Dear Susan,

I went to my doctor because I feel depressed. (My ex-boyfriend just got engaged!) He prescribed an anti depressant, and made the suggestion that I see a therapist. I have never been to one before. What will we talk about, and how is talking going to make me feel better?

Anonymous, London


Dear Anonymous,

Depression is something that just over 8% of the population suffers from, so in London that translates to approximately 32,000 people!

Many people seek treatment but many don’t. They know that they ‘feel lousy’, but don’t realize how highly treatable depression usually is.

Anti-depressant medications available today are very effective and have fewer side effects than in the past. They can be very helpful to those whose lives have become difficult to manage as a result of their depression.

At your first meeting, a psychotherapist will likely want to assess how severe the depression is, by asking you questions about your ability to cope with everyday activities and stresses, your sleep habits, appetite etc. A therapist may also ask you about any recent trauma or loss you may have been through.

The second thing a therapist will probably do is look for underlying causes for the depression. For example, are you having difficulties in a relationship?

Was there dysfunction in your family of origin? Are you experiencing stress related to work or finances? Often, the therapist will work with these causes rather than just work with the depression alone, which can be a symptom of the underlying problem, rather than the problem itself.

Frequently, depression arises when someone is actually very angry about something but for whatever reason doesn’t feel able to express that anger, or doesn’t even realize that he or she is angry in the first place. So helping a client recognize the underlying causes of their depression can feel very empowering to them!

Third, a therapist will also help you consider your perceptions and thought processes. If the way you are thinking is contributing to your depression, the therapist may provide you with cognitive tools and skills to help you cope with problems you may be experiencing. For example, the therapist may ask you to record your negative thoughts, when they occur and how they make you feel.

Your therapist will recognize that your situation is completely unique. Consequently, the things you will discuss together are difficult for me to predict.

No two depressions are alike. One person may need to examine and address her unhappiness in her present relationship while another person may need to re examine a childhood trauma to understand why they have become depressed now. That’s why psychotherapy is so important. Medication alone won’t address these key things.