If you’ve been feeling persistently low, unmotivated, or hopeless, and ordinary things have started to feel harder than they should, you’re not alone. I’m Tara O’Donoghue, a senior psychotherapist offering evidence based therapies which specialise in treating depression.
Depression can make you feel unlike yourself. You might have lost interest in things you used to enjoy, find everyday tasks exhausting, or feel disconnected from the people around you. Some people withdraw noticeably; others keep working and functioning outwardly while feeling emotionally depleted underneath. However it shows up for you, therapy can help you understand what you’re going through and take manageable steps forward.
Below, I explain how depression is understood, how talk therapy can help, and what working together would actually be like.
What is depression?
Depression is more than a low mood that passes. It’s a persistent sense of sadness, hopelessness, or loss of interest that affects how you think, feel, and cope day to day. It can affect your body too, not just your mind. It looks different from person to person, can range from mild to severe, and doesn’t always have one obvious cause.
What are the causes?
The causes of depression are usually a combination of genetic, biological, environmental, and psychological factors. Common triggers include stress, trauma, grief, chronic illness, and major life changes.
Sometimes there’s a clear reason someone becomes depressed, and sometimes there isn’t one obvious cause at all. Either way, what you’re experiencing is real and treatable.
Am I depressed?
Depression affects everyone differently, so you may recognise some of these signs and not others. This list can help you notice possible signs, it isn’t a diagnosis, which only a qualified professional can provide after speaking with you. You may experience:
- Persistent feelings of sadness, anxiety, or emptiness
- Loss of interest or pleasure in hobbies or activities
- Sleep disturbances, such as insomnia or hypersomnia
- Changes in appetite or weight
- Fatigue or loss of energy
- Difficulty concentrating or making decisions.
- Feelings of worthlessness or guilt
- Thoughts of self-harm or suicide
There are different tests and assessment tools used to diagnose depression, including questionnaires and psychological interviews.
The PHQ-9 is a short, widely used questionnaire that can help you get a sense of how low your mood has been over the past two weeks. You’re welcome to complete it yourself, you can find the PHQ-9 questionnaire here. It’s a helpful starting point, but it isn’t a diagnosis on its own; the results are most useful when discussed with a qualified CBT therapist who can understand them in the context of your life.
If you’re concerned about your mood, or think you may be experiencing depression, it can help to talk it through with someone. I offer online sessions and in-person home visits across London. Get in touch to arrange an appointment.
How can therapy help with depression?
Depression can feel like being stuck but it’s something you can work through with the right support. Therapy such as CBT or BA gives you space to understand what’s contributing to how you feel and to start moving forward at a pace that works for you. Over time, therapy for depression can help you:
- Understand what may be contributing to your low mood
- Notice the patterns of thinking and behaviour that can keep low mood going
- Work with difficult thoughts and emotions rather than being overwhelmed by them
- Gradually reconnect with activities and people that matter to you
- Ease the harsh self-criticism that often comes with depression
- Build healthier ways of coping with stress and difficult feelings
- Take manageable steps back towards daily life, work, and relationships
Everyone’s experience of depression is different, so therapy isn’t one-size-fits-all. The aim is to help you feel more like yourself again, not through quick fixes, but through steady, meaningful change.
What talk therapy actually involves
If you’ve never had talk therapy before, it’s natural to wonder what actually happens. Talk therapy simply means talking things through with someone trained to help in a calm, confidential space, at your own pace. There’s no pressure to have everything figured out.
In practice, therapy usually involves:
- Talking about what you’ve been experiencing and how it’s affecting you
- Making sense of your thoughts, feelings, behaviours, and the patterns between them
- Identifying what you’d like to feel or do differently
- Agreeing together on an approach that suits you
- Trying out practical strategies where they’re helpful
- Reviewing how things are going and adjusting as we go
It isn’t about being told what to do or being judged. We work together, and you stay in control of what you share and what you’d like to focus on.
Talk therapy for depression: CBT and other approaches
1. Cognitive Behavioural Therapy
Cognitive Behavioural Therapy (CBT) is one of the talk therapies recommended by NICE for depression for overcoming depression, improving low mood, and enhancing mental well-being (see NICE guidelines).
CBT helps you notice and question the negative thoughts and beliefs that can come with depression. For example, thoughts like: ‘I’m not good enough,’ ‘nothing will ever change,’ or ‘there’s no point in trying.’ When you’re depressed, thoughts like these can feel like simple facts. CBT helps you step back, examine whether they’re really true or helpful, and gradually build more balanced, realistic ways of thinking.
2. Behavioural Activation
CBT also includes practical, behavioural strategies, an approach known as Behavioural Activation (BA).
When you’re depressed, it’s common to withdraw and do less which makes complete sense, because everything feels harder and motivation drops. But doing less also means fewer moments of connection, achievement, or enjoyment, which can lower mood further and make it even harder to get going. It becomes a cycle that keeps low mood in place.
Behavioural Activation gently works to break that cycle. Rather than waiting to feel motivated first, we look together at small, meaningful activities you can gradually reintroduce at a realistic pace, and with understanding for how difficult that can be. It’s never about simply ‘doing more’; it’s about slowly rebuilding the things that give your days meaning. BA is recommended in the NICE guidelines for treating depression.
During CBT, individuals collaborate with their psychotherapist to develop a personalised treatment plan as part of talk therapy for depression, alongside value-directed goals and strategies for managing low mood.
CBT and Behavioural Activation usually take place over a structured course of 12-20 sessions , and the two are often combined, which can be an effective way to work through depression and reduce the chance of relapse. How long therapy lasts depends on both you and myself. Some people find shorter-term work helpful, while others prefer ongoing support.
Sessions typically last 60 minutes and take place weekly.
3. Compassion Focused Therapy
Depression often comes with a harsh inner voice, constantly criticising yourself, feeling you’re not good enough, or carrying a sense of shame. Where this is part of your experience, Compassion Focused Therapy (CFT) can help. It focuses on developing a kinder, more understanding relationship with yourself, so you can begin to respond to difficult moments with more self-compassion rather than self-blame.
Why work with me?
People come to therapy for depression at very different points. Some feel they’ve hit a wall; others aren’t sure their low mood is ‘serious enough’ to justify getting help. If you’re keeping going at work or at home but feel depleted underneath, if a difficult life event has left you struggling, or if you’ve simply lost the sense of being yourself, therapy may help. You don’t need to be at crisis point, and you don’t need to have it all figured out before getting in touch.
I’m Tara O’Donoghue, a Senior Psychotherapist based in London with over 17 years’ experience in delivering evidence based psychological therapy. I work with individuals across London who may appear to be coping outwardly while struggling underneath.
I integrate Cognitive Behavioural Therapy (CBT), Compassion-Focused Therapy (CFT) and EMDR within a structured, formulation-led approach. Alongside easing symptoms, we work with what matters most to you: your values and the kind of life you want to move towards, so progress is something you actually feel, not just measure. My style is collaborative and led by your needs, at a pace that feels manageable.
I offer both online sessions and in-person home visits across London, so you can have support in the way that suits you best.
What to expect from your first session
The first session is often the part that feels most daunting so it helps to know there’s nothing you need to prepare. You don’t have to explain everything neatly, or even know where to start. You can simply talk about what’s been going on, and I’ll help guide the conversation from there.
Mostly, the first session is also called an assessment. The assessment is 90 minutes and includes questionnaires sent to you beforehand which I ask for you to complete and send back prior to our meeting. This means when we meet I will already have an understanding of what may be happening for you and use our time most efficiently, then within 48 hours of the assessment I will send you a summary of findings including a personalised treatment plan to help you achieve your goals. From there we explore what the next steps.
Contact
If you’re struggling with depression and would like to explore whether therapy could help, I’d be glad to hear from you. Get in touch to talk through what you’re experiencing and arrange an initial appointment. There’s no pressure, just a chance to see whether we’re a good fit.
You can email me at info@homebasedtalkingtherapy.com, or use the contact form.
Websites and additional information
The National Institute for Health and Care Excellence (NICE) publishes guidelines on recommended treatments for depression, which you can read here.