Therapy for Depression. What It Is and How It Can Actually Help.

Understanding depression

Depression is more than having a rough week. It can affect your mood, your body, your motivation, and how connected you feel to other people. It can also show up as physical symptoms, like headaches, stomachaches, or body pain, not just sadness.

One important thing to know up front: depression is not a character flaw. You do not need to “earn” help by hitting rock bottom. If things feel heavy, numb, or stuck, that is enough reason to reach out.

If you do not feel safe, or you are thinking about harming yourself, get immediate help. In the US, you can call or text 988, call 911, or go to your nearest ER.

Symptoms of depression

Depression symptoms look different for different people. Common signs include:

• Feeling sad, empty, hopeless, or numb most days

• Being more irritable than usual (this is common in teens)

• Losing interest in things you normally care about

• Sleeping too much, not sleeping enough, or waking up a lot

• Appetite changes and weight changes

• Low energy, moving slower, or feeling “heavy”

• Trouble focusing, remembering, or making decisions

• Feeling guilty, worthless, or like a burden

• Pulling away from friends and family

• Physical aches or pains that do not have a clear reason

• Thoughts of death, self-harm, or suicide

OK, I’m feeling depressed, so now what?

Here is a simple plan. You do not have to do all of this at once.

1. Name it gently.
   Try: “I think I might be dealing with depression symptoms.”

2. Track the basics for 7 days.
   Sleep, energy, appetite, mood (0 to 10), and what is getting harder (work, school, parenting, basic care). This makes it easier to get a clear depression diagnosis.

3. Book a medical check-in.
   A provider may screen for health issues that can look like depression, like thyroid problems, and review medications or substances that could be affecting mood.

4. Start therapy for depression.
   Therapy can help you get unstuck, build coping tools, and reduce the shame loop that often comes with depression.

5. If it feels urgent, treat it like urgent.
   If you are at risk of harming yourself, call or text 988, call 911, or go to the ER.

Diagnosis

A depression diagnosis is usually based on the whole picture, not one test. Many providers use a mix of:

• Questions about symptoms, stress, and daily functioning

• A mental health evaluation (sometimes with questionnaires)

• Medical screening (a physical exam and sometimes lab tests)

• DSM-5 criteria to confirm what fits and what does not

To make the appointment easier, bring notes on when symptoms started, how sleep and appetite changed, what feels hardest right now, and any big stressors. Also mention any past periods where you felt unusually “wired,” slept very little, took bigger risks, or felt like your mood was way up, because that can change the diagnosis and the treatment plan.

Getting the diagnosis right matters because it helps match you with the right treatment for depression.

Types of depression

Depression is not one-size-fits-all. A clinician may describe depression using “types” or specifiers, such as:

• Major depressive disorder (major depression)

• Persistent depressive disorder (dysthymia)

• Peripartum depression (during pregnancy or after birth)

• Seasonal pattern (symptoms that show up in certain seasons)

• Depression with anxious distress (depression plus strong anxiety)

You do not need to sort this out alone. A good assessment helps clarify what is going on.

Other disorders that can cause depression symptoms

Some conditions can look like depression, overlap with it, or change how treatment should work. Examples include:

• Bipolar disorders, which include depressive episodes

• PMDD, where mood symptoms track with the menstrual cycle

• Substance or medication-related mood changes

• Medical conditions that impact energy, sleep, or mood

If you have wondered, “Why is this happening to me?” this is part of the answer. It is not always about willpower.

Treatment for depression

Most people do best with a plan that fits their life and symptoms. Common parts of treatment for depression include medication, therapy, lifestyle support, or a higher level of care when symptoms are severe.

Many people do best with medical support plus therapy for depression.

Medications

Antidepressants can reduce symptoms for some people, especially with moderate to severe depression. There are different categories (like SSRIs and SNRIs), and it can take time to find the best fit.

A few practical notes:

• It often takes several weeks to feel the full benefit.

• Side effects can show up sooner than benefits, and often improve over time.

• You may need a few tries or adjustments, and that is common.

• Do not stop antidepressants suddenly without talking with your prescriber.

• If you are pregnant, postpartum, or breastfeeding, ask your provider about options and safety.

• For some people under 25, early medication changes can come with an increased risk of suicidal thoughts, so monitoring matters.

If medication is part of your plan, ask your prescriber what to watch for, how to reach them if side effects show up, and when you should follow up. That kind of clarity can lower anxiety and make the process feel less scary.

Therapy for depression

Therapy for depression is not just talking. It is learning skills and building support so daily life feels more doable.

Two therapy approaches often used for depression are:

• CBT (Cognitive Behavioral Therapy), which helps you notice unhelpful thought patterns and behavior loops, then practice different responses.

• IPT (Interpersonal Therapy), which focuses on relationships, grief, conflict cycles, communication, and support.

In therapy, you might work on:

• Creating a realistic routine when motivation is low

• Responding to negative self-talk without believing every word

• Learning coping skills for stress, overwhelm, and rumination

• Improving boundaries and support (isolation can make depression worse)

• Building a relapse-prevention plan, so you notice early warning signs sooner

Alternate formats for therapy

Therapy can happen in different formats, including video sessions, structured online programs guided by a clinician, and workbooks or between-session exercises. For many people in Pennsylvania, telehealth makes therapy for depression easier to fit into work, school, parenting, or a tight schedule.

Apps can offer support, but they are not a replacement for therapy or medical care when depression symptoms are intense or getting worse.

Hospital and residential treatment

Sometimes depression becomes severe enough that weekly therapy is not enough. Higher levels of care can include inpatient hospitalization or structured day programs. These options can help when someone cannot stay safe, cannot care for themselves, or needs more support to stabilize.

Other treatment options

If standard treatment has not helped enough, other options exist, like TMS or ECT, and your medical team can help you understand whether they make sense for you.

Some “add-on” supports can also help alongside therapy and medical care:

• Regular movement (even small amounts)

• Stress management skills (like breath work or muscle relaxation)

• Support groups and community support

• Caution with supplements, since some can interact with medications

Depression in children and adolescents

Depression in kids and teens does not always look like sadness. It can look like irritability, anger, shutdown, school refusal, or a big drop in motivation. If you are a parent and you are seeing a change that lasts two weeks or more, or your child’s functioning is sliding, it is worth getting an evaluation.

Start with a pediatrician or primary care provider, and consider therapy for depression too. If your teen talks about self-harm, death, or not wanting to be here, treat it as urgent and get immediate help.

Practice these coping skills every day

You do not have to be motivated first. With depression, motivation often shows up after you start. Pick one or two of these and repeat them.

1. Meaning: Do one small act of service. Text someone support, help a neighbor, or do one helpful thing for your future self.

2. Your goals: Set a goal that is in your control, manageable, realistic for today, and measurable.

3. Pleasant events: Schedule one pleasant thing on purpose. Keep it simple, like music, a short show, or a walk outside.

4. Engagement: Come back to the present. Name 5 things you can see, or focus on one task for 2 minutes.

5. Exercise and food: Aim for steady basics. A short walk counts. A real meal counts. Water counts.

6. Relationships: Reduce isolation. Send one text, sit with someone, or ask for a small check-in.

7. Sleep regularly: Keep your wake-up time steady when you can. If your brain wants to solve life at 2 a.m., write it down and come back to it tomorrow.

FAQ: Therapy for Depression

• Does therapy for depression work?

  For many people, yes. Therapy can reduce symptoms, teach coping skills, and help prevent relapse.

• What type of therapy is best for depression?

  There is no single best fit for everyone. CBT and IPT are two common, evidence-based options. The best choice depends on your symptoms, stressors, and what keeps you stuck.

• How long does therapy for depression take?

  It depends. Some people feel change in a few weeks, others need longer support. A good therapist will help you set a pace and adjust the plan as you go.

• What happens in the first therapy session?

  Usually you will talk about what is going on, how it is affecting your life, what you have tried, and what you want to be different. You may also talk about sleep, energy, appetite, and safety.

• Do I need medication, or can therapy be enough?

  Some people do well with therapy alone, especially with mild to moderate depression. Others benefit from medication, especially when symptoms are severe, long-lasting, or affecting daily functioning. You can decide with a therapist and a medical provider.

• Do you offer therapy for depression at Emberly Counseling?

  Yes. Emberly Counseling supports teens and adults in Pennsylvania with depression, anxiety, trauma, OCD, relationship strain, and pregnancy and postpartum challenges. Our style is down-to-earth, trauma-informed, and focused on practical tools you can use between sessions.