Depression Therapy

Depression Therapy in Frederick, MD

Trauma-informed care for depression with roots in loss, shame, or earlier experiences.

Reviewed by Sarah Martin, LCPC, Clinical Director Last updated April 25, 2026 8 min read

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What is depression?
Depression and trauma
Common forms depression takes
Does this sound like you?
How we treat depression
When to reach out
Frequently asked questions

If you are having thoughts of harming yourself, please call or text the 988 Suicide and Crisis Lifeline, available 24/7. If you are in immediate danger, call 911. The information on this page is meant to support people considering ongoing therapy and is not a substitute for crisis care.

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Does any of this sound like you?

You get out of bed, get through the day, and still feel like nothing in it reached you.
The things you used to look forward to are still on the calendar, but you can't find the wanting anymore.
Some version of this has been with you so long you're not sure who you'd be without it.
You keep telling yourself you should be past this by now, and that voice is sharper than it used to be.
You pulled back from people you love, and now you don't know how to find your way back in.

We see a lot of depression that has roots. Loss that didn't get to finish, shame that started earlier than the current chapter, a heaviness that has been quietly present for as long as you can remember. The work here goes underneath the mood to whatever is actually holding it in place, at a pace your body can stay with.

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What is depression?

Depression is a clinical condition that involves persistent low mood, loss of interest or pleasure, and changes in how a person sleeps, eats, thinks, and functions, lasting for weeks or longer. It is not the same as ordinary sadness, even though sadness is part of how depression often shows up. Depression affects how the body operates as much as how the mind feels.

Depression is one of the most common mental health conditions worldwide. The National Institute of Mental Health estimates that around 8% of U.S. adults experience a major depressive episode in any given year, and CDC data indicate roughly one in five U.S. adults will experience depression across their lifetime. The shape of depression varies. For some it is heavy and steady. For others it comes and goes. For others it lives more in the body than in the mood. All of these are real and all of them respond to treatment.

Depression is treatable. That does not mean it is always easy to treat or that one approach works for everyone. Some depression responds quickly to therapy. Some takes longer. Some benefits from a combination of therapy, medication, and other supports. The work begins with understanding what's actually driving your specific experience.

Why depression often connects to trauma and unresolved loss

Many people who come to us for depression have a history that includes specific painful experiences: loss, rejection, failure, betrayal, shame, or trauma in childhood or adulthood. The depression in their present life is often connected to those experiences in ways that have not been fully resolved. The body and mind kept moving forward without finishing the work of processing what happened. Long-running cohort research shows that early adverse experiences significantly increase lifetime risk of depression, partly through lasting changes to the body's stress response system.

When depression has roots like this, addressing only the present-day symptoms (managing thoughts, building habits, behavioral activation) often helps but sometimes hits a ceiling. Below the level of "what I'm thinking" sits the level of "what my body and nervous system are still carrying." A trauma-informed approach works at both levels, which is part of why this kind of work tends to help with depression that has been more entrenched.

That said, not all depression is trauma-driven. Some people experience depression with primarily biological roots: family history, hormonal contributors, the long arc of seasonal patterns, or post-illness depression that follows a medical event. Some depression is connected to current life circumstances that are objectively heavy. Therapy can help across the range, and the right approach depends on what's actually underneath.

Common forms depression takes

Depression doesn't show up the same way in everyone. The categories below are useful for understanding what you might be experiencing. You don't need a formal diagnosis to benefit from therapy.

Major depressive episodes

Periods of significantly lowered mood lasting at least two weeks, often much longer, marked by persistent sadness, loss of pleasure, changes in sleep and appetite, fatigue, difficulty concentrating, and sometimes thoughts of death or self-harm. May happen once or recur in episodes across a lifetime.

Persistent depression (dysthymia)

A lower-grade but longer-lasting form of depression, often present for years and sometimes most of a person's life. The symptoms are typically less acute than a major depressive episode but more chronic. Many people with persistent depression say they don't remember a time without it.

Postpartum and perinatal depression

Depression that emerges during pregnancy or in the months after birth. It is common, distressing, and treatable. It is also distinct from "baby blues," which typically lift within two weeks. Postpartum depression that lasts longer or interferes with bonding, sleep, or function deserves professional support.

Grief that has become depression

Grief is not depression, but grief can sometimes evolve into depression, particularly when the loss was sudden, traumatic, or complicated by unresolved feelings. The line between active grief and depression rooted in unresolved loss is not always clear, and a clinician can help you tell them apart.

Treatment-resistant depression

Depression that has not fully responded to previous treatment is sometimes called treatment-resistant. The label can feel discouraging but is often a sign that a different angle is needed. A trauma-informed approach can help when more cognitive or symptom-focused work has not been enough, particularly if there is unprocessed material in the background that earlier treatment did not reach.

Does this sound like you?

Some of the felt experiences that bring people to depression therapy:

Persistent low mood, sadness, or emptiness that has lasted weeks or longer
Loss of interest or pleasure in things that used to matter to you
Heavy fatigue that doesn't improve with rest
Sleep that has shifted: too much, too little, or never quite restful
Changes in appetite or weight
A persistent inner critic or sense of being fundamentally not enough
Difficulty concentrating, making decisions, or remembering things
Withdrawal from people you used to feel connected to
A sense that the future feels closed off or pointless

If any of that resonated, you are in a reasonable place to consider therapy. And if you're not sure yet, that's fine too. A consultation can help you sort through what you're experiencing.

How we treat depression

Depression responds to several evidence-based approaches. The right one depends on what's underneath your specific depression, your history, and what feels right to you.

EMDR therapy

EMDR can be effective for depression when there is identifiable underlying material driving it: specific painful events, unresolved loss, persistent shame connected to earlier experiences, or trauma. EMDR helps process those memories so they stop feeding the cycle of low mood and negative self-belief. It does not erase what happened. It changes your relationship to it. For more on the protocol itself, see how EMDR works.

Attachment-based and relational work

For depression with roots in early caregiving, attachment patterns, or relational wounds, work that engages those patterns directly can shift what cognitive approaches alone leave untouched. This often happens in parallel with other modalities rather than instead of them.

When medication is part of the picture

For moderate-to-severe depression, medication is often a useful part of treatment, particularly when symptoms are heavy enough that engaging in therapy itself feels out of reach. The APA's clinical practice guideline for depression notes that combined therapy and medication generally outperforms either alone for more severe presentations. Medication does not replace therapy; it can make therapy more accessible. Many of our clients work with us on the therapy side while seeing an outside prescriber for medication. Whether medication is right for you is a conversation between you, your therapist, and a prescriber. We also offer medication management directly through our practice.

When to reach out

If you have been wondering whether what you're experiencing is depression and whether therapy might help, that is reason enough to start a conversation. You don't need a diagnosis. A consultation can help you sort through what's going on and what kind of support fits.

Some signs that point more clearly toward needing professional support: low mood that has lasted more than two weeks, loss of interest in things you used to care about, persistent sleep or appetite changes, hopelessness, withdrawal from people, or thoughts that the world would be better without you in it. The last one in particular is reason to seek help right away rather than wait.

Depression often tells you that reaching out won't help, that you're not worth the effort, or that you should wait until you feel better before calling anyone. That is the depression talking, not the truth. If reaching out feels right, we would be glad to help. If it doesn't yet, that's fine too, and the door stays open.

If you are having thoughts of harming yourself

Outpatient therapy is meant for ongoing work and is not the right tool for an active crisis. Please call or text the 988 Suicide and Crisis Lifeline, available 24/7. If you are in immediate danger, call 911 or go to your nearest emergency room. Once you are stable, ongoing therapy can be part of how you build a different relationship with these thoughts.

Frequently Asked Questions

What's the difference between depression and sadness?

Sadness is a normal emotional response to a specific situation that lifts as the situation eases or as time passes. Depression is more persistent, more pervasive, and harder to shift through ordinary means. It typically lasts at least two weeks (and often much longer), affects sleep, appetite, energy, and concentration, and brings persistent thoughts of worthlessness or hopelessness. Depression is a clinical condition; sadness is part of being human.

Can EMDR help with depression?

Often yes, particularly when depression is connected to specific painful experiences (loss, rejection, failure, shame, traumatic events). EMDR can help process the underlying memories so they stop feeding the cycle of low mood and negative self-belief. EMDR is most effective for depression when there is identifiable material driving it; for depression with primarily biological roots, other approaches and medication often play a larger role.

How long does depression therapy take?

It depends on the depth and duration of the depression and what's underneath it. Some people see significant improvement in three to six months of regular therapy. Long-running depression with deeper roots typically takes longer, often a year or more of consistent work. Your therapist will check in with you about progress and adjust the plan as the work develops.

Do I need medication for depression?

It depends on what's driving the depression and how severe the symptoms are. Many people benefit from therapy alone. Some find that medication, particularly for moderate-to-severe depression, makes therapy more accessible and the broader work more possible. Whether medication is right for you is a conversation between you, your therapist, and a prescriber. We do not require medication for anyone, and we coordinate with outside prescribers when medication is part of the picture.

Is depression therapy covered by insurance?

Yes, in most cases. Depression is a recognized clinical diagnosis and therapy with a licensed mental health professional is typically covered. Coverage depends on your specific plan and diagnosis. We accept CareFirst BCBS and offer self-pay options. Contact your insurance provider to verify your mental health benefits.

Can therapy help if my depression keeps coming back?

Often yes, though the work may look different than for a first episode. Depression that has been recurrent or treatment-resistant often benefits from approaches that go below the symptom level to the underlying patterns: trauma history, attachment patterns, chronic shame, unresolved grief. A trauma-informed approach can help when more cognitive or symptom-focused work has not been enough. That said, some depression responds best to a combination of therapy, medication, and other supports; your therapist can help you think through what fits.

Can I do depression therapy via telehealth?

Yes. Depression therapy translates well to telehealth, including EMDR. Some clients find video-based therapy easier to keep up with when getting out of the house feels heavy, which is a common experience with depression. We have a separate page on telehealth therapy with more detail on how it works.

What if I'm thinking about hurting myself?

Outpatient therapy is meant for ongoing work and is not the right tool for an active mental health crisis. If you are having thoughts of harming yourself, please call or text the 988 Suicide and Crisis Lifeline, available 24/7. If you are in immediate danger, call 911 or go to your nearest emergency room. Once you are stable, ongoing therapy can be part of how you build a different relationship with these thoughts.

Clinically reviewed by

Sarah Martin, LCPC, NCC

Clinical Director, Trauma Specialists of Maryland

Sarah is a Licensed Clinical Professional Counselor and Board Certified Counselor with over 8 years in the mental health field. She is trained in EMDR, and works with clients across the range of mood presentations, including depression rooted in earlier experiences, unresolved loss, and trauma history.

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If you'd like to talk through what you're experiencing

A consultation can help you figure out whether therapy is the right next step and, if it is, who on our team would be a good fit. Reaching out is its own kind of brave, and we know that.