No single therapy is best for everyone with depression. Cognitive behavioural therapy (CBT), interpersonal therapy, behavioural activation and counselling all have good evidence behind them. The best choice for you depends on how severe your depression is, what has helped or not helped before, and whether you feel you can work with the therapist.
If you are reading this while feeling low, you are not being dramatic and you don't need a crisis before asking for help. Below, our therapists explain how each approach works and what might suit you.
How depression treatment depends on severity
Most people have low days, especially after a hard week or a loss. Depression is different. A low mood, loss of interest, poor sleep, tiredness or harsh self-criticism lasts most days for two weeks or more and starts to affect work, relationships or simply getting through the day. If that sounds familiar, we would suggest talking to your GP or a qualified therapist. They can help you work out what is going on, and they can rule out physical causes.
The HSE's guidance on treating clinical depression matches treatment to severity:
- Mild depression: physical activity, self-help, support from people around you and online CBT. Your GP may also suggest checking in again within about two weeks.
- Mild to moderate depression: talking therapies, especially CBT and counselling, with an accredited therapist.
- Moderate to severe depression: antidepressants together with talking therapy, and sometimes a referral to a community mental health team.
"Waiting to see" can be a sensible first step for mild symptoms, but only if you set a date to review how you are. The NHS guidance on depression treatment describes reviewing progress after two to four weeks. If things haven't lifted by then, that is your cue to look for more support. Don't keep waiting.
How psychotherapy and counselling help with depression
Psychotherapy helps you notice the patterns that keep depression going. These can be thoughts like "I always get it wrong", withdrawing from friends, or a relationship where your needs never get heard. Some of these patterns are recent. Others go back years, and understanding where they came from can loosen their hold.
In practice, therapy usually means agreeing on what you want to change, talking through what is hard right now and, where it helps, looking at earlier experiences. Some approaches include practising skills between sessions. Your therapist should also review progress with you along the way, so you both know whether the approach is working.
So is counselling good for depression? For many people, yes. Counselling gives you a confidential space with someone who is on your side, and the HSE lists it among the recommended talking therapies for mild to moderate depression. If your depression is more persistent or severe, a more structured therapy may be recommended, often alongside medical support. You can read more about our approach on our therapy for depression page.
The relationship with your therapist matters a great deal, and you should feel safe and respected. But therapy is also active work, and change often comes gradually. A few sessions in, you may only notice that some days feel a little less heavy. That is real progress.
Common therapies for depression compared
The talking therapies most often recommended for depression work in different ways. This table sets them side by side.
| Therapy | What it focuses on | Typical techniques | Who it may suit |
|---|---|---|---|
| Cognitive behavioural therapy (CBT) | How thoughts, feelings and actions feed each other | Spotting unhelpful thinking, cognitive restructuring, activity scheduling, problem-solving | People who like a practical, structured approach with tasks between sessions |
| Behavioural activation | The link between what you do and how you feel | Monitoring activity, gradually returning to routines that feel meaningful or rewarding | People who have withdrawn and stopped doing things they used to value |
| Interpersonal therapy (IPT) | Relationships and life changes | Working through conflict, role changes (a new baby, a move, retirement), grief and isolation | People whose low mood is tied up with relationships or a big transition |
| Psychodynamic or psychoanalytic psychotherapy | Patterns that may sit outside awareness, often rooted in earlier experiences | Open conversation, exploring recurring feelings and relationships | People who want to understand why depression keeps returning |
| Mindfulness-based cognitive therapy (MBCT) | Noticing low mood early, without getting pulled under by it | Mindfulness practice combined with CBT skills | People who have had several episodes and want to reduce the risk of relapse |
| Behavioural couples therapy | The relationship itself | Improving communication and reducing conflict together | Couples where relationship problems are feeding the depression |
Cognitive behavioural therapy has the largest research base, but that doesn't make it the right choice for everyone. If you have tried CBT before and it felt too surface-level, psychoanalytic psychotherapy may suit you better. If tension at home is part of the picture, couples counselling can work alongside individual support. The HSE recommends mindfulness for people who have had three or more episodes of depression. Dialectical behaviour therapy (DBT) helps with intense emotions and self-harm, but it isn't usually a first-line treatment for depression alone.
When you choose, think about your symptoms, your relationships, what you have tried before, your practical constraints and what you prefer. Whatever approach you choose, the therapist should be properly trained in it.
Antidepressants, combined treatment and specialist care
For moderate to severe or long-lasting depression, the NHS says that combining an antidepressant with talking therapy such as CBT usually works better than either alone. Regarding medication, SSRIs (selective serotonin reuptake inhibitors) are usually the first type offered, because they work as well as older antidepressants and tend to have fewer side effects. Your GP or psychiatrist should guide every decision about medication, including when and how to stop. Stopping suddenly can cause withdrawal symptoms.
If depression is severe or hasn't responded to treatment, your GP may refer you to a community mental health team. These teams can include psychiatrists, psychologists, specialist nurses and occupational therapists. Treatments such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) are used in specific situations after specialist assessment. They are not alternatives to that assessment.
Everyday foundations matter too: sleep, movement, regular meals and time with people who care about you. Please talk to your doctor before taking St John's wort or other supplements. The NHS notes that their strength varies between products and that they can interact with other medicines.
Finding a qualified depression therapist in Ireland
There are three main routes to therapy for depression in Ireland. You can talk to your GP, use HSE services, or contact a private therapist directly. You don't need a GP referral to see a private therapist. If you have a medical card, the HSE's Counselling in Primary Care service offers up to eight free sessions for adults, with a referral from your GP or another health professional. Waiting times and access vary by area.
Whoever you see, it is reasonable to ask about:
- their qualifications and experience with depression
- membership of a professional body such as the Irish Association for Counselling and Psychotherapy (IACP), the Irish Association of Humanistic and Integrative Psychotherapy (IAHIP) or the Psychological Society of Ireland (PSI)
- the approach they use and why
- fees and cancellation terms
- whether they attend regular clinical supervision
Our therapists work in person in Dublin and Galway, and through online therapy across Ireland. Online sessions can work well if you have a private, quiet space, and they save the commute on days when getting out the door feels like too much. Each therapist's profile on our website shows their training and the issues they work with, so you can choose someone who feels right before you book.
If you are at immediate risk of harming yourself, call 112 or 999, go to your nearest emergency department, call Samaritans free on 116 123, or see the HSE's urgent and emergency care page.
FAQs
How many therapy sessions might I need for depression?
It varies. Guided self-help usually runs for around six to eight sessions, and short courses of structured therapy such as CBT often last for a set block of weeks. Deeper or longer-standing difficulties can take longer. We would suggest agreeing a review point with your therapist early on so you can decide together whether to continue. When you start to feel better, our post on maintaining positive changes may help you hold on to them.
What happens in a first therapy session for depression?
Your first session is mostly a conversation. Your therapist will ask what has been happening, how long you have felt this way, how you are sleeping and coping, and what you hope will change. They will also ask about your safety. You don't have to share everything at once. Our guide to what to expect in your first therapy session covers this in more detail.
How much does depression therapy cost in Ireland?
Private fees vary by therapist and session type. Our current fees are on our prices page, and we keep a low-cost counselling option for people who would otherwise go without. Your health insurance or employee assistance programme may cover some sessions, so it is worth checking. We would much rather you got support somewhere than waited until you could afford it.
Taking the next step
You don't need to know which therapy you need before you get in touch. Working that out is part of what the first conversation is for. Together we can talk through your symptoms, what you would prefer and which approach makes sense for you, in Dublin, in Galway or online. If you would like to understand depression a little more first, our piece on self-reproach in depression is a gentle place to start. Whenever you feel ready, you can book a session with one of our therapists.