David J. Hellerstein, MD
Areas of Expertise / Conditions Treated
- Professor of Clinical Psychiatry
- Research Psychiatrist, New York State Psychiatric Institute
Dr. David J. Hellerstein is a research psychiatrist at the New York State Psychiatric Institute, New York, NY, and Professor of Clinical Psychiatry at the Columbia University Medical Center. He was formerly the Clinical Director of the Institute. He specializes in the treatment of mood and anxiety disorders, with a particular focus on the medication treatment of persistent depressive disorder, or chronic depression.
Dr. Hellerstein is Interim Director of the Depression Evaluation Service, which conducts studies on the medication and psychotherapy treatment of conditions including major depression, chronic depression, and bipolar disorder..
He has published over 100 scientific articles and book chapters on subjects including the treatment of dysthymic disorder (persistent depressive disorder), supportive psychotherapy, behavioral activation therapy, and the use of new media in psychiatry.
Dr. Hellerstein has also received national recognition for his literary writing, and has been awarded the Pushcart Prize, several MacDowell Colony Fellowships, and a fellowship at the Virginia Center for Creative Arts. His books include Battles of Life and Death (essays about medical training), Loving Touches (a novel), and A Family of Doctors (a memoir of five generations of doctors in one family). His journalism has been published in magazines including Harper’s and The New York Times Magazine.
His book, Heal Your Brain: How the New Neuropsychiatry Can Help You Go From Better to Well, was published by the Johns Hopkins University Press. A Distinguished Life Fellow of the American Psychiatric Association, he has served as President of the New York County District Branch of the American Psychiatric Association.
He has a private practice in psychiatry and psychopharmacology. His office is located at: 271 West 70th St., #1F, New York, NY 10023, tel. 212-875-1357.
He has a blog on Psychologytoday.com at: Heal Your Brain
He discussed his research on Blogtalk Radio: Depression and Brain Circuits
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Credentials & Experience
Education & Training
- Stanford University Medical School
- Internship: NewYork-Presbyterian Hospital/Weill Cornell Medical Center
- Residency: New York Hospital - Cornell Medical Center
- Residency: NewYork-Presbyterian Hospital/Weill Cornell Medical Center
- Fellowship: New York State Psychiatric Institute
Over the past few decades, there has been a revolution in the treatment of chronic depression. We really can treat this illness effectively in many people. This couldn’t be said twenty or twenty-five years ago.
For over 20 years, Dr. Hellerstein has conducted clinical trials using a wide variety of antidepressant medications in the treatment of chronic depression. He has a particular interest in what the DSM5 calls Persistent Depressive Disorder, and what was previously known as dysthymic disorder. This is a form of depression lasting a minimum of two years, and often present for decades before an individual seeks treatment. In addition to studying various classes of medications including the SSRIs, NDRIs, SNRIs and others, Dr. Hellerstein has conducted psychotherapy research studies. Most recently he completed a study of behavioral activation therapy to improve work functioning in individuals whose chronic depression has responded to antidepressant medication.
Beginning several years ago, Dr. Hellerstein has added repeated MRI imaging to his randomized placebo-controlled clinical trials. MRI imaging is done before treatment is started and after 10 to 12 weeks of antidepressant or placebo treatment. Working in collaboration with MRI experts Dr. Bradley Peterson, Dr. Jonathan Posner and others, these groundbreaking studies will provide new understanding of the effects of chronic depression on the brain's structure, functioning, connectivity, and chemistry. One recent publication (2013) in JAMA Psychiatry determined that a particular brain network, the default mode network, has abnormally increased activity in chronic depression, which returns to the level found in healthy individuals with medication treatment but not with placebo treatment. Another recent publicatin (2017) in Molecular Psychiatry demonstrated how the brain adapts to persistent depression by thickening the cerebral cortex, presumably to compensate for overactivity of lower brain centers; and how after treatment with medication (but not placebo) the cortical thickness returns to a more normal level. These studies provide evidence of brain 'plasticity' in people with depression, and show how disorders and treatment can resculpture the brain's very anatomy as well as connectivity.
His recently-compled study, desvenlafaxine vs. placebo in chronic depressive disorder is using repeat MRI scanning in an attempt to replicate the findings of the previous study that used duloxetine, another antidepressant medication.
- Medication treatment of dysthymic disorder (chronic depression)
- Brain imaging research, using MRI scanning
- Research on behavioral activation therapy
- Research on supportive psychotherapy
THIS STUDY IS NO LONGER RECRUITING
The investigators are studying a new antidepressant medicine, desvenlafaxine, for the treatment of people with chronic depression. Desvenlafaxine (trade name Pristiq) has been approved by the FDA for the treatment of major depression.
The investigators are testing whether this medicine is also effective for adults with a type of chronic depression that is less severe than major depression. This condition is also known as dysthymic disorder or dysthymia. Chronic depression, lasting two or more years, often causes significant suffering and impairment.
In addition, the investigators are using MRI imaging, which uses magnetic signals to make pictures of the brain's structure and also of its functioning. The purpose of MRI imaging in this study is
Anatomical and functional MRI findings in chronic depression treated with duloxetine vs. placebo
Role: Principal Investigator (co-PI Bradley Peterson)
Desvenlavaxine vs. placebo in the treatment of chronic depressive disorder (CDD)
Role: Principal Investigator (Bradley Peterson, MD co-PI)
TRANSFORM DEPCARE: A THEORETICAL APPROACH TO IMPROVING PATIENT ENGAGEMENT AND SHARED DECISION MAKING FOR MINORITIES IN COLLABORATIVE DEPRESSION CARE (Federal Gov)
Sep 30 2017 - Jul 31 2022
DESVENLAFAXINE FOR C (P&S Industry Clinical Trial)
Dec 14 2011 - Dec 14 2016
COMBINING ANTIDEPRESSANTS TO HASTEN REMISSION FROM DEPRESSIO N (Federal Gov)
Jul 1 2010 - Jul 31 2012
- Hellerstein David J: Heal Your Brain: How the New Neuropsychiatry Can Help You Go From Better to Well Johns Hopkins University Press, Baltimore, MD, 2011
- Posner J, Hellerstein DJ, Peterson B: Antidepressants normalize the default mode network in patients with dysthymia. JAMA Psychiatry 2013;70
- Bansal R, Hellerstein DJ, Peterson BS. Evidence for neuroplastic compensation in the cerebral cortex of persons with depressive illness. Molecular Psychiatry 2017.
- Hellerstein David: A Family of Doctors, Hill & Wang (hardcover), Ivy Books (paperback). New York, NY, 1994/1995
- Hellerstein DJ, Skodol AE, Petkova E, Xie H, Markowitz JC, Yen S, Gunderson J, Grilo C, Daversa MT, McGlashan TH. : The impact of comorbid dysthymic disorder on outcome in personality disorders. Comprehensive Psychiatry 2010;51: 449-457
- Hellerstein DJ, Agosti V, Bosi M, Black SR: Impairment in psychosocial functioning associated with dysthymic disorder in the NESARC study.& Journal of Affective Disorders 2010;doi:10.1016/j.jad.2010.04.013