• Clinical or situational. Depression is a general feeling of sadness and may refer to a chemical imbalance that may be alleviated by medication and may be inherited. Situational depression is when your depression is a direct result of something that is happening now or has happened in the past. This also may be helped by medication.
  • Chronic or acute. Chronic depression is when you have a depressed feeling most of the day and/or most days. Acute or severe depression is when you have a deep and unrelenting feeling of sadness that will not ease. 
  • Mild or Major. Depression can be mild in which case it is not interfering with your daily living. In major depression you have great difficulty performing daily activities. 



  • Suicidality includes thinking about ending your life (suicidal ideation), or attempting to end your life. This is always very serious. It is not a manipulation. Talking about it doesn’t mean the person is not going to act on it. Anyone who is thinking about or talking about ending their life should be referred to a mental health professional or the National Suicide Hotline at 800.273.8255. Not often talked about is passive suicidality which includes engaging in high risk behavior that could result in death.

    • Self-harm 
      • Self- harm aka self-injury is not a diagnosis but is a sign of emotional distress. It is serious but  not necessarily directly related to suicidality. It offers an immediate relief from emotional pain but results in shame and ultimately to the return of the painful emotions. It may occur only once or be habitual. In any case it should be directed to a mental health professional It can lead to life threatening injuries.
    • Relationship Issues 
      • Issues in any relationship is a huge stressor and a loss of emotional stability and support. It refers to strained, high conflicted or broken relationships with another person or people. Although I do not work directly with couples, I will consider a few sessions with another person to work on a particular issue. These relationships include but are not limited to:
        • Child
        • Parent
        • Partner
        • Workplace