of just getting through the day through online therapy.

Get Started

Woman by a placid lake - depression therapy in CA

My Approach to Depression Therapy

My work is warm, direct, and integrative. I use a combination of attachment theory, relational psychodynamic work, and Cognitive Behavioral Therapy (CBT) to address both the symptoms and the root causes of depression. Depression rarely exists in isolation—it's often connected to deeper patterns, unresolved grief, relationship struggles, and feelings of disconnection from yourself and others.

I offer online individual therapy and couples therapy for depression throughout California. All sessions are conducted via secure video platform (Zoom) from wherever you feel most comfortable. This work isn't about forcing positivity or "just thinking happy thoughts"—it's about understanding what your depression is telling you and building the capacity to feel alive again.

Unlike approaches that focus only on symptom management, my goal is to help you make lasting change by:

Understanding the Roots

We explore why your depression shows up, connecting past experiences, losses, and relationship patterns to your present struggles so you have more clarity about what you need.

Reconnecting with Yourself

We work on rebuilding connection—to your feelings, your needs, your body, and the parts of yourself you've been disconnected from.

Building Sustainable Energy

Therapy helps you develop realistic strategies for managing low energy, motivation struggles, and the practical challenges of living with depression.

What is Depression?

Depression is more than just feeling sad. It's a persistent low mood, loss of interest in things that used to matter, and a sense of heaviness that affects your energy, sleep, appetite, and ability to function. Depression can make even small tasks feel overwhelming, and it often comes with harsh self-criticism and feelings of worthlessness.

Common depression symptoms include:

Persistent sadness, emptiness, or hopelessness
Loss of interest or pleasure in activities you used to enjoy
Fatigue and lack of energy, even after rest
Difficulty concentrating, making decisions, or remembering things
Sleep disturbances (sleeping too much or too little)
Appetite changes (eating too much or too little)
Feelings of worthlessness, excessive guilt, or self-blame
Withdrawal from friends, family, and activities
Physical symptoms: headaches, body aches, digestive issues

Woman on a hike in the moutanis taking a break sitting on a rock - Online therapy in CA

Depression in Women

Women are twice as likely as men to experience depression. This disparity is partly biological (hormonal fluctuations affect mood), but also cultural and social. Therapy for women with depression addresses both individual symptoms and the broader context of gendered expectations and pressures.

Cultural Factors and Gender Roles

Women often face unique stressors that contribute to depression:

Pressure to manage emotional labor and mental load in relationships
Difficulty setting boundaries due to socialization to be "nice" and accommodating
Perfectionism in balancing career, relationships, and family
Body image struggles and societal appearance standards
Caregiver burden and difficulty prioritizing self-care

Depression and Hormonal Changes

Hormonal changes during menstrual cycles, pregnancy, postpartum, and perimenopause can trigger or worsen depression. Many women experience:

Premenstrual Dysphoric Disorder (PMDD)
Postpartum depression
Perimenopause depression

Types of Depression.

Persistent low mood, loss of interest, and significant impact on daily functioning lasting two weeks or longer.
Chronic low-grade depression lasting years. You function, but never feel quite right.
Depression following childbirth, beyond typical "baby blues," affecting bonding and functioning.
Depression that follows seasonal patterns, typically worse in fall/winter months.
Depression and anxiety occurring together, creating a cycle of worry and low mood.
Depression triggered by specific life events (breakup, job loss, major transition) that feels overwhelming.

Woman swimming in a lake, trying to overcome burnout - therapy for people pleasing

Causes and Risk Factors for Depression

Biological and Genetic Factors.

Research shows that depression has a genetic component. If you have family members with depression, you're more likely to experience it yourself. Brain chemistry, including neurotransmitter imbalances involving serotonin, dopamine, and norepinephrine, also plays a role in depressive disorders.

Trauma and Stressful Life Events

Past trauma, major losses, chronic stress, or significant life transitions can trigger or worsen depression. This includes childhood trauma, relationship losses, career setbacks, health crises, or accumulated stress over time.

Early Familial Experiences.

Childhood experiences significantly impact adult depression. Neglect, criticism, invalidation of emotions, or growing up in an environment where feelings weren't allowed can create patterns of disconnection and self-suppression. Insecure attachment styles, developed through early relationships, often underlie chronic depression.

Learned Patterns and Beliefs.

Depression can be reinforced by learned patterns: suppressing emotions, harsh self-criticism, difficulty asking for help, or believing your needs don't matter. These patterns become automatic over time, making depression feel like "just how I am."

How I Work With Depression.

I use an integrative approach, which means I pull from multiple modalities depending on what you actually need—not what a manual says should work. The goal isn't to eliminate all sadness or struggle. It's to help you feel like yourself again—to reconnect with what matters, to have energy for your life, and to stop feeling like you're just surviving. Here's what that looks like:

A hand feeling the grass in the wind - therapy for relationship anxiety

CBT focuses on the relationship between your thoughts, feelings, and behaviors. It helps you identify negative thought patterns—catastrophizing, self-blame, all-or-nothing thinking—and develop more balanced perspectives. It's one of the most researched treatments for depression.

But I don't do worksheet-based CBT. I'm not going to hand you a thought log and send you home. Instead, we look at your thinking patterns together in real time. When you say "I'm worthless," I'll stop you and point out that your depression is telling you lies. The goal isn't just challenging negative thoughts—it's understanding why your brain defaults to them in the first place.

Cognitive Behavioral Therapy (CBT)

A woman's eye peaking out from behind a tropical leaf - therapy for depressive mood

Psychodynamic and Attachment Work

This is where we go beneath the surface. Psychodynamic therapy looks at the unconscious patterns and early experiences fueling your depression. Attachment-based work explores how your early relationships—particularly with your parents—shaped your beliefs about whether you matter, whether you're allowed to have needs, and whether it's safe to feel.

If you learned early on that your feelings were too much, that asking for help made you a burden, or that you had to take care of everyone else's emotions—those patterns are likely showing up now as depression. We look at how these old patterns are playing out in your current relationships and self-concept, so you can make different choices. When you understand why you default to self-suppression or emotional shutdown, those patterns lose their automatic power.

Hands holding the seedling of a fern - therapy for depression

Depression disconnects you from your body and present moment. Mindfulness helps you notice what you're feeling—physically and emotionally—without immediately judging or trying to fix it.

Mindfulness isn't about "being positive" or forcing yourself to feel grateful. It's about noticing where depression lives in your body. The heaviness in your chest. The exhaustion in your limbs. The fog in your head. And learning to respond with compassion instead of criticism. I teach practical techniques that help when you're feeling numb or overwhelmed.

Mindfulness and Body-Based Work

Young woman sitting on a grassy hill looking towards the coast - addressing depression in therapy

Behavioral activation is about gradually reintroducing activities that matter to you, even when motivation is nonexistent. Depression tells you to withdraw, but withdrawal feeds depression. We work on breaking that cycle.

I'm not going to tell you to "just go for a walk" or hand you a list of self-care activities. We identify what actually feels meaningful to you—not what Instagram says you should do—and build sustainable, tiny steps toward re-engagement. The goal is rebuilding connection to your life in a way that feels doable, not adding more things to your "should do" list.

Behavioral Activation

Who Benefits from Therapy for Depression

Women with Persistent Low Mood

If you experience:

Feeling sad, empty, or numb most days
Going through the motions but not really feeling present
Crying easily or feeling like you want to cry but can't
Loss of motivation to do things you used to care about
Feeling disconnected from yourself and others

Therapy helps you understand what's beneath the depression, process unresolved emotions, and rebuild connection to yourself and your life.

Women with High-Functioning Depression

If you experience:

Looking fine on the outside but struggling internally
Managing to go to work but barely functioning otherwise
Accomplishing things but feeling empty inside
Exhaustion from pretending you're okay
Guilt about being depressed when "nothing is wrong"

Work focuses on acknowledging the real struggle beneath the high-functioning exterior and addressing what's actually draining you.

Women experiencing Loss of Interest

If you experience:

Nothing feels enjoyable anymore
Activities that used to bring pleasure now feel pointless
Difficulty feeling excited or looking forward to anything
Going through the motions at work, in relationships, in life
Wondering "what's the point?"

Therapy addresses the disconnection and helps you find meaning and engagement again, even when it feels impossible.

Women Dealing with Grief and Loss

If you experience:

Depression following a significant loss (death, breakup, job loss)
Unresolved grief from past losses catching up with you
Feeling stuck in sadness that won't lift
Difficulty moving forward after a major life change
Complicated feelings about loss (relief mixed with guilt, anger mixed with sadness)

Therapy provides space to process grief, validate complex emotions, and find a way to carry loss without being consumed by it.

FAQs about Depression

If depression is interfering with your ability to function, feel present, or enjoy life—even occasionally—therapy can help. You don't have to be "bad enough" to deserve support.
Yes. Depression is highly treatable. Therapy helps you understand patterns, process underlying emotions, challenge negative beliefs, and build practical skills for managing symptoms. Many people see significant improvement within a few months.
Sadness is a normal emotion that comes and goes in response to specific situations. Depression is persistent low mood that lasts weeks or months, affects your functioning, and often includes physical symptoms like fatigue and sleep changes. Depression can exist even when "nothing is wrong."

It varies. Many people begin to notice shifts within the first 2-3 months, but deeper pattern work often takes 6-12 months or longer. The goal isn't quick fixes—it's sustainable change.
Medication can be helpful for some people with depression, particularly when symptoms are severe or getting in the way significantly with how you’re functioning. As a psychologist (not a psychiatrist), I don't prescribe medication, but I can help you determine if a medication consultation might be beneficial and provide referrals to trusted psychiatrists. Many people successfully manage depression through therapy alone, while others benefit from a combination of therapy and medication.
Burnout is typically:
- Related to a specific area of life (usually work)
- Improves somewhat with rest or time away
- Feels more like exhaustion and cynicism than sadness
Depression is typically:
- Affects all areas of life
- Persists even with rest or changes in circumstances
- Includes emotional numbness, worthlessness, and loss of interest
- Accompanied by physical symptoms
If you're unsure, a consultation can help clarify whether what you're experiencing is burnout, depression, or both occurring simultaneously.