Depression rarely announces itself. More often, it creeps in. Things that used to matter start to feel flat, everyday tasks take far more effort than they should, and it gets harder to remember what feeling like yourself was like. Many people keep functioning on the outside, going to work and looking after others, while privately feeling heavy, numb or hopeless.
What depression can feel like
- Low mood that lingers for weeks, or keeps coming back
- Losing interest or enjoyment in things you used to care about
- Exhaustion, and everything feeling like an effort
- Sleeping much more, or much less, than usual
- A harsh inner voice: guilt, self-blame, feeling like a burden
- Finding it hard to concentrate or make decisions
- Pulling away from people, even those you are close to
- Feeling hopeless about the future
The cycle that keeps it going
Depression tends to feed itself. When mood drops, energy and motivation drop with it, so it makes sense to do less: cancel plans, put things off, stay in. In the short term that brings some relief. Over time, though, there is less in life that brings enjoyment or a sense of achievement, and more time alone with thoughts that are already turning against you.
Those thoughts are often harsh and sweeping: I'm useless. Nothing will change. What's the point? They feel like facts rather than symptoms, and they make it even harder to do the things that might help. The longer the cycle runs, the more it can start to feel like who you are, rather than something that is happening to you.
When depression comes with other difficulties
Depression often arrives alongside other problems, or because of them. Years of anxiety, the exhaustion of burnout, the relentless standards of perfectionism, or a long-standing sense of not being good enough can all wear mood down over time. Part of a careful assessment is understanding how these fit together, so that treatment works on what is really keeping things stuck.
How CBT helps with depression
CBT is one of the most effective treatments for depression, and it is recommended in the UK's NICE guidelines. We work systematically. First, we build a clear picture of your own cycle: what tends to bring your mood down, what you have stopped doing, and the thoughts that keep it going. Then, step by step, we work on it, gradually rebuilding the activities and connections that matter to you (an approach known as behavioural activation), loosening the grip of self-critical thinking, and finally putting a plan in place so that you can spot early warning signs and stay well.
The work is tailored to you. Depression looks different from person to person, and treatment follows your situation, your pace and what matters most in your life, not a fixed script.
Online or in person
Most of my sessions are online, by secure video, across the UK. I also see people in person on Thursdays at Re-Mind The Body Therapy Centre, 260a Kilburn Lane, London W10 4BA, about five minutes' walk from Queen's Park station and close to Kilburn, Maida Vale, Kensal Green and West Hampstead. CBT for depression works well online, which can also make it easier to keep going on days when getting out feels hard.
Is this the right service for you?
I work with adults (18 and over) on a private, self-pay basis. My practice is suited to adults who are managing their day-to-day lives, even if that takes considerable effort, and who are not currently at risk. It starts with a free 10-minute phone call, so we can talk about what's been happening and whether I can help. From there, the first session is a 50-minute assessment. If I think a different service would suit you better, I'll say so and help you think about where to turn.
If you are having thoughts of ending your life, or feel unable to keep yourself safe, please don't wait for an appointment. Call 999 or go to A&E, call NHS 111, or contact Samaritans, at any time, on 116 123.
