Depression therapy in Brighton and East Sussex

What is depression?

Depression is a mental health condition that lowers mood, drains energy and makes it harder to find interest or pleasure in everyday life. Clinically significant depression, sometimes called major depressive disorder, usually lasts for two weeks or more and affects how a person thinks, feels and functions throughout that time, well beyond an ordinary bad day.

It can build slowly over months, or follow a clear trigger such as bereavement, redundancy, a relationship ending or a health scare. For some people it arrives without an obvious cause at all. Depression often sits alongside anxiety, and the two can feed into each other, so a low mood that comes with constant worry or a racing mind is just as relevant to bring to therapy as low mood on its own. We are clinical psychologists supporting adults across Brighton and East Sussex, working online with depression using approaches grounded in evidence rather than guesswork.

Symptoms of depression

Depression looks different from person to person, but common signs include:

• a low or flat mood most of the day, most days
• losing interest in activities that used to matter
• disturbed sleep, either sleeping too little or too much
• low energy and a sense of everything feeling like an effort
• poor concentration or difficulty making decisions
• changes in appetite or weight
• feeling worthless, guilty or self-critical
• moving or speaking more slowly than usual, or feeling agitated and restless
• recurring thoughts of death or of not wanting to be here

A few of these on their own do not necessarily mean depression. What matters clinically is how many symptoms are present, how long they have lasted and how much they are affecting work, relationships and daily routines.

Types of depression

Depression is not a single, fixed experience. Presentations include a single depressive episode, recurrent depressive disorder where episodes come and go over time, and persistent low-grade depression that lasts for years without lifting fully, sometimes called dysthymia. Some people experience depression with strong anxiety, others with high irritability, and others with low mood so severe that getting out of bed or eating regularly becomes difficult. Postnatal depression and depression linked to a physical health condition are also recognised, distinct presentations that may need a different emphasis in treatment. Working out which pattern fits is part of the initial conversation, not something to work out alone beforehand.

Online therapy for depression: what to expect

Sessions take place over secure video call, usually on a weekly basis to begin with. The first session focuses on understanding your history, current symptoms and what has and has not helped before, so that therapy is shaped around your situation rather than a generic script. From there, sessions follow an agreed structure, reviewing progress, working through specific techniques and adjusting the pace as needed.

Online therapy for depression has a solid evidence base. Reviews used by NICE show that therapy delivered remotely produces outcomes broadly comparable to in-person sessions for depression and anxiety, and for many people it removes the added effort of travel at a time when energy is already limited. You will need a private space and a stable internet connection, but nothing more specialised than that.

Our approach

Treatment recommendations follow NICE guidance for depression, which means cognitive behavioural therapy, or CBT, is usually the starting point. CBT looks at the link between thoughts, feelings and behaviour, and helps identify unhelpful patterns of thinking and avoidance that keep low mood going. Behavioural activation, which gradually rebuilds engagement with activities that bring meaning or achievement, is often used alongside it, particularly when low energy has led to withdrawing from ordinary routines.

For some presentations, interpersonal therapy, which focuses on relationship patterns and life transitions connected to the depression, is a better fit. Where depression has recurred more than once, mindfulness-based cognitive therapy is a NICE-recommended option for reducing the likelihood of future episodes once the current one has lifted. Where depression sits alongside anxiety or follows a difficult life event, treatment often draws on more than one approach instead of following a single model rigidly. Which approach applies is agreed together and reviewed as therapy goes on.

What does depression therapy involve?

Early sessions usually involve mapping out how the depression developed and what keeps it maintained, including sleep, activity levels, relationships and patterns of thinking. From there, therapy is practical: identifying small, achievable changes to daily activity, testing out unhelpful beliefs instead of accepting them as fact, and building skills for managing low mood when it resurfaces.

Homework between sessions is common, whether that is a brief activity log, a written reflection or a specific behavioural experiment. Progress is not always a straight line. Some weeks will feel harder than others, and that is factored into the pace rather than treated as a setback. Sessions continue for as long as they are useful, with regular check-ins on whether the current approach is working and whether anything needs to change. Throughout, the focus stays on what is realistic given your current energy and circumstances, instead of expecting a fixed amount of change by a fixed date.

Frequently asked questions

Below are some of the questions adults most often ask before starting depression therapy, covering timescales, long-standing low mood, medication and what to do if things feel urgent.

When to seek help

It is worth getting in touch if low mood has lasted more than two weeks, if it is affecting your work, relationships or ability to manage daily life, or if you notice yourself withdrawing from things and people that usually matter to you. It is also fine to get in touch if you are simply unsure whether what you are experiencing counts as depression, since working that out together is part of the first session.

If you are having thoughts of harming yourself or of suicide, please contact your GP, call NHS 111, or speak to the Samaritans on 116 123, available any time. If you or someone else is in immediate danger, go to your nearest A&E or call 999. These services are equipped for urgent support in a way that a scheduled therapy appointment is not, and using them alongside or ahead of therapy is entirely appropriate.