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Executive Director

Kenneth Ellis, Ph.D.

Clinical Director

Susan Minsky, Ph.D, M.P.


Jing Zhang, M.D, Ph.D.
Larry K. Grubb, M.D.

Aurelio S. Zerla, M.D.
Apurva Makadiya, M.D.


William Dean Charmak, Ph.D, M.P.
Melanie Sholtis, Psy.D.
Roseanne M. Middleton, Ph.D.
Virginia Zimmerman, Ph.D.
Ida C. Deliberis, Psy.D.
Monique Reynolds, Ph.D.
Ilana Ilkovich Burgh, Psy.D..
Tara Acevedo, Psy.D., J.D.
Geeta Sarphare, Ph.D.
Margaret Farrell, Psy.D.
Johari Massey, Ph.D.


Jing Zhang, M.D.,Ph.D.

Dr. Zhang is a Licensed, Board Certified, Psychiatrist with 10 years of experience treating psychiatric disorders for adolescents and adults, mainly psychiatric medication management. Areas of specialty include: patients with depression, bipolar disorder, anxiety disorders, phobias, obsessive-compulsive disorder, PTSD, ADD/ADHD, adjustment disorder, schizophrenia and schizoaffective disorders.

Dr. Zhang obtained her MD degree from Henan Medical School and completed her residency training at the University of Chicago. Before joining the Columbia Counseling Center, Dr. Zhang worked for Kaiser Permanente in Fairfax County as a full-time psychiatrist. In addition, Dr. Zhang had 5 years psychiatric research experience at the National Institute of Mental Health, NIH (Bethesda) and obtained a Ph.D. degree in Physiology from the Uniformed Service University of Health Sciences.
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Larry K. Grubb, M.D.

Dr. Larry Grubb has a vast range of experience as a Psychiatrist with 2 Board Certifications in Adult Psychiatry and in Child and Adolescent Psychiatry. He has 30 years of experience providing Psychiatric Services within a military community. Dr. Grubb received his Medical Degree from the University of Kentucky in 1985. He completed a 4 year Residency in Psychiatry at the Naval Medical Center in California and a 2 year Fellowship in Child and Adolescent Psychiatry at Walter Reed Army Medical Center in DC.

In addition to joining the staff at the Columbia Counseling Center, Dr. Grubb currently works at the US Navy, Behavioral Health Directorate, National Naval Medical Center- Outpatient Psychiatrist and Former Head, Traumatic Stress and Brain Injury Service. He has been involved in the evaluation and treatment of inpatients and outpatients who present with psychological disorders secondary to exposure to trauma and who have suffered brain trauma in combat or in civilian environments. In addition to treating Posttraumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI), he serves as an expert in military Disability Evaluation. Further, Dr. Grubb has provided consultation for Bariatric Surgery Evaluations.

During his military career, Dr. Grubb provided mental heath services and direct patient care to children and adults. In addition, he was employed at the Pentagon and Headquarters of Navy Medicine where he was in charge of accession and disability policies for all the military services.

Dr. Grubb specializes in Medication Management of psychiatric and pharmacologic intervention for a full spectrum of psychiatric disorders. His broad based experiences enable him to effectively treat children, adolescents, and adults who present with mood disorders including depression and bipolar disorder, anxiety disorders, attention and impulse-control disorders such as ADHD, and more severe mental illness.

Currently, Dr. Grubb has a specialty interest in treating patients with Eating Disorders and providing Weight Management Intervention. He is the author of the book “Solving the Weight Loss Puzzle,” and the eBook “Get Your Head Out of the Refrigerator.” His CD “Reaching Your Natural Weight” has received much praise from parents and educators. These are exciting endeavors as physicians and psychologists attempt to address the serious increasing childhood obesity problem with comorbid disorders such as diabetes.

Dr. Grubb is available to see patients at CCC on Saturdays including Child, Adolescent, and Adult patients for Medication Evaluation and Management who present with Mood Disorders, Anxiety Disorders, Eating Disorders, Sleep Disorders, ADHD, and more complex Disorders who may require a consult for differential diagnoses and pharmacological intervention.

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Aurelio S. Zerla, M.D.

Dr. Zerla is a Board Certified Psychiatrist with more than 25 years of experience in various clinical settings, including inpatient hospital units, outpatient departments and private practice. He received his Medical Degree from the Medical School at the University of Perugia, Italy, his psychiatric training at Sheppard-Pratt Hospital and psychoanalytic training at the Washington Psychoanalytic Institute, where he is now a faculty member. He has served as staff psychiatrist at Sinai Hospital in Baltimore, medical director of a community mental health center in Baltimore County, chief of psychiatry at Frederick Memorial Hospital, and most recently as staff psychiatrist at Meritus Medical Center in Hagerstown.

Dr. Zerla has extensive experience diagnosing and treating depression, bipolar disorder, anxiety and panic disorders, phobias, psychoses, post-traumatic stress disorder, stress induced adjustment disorders, grief reactions complicated by depression, and adult ADHD.

Dr. Zerla provides psychiatric evaluations and medication management with special attention to individual needs, including attention to each patient’s personal history, his or her specific context, stressful or traumatic life experiences or circumstances, each patient’s particular concerns about, or fears of medications, all of which he approaches with patience, warmth, understanding and helpful explanations that facilitate treatment and the patient’s sense of comfort and trust.
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Apurva Makadiya, M.D. Board Certified Psychiatrist

Dr. Apurva Makadiya is a Diplomate of the ABPN and a Maryland Licensed and Board Certified Psychiatrist providing medication evaluation and management for adolescents and adults. Areas of expertise include: Mood Disorders -Depressive Disorders, BiPolar Disorders, Anxiety Disorders,Panic Disorder, PTSD, Eating Disorders, Sleep Disorders, Psychotic Disorders, Neurodevelopmental Disorders, ADHD,OCD, and Substance Abuse.

Dr. Makadiya obtained his medical degree in India in 2005 and completed a 4 year Psychiatry Residency in 2013. He has Inpatient and Outpatient Psychiatry experience in Substance Abuse and Rehabilitation at the VA Medical Center. He is bilingual in English and Hindi.
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William Dean Charmak, Ph.D., M.P.

Dr. Charmak is a licensed psychologist with 24 years of experience providing individual, family and couples psychotherapy. Services are provided to adults and adolescents over the age of 15. Areas of specialization include depression, bipolar illness, anxiety, Post-traumatic Stress Disorder, addictions, geriatric services, oncology, and other chronic illnesses, developmental disabilities, psychopharmacology, executive coaching and organizational consultation.

Dr. Charmak obtained a PhD in Clinical Psychology from California School of Professional Psychology-Fresno and Post Doctoral Master of Science Degree in Clinical Psychopharmacology from Alliant International University/California School of Professional Psychology. He is the recent co-author of Successful Aging: Optimizing Strategies for Primary Care Geriatrics, in Reichel’s Care of the Elderly, Sixth Edition, 2009, Cambridge University Press.
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Melanie Sholtis, Psy.D.

Dr. Melanie Sholtis is a licensed psychologist, with 6 years of experience providing individual, couples, and family therapy with adolescents and adults. She has worked in a variety of settings, including substance abuse treatment, hospitals, private practice, and forensic settings. In addition to her experience in psychotherapy, Dr. Sholtis has extensive experience providing psychological, forensic, and psychoeducational assessments to a wide variety of patient populations.

Dr. Sholtis received her Psy.D. in Clinical Psychology from the American Professional School of Psychology. Her areas of specialty include: anxiety disorders, depression, mood disorders, PTSD, anger management, family therapy, behavioral techniques, and psychological assessment.
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Roseanne M. Middleton, Ph.D.

Dr. Roseanne Middleton is a Licensed Psychologist who has been in private practice for over 15 years. She received her doctorate from Texas Tech University and completed a two-year internship at the Institute of Pennsylvania Hospital with specialized training in the treatment of trauma. Dr. Middleton’s therapeutic style was shaped by a background emphasizing psychodynamic and cognitive behavioral interventions focusing on the development of skills to improve psychosocial well-being and strengthen relationships.

Dr. Middleton provides services for adults as well as older adolescents seeking treatment for a range of mental health concerns including depression and anxiety, Panic Disorder, Obsessive Compulsive Disorder, and Post Traumatic Stress Disorder (PTSD). She specializes in treating individuals who have experienced trauma and problems forming or maintaining satisfying interpersonal relationships. In addition, Dr. Middleton focuses on treating couples to enhance communication and intimacy, as well as to negotiate the complexities of separation and divorce.

Geriatric services are another facet of expertise. Dr. Middleton has considerable experience working with elderly patients who face unique challenges related to aging and the impact of physical and cognitive debility on emotional health.

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Virginia Zimmerman, Ph.D.

Dr. Zimmerman is a Maryland Licensed Psychologist with 6 years of experience providing individual and family therapy to adolescents and adults. Her areas of specialty include: depression, anxiety, adjustment issues, relationship issues, eating disorders, and school/behavioral issues. She also has extensive  experience providing psychological and psycho-educational assessment, examining intellectual functioning, academic achievement, executive functioning, Attention Deficit Disorder and social/emotional functioning in children and adolescents. She has previous experience collaborating with public schools to create optimal learning environments based on the students’ individual strengths and needs, working as a Pennsylvania Certified School Psychologist for several years.

Dr. Zimmerman received her Ph.D. in Clinical Developmental Psychology from Bryn Mawr College in 2007. She completed a Postdoctoral Fellowship at the Renfrew Center providing individual, group, and family therapy for women struggling with Eating Disorders. Other previous treatment settings include university counseling centers, public school systems, private practice, and court-mandated treatment.

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Ida C. Deliberis, Psy.D.

Dr. DeLiberis is a Maryland Licensed Clinical Psychologist, with 7 years of experience in providing individual, couples, family, and group therapies to adolescents and adults. She has worked in a variety of settings, including public school systems; private practice; mental health clinics; substance abuse treatment centers, and forensic settings. Dr. DeLiberis also has extensive experience providing neuropsychological, psychological, and psychoeducational assessments to psychiatric and medically referred adolescents and adults.

Dr. DeLiberis received her Psy.D. in Clinical Psychology from the American School of Professional Psychology at Argosy University. Through her post-doctoral training, she concentrated extensively on group and individual therapy with adolescents and conducting psychoeducational and psychological assessments. Dr. DeLiberis has also worked as a School Psychologist, where she focused on the treatment of adolescents with special education needs, including academic, behavioral, and social-emotional difficulties.

Dr. DeLiberis has a particular interest in working with couples and families in therapy to address conflict, communication, parenting strategies, mental health, and other relationship issues. Dr. DeLiberis also works with adolescents and their families on behavior and school-related issues. Specific areas of clinical expertise and interest include: anxiety disorders, mood disorders, ADHD, PTSD, anger management, trauma, women’s issues, adjustment issues/life transitions, relationship conflicts, school/behavioral problems and high-risk teen behaviors. Dr. DeLiberis is available to see adolescents and adults over the age of 13.

Dr. DeLiberis is also a member of the Maryland Psychological Association and the American Psychological Association.

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Monique Reynolds, Ph.D.

Dr. Reynolds is a licensed clinical psychologist with over 10 years of experience in the field of mental health including teaching, research, and providing therapy to children, adolescents and adults. Her areas of specialization include: Depression, Anxiety, Obsessive-Compulsive Disorder, Complex Trauma, and Child Behavioral Disorders. She completed a year of specialized training in the VCU Anxiety Clinic and several years of additional training in providing psychological and psycho-educational assessments. Dr. Reynolds has also worked in multiple public school systems engaging with parents and schools to help children and adolescents overcome barriers to success.

Dr. Reynolds obtained her Bachelor’s degree in Psychology from Yale University and received her Ph.D. in Clinical Psychology from Virginia Commonwealth University in 2009. Prior to this, she completed training with the Multicultural Center for Human Services in Northern Virginia and the University of Maryland, Baltimore. With a strong foundation in cognitive behavioral therapy and an integrative holistic approach, Dr. Reynolds adapts the best evidence-based treatments to suit needs and strengths of each individual client.

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Ilana Ilkovich Burgh, Psy.D.

Dr. Burgh is a Virginia and Maryland licensed psychologist with 10 years of experience treating Adults and Adolescents 16+. Using Cognitive Behavioral and Integrative Therapy, Dialectical Behavioral Therapy, Life Coaching, Brief Solution Focused Therapy for individuals and couples presenting with Mood Disorders, Depression, Anxiety, Bipolar, Obsessive Compulsive Disorder, Trauma/PTSD and combat stress, Sleep Disorders, Psychotic/Schizophrenic Disorders, Adjustment Disorders, Stress & Life Transitions, Care Taker of Elderly Parents, Grief/Bereavement, Military/Veterans, VA Mental Health Disability Examinations, Postpartum Depression, Women’s Issues, Peer Relationships, Parenting Stress, Stress Management, Anger Management, Relationship Issues and Stress, Medical Issues, Substance & Alcohol Abuse, Co-Occurring Disorders (Dual Diagnosis), Self-Esteem Issues, Personality Disorders, Crisis Intervention, and Domestic Violence.

Dr. Burgh obtained a Psy.D. in 2007 at the American School of Professional Psychology/Washington DC Campus located in Arlington Virginia. She completed her APA Approved Internship at Hudson River Psychiatric Center (HRPC) in Poughkeepsie, NY and her Postdoctoral Fellowship at Springfield Hospital Center in Sykesville, MD with focus on Serious Mental Illness, forensic evaluations and court-mandated therapy, as well as trauma work. In addition, she worked in a variety of settings, including inpatient psychiatric facilities, hospital emergency rooms, community mental health centers, Veterans Affairs contracted sites, and community primary care clinics.

Dr. Burgh is a member of the American Psychological Association, Maryland Psychological Association, Virginia Psychological Association and is licensed to practice Clinical Psychology in Maryland and Virginia.

Tara Acevedo, Psy.D., J.D.

Dr. Acevedo is a Psychology Associate registered in the state of Maryland. She has eight years of experience treating many different clients in a variety of settings including private practice, hospitals, counseling centers, forensic facilities, and community behavioral health centers. Dr. Acevedo provides individual psychotherapy for adolescents and adults seeking treatment for a wide range of mental health concerns. She is experienced in working with individuals, families, and couples. Her areas of specialty include Depression, Anxiety, Mood Disorders, Trauma, Post-Traumatic Stress Disorder, Adjustment Issues, and Relationship Distress. Dr. Acevedo is also experienced in psychological evaluation and assessment.

Dr. Acevedo obtained her undergraduate degree from Swarthmore College and earned her Master’s Degree in Human Development from the University of Pennsylvania. She then received both her Psy.D. and her J.D. from Widener University. She completed her clinical internships at Widener University Counseling Center and the Delaware Psychiatric Center. Dr. Acevedo’s therapeutic style emphasizes both psychodynamic and cognitive behavioral interventions to improve relationships, develop skills, and increase psychological well-being. She is flexible and integrative in her approach in order to meet the needs and desired outcomes of each individual.
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Geeta Sarphare, Ph.D.

Dr. Geeta Sarphare is a Licensed Psychologist with more than 20 years of experience providing psychological services to both children, adolescents, and adults, including individuals with various developmental disabilities. She serves children from age 5 to adulthood with specialty training and experience working with preschool children demonstrating behavioral and emotional issues and providing parent training.

Dr. Sarphare received her Ph.D. from the Ohio State University, Department of Psychology with a specialization in Developmental & Intellectual Disabilities. She has a Masters in Special Education Teaching; Specialist in Education in Community College and Higher Education; Bachelor of Science in Microbiology and Biochemistry; and a Bachelor of Education in Special Education

Dr. Sarphare has extensive experience in treating various disorders, including Anxiety, Depression, Attention Deficit Hyperactivity Disorder, behavioral disorders, autism spectrum disorder, Post-Traumatic Stress Disorder, Obsessive Compulsive Disorder, school issues, self-mutilation, and family issues.

While earning her Ph.D., Dr. Sarphare worked as a research assistant on several projects involving psychotropic medications, and taught Psychology. She also served as a Consulting Psychologist to community providers, conducting in-staff training and instructing parents to implement treatment plans in the home-setting.

Dr. Sarphare is licensed in Maryland and Delaware. She is certified by the Council for the National Register as a Health Service Provider in Psychology. She is a member of the Maryland Psychological Association and American Psychological Association.
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Margaret Farrell, Psy.D.

Dr. Farrell is a Licensed Psychologist with 9 years of experience providing individual psychotherapy to children, adolescents, and adults. Her primary approach to treatment is Cognitive Behavioral.

Dr. Farrell received her Psy.D. in Clinical Psychology from Widener University, with a focus in Health Psychology. During her pre-doctoral training, she provided therapy in a variety of settings, including working in a private practice to help facilitate social skills for children with ADHD, working in an outpatient practice within a hospital with individuals presenting with co-occurring medical and psychological diagnoses, in an inpatient physical rehabilitation setting working with patients undergoing physical and cognitive rehabilitation after surviving strokes, spinal cord injuries, and other acquired disabilities, and in a college disabilities services department, helping undergraduates with study skills, social acclimation, self-care and mood management during their transition to college.

Her post-doctoral work has involved providing therapy in outpatient group and private practice settings, specializing in treating children, adolescents and young adults presenting with a variety of anxiety disorders, mood disorders, interpersonal and relational problems, behavior issues and adjustment disorders.

Dr. Farrell also provides parent consultation and enjoys collaborating with medical providers and educational staff to ensure comprehensive and collaborative care for the patients she serves. Her graduate research involved the study of posttraumatic growth, or positive change that can result from overcoming traumatic life experiences. She is grateful to have the opportunity to witness the courage and resilience that often emerges from individuals as they process challenging life events.

Johari Massey, Ph.D.

Dr. Johari M. Massey is a Licensed Clinical Psychologist with over 10 years of experience working with children, adolescents, and adults in both clinical and research settings. Dr. Massey has experience providing individual, group, and family therapy and conducting psychoeducational assessments. In addition, Dr. Massey has conducted clinical research with individuals exposed to trauma and focusing on factors associated with outcomes and treatment engagement. Dr. Massey has also worked in a number of settings and has been trained in a number of different treatment modalities.

Dr. Massey received her Ph.D. in Clinical Psychology from Teachers College, Columbia University and completed her internship at The Help Group in California. In addition, she was awarded and completed fellowships at Yale University School of Medicine and Johns Hopkins Bloomberg School of Public Health. Dr. Massey provides services for children 4 years and older, as well as adolescents and adults presenting with a number of challenges. Dr. Massey’s areas of specialty include: anxiety, depression, school refusal/problems, ADHD, behavioral problems, self-mutilation/harming, PTSD, trauma (including emotional, physical and sexual abuse, and domestic violence, etc.), grief and loss, learning disabilities, eating disorders (mild), bipolar disorder, gender/sexual identity issues, substance abuse (minor), social skills, relationship issues, parent-child conflict, autism (mild), and psychosis.
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Previous Articles

Dream a Little Dream

It is common practice in psychoanalysis for the patient to report the content of dreams as part of treatment. Sigmund Freud believed that dreams were a window into the unconscious mind. Therefor, by understanding and interpreting the content of dreams the patient would reveal thoughts and images that would possibly clarify current or past experiences, feelings and actions.

Dream analysis, once in vogue for both patients and doctors, has given way to what is termed cognitive-behavioral therapy, or CBT. A CBT approach to treatment might view dream content as random neural activity. However, if one considers the complexity of our dreams and the fact that there are repetitive themes and images,frankly, that hardly seems “random.” CBT examines cognition,our manner of thinking about issues. It also evaluates and treats behavioral concerns, like nail biting, smoking or other compulsive behaviors. Dream analysis is more within the realm of psychotherapeutic approaches that incorporate a deeper analysis of the complex developmental issues, or psychodynamics, which are the causal basis of personality and cognitive concerns.

The dream is divided into two components. The first level of analysis is the manifest content ( which is the actual experience of the dream). “I was driving my car down a mountain road and I had no brakes!” The second level is the latent content of the dream,( what the dream really means). In this case it might be a feeling of loss of control or an inability to control something. We dream in symbols. If we identify certain people in the dream that image could be a “stand-in” for someone else. Dreaming about snow could represent depression or a desire to “cover up” something or jus a pleasant memory of childhood.. So, how do we know the “correct” interpretation? The symbolic items in the dream can be better understood if interpreted within the context of that particular person. Freud suggested that we dream in symbols to “protect” our sleep. If we see through the symbolic process it can cause anxiety and would awaken us, possibly identified as a nightmare.

Dreams can be viewed as the dreamer’s attempt to “work through” or resolve some conflict that they are experiencing in reality. Another aspect of the dream is “wish fulfillment.” Within a dream one can see themselves mastering a task or problem. Apparently, we experience dreaming several times on most nights, even if we do not recall the experience. However, some medications can interfere with neurological function and inhibit dreaming. Interestingly, we seem to have a need to dream.In a classic study people were awakened as they began to dream.It was easy to identify the dream state since dreams are accompanied by rapid eye movements that can be identified and recorded. This procedure occurred for several days. Finally when the subjects were allowed to sleep, their number and frequency of dreams increased. Deprived of dreams, people began to dream more; possibly to make up for the deficit. Dream deprivation increases dreaming when subjects are permitted to have normal sleep.

Finally, dreaming is the only time that we can really “time travel.” One can be a young child in the dream and instantly become a teen or young adult. While the meanings in dreams may be elusive, they can provide meaningful thoughts and ideas that can help the patient to overcome the challenges and the demands of life that have brought them to treatment.

The Columbia Counseling Center offers an eclectic and integrated approach to treatment. The doctors on our staff are trained in the use of multiple techniques and strategies to relieve anxiety, improve mood and effectively modify coping strategies.

You can call 410 992 1949 for the first available appointment.

The Serotonin – Depression Connection

Recent articles( such as this piece from have posited the notion that serotonin is not a significant component of the depressive process .Further, that drug companies, having developed serotonin enhancing medicines, began an advertising campaign to “convince” the public that serotonin was the “cure” for depression.The idea that drug companies would conspire to mislead the public is quite questionable ( although I do enjoy a good conspiracy theory). One of the problems is that we cannot measure serotonin in the brain directly. Further, if we manipulate serotonin with an SSRI (selective serotonin re-uptake inhibitor), this also disturbs the balance of norepinephrine and dopamine- two of the major neurotransmitters. Now, it is really more complicated than this. There are many sub-types of each of these substances so it is not a simple matter of manipulating one of these chemicals.There are also many sub-types of receptor sites in the brain. The more we learn about the chemistry and structure of the brain, the more complicated it becomes.

The data from numerous studies indicates that psychotropic medications may only work about 50% of the time. In addition, psychiatrists may have to try a number of different medications in order to gain a positive effect. Of course, patient compliance is always a problem. It is not a good idea to wash your Prozac down with scotch whiskey – but I have had a number of patients who have done just that!

Michael Greger points out that diet ( whole food plant based nutrition) and exercise may be just as effective as some anti-depressants. While there is merit to this assertion, trying to get a depressed patient to exercise and eat properly is quite challenging – to say the least! It is my impression that “comfort foods” carbohydrates, potatoes, bread, mac and cheese act as “comfort foods” because they do, in fact, raise serotonin levels along with a number of other “calming” chemicals (such as tryptophan) that do cross the blood-brain barrier. Unfortunately, a bag of potato chips only increases serotonin levels for a couple of hours.

It does appear that cortisol is a precipitating chemical in the depressive process and influences a decrease in certain neurotransmitters. Indeed, being in a stressful situation for two to six weeks can trigger a depressive episode. This is chemistry, not “psychological” weakness. The notion that neurotransmitters are the causal factors in the depressive process is strengthened by the apparent genetic relationships within families. If we examine the family of origin of a depressed patient we will find both genetic and psychogenic factors that contribute to the depressive process. Further, it is interesting to note that if a particular antidepressant medication is effective for a “blood relative” ( biological parent or sibling) there is a high probability that the medicine will be effective for the patient.

The “holy grail” of treatment for depression will not be easily discerned. Light therapy can be effective. Likewise, trans-cranial stimulation shows promise. Various approaches in psychotherapy can be quite effective. However, anti-depressant medicines will continue to be a major component of treatment.Columbia Counseling Center’s integrated treatment protocol carefully evaluates the multiple causal factors in depression and provides both pharmacological and psychotherapeutic approaches for maximum effective treatment of depression.
Call 410 992 9149 for the next available appointment.

The Most Powerful Treatment for Depression

The title of this 2008 study says it all: “Faster remission of chronic depression with combined psychotherapy and medication than with each therapy alone”. The study of over 650 patients with depression compared medication treatment alone to medication treatment plus psychotherapy. The results were clear: patients on medication and therapy recovered from chronic (meaning repeated episodes of) depression faster than patients on either treatment alone.

Many studies over the years have identified both cognitive-behavioral therapy and interpersonal psychotherapy as being just as effective as medication in reducing symptoms of moderate depression. Other studies have shown that the improvements gained in therapy alone can last longer than the improvements gained from medication alone.

In my opinion, it’s the minority of cases that improve on just medication. The job of antidepressant medicine is to reduce the most immediate and troubling symptoms that interfere with your ability to function at home, at work, and socially: low energy, loss of interests, poor concentration, crying spells, hopelessness, and suicidal thoughts. The job of therapy is to identify the life issues that have led to depression and make changes in how you deal with those issues so they stop depressing you.

Therefore, we have two powerful and effective tools to treat depression. Use them together and you are likely to get the fastest and most enduring relief from your symptoms. At Columbia Counseling Center, the psychiatrists and therapists are all under one roof and we work with each other to ensure that your treatment is coordinated and efficient.

Written by: Dennis Glick, M.D. Board Certified Psychiatrist at The Columbia Counseling Center

Generalized Anxiety Disorder (GAD) is a common and recurring condition. Typical symptoms include near-daily worry, anxiety, tension, feeling on edge, irritability, and sleep disturbance. Features of panic attacks and/or social anxiety may also be present. Your primary care doctor may have already ruled out medical causes such as thyroid, electrolyte, cardiac, or nutritional abnormalities.

Cognitive-behavioral therapy (CBT) is a very effective form of treatment, typically requiring 6 to 12 weekly sessions that may include the use of workbooks and homework. The SSRI and SNRI antidepressant medications (Prozac, Paxil, Zoloft, Celexa, Lexapro, Effexor, Cymbalta, and Pristiq) are highly effective and should be continued for a period of 6 to 12 months following symptom reduction. Benzodiazepines such as Xanax, Ativan, and Klonopin are best used on a temporary basis due to the risks of addiction, memory impairment, physical incoordination, and potentially endangering combinations with alcohol and pain killers. Other medicines such as Buspar, Vistaril, Gabapentin, and Seroquel are occasionally used but are not specifically approved for treatment of GAD.

Many patients will benefit from the combination of CBT and medication. The Columbia Counseling Center is uniquely able to provide coordinated treatment as our staff includes both psychiatrists and psychologists specifically trained to diagnose and treat GAD and other anxiety and mood disorders. Your clinicians work together to ensure you are receiving the most effective treatments for your condition.