We can all have periods of low mood, perhaps when a big life change knocks our confidence or for others it might be that it happens gradually over time. There are usually physical signs like tiredness, sleep or appetite problems. Mental ones include lacking motivation, concentration and confidence. Negative self-judgments can become crippling.

With depression, people might, understandably, withdraw to cope to start with and then find it harder and harder to face things. When really low, people can find life unmanageable and feel hopeless and suicidal.

There are a range of NICE-recommended treatments for Depression. Behavioural Activation is a type of CBT that tries to understand behavioural patterns as a natural response to the environment you’re in. That is, if there’s lots of stress and demand and you’re finding many things you do unrewarding, it’s not that surprising that your mood reduces. Instead with therapy, the aim would be to start to build in activity that you really value and find enjoyable and create more positive connections.

Acceptance and Commitment Therapy is a great therapy for Depression. It also embodies these principles but additionally includes lots of experiential exercises, changes in perspective to help understand yourself and teaches mindfulness as a way of changing how you relate to your own experience. Mindfulness Based Therapy is particularly recommended for people who are risk of relapsing after depression treatment. Studies have shown that it can help people who are prone to depression recurring and help to maintain better mental health.

Cognitive Therapy is another form of CBT which can include some of these elements but is more focussed on understanding and changing thought patterns and beliefs. These ‘cognitions’ might be about yourself, others, the world or the future and undermine how you feel about all these things. It takes more of a lifespan or ‘longitudinal’ approach to work out what shaped beliefs in the first place and then uses lots of techniques to try and foster more balanced and helpful ones. For examples someone who has lived with depression for a while might think they are useless or blame themselves unnecessarily. The aim is to develop more adaptive and hopefully kinder perspectives and to start testing these out in different ways to see if they hold.