Open Circle Counseling

When Depression Won't Let Go: Therapy That Meets You Where You Are

The alarm goes off, and the heaviness is there. The day stretches out ahead like something to survive. Caffeine, the obligations, alongside low energy and sadness. Doing the bare minimum. Struggling to concentrate, to finish tasks, to hold back the tears. You move through it, but a part of you is so low — shut down, unreachable, waiting for the moment you can go back to bed. Because bed is the one place where nothing is required of you.

Reaching out to friends takes more than you have. And if you've been here long enough, many of them have disappeared anyway. So you stay inside the thought loops—what is wrong with me? Why can't I just pull out of this, be grateful, be happy? I spend so much of my life feeling this way—how can I make this stop?

Or maybe your depression shows up differently. You function. By most measures, you function well. You are able to fight through the depression. You have energy, you can be social, you get things done. But there is an emotional flatness beneath the surface—a fog that has settled so gradually you’re not sure when it arrived. You tend to doubt yourself; it’s hard to accept compliments because, if they only knew. You worry you are a bad parent, spouse, or friend. You are really hard on yourself, and at times, the guilt feels never-ending.

Or perhaps your depression shows up as irritability, anger, or zero patience. The short fuse that seems to ignite out of nowhere—a comment from your partner, something small your kid does, a minor frustration at work, the house not being clean—and suddenly there’s an anger that feels outsized and out of control. Followed quickly by shame and guilt and sadness. The anxiety that hums underneath everything, tightening your chest even when nothing specific is wrong. A nervous system that feels permanently braced for something, even when you can’t name what.

Depression carves grooves into the way you think—deep, worn ruts that the mind slides into automatically, almost without noticing. The negative thoughts and emotions feel like facts. Like clear-eyed assessments of reality. That is one of depression’s most powerful and most cruel tricks.

And then the fog lifts a little. You have a few better days, maybe even a few better weeks or months. And then it comes back. The dip returns—sometimes gradually, sometimes like a door closing—and with it comes something almost worse than the depression itself: the defeat of being here again. The cycle itself becomes part of the wound.

Whether depression pulls you under or quietly hollows you out, one thing is often true: you’ve been living with this for a long time, things aren’t getting much better, and you are exhausted.

Yet there are ways to manage this illness, to not have it take over your life. To have more good days than awful days. To live, rather than just survive and suffer.

As a therapist who specializes in depression and other mood disorders, I understand how deep the roots of depression can feel—your experience of depression is unique, so your treatment should be too. Working together in therapy, we can better understand your symptoms and cycles, and use the right strategies to lift the heavy wet blanket.

You are not broken. You are not alone.

Depression is one of the most common—and most misunderstood—mental health conditions in the world. The National Institute of Mental Health estimates that more than 21 million adults in the United States experience at least one major depressive episode each year. Many more live with chronic, low-grade depression (sometimes called dysthymia or persistent depressive disorder) for years without ever receiving the right support.

 And yet, depression carries enormous shame. People tell themselves they should be able to "just get over it"—especially when things look fine on the surface. And one of the hallmarks of depression is low energy—it can be hard to muster the motivation to seek out support. An even more difficult hurdle to overcome can be the sense of hopelessness and the belief that nothing will get better.

Yet you deserve, and probably need, specialized help. Not because you are a failure, but because this brain illness is a tough one to handle on your own.

What Does Depression Actually Feel Like?

Depression does not look the same for everyone. Here are some of the ways depression shows up:

 The "Bottom of the Well" Depression

•       Persistent sadness, emptiness, or hopelessness that doesn't lift

•       Profound fatigue—even after sleep, your body feels like lead

•       Inability to concentrate, make decisions, or think clearly

•       Withdrawing from friends, family, and activities you used to care about

•       Sleeping too much or struggling to sleep at all

•       Feelings of worthlessness, shame, and guilt that feel larger than any specific event

•       In more severe cases, thoughts that life is not worth living

 High-Functioning ("Masked") Depression

•       You appear fine—or even successful—to the outside world

•       But privately, you feel empty, numb, or like you're just going through the motions

•       You feel like an imposter, or that people would be shocked to know how you really feel

•       Joy and pleasure are either absent or muted—things that used to make you happy no longer do

•       Irritability, low patience, and a short fuse—especially at home

•       A sense of disconnection from your own life, even when things look good on paper

Depression in Parents and Caregivers

Parenting and caregiving with depression carries its own particular weight. The guilt can be relentless—the sense that your low mood, isolation, short temper, or emotional unavailability is somehow damaging your children. You may find yourself snapping over small things, then spiraling in shame afterward. You may feel like you're missing moments you can't get back. Or that, you just don’t have the energy to always be a ‘good’ parent.

 This is one of the most important things I want you to hear: understanding the nature of the disease and receiving the best treatment can improve the quality of the relationship with your family and yourself. And reaching out for help is one of the most meaningful things you can do for them.

Types of depression Open Circle Counseling, Amanda Rebel, LMFT, Treats

Major Depressive Disorder (MDD)

Clinical term: Major Depressive Disorder (DSM-5)

•      Periods of severe depressive symptoms lasting two weeks or more, often cyclical throughout a person's life.

•      May include significant changes in sleep, appetite, energy, and concentration.

•      A clinical diagnosis requires five or more symptoms present during the same two-week period, representing a change from previous functioning.

 Persistent Depressive Disorder (Dysthymia)

Clinical term: Persistent Depressive Disorder / Dysthymia (DSM-5)

•      A longer-lasting, lower-grade depression that can feel like "just the way I am."

•      Lasts two years or more in adults and often goes unrecognized because it rarely becomes dramatically severe.

•      Previously known as Dysthymia, this DSM-5 term also encompasses what was once called Chronic Major Depression.

 Situational Depression (Adjustment Disorder with Depressed Mood)

Clinical term: Adjustment Disorder with Depressed Mood (DSM-5)

•      Sometimes called "situational depression" in everyday language — depression triggered by a specific life event such as grief, job loss, divorce, health challenges, or major transitions.

•      Real and can be just as debilitating as other forms of depression. Symptoms typically develop within three months of the triggering event.

•      Effective, targeted therapy can make a significant difference in recovery.

 Postpartum Depression (Peripartum Depression)

Clinical term: Major Depressive Disorder with Peripartum Onset (DSM-5)

•      Commonly called postpartum depression — the clinical name reflects that depression can begin during pregnancy, not only after birth.

•      Goes far beyond the "baby blues" and can involve profound sadness, anxiety, detachment, and guilt.

•      Affects far more parents than are formally diagnosed. It is common, not your fault, and treatable.

 Depression with Anxiety (MDD with Anxious Distress)

Clinical term: Major Depressive Disorder with Anxious Distress Specifier (DSM-5)

•      Depression and anxiety frequently occur together — depression flattens motivation while anxiety keeps the mind racing, creating a relentless cycle.

•      Clinically, the DSM-5 applies a specifier called "with anxious distress" to the depression diagnosis when these symptoms co-occur.

• In some cases, a separate anxiety disorder, such as Generalized Anxiety Disorder, may also be diagnosed alongside MDD. Effective treatment addresses both.

 Not sure which type applies to you? That's okay — many people experience overlapping symptoms. Reach out, and I’ll help you find clarity and a path forward

What To Expect

Using a combination of behavioral therapies, creative exercises, and holistic lifestyle changes, as well as a possible additional modality of ketamine-assisted therapy, my goal is to help you discover a way to navigate and approach life with greater brightness and lightness. I will also incorporate psychoeducation to help you understand the cycle of depression so you can better anticipate and manage your symptoms. 

I believe in steppingstones. Small shifts, taken one at a time, are how real change happens. I will celebrate the small wins with you, because with depression, small wins matter enormously.

Therapeutic Approaches I Use

•      Interpersonal and Social Rhythm Therapy (IPSRT) IPSRT is based on the understanding that stable daily routines — especially sleep — play a powerful role in regulating mood. When life disruptions throw off our rhythms, depression can take hold or deepen. IPSRT helps you identify the connection between your biological patterns and your emotional state, and build the kind of structure and stability that supports lasting mood balance.

•       Dialectical Behavior Therapy (DBT) DBT teaches concrete, practical skills for managing painful emotions, tolerating distress without making things worse, and building a life that feels more worth living. These are tools you can use in real time—not just insights you arrive at in a session.

•       Mindfulness-Based Approaches Learning to observe your thoughts and feelings without being consumed by them is a cornerstone of depression recovery. Mindfulness-based approaches help you step out of the depressive thought spiral and reconnect with the present moment—gently and without judgment.

•       Somatic and Body-Based Work Depression lives in the body as much as the mind. Breathwork, grounding techniques, relaxation exercises, and somatic awareness help you reconnect with your physical self and begin shifting your nervous system out of shutdown states.

•       Expressive Arts Therapy Sometimes words are not enough—or they're not available. Expressive arts allow you to access emotions, memories, and inner resources through creativity and imagery. This is especially powerful when depression has left you feeling flat, stuck, or disconnected from yourself.

•       Ketamine-Assisted Therapy For those who have not found adequate relief through traditional therapy or medication alone, ketamine-assisted therapy offers a powerful and increasingly recognized option. Ketamine can create a window of neurological openness—temporarily loosening the grip of entrenched negative thought patterns and allowing deeper therapeutic work to take place. As a full-service provider, I integrate ketamine sessions with preparation and integration therapy, so the experience is held within a meaningful, supportive therapeutic relationship rather than occurring in isolation. This approach can be particularly effective for treatment-resistant depression, and for clients who feel stuck in cycles they haven’t been able to break through other means.

 Psychoeducation

Understanding your own depression—how it cycles, what triggers it, how your nervous system works—is genuinely empowering. When you can recognize the patterns, you can begin to work with them rather than being blindsided. I weave education throughout our work together so you leave every session understanding yourself a little better.

What to Expect in Depression Therapy at Open Circle Counseling, with Amanda Rebel, lmft

We will start by creating a space that feels safe enough—not perfect, not forced, but genuinely supportive. You don't need to arrive with polished insights or the right words. You just need to show up.

 Together, we will explore the roots of your depression, map your patterns, identify your triggers, and start building real coping tools. We will work on both the immediate (what do I do when the wave hits?) and the deeper (why does this keep happening, and what needs to change?).

If you are working with a psychiatrist or prescriber, I am happy to collaborate with them to make sure your care is coordinated and comprehensive. Therapy and medication often work best together, and I take an integrative view of your overall well-being.

 Progress in depression therapy is not always linear. There will be harder weeks. But over time, with the right tools and a consistent therapeutic relationship, most people find that the episodes become less frequent, less severe, and shorter in duration. The fog begins to lift—not all at once, but gradually, steppingstone by steppingstone.

Still unsure if therapy is right for you?

I've tried therapy before, and it didn't help. Why would this be different?

I hear this often—and I understand the hesitation. Not every therapist and every client is the right fit, and not every approach works for every person. And since the nature of depression can be cyclical, sometimes what has worked in the past no longer does. So new tools and approaches may be what is needed.

 My approach to depression is eclectic and deeply individualized—I don't apply a one-size-fits-all model. I integrate body-based, creative, and skills-focused methods that go beyond traditional talk therapy. I also bring lived experience to the work, which means I'm not just drawing on theory.

 I encourage anyone who is on the fence to schedule a free consultation call with me. This gives you a chance to ask questions, get a sense of how I work, and decide whether this feels like a good fit—with no obligation.

I'm a parent. I feel so guilty that my depression affects my kids. Where do I even start?

First: the guilt you feel is evidence that you care deeply about your children—not that you are a bad parent. Depression distorts our self-perception, and it can make us feel like our struggles are causing irreparable harm. That is the depression, the illness talking, and there are ways to not only shift this perspective, but also to show up with more presence and energy for our kids.

Parenting with depression is one of the most isolating experiences there is. In therapy, we create space to process feelings and thoughts—and to develop practical strategies for staying regulated and proud of how we parent, even on hard days.

 The most important thing you can do for your children is take care of yourself. Asking for help is not a weakness. It models exactly what you want to teach them.

 I function okay most of the time. Do I really need therapy?

You function ok, and yet do you feel ok? High-functioning depression is still depression. The absence of a crisis does not mean the absence of suffering. If you are moving through your days on autopilot, feeling emotionally flat, privately exhausted, or wondering if this is just "as good as it gets"—you deserve support. Perhaps it is a briefer duration of support, but consider reaching out to see if therapy could be helpful for your situation.

I barely have energy to get through the day. How am I supposed to do therapy?

This is a common depression bind—the very condition that most needs treatment makes it hardest to seek treatment. All I ask is that you make one small move: reach out for a consultation call. Then we’ll talk, and then we’ll see what the next step feels manageable for you. We’ll keep it simple.

You Don't Have to Keep Feeling This Way

Depression is not a character flaw. It is not who you are. It is a brain illness that can be managed.

 Therapy can give you back access to yourself—to your energy, your capacity for joy, your ability to be present with the people you love. To know what to do when you feel a depression cycle starting. To have a life that feels like yours again.

 I work with adults in Colorado both in person and online, and with residents of California online. My office is physically located in Wheat Ridge, CO. If you're ready to take a first step—or even just curious whether this might be right for you—I invite you to reach out for a free consultation