Depression

What is depression?

Depression is a mental health condition marked by a persistent low mood, loss of interest in things you’d normally enjoy, and changes in energy, sleep or appetite that last most of the day, most days, for two weeks or more. It affects thinking, motivation and physical wellbeing alongside mood.

Depression is one of the most common mental health difficulties in the UK, and it ranges from a mild, lingering low mood through to severe episodes that make it hard to get out of bed, work or keep up with relationships. It differs from ordinary sadness or a difficult patch because it tends to persist, deepen and spread into most areas of daily life rather than lifting on its own after a few days. A clinical psychologist will use a structured assessment alongside a full conversation about your history and circumstances to understand the particular pattern of your depression and what is keeping it going.

Symptoms of depression

Symptoms vary between people, but common features include a low or flat mood for most of the day, losing interest in activities you used to enjoy, and tiredness or low energy that persists even after rest. Concentration and decision making often become harder, small tasks can feel disproportionately difficult, and motivation can drop away almost entirely.

Sleep and appetite frequently change too. Some people sleep far more than usual and still feel exhausted, while others struggle to fall or stay asleep. Eating patterns can shift in either direction, with some people losing interest in food and others eating more than usual for comfort. Many people also notice feelings of worthlessness, guilt or hopelessness, a slower way of moving or speaking, and in some cases thoughts of death or self-harm. Physical symptoms, such as headaches, digestive problems or unexplained aches and pains, are common too, and are sometimes the first sign that something is wrong before the emotional symptoms are named.

Types of depression

Depression is not a single, uniform experience. Major depressive disorder describes a period of low mood and related symptoms lasting at least two weeks and significantly affecting daily functioning. Persistent depressive disorder, sometimes called dysthymia, involves a lower grade but longer lasting low mood that can continue for two years or more, often becoming so familiar it feels like part of someone’s personality rather than a treatable condition.

Some people experience depression alongside anxiety, with worry and low mood feeding into each other. Others notice a seasonal pattern, with symptoms worsening in autumn and winter and easing in spring and summer. Postnatal depression affects some new parents in the months after having a baby, and depressive episodes can also occur as part of bipolar disorder, alongside periods of elevated mood. A thorough assessment helps identify which pattern best fits your experience, since this shapes the therapy approach most likely to help.

Online therapy for depression: what to expect

Sessions take place over video call, so you can speak to a psychologist from home or anywhere with a private space and a reasonable internet connection. Before your first session, you will usually complete a short questionnaire covering your symptoms, history and current circumstances, so your psychologist has some context before you meet.

The first session itself is an assessment: a detailed conversation about what you are experiencing, when it started, and what has happened in your life that might be relevant. From there, you and your psychologist agree a plan together, including which approach to use and roughly how many sessions to expect, though this varies from person to person depending on what you bring to therapy. Meeting online removes some of the practical barriers of travel, parking and childcare, and some people find they can speak more openly from a familiar room than they would in an unfamiliar building.

Our approach

We draw on therapy approaches recommended by the National Institute for Health and Care Excellence (NICE) for depression, principally cognitive behavioural therapy, which examines the links between thoughts, feelings and behaviour, and behavioural activation, which focuses on rebuilding the activity and routine that depression tends to erode. For some people, an approach that looks at relationships, roles and life changes connected to their low mood is more useful.

Your psychologist will tailor the approach to your particular circumstances rather than applying a fixed programme regardless of what you describe, and will check in regularly on what is working and what needs to change. Depression can have several contributing causes at once, including life events, physical health, sleep and long-standing patterns of thinking, and a good assessment tries to account for all of them.

What does depression therapy involve?

Therapy usually starts with understanding what keeps your depression going: the thoughts, avoidance patterns and daily habits that maintain low mood even once the original trigger has passed or faded. Sessions might involve identifying and testing unhelpful thinking patterns, gradually reintroducing activities that used to bring a sense of achievement or enjoyment, or working through a specific loss, conflict or life transition that sits behind the low mood.

Between sessions, you are likely to be asked to try small, practical steps and notice what happens, since change tends to come through practice rather than conversation alone. This might mean adjusting a daily routine, reaching out to someone you have been avoiding, or building in small periods of activity even when motivation is low. Progress with depression is rarely a straight line, with better weeks and harder ones, and your psychologist will help you notice movement even when it feels slow or uneven.

Frequently asked questions

The questions below cover points that come up often, including how long therapy for depression tends to take and what to do if you are already taking medication. If your question is not answered here, you are welcome to ask directly when you get in touch.

When to seek help

It is worth seeking support if low mood is affecting your work, relationships or ability to manage daily life, or if it has lasted more than a couple of weeks without easing. Depression can build gradually, so it is common to under-estimate how much it has affected you until someone else notices or until a particular task becomes unmanageable.

If you are having thoughts of harming yourself or feel you may be at risk, please contact your GP, call 111, or in an emergency call 999. Samaritans are available free, day or night, on 116 123. This site is not a crisis service and cannot respond in an emergency. We will update this site as the practice develops.