Depression Therapy in New Jersey
Colleen Makowsky, LPC offers depression therapy for adults across New Jersey — persistent low mood, postpartum depression, situational depression, and the kind that just won’t lift.
Depression isn’t always sad. Sometimes it’s flat — no energy, no motivation, no interest in things you used to care about. The work is practical: small concrete moves, cognitive patterns, and naming what’s underneath. Online, NJ statewide. Adults only. CBT, ACT, and behavioral activation.
Colleen Makowsky offers depression therapy in New Jersey for how depression actually feels
Most couples who reach out aren’t in a single big crisis. They’re in a slow accumulation — small disagreements that didn’t resolve, communication patterns that became defaults, distance that crept in without anyone naming it. Marriage counseling is for naming that out loud, in a room where both people get heard.
Persistent depressive disorder — when it’s been the baseline for years
Chronic low mood lasting two-plus years (formerly “dysthymia”). Often pre-dates any acute trigger. People describe it as “this is just how I am” or “I’ve been this way as long as I can remember.” CBT challenges the assumption that this is identity rather than pattern; ACT works on movement in the directions you value despite the mood not catching up first.
Situational depression — when something specific kicked it off
Depression following a discrete event: job loss, breakup, diagnosis, move, identity shift, parenting transition. The depression is a response to the situation, not a permanent state — though it can become persistent if the underlying loss isn’t named. SFBT-leaning work + behavioral activation are usually the entry points here.
Postpartum mood — adult perinatal depression
Depression in the months (or year-plus) after childbirth. Hormonal shift, chronic sleep deprivation, identity reorganization, isolation. Colleen works with the adult — not the child. The work covers mood, identity, return-to-self, and the experience of caregiving while running on empty. Specialized infant-bonding work is refer-out to a colleague.
Chronic low mood and anhedonia — the flat version of depression
No clear sadness, just dimness. Loss of interest in things you used to enjoy. Difficulty caring. Difficulty starting anything. Behavioral activation — a CBT/ACT intervention — is the entry point: moving the body before the mood catches up, in 15-minute commitments instead of heroic overhauls.
Grief-adjacent depression — when loss tipped into depression
Grief that became something more. Bereavement, divorce, role loss, identity loss. If grief is the primary lens, the grief and loss page goes deeper; if depression is now the dominant pattern — the flatness, the motivation drop, the loss of meaning — that’s this page.
Three approaches that match how depression actually behaves
Depression responds to different angles depending on whether the cognitive loop, the motivation system, or the values map is the entry point. The three approaches below pick up where each lives. Colleen blends them session-to-session based on what your depression is actually doing.
Cognitive Behavioral Therapy (CBT)
For the thought loops that fuel low mood — “nothing will change,” “I’m the problem,” “what’s the point.” CBT tests the prediction against what actually happens, untangles the cognitive distortion, and builds practical responses you can use when the loop is loud. Strong evidence base for depression, especially situational and persistent presentations.
Acceptance and Commitment Therapy (ACT)
For when reasoning with the depression hasn’t moved it. ACT works on action despite the mood — naming what you actually value, taking small steps in those directions even when the energy isn’t there. Good fit for chronic low mood, anhedonia, and depression that’s resistant to “just think positive” framing.
Behavioral activation
Not a separate modality — it’s a CBT/ACT intervention that often anchors depression work. The principle: act first, motivation follows. Small concrete moves (a walk, a call, a meal) interrupt the depressive cycle. Builds in 15-minute commitments, not heroic overhauls. Particularly useful for anhedonia and low-motivation depression.
Depression and anxiety co-occur often; if both are showing up, we start with the one most interfering with daily life. If trauma is underneath the depression, the trauma therapy page goes deeper — including an honest note on what Colleen is and isn’t trained in.
Colleen’s depression work is grounded in what actually moves the needle
Depression responds to method. The three claims below aren’t a sales pitch — they’re what the evidence base actually says about what helps, paired with Colleen’s honest hedge on what she does and doesn’t promise.
CBT and behavioral activation have decades of evidence for depression
APA Division 12 lists CBT as a first-line evidence-based treatment for major depressive disorder. Behavioral activation has strong meta-analytic support across persistent and situational presentations — sometimes outperforming more complex protocols. Colleen leads with whichever fits the depression’s shape: cognitive work when the thought loop is loud, behavioral activation when the motivation system is the missing piece.
Action moves depression more than insight does. Insight helps you understand it; action moves it.
Depression often needs the body before it needs the thoughts
When motivation is the missing piece, talking about it doesn’t restore it. Small concrete actions — within the limit of what’s actually possible right now — re-train the system that “doing matters.” The work meets you at the energy level you actually have, not the one you’d have if the depression were already gone.
Start with what you can actually do today, not what you could do if the depression were already gone.
Short-term focus, ongoing flexibility
Most depression work runs three to twelve months. Some clients land in five months with a recovery toolkit. Others stay longer for relapse prevention or to address persistent patterns underneath the mood. The hedge is honest — Colleen doesn’t quote session counts, because depression doesn’t honor session counts.
Good therapy is practical. You should leave each session with something you can use — not just insight that stays in the room.
How we start — your first three steps
Reach out
Send a quick note through the contact form or call (551) 305-3742. Two fields: name and best way to reach you. Don’t include health details up front; we’ll talk through what’s going on verbally on the call.
15-minute call (free)
We get on the phone for fifteen minutes. You tell me what’s bringing you in, what you’ve tried, and whether what I do is a fit. If it’s not, I’ll point you in a useful direction. No charge. No pressure either way.
First session, then ongoing work
Sessions run 38 to 53 minutes, by secure video, weekly to start. Depression work typically runs three to twelve months — varies by client. You’ll know inside three or four sessions whether the fit is right.
WHAT A SESSION LOOKS LIKE
What a depression therapy session actually looks like
Practical sessions, by secure video. Here’s what a depression session actually covers — and what you leave with.
Colleen’s view of where depression often comes from
Depression rarely has one cause. It has patterns — old ones from childhood, recent ones from stress accumulation, biological ones from the perinatal window, and circumstantial ones from life chapters. Naming the pattern changes how you work with it.
Family-of-origin patterns — what got learned about feelings growing up
Depression often runs in families partly because of inheritance, partly because the “what do we do with sadness” script was learned. The household that didn’t talk about feelings, the parent who modeled persistent low mood, the family that treated emotions as inconvenience — the script gets imported. Naming it, and choosing differently, is part of the work.
Long stretches of unmanaged stress
Depression sometimes builds quietly over years of pressure that never got step-down time — caregiving, career, financial precarity, chronic illness. The depression is the system’s exhaustion signal. Reducing the input matters; teaching the system that “rest is allowed” matters more.
Postpartum and hormonal windows
The months after childbirth carry real biological risk for depression in adults. Sleep deprivation, hormonal shifts, identity reorganization, isolation — all compound. Colleen works with the adult side of this; for specialized infant-bonding work or medication evaluation, she refers to a colleague who specializes in that work.
Grief that became depression
Sometimes grief doesn’t lift — it converts into a persistent low-mood pattern. The grief and loss page goes deeper on the bereavement side; this page is for when depression has become the dominant frame — flatness, motivation loss, loss of meaning that outlasted the active grief window.
Identity or role loss without a replacement
Job loss, divorce, empty nest, retirement, immigration, transition out of a long-held identity. When a role disappears and nothing has filled the space it occupied, depression often moves in. SFBT helps map the next role-shape — not by replacing the old role on a timeline, but by finding what fits now.
It might be time to reach out if…
Most people wait too long — partly because depression convinces you that nothing is going to help anyway. The signs you’re past the “I’ll push through” line usually look like this.
If three or four of these are landing, that’s usually a signal it’s worth a 15-minute conversation. Reaching out doesn’t mean committing — it means starting.
Colleen Makowsky offers depression therapy across New Jersey
Colleen Makowsky
MA · LPC · NCC · CCTP · CAIMHP
Licensed counselor in Fort Lee, NJ. Adults and couples across all of New Jersey by secure video.
MA in Community Counseling, Montclair State University.
Trauma-informed (CCTP) · CBT · ACT · behavioral activation for depression work.
OUR LOCATION
Online counseling across New Jersey
I’m a service-area provider — I work with adults and couples statewide by secure video. My base is Fort Lee, NJ (Bergen County), but you can see me from anywhere in New Jersey.
Hours
Mon–Fri by appointment
Sat & Sun: Closed
Phone
(551) 305-3742
EXPLORE OTHER SERVICES
Other ways Colleen works
Anxiety Therapy · Trauma Therapy · Grief & Loss Counseling · Self-Esteem & Life Transitions · Individual Therapy
Depression therapy FAQ
What does insurance cover?
Colleen accepts Aetna, Cigna/Evernorth, Optum/UnitedHealthcare/Oxford, Horizon BCBS NJ, Oscar, Medicare, and most EAPs. Out-of-network superbill available on request. Medicaid is not accepted. See the insurance and cost page for carrier-by-carrier specifics.
How long are sessions?
Sessions run 38 to 53 minutes. The range reflects the work — not the insurance-billing default of 50 minutes. Weekly to start; cadence is reviewed together as the work progresses.
How long does depression therapy take?
Three to twelve months is the standard frame, varies by client. Some people land in five months with a recovery toolkit. Others stay longer for relapse prevention or to address persistent patterns. Colleen doesn’t quote session counts — she hedges honestly.
Do you prescribe antidepressants?
No. Colleen is a Licensed Professional Counselor (LPC) — talk-therapy only, no prescribing. If medication is part of your plan or worth exploring, that work happens with a psychiatrist, psychiatric nurse practitioner, or primary care doctor. The therapy and the medication side can run in parallel without conflict.
I have depression AND anxiety — do I have to pick which to work on?
No. Depression and anxiety co-occur often. We start with whichever is most interfering with daily life; the other usually starts to shift as we work. The treatment overlaps more than people expect — CBT and ACT both address both.
I’m in the postpartum window — can you work with me?
Yes. Colleen works with adults in the perinatal window on the depression side: low mood, identity shift, isolation, sleep deprivation, return-to-self work. For specialized infant-bonding work or medication evaluation, Colleen can refer to a colleague who specializes in that.
What if therapy hasn’t worked for me before?
Worth talking about on the free 15-minute call. Sometimes the fit was off, sometimes the modality didn’t match the depression’s presentation, sometimes the timing wasn’t right. Colleen asks what you’ve tried so she’s not running the same play twice.
RELATED SPECIALTIES
Anxiety Therapy in NJ · Grief & Loss Counseling in NJ · Self-Esteem & Life Transitions in NJ
READY TO START?
Schedule your free 15-minute consultation
If the dimness has lasted longer than feels right, that’s already worth a 15-minute conversation. No commitment — just a starting point.