Depression therapy onlineFind meaning, energy and connection again.

Depression is more than sadness. Clinicians look for a persistent low mood, or a loss of interest and pleasure, that lasts for most of the day on most days for at least two weeks, together with changes such as disturbed sleep, low energy, difficulty concentrating, changes in appetite, feelings of worthlessness or guilt, and in some cases thoughts of death or suicide. The WHO describes it as different from ordinary mood fluctuations and from the feelings we all have about everyday life (WHO).

It also looks different from person to person. Some people feel tearful and heavy; others mostly feel numb, irritable or exhausted, and only recognise depression when someone else names it. For people living in another country, it can be tangled up with loneliness, a career or relationship change, or the slow fatigue of functioning in a second language and an unfamiliar system. None of these make it less real, and none of them mean you have failed at adapting.

What depression is not is a weakness of character or something you should be able to think your way out of. Low mood changes how we interpret events, how much energy we have to act, and how kindly we speak to ourselves, which is part of why it tends to keep itself going.

The evidence for talking therapy in depression is broad. A network meta-analysis covering 331 randomised trials and more than 34,000 patients found that the main types of psychotherapy, including cognitive behavioural, interpersonal, problem-solving and behavioural activation approaches, were all more effective than usual care, with few significant differences between them; most still showed effects at 12-month follow-up (Cuijpers et al., 2021). The authors suggest that patient preference and availability may matter as much as the specific model.

NHS guidance lists a similar range of options, typically running for around 8 to 16 sessions, and notes that for more severe depression a combination of an antidepressant and talking therapy usually works better than either alone (NHS). The WHO likewise says that psychological treatments are the first treatments for depression, and that in moderate and severe depression they can be combined with medication prescribed by a doctor (WHO).

Our therapists take an evidence-informed, integrative approach. In plain terms, that means we do not force you into one technique; we combine what the research supports with what makes sense for you. Depending on what you bring, therapy may include:

Consider reaching out to a therapist or doctor if:

• low mood or loss of interest has lasted more than two weeks;
• you are struggling to work, study, look after yourself or keep up with relationships;
• you are relying on alcohol or other substances to get through the day;
• you have started to feel hopeless about the future;
• you have thoughts that life is not worth living.

If you have thoughts of ending your life, please do not wait for a therapy appointment. Contact emergency services or a crisis line straight away, or go to the nearest emergency department. Online therapy is not an emergency service.

It is also worth seeing a doctor if you have not had a recent check-up, because some physical conditions and medicines can affect mood. Therapy and medical care can work well side by side.