Depression and low mood

What is depression?

Depression is a common but serious mental health condition characterised by persistent low mood, loss of interest or pleasure, and a range of emotional, cognitive and physical symptoms. It goes well beyond ordinary sadness or having a bad week. Depression changes the way you think about yourself, your life and your future, often creating a distorted lens through which everything looks bleak, hopeless or pointless.

At a psychological level, depression typically involves a combination of negative thinking patterns, reduced activity, and withdrawal from the things that normally give life meaning. These factors interact to create a vicious cycle: low mood leads to withdrawal, withdrawal leads to a loss of positive experiences, and that loss deepens the low mood further. Understanding this cycle is the first step towards breaking it.

Depression can affect anyone, regardless of age, background or life circumstances. It is not a sign of weakness or a character flaw. It is a recognised clinical condition with well-understood psychological mechanisms, and it responds well to evidence-based treatment. In the UK, depression is one of the most common reasons people seek psychological support, and the research behind effective therapy is extensive.

Symptoms of depression

Depression affects people differently, but common symptoms include:

• Emotional: persistent low mood, feelings of sadness or emptiness, hopelessness, guilt, worthlessness, irritability, loss of interest or pleasure in activities you used to enjoy
• Cognitive: difficulty concentrating, indecisiveness, negative thinking about yourself and the future, memory difficulties, self-critical thoughts, thoughts of self-harm or suicide
• Physical: fatigue and low energy, changes in appetite or weight, disturbed sleep (too much or too little), aches and pains with no clear physical cause, reduced libido, feeling physically slowed down
• Behavioural: withdrawing from social contact, reduced activity levels, neglecting responsibilities, difficulty getting started on tasks, loss of motivation, giving up hobbies or interests

One of the most insidious features of depression is the way it distorts your thinking. When you are depressed, your mind tends to filter out positive information and amplify the negative, making it feel as though things have always been this way and always will be. This is not reality. It is the depression talking, and it is something therapy can directly address.

Types of depression

Depression presents in several forms:

• Major depressive disorder: one or more episodes of depression lasting at least two weeks, with significant impairment to daily functioning
• Persistent depressive disorder (dysthymia): a chronic, lower-level depression lasting two years or more, where you may function but rarely feel well
• Seasonal affective disorder (SAD): depression that follows a seasonal pattern, most commonly worsening in autumn and winter
• Postnatal depression: depression that develops in the weeks or months after having a baby, affecting your ability to care for yourself and bond with your child. Our perinatal mental health service offers specialist support for this.
• Recurrent depression: repeated episodes of depression with periods of recovery in between

Depression also commonly co-occurs with other difficulties, including anxiety, stress, low self-esteem and burnout. When multiple difficulties are present, your psychologist will develop a formulation that accounts for the full picture rather than treating each issue in isolation.

Online therapy for depression: what to expect

Depression is one of the most well-researched difficulties in clinical psychology, and effective treatments are available. Whether you are looking for a depression therapist online or exploring your options for the first time, our clinical psychologists can help. We use a range of approaches including:

• Cognitive behavioural therapy (CBT): the most established therapy for depression, targeting the negative thought patterns and behavioural withdrawal that maintain low mood through structured, practical techniques
• Behavioural activation: a focused approach that helps you gradually re-engage with activities and routines that bring a sense of achievement or pleasure, directly tackling the withdrawal cycle
• Acceptance and commitment therapy (ACT): helps you develop a different relationship with difficult thoughts and feelings so they have less power over your behaviour, while reconnecting with what matters to you
• Compassion-focused therapy (CFT): particularly helpful when depression is accompanied by intense self-criticism, shame or a harsh inner voice
• Schema therapy: works with the deeper, longstanding patterns and core beliefs, often developed in childhood, that make you vulnerable to depression
• Mindfulness-based cognitive therapy (MBCT): specifically designed to prevent relapse in recurrent depression, combining mindfulness practices with cognitive therapy principles
• Interpersonal therapy (IPT): focuses on the relationship between depression and interpersonal difficulties, helping you improve communication patterns and resolve conflicts that may be maintaining your low mood

The choice of therapy depends on the nature of your depression, what is driving it, and what suits you best. Your psychologist will discuss the options with you and explain the rationale behind their recommendation.

Our approach

At The Online Psychologists, we take depression seriously. We know how debilitating it can be, and we know that when you are in the grip of it, even reaching out for help takes significant effort. We aim to make the process as straightforward as possible.

All of our psychologists are HCPC-registered clinical psychologists with extensive experience in treating depression and low mood. When you contact us, we take the time to understand your difficulties before carefully matching you with a psychologist whose expertise and approach are well suited to your needs. This personalised matching process helps ensure you are working with someone who has the right skills for your particular presentation, whether that is a first episode of depression, a chronic pattern, postnatal difficulties, or depression linked to deeper issues of self-worth and identity.

Our sessions are delivered entirely online via secure video, which means you can access specialist support without the barriers of travel, waiting rooms, or needing to find the energy to leave the house, something that matters enormously when motivation and energy are already low. Research consistently demonstrates that online therapy is as effective as face-to-face therapy for depression.

We use evidence-based approaches including CBT, ACT, CFT, schema therapy, IPT and mindfulness-based approaches. Rather than applying a single model to everyone, your psychologist will tailor the treatment to what will work best for you, drawing on their clinical judgement and the research evidence.

What does depression therapy involve?

Therapy for depression is a structured, collaborative process designed to help you understand what is maintaining your low mood and take meaningful steps towards recovery. Here is what it typically looks like.

Assessment. The first one or two sessions are focused on getting a thorough understanding of your depression, including when it started, what triggers it, how it affects your daily life, and what you have tried before. Your psychologist will also ask about your personal history and relationships, as these often contain important clues about the patterns driving your low mood. By the end of the assessment, you will have a shared formulation, a clear, personalised map of what is keeping your depression going.

Early sessions. In the initial phase of therapy, the focus is often on stabilisation and building momentum. If you are very withdrawn or low in energy, your psychologist may begin with behavioural activation, helping you identify small, manageable activities that can start to shift your mood. Even simple changes, like re-introducing a brief daily walk or reconnecting with a friend, can begin to interrupt the withdrawal cycle.

Core therapy. As therapy progresses, the work goes deeper. In CBT, this might involve identifying and challenging the negative automatic thoughts and underlying beliefs that fuel your depression, such as “I’m a failure” or “nothing will ever change.” In schema therapy, you might explore the origins of these beliefs and develop new ways of relating to yourself. In CFT, the focus may be on softening a harsh inner critic and cultivating self-compassion.

Between-session work. Therapy for depression is most effective when the work extends into your daily life. Your psychologist may ask you to complete mood diaries, schedule activities, practise specific techniques, or carry out behavioural experiments between sessions. This between-session work is tailored to where you are in the process and is always discussed collaboratively, never just assigned as homework.

Relapse prevention. As you begin to feel better, the focus shifts to consolidating your gains and reducing the risk of future episodes. This might involve developing a personalised relapse prevention plan, identifying your early warning signs, and building a toolkit of strategies you can draw on if low mood starts to return. If you have a history of recurrent depression, MBCT may be incorporated specifically to reduce the likelihood of relapse.

Frequently asked questions

How long does therapy for depression take? This depends on the nature and severity of your depression. A typical course of CBT for a single episode of moderate depression might involve 12 to 20 sessions. For more longstanding or complex difficulties, particularly where depression is linked to deeper patterns of self-criticism or early life experiences, a longer course of therapy such as schema therapy may be recommended. Your psychologist will discuss expected timescales with you at the outset.

Can therapy help if I have been depressed for years? Yes. Even chronic or longstanding depression can respond to the right treatment. Persistent depressive disorder and recurrent depression often benefit from approaches that go beyond standard CBT, such as schema therapy, CFT or MBCT. These approaches are designed to address the deeper patterns that keep you vulnerable to depression over time.

What if I am taking antidepressants? Therapy and medication can work well together. Many people benefit from combining the two, particularly in moderate to severe depression. Your psychologist will not ask you to stop medication and will work alongside your prescriber. Over time, therapy can give you the skills and understanding to manage your mood more independently, which some people find reduces or eliminates the need for medication, though this is always a decision to make with your GP or psychiatrist.

I am having thoughts of self-harm. Should I still contact you? If you are in immediate danger, please contact your GP, the Samaritans (116 123) or emergency services (999). If you are experiencing thoughts of self-harm or suicide but are not in immediate crisis, we can absolutely support you. Our clinical psychologists are trained to work safely with people who are experiencing suicidal thoughts, and this will be discussed openly and without judgement as part of your therapy.

When to seek help

If low mood has persisted for more than two weeks, if you have lost interest in things you normally enjoy, or if depression is affecting your ability to work, maintain relationships or look after yourself, professional support can help. Depression is not a character flaw or something you should be able to push through on your own. It is a recognised condition that responds well to treatment. If you are experiencing thoughts of self-harm or suicide, please seek help immediately through your GP, the Samaritans (116 123) or emergency services.