Mood, Motivation, Meaning
Dr. Rieke's approach addresses not just mood but motivation, meaning, and the physical rhythms that shape how we feel — for when you're going through the motions but feel like you've lost access to yourself.
When Depression Isn't Just Sadness
Depression doesn't always look like sadness. Sometimes it looks like numbness, exhaustion, irritability, or simply going through the motions of a life that no longer feels like yours. It can affect sleep, appetite, motivation, and the ability to concentrate or feel pleasure in things that used to matter.
How Therapy Helps
Therapy for depression looks at the whole picture — mood, thought patterns, daily habits and rhythms, and the sense of meaning and connection in a person's life — rather than treating low mood as an isolated symptom. The goal is not just symptom relief, but rebuilding a felt sense of motivation, purpose, and access to yourself. Sessions may draw on:
- Cognitive-behavioral therapy (CBT) — working with the thought patterns that keep low mood and hopelessness in place.
- Behavioral activation — deliberately rebuilding contact with meaningful, rewarding activity, even in small steps, to break the withdrawal-low mood cycle.
- Mindfulness-based approaches — building a different relationship to difficult thoughts and feelings, so they pass through rather than take over.
- Attention to rhythm and routine — sleep, movement, and daily structure, which shape mood far more than most people expect.
What the Research Says
Depression is common, and it's also one of the most researched — and treatable — mental health conditions there is:
- An estimated 21 million U.S. adults (8.3%) had at least one major depressive episode in the past year, with young adults affected at the highest rate.National Institute of Mental Health →
- Cognitive-behavioral therapy is a well-established treatment for depression — a large meta-analysis found it effective on its own, and even more effective combined with medication, with lower relapse rates than medication alone.NCBI / PMC review →
- Behavioral activation — re-engaging with meaningful, rewarding activities — performs comparably to cognitive therapy and antidepressant medication as a stand-alone treatment.APA Society of Clinical Psychology →
- Regular physical activity can ease depression and anxiety symptoms and is recommended as a complement to — not a replacement for — therapy.Mayo Clinic →
- For clients with a history of recurrent depression, mindfulness-based cognitive therapy has been shown to meaningfully reduce the risk of relapse — performing at least as well as ongoing maintenance medication.NCBI systematic review →
This is Tier One clinical therapy, which may be covered by insurance. All sessions are provided by Dr. Karina Rieke, PhD, LMHC-D, licensed in New York, Florida, and Nevada. All sessions are held online through secure video.