Depression

What is depression?

Depression is a mental health condition involving a persistently low mood, loss of interest in everyday activities, and changes in sleep, appetite or energy that last most of the day, most days, over several weeks or more.

It ranges from a mild, low-grade version that quietly shapes your week to a severe episode that makes basic tasks feel unmanageable. The clinical name is major depressive disorder, though plenty of adults experience some of these symptoms without ever receiving that formal label. Depression differs from ordinary sadness or a rough patch, in that it tends to persist and to colour how you see yourself, other people and what comes next, rather than lifting within a few days.

We work with adults across Bromley and the surrounding parts of south east London, including Beckenham, Chislehurst, Shortlands, Bickley, Hayes and Petts Wood, offering clinical psychology support delivered online. That means sessions happen over video call wherever you are, rather than requiring a trip into the town centre around The Glades or a trip on the Southeastern and Thameslink services that run from Bromley South into Victoria and London Bridge in around twenty minutes.

Symptoms of depression

Depression shows up differently from person to person, but common features include a flat or low mood most of the day, losing interest in activities you would normally enjoy, and a drop in energy that makes even small tasks feel heavy. Sleep is often disrupted, either through insomnia or sleeping far more than usual, and appetite can shift in either direction too. Concentration tends to suffer, decisions become harder to make, and many people describe a persistent sense of guilt, worthlessness or self-criticism that feels out of proportion to events. Physical symptoms are common as well: headaches, digestive changes, and a general heaviness in the body that has no clear medical cause. In more severe depression, thoughts can turn to death or self-harm, which is covered further under when to seek help below.

These symptoms do not need to appear all at once or at full intensity for depression to be worth addressing. A gradual decline in interest, motivation and mood that has lasted more than two weeks is generally enough reason to seek an assessment.

Types of depression

Depression is not a single, uniform experience. Major depressive disorder refers to one or more distinct episodes of low mood and related symptoms severe enough to affect daily functioning. Persistent depressive disorder, sometimes called dysthymia, describes a lower-grade but longer-lasting pattern, often present for two years or more, which can be harder to notice precisely because it becomes familiar. Seasonal patterns exist too, where mood dips during darker months and lifts as daylight returns. Depression can also occur alongside anxiety, grief, chronic pain or major life changes, and in those cases it is rarely useful to treat the depression as separate from what surrounds it. Postnatal depression and depression linked to hormonal changes are further variants that follow their own course and timing. Getting the type right matters less than getting an accurate picture of how the symptoms actually show up for you, which is where an initial assessment does most of its work.

Online therapy for depression: what to expect

Sessions take place over video call at a time you arrange in advance, in a space where you can speak without being overheard or interrupted. The first session is usually an assessment, where a psychologist asks about your current symptoms, their history, and what else is going on in your life, so that any recommendations are grounded in your actual circumstances rather than a generic checklist. From there, sessions typically run weekly or fortnightly, each lasting around fifty minutes, though this is reviewed and adjusted as therapy goes on. Online delivery removes the need to travel, which matters if depression has already made leaving the house harder than it used to be, and it works well for people commuting from Bromley South or Bromley North into London who find it difficult to fit in-person appointments around a working week.

Our approach

We draw primarily on cognitive behavioural therapy, an approach with a substantial evidence base for depression and one that NICE guidance recommends as a first-line treatment for adults with mild to moderate symptoms. Cognitive behavioural therapy looks at the links between thoughts, feelings, physical sensations and behaviour, and helps identify patterns, such as avoidance or harsh self-judgement, that keep low mood in place even after the original trigger has passed. Where it fits the person and their history better, we also draw on other evidence-informed approaches, including behavioural activation and elements of acceptance and commitment therapy. No single method suits everyone, so the approach used in your sessions is shaped by what the assessment reveals rather than applied as a fixed template. Throughout, the aim is a working relationship where you feel able to speak plainly about what is actually happening, since that honesty tends to matter more to outcomes than any particular technique.

What does depression therapy involve?

Early sessions usually focus on understanding your symptoms in detail: when they started, what makes them better or worse, and how they interact with sleep, relationships, work and any other stresses. From there, therapy often moves into practical work, such as noticing and questioning unhelpful thought patterns, gradually reintroducing activities that low mood has pushed out, and building routines around sleep and daily structure that support recovery rather than working against it. Between sessions, you may be asked to try small, specific tasks, such as noting your mood at set points in the day or testing out a belief that has been driving avoidance. Progress in depression therapy is rarely a straight line, and setbacks within a course of treatment are ordinary rather than a sign that things have gone wrong. Sessions are reviewed periodically so that the focus can shift as your symptoms change.

When to seek help

It is worth seeking help once low mood, loss of interest or the other symptoms described above have lasted more than two weeks and are affecting work, relationships or daily functioning, rather than waiting for things to become severe first. If you are having thoughts of harming yourself or ending your life, this website is not the right place to manage that alone. In an emergency, call 999 or go to your nearest A&E department. For urgent mental health support outside of an emergency, call 111 and select the mental health option, or contact the Samaritans free on 116 123, available at any hour of the day or night. Once any immediate risk has been addressed, get in touch and we can talk through whether psychological therapy is a suitable next step for you.