Depression Doesn’t Happen Just In the Winter. S.A.D.

Here’s What to Know About Summertime Sadness (S.A.D.)

June 5, 2018 – While classic winter S.A.D. is confusing, summer SAD is even trickier. By most estimates, between 5% and 10% of the U.S. population experiences S.A.D.,,Seasonal Affective Disorder.  But only a small portion of Americans, somewhere around 1% of the total population, have flare-ups in the summertime, says Dr. Norman Rosenthal, a SAD expert and a clinical professor of psychiatry at the Georgetown University School of Medicine.

Whenever it occurs, SAD can be a difficult condition to diagnose. It’s defined as major depression that follows a seasonal pattern for at least two years, according to the National Institutes for Mental Health. But since it’s a subtype of @depression, rather than a completely distinct condition, it can be hard to tell whether symptoms such as dips in mood and energy, sleep issues, feelings of hopelessness or worthlessness, changes in appetite and difficulty concentrating point to SAD or another type of depression. It can also be difficult to distinguish between true SAD and the less severe “winter blues.”


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Advantages and Disadvantages of Online Counseling and In-person Counseling


Did you know that only a limited number of people who are referred by a physician to seek mental health services ever receive those services? Why is this?

Is it because they do not want to get well, or are there other factors? As you might guess, the reasons are many; and among them is the problem that acquiring counseling services is too difficult. Consider this. A man suffering from depression, to receive counseling must:

  1. Overcome his apprehension, embarrassment and fear of seeking counseling
  2. Come to terms that people in his community might find out he is in therapy
  3. Locate and research reputable local counseling services
  4. Make contact with a service (usually by phone) to schedule a session
  5. Accept, if insurance is to be used, that he will be diagnosed with a psychological disorder that will go in his health record
  6. Maintain motivation and courage while waiting for a scheduled session—the wait is often weeks or longer
  7. Execute his intentions of arriving at the counseling appointment (which may necessitate taking time off work).

For a person struggling with even common life-issues, this is a copious series of tasks. And what’s more, we—as counselors—cannot do much to make it easier. We often have long waiting lists for new clients, slow intake processes, and business hours that conflict with client work schedules. We have no option but to allow clients to suffer social stigma, to require them to travel to an unfamiliar place; to arrive promptly and presentably, all while battling depression, anxiety, grief, or perhaps the greatest personal crises of their lives.

And still we wonder, “Why is the compliance rate so low?”

Perhaps you’ve noticed these problems. If so, you’re among a growing number of counselors who are considering taking on the challenge of providing therapy services though methods such as telephone, email, text-chat, and even videoconference. Remember though, online counseling is more than an alternative for clients who “just can’t make it in” for in-person counseling.

The table below lists many suggested benefits of online counseling, aside from convenience.

In-person counseling


Has proven to be effective over many years of research and study

New research shows eCounseling to be effective, and sometimes more effective than in-person counseling

Has proven to be effective for building rapport/relationship between counselor and client

New research shows eCounseling is effective for building rapport/relationship between counselor and client.

A client has 45-50 minutes to tell his/her story

A client has unlimited amounts of time to detail his/her story by email.

Persons are often seen by members of their community at the counseling office

Due to the distance of the counselor , and absence of the counseling office, social stigma is eliminated

Clients can seek out the best counselor in their area

Clients can look outside their area for an excellent counselor

Client and counselor must show up during a designated time and at a designated location

Client and counselor do not meet at a designated place, and sometimes there is no designated time

Rates can be expensive, especially in urban areas

Clients benefit from lower overhead costs of counselors

Usually takes place during business hours: 9-5, Monday-Friday

Has potential for extended and flexible hours

Is difficult for the sick or immobile

Is accessible to homebound and ailing persons

There is risk of counselor sexual or social misconduct

There is less potential for counselor sexual or social misconduct

Are often client waiting lists

A counselor is always available

A counselor might not be experienced with the client’s presenting problem

Clients can search far and wide for a counselor experienced with their problem issues

Counselor may not be knowledgeable of the client’s ethnicity or language

Clients can select a counselor knowledgeable of their ethnicity and language

Client needs to overcome their apprehensions and fears of seeking counseling

Feeling more anonymous, clients with apprehensions and fears are more likely to seek counseling

Is ideal for clients who communicate well verbally

Is ideal for clients who communicate well verbally or by writing

Clients commit time to commuting, and often the ‘waiting room’ experience

Client time is spent on counseling issues

Clients feel an empty space between sessions

With email, there is no “end” to a conversation, so clients feel continually in dialog with their counselor

Clients may be intimidated by the counselor

Clients are less likely to feel intimidated by the counselor

Clients may forget their feelings, resolutions, and commitments spoken in session

Clients are able to save writings regarding their feelings, resolutions, and commitments

Clients might forget a counselor’s guidance and advice

Clients are able to save counselor’s guidance and advice, if it is in writing

Clients might not see clearly their progress

Saved text is a testament to a client’s treatment progress.

Therapy by Phone Good Against Depression




By Kristina Fiore, Staff Writer, MedPage Today

Published: June 05, 2012

Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Action Points

  • Although psychotherapy effectively treats depression and is preferred to antidepressants by many primary care patients, only a small percentage of patients follow through and the attrition rate is high. This randomized study examined the efficacy of telephone-administered cognitive behavioral therapy of patients with major depressive disorder.
  • Note that the study found that providing cognitive behavioral therapy over the telephone compared with face-to-face resulted in lower attrition and close to equivalent improvement in depression, but at the cost of some increased risk of poorer maintenance of gains after treatment cessation.
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Novel Therapies for Cognitive Dysfunction Secondary to Substance Abuse; Brief Screening, Referral, and Cognitive Rehabilitation

Novel Therapies for Cognitive Dysfunction Secondary to Substance Abuse;  Brief Screening, Referral, and Cognitive Rehabilitation

Advances in the fields of neuropsychological assessment and neuroimaging have enormously expanded our knowledge about the profile and severity of cognitive deficits in patients with substance use disorders. Neuroscience studies have complemented this knowledge by revealing the neural adaptations induced by different substances (dopamine, glutamate, or serotonin) on specific cellular systems and by showing the structand dynamics of brain systems, including frontostriatal systems and paralimbic networks involved in motivation and cognitive control.1,2

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Activity: The Antidote to Depression

Activity: The Antidote to Depression

Most individuals who suffer from depression believe, “Once I feel better, I’ll start calling friends again/making dinner plans/playing golf/planning a vacation/etc., but right now, I just don’t have the will.” Most of these people are not aware of the research, conducted in numerous Cognitive Behavior Therapy studies, that has consistently demonstrated that those who suffer with depression have to put the cart before the horse. That is, in order to feel better, depressed people need to start getting actively re-involved with life right away even though they may not want to or believe they can.

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The Therapist Will See You Now, via the Web

SEE a therapist without leaving your home?

In an article in the American Journal of Psychiatry, Dr. Thomas F. Dwyer, a Massachusetts psychiatrist, says he has practiced “telepsychiatry,” via video teleconferencing, for five years. Its “adoption by psychiatrists and patients,” he predicts, “will proceed quickly if the organizers cope with the irrational responses of some users.”

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Who Needs DSM-5? A Strong Warning Comes From Professional Counselors

By Allen Frances, MD | June 8, 2011

I just received a very important email from Dr Dayle Jones who chairs the DSM-5 Task Force of the American Counseling Association (ACA). Counselors provide a wide range of therapy, rehabilitation, and support services in very varied settings (like colleges, community mental health centers, psychiatric hospitals, substance treatment agencies, and private practice).

There are more than 115,000 licensed professional counselors in the United States (far outnumbering the 40,000 psychiatrists as users of DSM). They (along with the 93,000 psychologists, 53,000 marriage and family therapists, and 198,000 social workers) have a deep interest in how DSM-5 will affect daily work with clients.

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Peer support – cheaper and just as effective as CBT

April 29, 2011

Train ordinary people to be more compassionate and psychologically helpful to each other. They could do as good as job as CBT therapists for depression and anxiety, argues psychotherapist Nicky Forsythe


I first became fascinated by the power of what I will call ‘educated peer support’ when I was training as a therapist in 1998.  Just a few months into an experiential group training, twenty-four of us had learned the essential skills of self-awareness, separating feelings from facts, articulating our inner experience, and providing the therapeutic experience of what is called ‘accurate empathy’ to one other. 

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Online Counseling: Can Online Counseling Help Me?


Online counseling, also known as e-therapy, is a relatively new development in the helping profession. Most people need some form of help at different points in their lives, and yet, sharing personal problems with a professional therapist over the internet or phone is new.

  • Are you one of those busy moms who has trouble finding a babysitter?
  • Are you a dawn to dusk professional who has no time to think, let alone visit, with a therapist to talk about a troubling personal or relationship issue?
  • Do health or distance issues make it hard to get to someone who can help you solve a personal dilemma?

If so, online counseling may be worth exploring to find out if it can provide you with the help that you need. You can receive help from the privacy of your own home and, if it is email therapy, you can start right away.

A lot of research shows that online counseling has success with many problems that clients face. It can be as effective as visiting a therapist’s office and yet is often less costly and may be available around the clock.

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