Depression is one of the most common reasons people seek therapy, and one of the most isolating experiences to carry. It can arrive with a clear cause, a loss, a life change, a period of sustained pressure, or it can emerge without an obvious trigger, which can make it harder to name and harder to ask for help with.

It is more than low mood. Depression involves a quality of heaviness or flatness that persists, that doesn’t lift with rest or distraction, and that affects how you function in daily life. It changes how you see yourself, how you experience relationships, and often how you understand the future.

What Depression Can Feel Like

Depression presents differently in different people. Common experiences include:

• Persistent low mood or sadness that doesn’t ease over time
• A loss of interest or pleasure in things that previously mattered
• Fatigue and a lack of energy that isn’t explained by activity levels
• Difficulty concentrating, making decisions, or completing ordinary tasks
• Changes in sleep, including difficulty dropping off, waking early, or sleeping significantly more than usual
• Changes in appetite or weight
• A sense of worthlessness, failure, or excessive guilt
• Irritability, restlessness, or a low tolerance for ordinary frustrations
• Physical symptoms without clear cause, including headaches, muscle pain, or digestive difficulties
• Withdrawing from relationships and activities
• Thoughts that life is not worth living

If you are having thoughts of suicide or self-harm, please contact your GP, call the Samaritans on 116 123, or attend your nearest A&E. These thoughts are a signal that you need support now, and you deserve to receive it.

Types of Depression

Depression isn’t a single presentation. Understanding which type you may be experiencing can help in finding the right support.

Major depression involves persistent low mood and associated symptoms for at least two weeks, affecting the ability to function in daily life. It may occur as a single episode or recurrently.

Persistent depressive disorder (dysthymia) describes a lower-level but chronic depression that lasts for two years or more. Because it persists rather than arriving acutely, it can be easy to normalise or mistake for personality.

Seasonal affective disorder (SAD) is a pattern of depression that follows the seasons, typically beginning in autumn and lifting in spring, connected to changes in light levels.

Postnatal depression develops after the birth of a child and is more significant and persistent than the low mood many new parents experience in the early weeks. It deserves prompt clinical attention.

Depression with psychotic features involves the addition of delusions or hallucinations to a depressive presentation and requires specialist clinical assessment and management.

What Causes Depression

Sometimes the cause is identifiable: a bereavement, a relationship ending, job loss, a health diagnosis, chronic stress, or a period of significant life change. At other times depression arrives without an obvious trigger, which can be confusing and contribute to self-blame.

From a psychodynamic perspective, depression often has roots that go deeper than current circumstances. It can be connected to grief that hasn’t been fully processed, to early relational experiences that shaped how you understand your own worth, to chronic patterns of self-suppression, or to losses, including emotional losses, that were never adequately mourned. Understanding those roots tends to produce more durable change than symptom management alone.

Depression and trauma are also frequently connected. Many people whose depression has felt treatment-resistant find that addressing underlying trauma, particularly developmental or relational trauma, shifts something that other approaches haven’t reached.

Should I See My GP?

Yes, it’s worth letting your GP know how you’re feeling. There can be physical factors contributing to low mood, including thyroid function and vitamin deficiencies, that are worth ruling out. Your GP can also discuss medication if that feels relevant. Medication and therapy are not mutually exclusive, and for some people a combination is the most effective approach. Psychotherapists don’t prescribe or manage medication, but I’m happy to work alongside your GP or psychiatrist if that’s part of your care.

How I Work With Depression

My approach to depression is relational and psychodynamic. That means I’m interested in the history behind the depression as much as its current presentation, in what it might be communicating, and in what conditions allow it to begin to lift. The therapeutic relationship itself is part of what helps. For depression that has roots in early relational experience, having a consistent, attuned, and genuinely safe therapeutic relationship offers something that insight alone cannot.

Some people find that relatively short-term work is sufficient to shift an episode and build enough understanding to manage future ones. Others find that longer-term depth work is what’s needed, particularly where depression has been present for many years or is connected to complex trauma or relational patterns. We can discuss what feels right for your situation as we begin.

Further Reading

• Herman, J. L. (1992). Trauma and Recovery. Basic Books.
• Miller, A. (1987). The Drama of Being a Child. Virago.
• Bowlby, J. (1988). A Secure Base: Clinical Applications of Attachment Theory. Routledge.