What depression actually feels like

Depression isn’t only sadness. More often it’s a flatness — things that used to matter stop landing, motivation drains away, and the effort of an ordinary day feels enormous. Low mood, lost interest, broken sleep, harsh self-criticism, pulling away from people: it tends to feed itself, because the less you do the worse you feel, and the worse you feel the less you do.

Why it keeps going

The withdrawal depression pulls you into — doing less, avoiding, retreating — is what keeps it turning. That isn’t laziness; it’s the condition doing its thing. Treatment works by interrupting the cycle, gently and deliberately, rather than waiting for the motivation to return on its own.

How CBT works with depression

CBT is often the most direct route here. Early on we build a shared picture of what’s keeping you stuck. The core method is behavioural activation — rebuilding activity and contact in small, planned steps, ahead of motivation rather than waiting for it, because with depression motivation tends to follow action, not precede it. Alongside that, cognitive restructuring helps you examine the self-critical thoughts that feel like facts but rarely hold up. It’s practical and structured, and most people feel some movement between the early sessions and the later ones.

When CAT is the better route

When depression keeps coming back — when it’s less a single episode than a familiar place you return to — the pattern underneath matters more than this particular dip. That’s where CAT fits. We map the patterns — often harsh, self-attacking ways of relating to yourself, learned a long time ago — as reciprocal roles, and early on I write you a reformulation letter setting out how they formed and what keeps them going. The choice between CBT and CAT is made together, at the first session. More on how I work.

What treatment looks like

Most courses run between 8 and 24 sessions, weekly to begin with. We usually start by getting the basics moving again, then work on the thoughts and patterns underneath. It isn’t instant, and I won’t pretend it is — but depression is very treatable, and most people feel the ground steady well before the end.

Common questions

I can’t face doing anything — how can therapy help? That’s the depression talking, and it’s exactly what we work with. Behavioural activation starts smaller than you’d expect, and builds from there — we don’t wait for you to feel like it first.

Will I have to take medication? That’s a conversation for you and your GP. Therapy works on its own and alongside medication; I’ll work with whatever you decide.

Is it normal to feel nothing, rather than sad? Yes. Flatness and numbness are as much a part of depression as sadness — many people describe feeling switched off rather than down.

What if it comes back? If depression is recurrent, CAT in particular targets the pattern, so a future dip is easier to catch and interrupt. Either way, you leave with tools you can reuse.

Depression, Low Mood & Lack of Motivation