In-person in Houston, online across Texas • In-network with Aetna, BCBS, Cigna, UHC/Optum, Tricare, Curative, Oscar • Therapy in English, Spanish, Portuguese, Farsi
Depression & Low Mood
Depression Therapy in Houston, TX
Depression is a term currently used for numbness, emptiness, loss of desire, a heaviness present in the background, and a sense of absence from one's own life. Some of these states remit and recur episodically, while others have persisted so long that the person no longer remembers being otherwise. Applying a single treatment plan to all of them is one reason so much treatment fails.
We want to establish when the depression began, what it may be concealing, and how it has shaped the person's days and relationships. Depression therapy at Real Talk is provided in person and online across Texas.
How We Work With Depression
Depression is more than a deficit of energy. It is a position the person has come to occupy in life, sometimes in relation to a loss that was never mourned, sometimes in relation to demands that could not be met, sometimes in relation to a version of themselves they have relinquished. The treatment works to understand that position, not simply to elevate mood. This tends to be slower than symptom management, and in our experience it is what allows change to be sustained.
We treat major depressive episodes, persistent depressive disorder, depression within bipolar disorder, and depression that has not responded to previous treatment. Where medication is part of the treatment, we coordinate with the prescriber.
Presentations We See
A first depressive episode. Recurrent depression, in which each episode has left residue and the person has organized their life around preventing the next. Persistent depressive disorder, the chronic low-grade form that patients often describe as their temperament. Depression secondary to loss, diagnosis, childbirth, or relocation. Bipolar depression, where treatment must account for the full cycle and for the risks of mistreating one pole. Depression that once presented as burnout and was managed as such. Depression that is related to unresolved grief. And the patient who is not in crisis but knows that something has gone out of their life and has not returned.
What We Pay Attention To
We pay attention to what the depression is about and to what it is connected. We attend to what it has rendered impossible to say or to want, to the history of the person's losses, and to what they were taught about what they were permitted to need. And we attend to risk continuously.
Why Doctoral Training Matters for Depression: Doctoral training matters most when depression is chronic or recurrent, when it is comorbid with anxiety, trauma, or serious relational difficulty, when the presentation is atypical or complicated by medical factors or bipolar illness. It also matters in outpatient care for patients following hospitalization, which requires a clinician who can sustain treatment through a difficult period rather than refer out at the first sign of deterioration.
Depression Therapy in Houston: Our Clinicians
Our clinical director reads every inquiry and recommends a clinician within minutes on weekdays, hours on weekends.
Questions About Depression Therapy
I have been on medication for years and still feel this way. Can therapy help?
Frequently, yes. Medication can reduce the weight of depression without addressing what it is about. That is usually where this work begins.
Do you work with bipolar disorder?
Yes. Several of our clinicians have experience with bipolar depression and with outpatient care following hospitalization. We coordinate with psychiatry.
How does this differ from what my primary care physician offered?
Primary care screens and prescribes, appropriately. Here the depression is listened to over time by a clinician trained to understand what maintains it.
Reading For Deeper Thinking
Shon Faye. Depression Is a Haunting.
Vogue, 2024. Read here.
Susanna Schrobsdorff. Depression Is a Pandemic.
Time, 2021. Read here.
John Welwood. Depression as a Loss of Heart.
The Sun, 1988. Read here.