Depression Therapy in Washington, DC

Psychoanalytic therapy for depression treats low mood by understanding what produces it, rather than only managing it. I am a licensed clinical psychologist and board-certified psychoanalyst practicing in Washington, DC, and I have worked with depressed patients for over fifty years. Sessions are held online by secure video.

Depression is not only sadness. More often it arrives as flatness — things that mattered stop mattering, the day becomes something to get through, sleep goes wrong at one end or the other, and a private commentary starts up about what all of this says about you.

For many people it is not a single episode but a recurrence. It lifts, life resumes, and some months or years later the same weather returns. That pattern is worth taking seriously, because it usually means the depression is anchored in something that was never worked through — a loss, a disappointment, a long-standing verdict about yourself formed well before the current episode.

I work with depression in weekly psychotherapy and in psychoanalysis, with patients from adolescence through old age, including when suicidal feelings are present. If you want the longer background first, I have written a complete guide to dealing with depression.

“The mood lifts first. The understanding is what keeps it from coming back.”

How depression shows up

Persistent low or flat mood
Loss of interest in what used to matter
Harsh self-criticism and guilt
Fatigue, and sleep that is too little or too much
Difficulty deciding or concentrating
Hopelessness about the future
Suicidal thoughts or feelings

The problem

When you can explain the depression and still cannot lift it

Most people who come to me about depression already have an account of it. They can point to the job, the marriage, the parent, the year it started. The account is usually accurate. It is also, on its own, not doing anything — and that gap between knowing and changing is the clearest sign that the trouble is organised somewhere below the level the explanation reaches.

Depression tends to be maintained by conflicts that stay out of awareness: anger that has nowhere to go and turns inward, grief that was never finished, dependence that feels shameful to admit, a standard set so high in childhood that nothing since has cleared it. What surfaces is not the conflict. What surfaces is the flatness.

This is also why encouragement has such a short half-life. Being told the situation is not as bad as it feels addresses the version of the problem you can describe, and the depression is generally living one floor down from that.

The method

How psychoanalytic therapy treats depression

You talk; I listen for what is underneath. Over regular sessions the same shape starts appearing in different material — in a memory, in a dream, in something that happened on Tuesday, and eventually in how you deal with me. That recurrence is the evidence. Once the pattern is visible in the present rather than reconstructed from the past, it becomes something that can change.

With depression the material is often anger and loss. Anger that could not safely be felt toward someone you needed gets turned on yourself, where it is experienced as worthlessness rather than as anger. Losses that were never mourned stay open. Naming these accurately, in the room, with someone who has no stake in you feeling better quickly, tends to do more than any amount of reasoning with the mood.

This is the same method used in psychoanalysis, applied at whatever frequency your difficulty actually needs. Most people start with weekly psychotherapy.

Which treatment fits

Which treatment fits depression

Depression treatment uses the same method at different intensities. We decide together in the free consultation, and we revisit the decision if the treatment is not moving.

Psychoanalytic psychotherapy

Once or twice a week at a fixed time. Where most people begin, and enough for a great many difficulties.

Psychoanalysis

Three to five sessions a week. The more thorough instrument, for difficulties that have returned after previous treatment.

Couples therapy

Ninety minutes with both people present, when the trouble lives between you rather than inside one of you.

Expected results

What treatment for depression can and cannot promise

No honest clinician can put a date on this, and I will not pretend otherwise. What I can describe is what tends to change, and roughly in what order.

The weight lifts

Mood, sleep and energy are usually the first things to move, often within the first months.

Self-criticism loses authority

The internal verdict becomes something you can hear as a voice with a history, rather than as the truth.

Losses get mourned

Grief that was stalled can finish, which is frequently what the depression was holding in place.

Recurrence becomes less likely

Change worked out at the level of the conflict tends to outlast the treatment rather than fade with it.

An honest caveat: severe depression sometimes needs medication alongside therapy, and I will say so and help you arrange a psychiatric consultation rather than let a treatment drift. If you are having thoughts of ending your life, that is a reason to start now, not a reason to wait — and if you are in immediate danger, call or text 988, the Suicide & Crisis Lifeline.

Your therapist

About Dr. John J. Hartman

Dr. John J. Hartman, licensed psychologist offering online therapy for depression in Washington, DC

I have practiced psychotherapy and psychoanalysis for over fifty years, and have spent much of that time teaching it — at UCLA, Michigan, and the University of South Florida, where I am currently Adjunct Professor of Psychiatry. As a Training and Supervising Psychoanalyst at the Florida Psychoanalytic Center, I am one of the analysts responsible for training other analysts.

A.B. Harvard College, magna cum laude with highest honors, Social Relations
Ph.D. University of Michigan, Clinical Psychology
Certificate Michigan Psychoanalytic Institute
FABP Board-certified psychoanalyst, American Board of Psychoanalysis
Training & Supervising Analyst Florida Psychoanalytic Center
Licensed Washington, DC (PSY200001229) · Florida · Michigan
PsyPact Telehealth authorized in participating PSYPACT jurisdictions, including Maryland and Virginia

Full credentials and appointments · scholarship and publications

Fees

What treatment costs

Individual sessions are $325 for 50 minutes; couples sessions are $475 for 90 minutes. The first 15-minute consultation is free and carries no obligation, and a sliding scale is available — ask whether you may be eligible.

Payment by cash, check, Venmo, Zelle, or wire. I do not bill insurance, but if your plan covers out-of-network mental health care you may be able to submit my bills to your insurer for reimbursement. Office hours are Monday to Friday, 10:00 am to 5:00 pm, by arrangement. Full fees and insurance details.

Common questions

Questions about therapy for depression

What kind of therapy is best for depression?

No single answer fits everyone. Structured treatments such as CBT work well for many, particularly for a first episode. Psychoanalytic therapy is the better instrument when depression has returned, or is tied to long-standing feelings about yourself, because it treats the conflict producing the mood.

How long does therapy for depression take?

Symptom relief often begins within the first few months. The understanding that makes the relief durable takes longer — usually a year or more of weekly work, sometimes considerably more if the pattern is long-standing. I would rather tell you that at the start than discover it with you later.

Do I need medication as well?

Sometimes. Antidepressants and psychotherapy work on different things and combine well, and for severe depression medication can make the therapy possible rather than replace it. I am a psychologist and do not prescribe, but I will tell you plainly if I think a psychiatric consultation is warranted and help you arrange one.

Can I see you if I do not live in Washington, DC?

Yes. All sessions are online by secure video. I am licensed in Washington, DC, Florida and Michigan, and through PsyPact I can treat residents of participating PSYPACT jurisdictions, including Maryland and Virginia.

Depression is treatable. Start with a conversation.

The first 15-minute consultation is free and carries no obligation. Online sessions only, for residents of Washington, DC, Florida and Michigan, and — through PsyPact — participating PSYPACT jurisdictions including Maryland and Virginia.

Call (813) 787-2048 Prefer to write first? Email Dr. Hartman

Online Therapy for Depression in Washington, DC