Depression lies to you. That's one of the first things I tell people who come to see me about it. It tells you nothing will help. It tells you it's your fault. It tells you things have always been this way and always will be. Every one of those statements is wrong.
Depression is more than feeling sad
Most people think depression means being sad all the time. Some people with depression don't feel sad at all. They feel empty. Numb. Flat. Like someone turned down the volume on everything.
Here's what depression can actually look like. You stop doing things you used to enjoy. Not because you've lost interest exactly, but because the effort feels impossible. You pull away from people. You sleep too much or hardly at all. Your concentration is shot. Making even small decisions feels overwhelming. You might feel irritable rather than tearful. You might feel nothing at all.
Some people function through it. They go to work, look after their kids, keep the house running. Nobody knows. But inside, everything is heavy. If that sounds familiar, you're not weak. You're exhausted from carrying something that shouldn't be carried alone.
How CBT tackles depression
Depression creates a vicious cycle. Low mood leads to withdrawal. Withdrawal means fewer positive experiences. Fewer positive experiences reinforce the low mood. Your thinking becomes increasingly negative and you start to believe the depression's version of reality.
CBT breaks into that cycle from two directions.
Behavioural activation
This is where we usually start. When you're depressed, you wait until you feel motivated before doing things. The problem is that motivation doesn't come back on its own. It follows action, not the other way around.
Behavioural activation means gradually rebuilding activity in your life. Not in a "just go for a run" way. In a structured, planned way that accounts for how depleted you are. We start small. Really small. A five-minute walk. Texting one friend. Cooking one proper meal instead of eating toast. Each small action generates a tiny bit of momentum. Those bits add up.
Thought challenging
Depression distorts thinking in predictable ways. You focus on the negative and filter out the positive. You generalise from one bad experience to everything. You blame yourself for things that aren't your fault. You predict the worst and treat it as fact.
In CBT, I'll teach you to spot these patterns as they happen. Not to replace negative thoughts with positive ones. That doesn't work and it feels fake. Instead, we develop more balanced, accurate thinking. The evidence-based kind. "I failed that interview" becomes "I didn't get that job, but I've got three others in the past two years." That shift matters more than it sounds.
The typical therapy journey
The first session is an assessment. I'll ask about your mood, your history, your daily life, what you've tried before. I need the full picture to plan treatment properly.
Sessions two and three usually focus on understanding your depression. We'll map out your specific cycle: the triggers, the thoughts, the feelings, the behaviours. This isn't navel-gazing. It's practical. Once you can see the pattern, you can start changing it.
From there, we move into active treatment. Behavioural activation comes first for most people because it gets things moving quickly. Then we layer in thought challenging and other techniques as your energy and concentration improve. Towards the end of therapy, we focus on relapse prevention, making sure you have a plan for staying well.
Most people need 12 to 20 sessions. Some need fewer. If your depression is longstanding or you've had multiple episodes, we might need to go deeper into core beliefs and longer-term patterns.
A real example
Someone came to see me who'd been depressed for over two years. They'd been signed off work twice. Their GP had tried two different antidepressants. Things had improved slightly with medication but they were still stuck. Getting through each day felt like wading through treacle.
In the assessment, a clear pattern emerged. They'd withdrawn from almost everything: friends, hobbies, exercise. Their days were work, sofa, bed. Repeat. The depression had convinced them that doing things wouldn't help and that people didn't really want to see them.
We started with behavioural activation. Tiny things. A ten-minute walk on Monday. Coffee with a colleague on Wednesday. Gradually, the list grew. Their mood didn't transform overnight, but after four weeks they said something telling: "I didn't enjoy the walk exactly, but I didn't dread it either." That's progress.
Over 16 sessions, we rebuilt their activity levels, challenged the core beliefs driving the withdrawal, and developed a relapse prevention plan. Six months later they were back at work full-time and had rejoined a five-a-side team. Still on medication. Still had bad days. But the depression no longer ran their life.
Pricing and next steps
Sessions cost £60 for 50 to 60 minutes. I offer concessions for veterans, serving personnel, and blue light workers.
Depression makes everything feel harder, including picking up the phone. But that one call can change the direction of things. Book a free 15-minute consultation or call me on 07469 870 295.
You might also want to read about my general CBT approach or how I work with related issues like anxiety and low self-esteem.
