Depression can affect far more than mood. You may feel exhausted, disconnected, unmotivated, self-critical or unable to enjoy things that used to matter. Everyday tasks can begin to feel disproportionately difficult, and it can become harder to imagine that anything will change.
Sometimes low mood follows a clear loss, relationship difficulty, illness, prolonged stress or major life change. At other times there is no single obvious cause. Therapy can provide a place to understand what is happening, identify what may be keeping the problem going and begin creating movement again.
What depression can feel like
Different people experience depression differently. Common experiences can include:
- Persistent sadness, emptiness or emotional numbness
- Loss of interest or pleasure
- Low energy and difficulty getting started
- Sleep or appetite changes
- Difficulty concentrating or making decisions
- Withdrawal from people or activities
- Guilt, hopelessness or harsh self-criticism
- Feeling that life has become stuck or very small
Why the cycle can become self-reinforcing
When we feel low, it is understandable to withdraw, avoid difficult tasks and reduce activity. Unfortunately that can also mean fewer opportunities for pleasure, connection, achievement and confidence. The resulting loss of momentum can then deepen the low mood.
Part of the work may therefore involve understanding the emotional and relational factors behind the depression while also finding practical ways to reintroduce activity, connection, purpose and choice.
How I may work with low mood
I do not use one fixed method for everybody. Depending on what is happening, therapy may include psychotherapy or counselling, work with difficult past experiences, practical behavioural strategies, and focused approaches for particular emotional responses.
For some people, understanding and talking are central. For others, insight is already present but the emotional response has not changed. The work can then become more focused on learned responses, avoidance, self-criticism, shame, loss or other patterns that are keeping the problem active.
When difficult experiences are part of the picture
Low mood can sometimes be closely connected with bereavement, rejection, bullying, relationship experiences, loneliness, loss of identity or long periods of stress. We can explore those experiences without assuming that you need to repeatedly relive everything that happened.
If you are already receiving treatment
If you are taking antidepressant medication or receiving support from a GP, psychiatrist or another mental-health service, therapy can often sit alongside that care. I will not advise you to change prescribed medication; medication questions should be discussed with the clinician responsible for prescribing it.
If you need urgent help
Thinking Free is not a crisis or emergency service. If you feel unable to keep yourself safe, are at immediate risk, or need urgent mental-health support, please use NHS urgent mental-health services, call NHS 111 and select the mental-health option where available, contact your GP/crisis team, or call 999 in an emergency. Samaritans are available 24 hours a day on 116 123.