CBT for Depression
Depression changes what you do and how you think. CBT works on both
Depression doesn’t just lower your mood. It changes what you do, pulling you away from people, routines and the things that used to matter. It also changes how you think, filling your mind with negative, hopeless thoughts about yourself and your life. CBT is one of the most researched treatments for depression, and it works on both.
Common signs of depression
It doesn't always look like sadness
Sometimes people describe feeling flat or empty. Others notice they’re exhausted, irritable, or pulling away from the things that matter. If several of these sound like you, and have done for a couple of weeks or more, it’s worth reaching out.
Low mood
Feeling sad, empty or hopeless, or being tearful. Some people mainly feel irritable instead.
Loss of interest or pleasure
Things you used to enjoy no longer feel worthwhile or rewarding.
Changes in appetite or weight
Eating much more or much less than usual, or noticeable weight loss or gain without trying.
Changes in sleep
Difficulty sleeping, or sleeping far more than usual.
Feeling slowed down or restless
Moving or speaking more slowly, or being unable to settle, in a way others might notice.
Tiredness or low energy
Even small tasks feel exhausting.
Feeling worthless or guilty
Low self-esteem, harsh self-criticism, or guilt that is out of proportion to the situation.
Difficulty thinking
Trouble concentrating or making decisions.
Thoughts of death or of harming yourself
This includes feeling that life isn’t worth living.
Many people find their symptoms don’t fit neatly into a list, and that’s fine. What matters is your experience, not the label. A proper assessment is the way to find out what’s going on and what can help.
If you’re having thoughts of harming yourself, please contact your GP or NHS 111, or call Samaritans free on 116 123 at any time. In an emergency, call 999.
Why low mood is hard to shift
When your mood drops, you tend to withdraw, and everything starts to look bleaker.
Low mood makes you withdraw: from people, from routines, from anything that once felt worthwhile. You might tell yourself “I don’t feel like doing that” or “I can’t be bothered”. That withdrawal feels protective in the moment, like curling up on the sofa when you’re ill, but it quietly removes the things that gave you routine, connection and reward. With less of that in your life, your mood drops further.
At the same time, low mood colours how you interpret everything. A missed reply becomes proof of abandonment. A mistake at work becomes proof of incompetence. These quick, often unnoticed interpretations are what Aaron Beck called automatic thoughts.
The two feed each other: your thoughts make it harder to act, and doing less gives your mind more “evidence” for those thoughts.
Two ways CBT can help
Changing what you do
Act first, and let the feeling follow.
Depression convinces you to wait until you feel better before doing anything. Behavioural activation, developed by Christopher Martell and Neil Jacobson, works the other way round. You build the life that supports a better mood by re-engaging with it deliberately, before motivation arrives. This is often described as working from the outside in.
Changing how you think
Sometimes your thoughts aren’t facts.
Aaron Beck’s cognitive therapy for depression works on two levels. First, it helps you notice thoughts, test whether they’re accurate, and replace them when needed. Then, as therapy progresses, we look at the deeper core beliefs behind them, such as “I’m not good enough”, and build more balanced ones. It’s one of the most researched treatments for depression. → Read more
What to expect
CBT for depression is active and structured. Most people attend weekly, for roughly 12 to 20 sessions.
Sessions have an agenda
A short list of topics is agreed at the start, so time is spent on what matters most.
There's homework between sessions
Practicing outside the room, testing a thought or new behaviour, is where most of the actual change happens.
Progress is checked, not assumed
Brief mood questionnaires are used each session, so we can both see whether things are improving, and adjust the plan if not.
The evidence base
Cognitive therapy for depression has been studied since the 1970s and is one of the most extensively researched psychotherapies available. It's recommended as a treatment for depression by bodies including the UK's National Institute for Health and Care Excellence (NICE) and the American Psychological Association (APA).
Common questions from new clients
Ready to try a different approach?
You don’t need a diagnosis, or a clear idea of what’s wrong, to get in touch. Contact me to arrange an initial assessment, where we’ll talk through what’s been going on and what you’re hoping to get from therapy.