Depression ranges from persistent low mood to severe, life-limiting experience. Read on to find out how therapy for depression can help.
What Is Depression?
Depression is more than feeling sad or having a difficult few days. It tends to involve a persistent low mood or loss of interest in life, lasting weeks rather than days, and affecting how you feel, think, and function day to day.
Depressive symptoms range from mild to severe and may occur as a single episode or as recurrent episodes over a prolonged period.
The term low mood is often used more broadly and may describe subclinical depressive symptoms that nevertheless cause significant distress.
Many psychologists use the terms low mood and depression interchangeably in everyday practice.
Depressive symptoms are also commonly experienced alongside other difficulties, such as anxiety disorders, relationship stress, or physical health problems.
What Are the Symptoms of Depression?
Common symptoms include:
- Emotional
- Persistent sadness, tearfulness, or emotional flatness
- Reduced interest or pleasure in activities you previously enjoyed
- Feelings of worthlessness, shame, or excessive guilt
- Irritability or a sense of numbness
- Physical
- Persistent fatigue or loss of energy
- Sleep disturbance — difficulty falling or staying asleep, or sleeping more than usual
- Changes in appetite or weight
- Psychomotor changes — feeling physically slowed down, or conversely, restless and unable to settle
- Cognitive
- Reduced concentration or difficulty making decisions
- Negative thinking patterns, including self-critical or hopeless thoughts
- Recurrent thoughts of death or suicide
- Behavioural
- Withdrawing from relationships or social activities
- Losing motivation to engage with work, hobbies, or daily tasks
- Neglecting self-care or responsibilities
Not everyone experiences depression in the same way. Some people present with tearfulness and withdrawal; others primarily experience irritability, numbness, or exhaustion.
What Causes Depression?
Depression does not have a single cause.
Research consistently shows that depression arises from an interaction between:
- Body: some individuals have a temperament or genetic profile that increases susceptibility to depressive patterns.
- Mind: psychological factors (e.g., thinking styles, coping strategies).
- Actions: behavioural patterns such as reduced activity, social withdrawal, or avoidance.
- Past experience: developmental experiences including, for example, significant loss in childhood, attachment difficulties, or early relational disruption such as abuse or neglect.
- Trauma: experiences which were perceived as life threatening or life altering in significant and resulted in lasting symptoms. See the PSTD page for more information.
- LONG-TERM STRESS
- Ongoing external stressors
From a clinical psychology perspective, understanding how these factors interact in your particular case is more useful than identifying a single cause.
Low mood often reflects a system under sustained strain — sometimes following loss, burnout, trauma, chronic self-criticism, or prolonged relational stress. In other cases, the origins are more longstanding and developmental.
A thorough assessment allows us to develop a formulation — a collaborative understanding of how your depression developed and what maintains it in the present.
Is Depression a Chemical Imbalance?
The “chemical imbalance” explanation is widely circulated but overly simplistic.
While neurobiological processes are involved in mood regulation, depression cannot be reduced to serotonin levels alone. Psychological processes, stress physiology, attachment patterns, and environmental context all play significant roles.
For many individuals, psychological therapy is an effective first-line intervention, either alone or alongside medication.
How Is Depression Treated?
Treatment planning depends on severity, duration, risk factors, and personal preference.
In clinical psychology, therapy involves:
- Careful assessment
- Collaborative formulation
- Targeted intervention
- Ongoing review
The aim is not only to reduce symptoms, but to create meaningful and sustainable change in the patterns that contribute to low mood.
A range of evidence-based approaches may be used, including:
- Cognitive Behavioural Therapy (CBT)
- Behavioural Activation
- Compassion-Focused Therapy
- Acceptance and Commitment Therapy (ACT)
- Interpersonal or psychodynamic therapy
- Trauma-focused approaches (where relevant)
Rather than applying a single model rigidly, therapy is tailored to your specific needs and goals.
When Should I Seek Help for Depression?
You may benefit from professional support if:
- Low mood persists for several weeks or longer
- Symptoms interfere with work, relationships, or daily functioning
- You feel increasingly hopeless or disconnected
- You experience thoughts of harming yourself or suicide
If you are concerned about your immediate safety or feel at risk of acting on suicidal thoughts, seek urgent medical support via your GP, NHS 111, or emergency services (999).
What Does Therapy Involve?
Starting therapy can feel like a big step, particularly when you are already struggling. The first session is designed to be straightforward. There is no pressure to have everything figured out or to know exactly what you need.
Assessment usually takes one or two sessions. This is a chance for your therapist to understand your current difficulties, relevant history, and what you are hoping to change. It is also an opportunity to get a sense of how they work and whether therapy feels like the right fit.
From there, you and your therapist develop a shared understanding of your difficulties. This includes what may have contributed to them, and what keeps them going in the present. This is sometimes called a formulation, and it forms the foundation of the work. Rather than applying a fixed approach, therapy is shaped around your particular needs and goals.
Sessions are 50 minutes and typically take place weekly or fortnightly. The pace and focus are reviewed regularly as therapy progresses.
If you would like to explore whether therapy could be helpful, you are welcome to get in touch to arrange an initial conversation.
