Psychotherapy for depression is a structured talking treatment. It helps you understand and gradually change the patterns of thinking, feeling, behaving and relating that keep low mood going. For many people it works well on its own, and for others it works best alongside antidepressants. Which suits you depends on how severe your symptoms are, your circumstances and what you would prefer.
If you are thinking about harming yourself or feel unsafe right now, please don't wait for an appointment. Call 112 or 999, go to your nearest emergency department, or ring Samaritans free on 116 123. The HSE's urgent help for a mental health crisis page lists more supports.
How psychotherapy helps with depression
Psychotherapy is not advice from a friend, and it is not being told to think positively. It is a planned piece of work with a trained, accredited professional, built around regular sessions and a relationship where you can say things you may never have said out loud.
Depression can show up as a low mood that won't lift, losing interest in things you used to enjoy, exhaustion, poor sleep, changes in appetite, trouble concentrating, guilt, hopelessness and sometimes thoughts of self-harm. It can also make the world feel less friendly, so you pull back from people and spend more time alone with your own thoughts. That withdrawal usually makes things heavier.
Therapy works on that cycle from several sides. Together with your therapist you can notice the thoughts that keep pulling you down, make sense of painful experiences, look at what is happening in your relationships and build coping skills. Bit by bit, you start doing more again and reconnecting with people. Outcomes vary from person to person, but psychological therapies are recognised treatments for depression in the HSE's guidance on treating clinical depression and in NICE guideline NG222, the UK's guideline on depression in adults.
The main types of psychotherapy for depression
Several approaches have good evidence behind them, and no single method suits everyone. Some focus on what you are thinking and doing now. Others look at relationships, emotional patterns or experiences from earlier in life that still shape how you feel today. We think two things matter a great deal: the relationship with your therapist, and your own preferences. If an approach makes sense to you, you are more likely to stick with it.
| Approach | What it focuses on | Who may find it helpful |
|---|---|---|
| Cognitive behavioural therapy (CBT) | The links between thoughts, feelings and behaviour, and practical skills for breaking unhelpful cycles | People who want a structured, skills-based approach with tasks between sessions |
| Behavioural activation | Gradually getting back to activities that feel meaningful or rewarding | People whose depression has narrowed their days and drained their motivation |
| Interpersonal therapy (IPT) | Relationships, loss, conflict and life transitions | People whose low mood is tied to grief, a dispute or a big change in their role |
| Problem-solving therapy | Structured ways to break down and tackle manageable problems | People who feel overwhelmed by practical pressures piling up |
| Psychodynamic psychotherapy | Recurring emotional and relationship patterns, often rooted in earlier experience | People who want to understand why the same feelings keep coming back |
| Behavioural couples therapy | How relationship distress and depression feed each other | Couples where difficulties in the relationship are part of the picture |
Our therapists offer individual counselling and psychotherapy, cognitive behavioural therapy (CBT), psychoanalytic psychotherapy and couples counselling. If you'd like a longer comparison, our post on what therapy is best for depression goes into more detail.
Psychotherapy for mild, moderate and severe depression
Talking therapy can help at every level of depression. What changes is how intensive the support is and who else is involved.
When depression is milder, a GP may suggest keeping an eye on things for a short time. The NHS guidance on treating depression describes this as waiting a little while to see whether it improves by itself. That should still mean a check-in and support, not leaving persistent symptoms alone. The HSE describes physical activity as one of the main treatments for mild depression, along with self-help and lighter talking support.
For mild to moderate depression, structured psychotherapy is a common choice. The approach depends on your symptoms, what you would prefer, what has helped before and what is available.
For moderate to severe depression, the HSE and NHS both describe antidepressants, talking therapy, or the two together. If symptoms are severe, complex or bring real risk, your GP may refer you to a psychiatrist or a community mental health team. These teams can include psychologists, psychiatrists, nurses and occupational therapists.
We would always suggest that a GP or another suitable health professional assesses how severe your depression is, rather than you trying to judge it alone. If you ever feel unsafe, that needs urgent help first.
What happens in therapy, and how long it takes
A first session with us is mostly about listening. Your therapist will ask what has been happening, how long you have felt this way, how you are sleeping, working and getting on with people, and what you would like to be different. They will also ask about your safety, gently and directly, because that is part of looking after you. What you say is confidential, and your therapist will explain the limits: if there is a serious risk to you or someone else, they may need to involve others. Our post on what to expect in your first therapy session walks through it in more detail.
Later sessions usually look back over the week, explore a pattern or memory that has come up, practise a strategy and agree a small, realistic step before you meet again. Some therapy is short and structured. Some is longer and more open, depending on the approach, how severe and complex things are, and what you want from it.
We won't promise a set number of sessions or quick results. Many people benefit, but progress often shows first in coping better and getting through the day more easily, before mood fully lifts. Coming regularly and feeling at ease with your therapist both matter. We'd encourage you to review goals, symptoms and safety together from time to time, so you are never carrying on with something that isn't helping.
Psychotherapy, medication or both
This is often not an either-or choice. The right mix depends on how severe the depression is, how you responded to treatment before, any other health conditions, the risks involved, what you would prefer and what you can get access to. Psychotherapy alone is often offered for less severe depression. For moderate to severe depression, the HSE notes that having both treatments works better than one on its own.
Antidepressants include selective serotonin reuptake inhibitors (SSRIs) and several other classes, and the HSE says there are almost 30 types. Any decision to start, change or stop one belongs with your GP or psychiatrist. The NHS notes that you may get withdrawal symptoms when you stop, which is why coming off them suddenly isn't advised.
Other things help too: regular physical activity, steadier sleep and routine, guided self-help and time with people who support you. For a small number of people with severe depression that hasn't responded to other treatments, a specialist may recommend brain stimulation. Please be careful with St John's wort and other herbal remedies. The NHS points out that their strength varies between brands and batches, and the HSE warns they can affect other medicines you take. Check with a pharmacist or doctor first.
FAQs
How do I know if I need psychotherapy for depression?
If low mood, numbness or hopelessness has lasted a few weeks and is affecting your sleep, work or relationships, it is worth talking to someone. You don't need to reach a crisis point first, and you don't need to be sure it is "really" depression. Your GP can help you make sense of your symptoms, and you can contact a therapist directly without a referral. Our page on therapy for depression describes how we work with low mood.
How much does psychotherapy for depression cost in Ireland?
Private fees vary, so our current rates are on our prices page. We also keep a low-cost counselling option for people who would otherwise go without, and your health insurance or workplace assistance programme may cover some sessions. We would much rather you got support somewhere than waited until you could afford it.
Can I access psychotherapy for depression online or through the HSE?
Yes to both. We offer online therapy anywhere in Ireland, which can save you a commute and fit around work. Through the HSE, adults with a medical card can be referred by a GP for up to eight free sessions with Counselling in Primary Care. Your GP can also refer you to SilverCloud, the HSE's guided online CBT programme.
What should I do if psychotherapy is not helping my depression?
Say so to your therapist. It is useful information, not a failure on your part. Together you can look at whether the goals, the approach or the pace need to change, or whether a different therapist would suit you better. It is also worth seeing your GP to ask whether medication or more specialist support might help alongside therapy.
Taking the next step
Whenever you feel ready, you can contact us to talk about a first appointment, who is available and whether you would prefer to meet online or in person at one of our Dublin and Galway locations. Before you decide, ask us anything you like: a therapist's qualifications, how they work, fees, session format and their experience with depression. Asking these questions is a normal part of choosing a therapist.
If you are in immediate danger, call 112 or 999, go to your nearest emergency department, ring Samaritans on 116 123, or use the HSE's urgent and emergency care information.