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Areas of Expertise


Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home.

Depression symptoms can vary from mild to severe and can include:

  • Feeling sad or having a depressed mood

  • Loss of interest or pleasure in activities once enjoyed

  • Changes in appetite — weight loss or gain unrelated to dieting

  • Trouble sleeping or sleeping too much

  • Loss of energy or increased fatigue

  • Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable by others)

  • Feeling worthless or guilty

  • Difficulty thinking, concentrating or making decisions

  • Thoughts of death or suicide

Symptoms must last at least two weeks and must represent a change in your previous level of functioning for a diagnosis of depression.

Also, medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency) can mimic symptoms of depression so it is important to rule out general medical causes.

Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can occur at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime. There is a high degree of heritability (approximately 40%) when first-degree relatives (parents/children/siblings) have depression.



When someone has an anxiety disorder, their body goes into fight or flight mode at times when a neurotypical person wouldn't. This may be due to specific environmental or emotional triggers, or it may be less easy to spot a cause. The person experiences anxiety, fear and panic. It can also be very scary in itself to feel your body sort of slipping out of your control, having this fear response when your rational mind can't see a cause - and then, because that's scary, it makes you have an additional fear response. The body has physiological responses to fear that are fairly well-known. These include things like your mouth drying up and throat/stomach tightening, as your body turns off digestion systems to divert energy elsewhere, an increase in adrenaline (which has several different effects on the body, from a bitter taste in the mouth to being much more jittery), you can get tingling/pins-and-needles feelings in your extremities as your body focuses on core functions, your breathing quickens to get more oxygen into your blood. During an anxiety attack, the body experiences some or many of these changes, in addition to changes in the way you think which can create a vicious cycle that increases the anxiety/fear response.

Gender Issues

Gender Dysphoria is when your brain's identity for what gender you should be doesn't match your body. For pretty much everyone alive, we don't know what that feels like because our brains match our bodies. But there are studies showing that transgendered people have different brain chemistry than cisgendered people, that it's a case of their having a male brain in a female body, or vice versa, and because of that, they get feelings of being wrong, of awkwardness. A voice that continues to remind them that there is something wrong.

Like having the wrong hardware installed in your computer, and continuing to get driver error messages all the time, but you don't have another video card and everyone else is telling you that HP laptops are fine and they don't have problems so obviously you're just complaining, or should just learn to deal with a few pop up screens once in a while.

Trauma and PTSD

Imagine the brain is the needle on a record player. When a record is playing normally, that is like your brain processing events. Just playing along. Then it gets a deep scratch on the record. That is the trauma. The needle can’t get past it, so it just keeps replaying and responding as if it is going through the trauma. That is really hard on the brain and the body, so it starts to show signs of wear and breaking down... but it can’t get past that trauma so it is just skipping in it, trying to process and continue.

That is PTSD.

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