David J. Hellerstein, M.D., is a research psychiatrist at the New York State Psychiatric Institute, New York, NY, and Professor of Clinical Psychiatry at the Columbia University Irving Medical Center. He is Director of the Depression Evaluation Service (DES), which conducts studies on the medication and psychotherapy treatment of conditions including major depression, chronic depression, and bipolar disorder. Since 2019, the DES has taken a leadership role in conducting studies of psychedelic medications including psilocybin for depression and other disorders.
Dr. Hellerstein specializes in research and treatment of mood and anxiety disorders, particularly the medication treatment of chronic depression. His current studies include psilocybin in treatment-resistant depression, telepsychiatry treatment for women with depression and breast cancer, bone health in post-menopausal women receiving treatment for depression, and the use of esmethadone for major depression.
He has published over 150 scientific articles and book chapters on subjects including psychedelic drugs for treatment of psychiatric disorders; the treatment of persistent depressive disorder, bipolar depression, as well as supportive psychotherapy, behavioral activation therapy; and the humanities and medicine, particularly ‘narrative medicine.’ His neuroimaging research has been published in JAMA Psychiatry, Molecular Psychiatry, and other top journals.
Dr. Hellerstein has also received wide recognition for his literary writing. His new book The Couch, the Clinic, and the Scanner: Stories from Three Revolutionary Eras of the Mind is published by Columbia University Press. His journalism has been published in magazines including Harper’s and The New York Times Magazine. He writes a blog about applying neuroscience principals to psychiatric treatment for Psychologytoday.com: at Heal Your Brain.
His previous 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.
His private practice in psychiatry and psychopharmacology is located at: 271 West 70th St., #1F, New York, NY 10023 (tel. 212-875-1357).
Areas of Expertise / Conditions Treated
- Adult Psychiatry
- Mood and Anxiety Disorders
- Professor of Clinical Psychiatry
- Research Psychiatrist, New York State Psychiatric Institute
- NewYork-Presbyterian / Columbia University Irving Medical Center
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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.
- Brain imaging research, using MRI scanning
- Medication treatment of dysthymic disorder (chronic depression)
- 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)
- 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