Depression and low mood

Depression is a persistent lowering of mood, energy and interest that lasts for weeks rather than days. It often brings disrupted sleep, poor concentration and a pull towards withdrawing from people and activities. A clinical psychologist can help you understand what is keeping the low mood in place and build a structured way out of it.

What depression is and how it shows up

Depression is more than sadness. It typically involves a drop in energy and motivation, a loss of interest in things that used to matter, and changes to sleep and appetite in either direction. Concentration often suffers, small decisions can start to feel enormous, and self-critical thinking tends to intensify, with a persistent sense that things are your fault or will not improve.

Behaviourally, depression pulls people towards withdrawal. Cancelled plans, skipped exercise, unanswered messages and days spent avoiding tasks all feel protective in the moment, but they tend to deepen low mood over time by removing the activities and contact that would otherwise support it. This is sometimes called the depression spiral: doing less leads to feeling worse, which leads to doing even less.

Depression varies in severity and pattern. Some people experience a single episode linked to a clear event, a bereavement, a job loss, a relationship ending. Others experience a more recurring pattern that returns at intervals, sometimes without an obvious trigger. Postnatal depression is a distinct presentation with its own assessment and treatment pathway, covered separately on our perinatal mental health page.

Depression is also frequently accompanied by anxiety. Worry about the future, guilt about not managing as well as usual, or fear of letting people down can sit alongside low mood and reinforce it. Physical health plays a part too: chronic pain, poor sleep and reduced activity can all lower mood over time, which is one reason assessment looks at the whole picture rather than treating low mood as an isolated symptom.

When to seek help

It is worth speaking to a psychologist if low mood, loss of interest or fatigue have lasted two weeks or more and are affecting work, relationships or things you normally enjoy. Persistent sleep problems, a drop in appetite, difficulty concentrating and a sense of hopelessness about the future are all reasonable signs to act on. If you are having thoughts of harming yourself or ending your life, please see the crisis support information below before anything else.

How a clinical psychologist assesses and treats depression

Assessment looks at how long low mood has been present, what has changed in your life around it, how it affects sleep, appetite, concentration and relationships, and what keeps it going day to day. NICE recommends cognitive behavioural therapy (CBT) as a first-line psychological treatment for depression, alongside options such as behavioural activation and interpersonal therapy depending on presentation and severity.

CBT for depression typically combines behavioural activation, deliberately reintroducing activities that give a sense of achievement or connection even when motivation is low, with work on the self-critical thinking patterns that tend to accompany low mood. Where shame or harsh self-judgement is a significant feature, a psychologist may also draw on compassion-focused therapy (CFT) alongside CBT, since building a kinder internal response can make the behavioural work easier to sustain.

Sessions in the early stages often focus on tracking mood alongside daily activity, so that the link between what you do and how you feel becomes visible rather than assumed. From there, your psychologist will help you plan small, specific activities each week, seeing a friend, going for a short walk, finishing a task you have been putting off, and review together what happened and what it tells you. Over time this behavioural work is paired with looking more closely at unhelpful thought patterns, such as harsh self-criticism or all-or-nothing thinking, and testing whether they hold up against the evidence of your actual week.

What online sessions look like

Sessions run over secure video call, usually fifty minutes, at a time that works around your commitments. All you need is a private space and a reasonable internet connection. Given that withdrawal and low energy are often part of the picture, your psychologist will typically start with small, achievable behavioural steps between sessions rather than large changes, building momentum gradually as energy and motivation start to return.

Our approach

Depression can make even the idea of starting therapy feel like too much effort, which is understandable given how much it strips away energy and motivation. Your psychologist will factor that in from the first conversation, keeping early tasks small and manageable rather than expecting big changes straight away. As mood begins to lift, sessions tend to move from managing day-to-day functioning towards understanding the wider patterns that made you vulnerable to depression in the first place, so that the gains are more likely to hold once treatment ends.

Depression and life in Islington and north London

Islington’s N1 postcodes take in Upper Street, Angel, Highbury, Canonbury and Barnsbury, with the Victoria and Northern lines running through the area. Low mood does not stop for a working day, and for people commuting on the Victoria or Northern line, fitting in appointments around a demanding job can be part of what makes seeking help feel harder. Online sessions remove the extra step of travelling to a clinic, which can matter when energy is already limited.

Getting started

Sessions are online, so there is nothing to wait for before starting. If you are ready to talk to someone, our get started page is the quickest way in, and we will match you with a psychologist suited to your needs.

If you need support right now

If you are in crisis or thinking about harming yourself, please don’t wait for an appointment. Call 999 in an emergency, contact NHS 111 and select option 2 for a mental health crisis, or call the Samaritans on 116 123, free, at any time, day or night.