Specialism
Therapy for depression, postnatal depression and low mood
CBT for flatness, exhaustion and the loss of things that used to matter — including low mood after having a baby. Online across the UK, in English or Spanish.
Does this sound familiar?
Everything takes more than it should. Getting up, answering a message, making food, the shower you keep meaning to have. The things you used to enjoy are still there, and you feel nothing much when you do them, so gradually you stop.
Your mind has become a hostile commentator. Lazy. Useless. A burden. Everyone would be better off. And because you are exhausted, you have no energy left to argue with any of it, so it goes unchallenged all day.
Sometimes there is an obvious reason — a loss, a birth, a job, an ending. Sometimes there is not, and that makes it worse, because you cannot even justify feeling like this. Either way it is not a character flaw, and it does not lift by being told to cheer up.
The world has usually shrunk to fit. The messages you have not replied to, the invitations that stopped coming because you kept saying no, the room that needs tidying and reproaches you every time you walk past it. Each of those is now evidence for the prosecution, which is exactly how depression keeps itself going.
How I treat depression
CBT for depression is one of the best-evidenced treatments there is, and NICE recommends it across the range of severity. Two strands do most of the work.
The first is behavioural activation, and it comes first for a reason. Depression tells you to wait until you feel like it; the evidence says the feeling follows the doing, not the other way round. So we rebuild activity deliberately and in small, realistic steps — starting from where you actually are, not where you think you should be.
The second is the thinking. Not positive thinking, which nobody with depression finds convincing, but learning to notice the harshest conclusions as they arrive and to check them against what is actually true. Where the low mood follows a birth, a bereavement or a trauma, we work with that directly — and if what you are describing needs a GP, medication or a specialist perinatal service alongside therapy, I will tell you so clearly.
We also protect against the next episode, because depression has a habit of returning. That means understanding what preceded this one, what your own early signs look like, and building a plan you would actually follow when you are unwell rather than one that assumes the energy you have when you are well.
What to expect
We begin with an assessment across one or two sessions, including how low things have been and whether you are safe. A typical course runs 12–20 weekly sessions of 50 minutes. The early weeks are deliberately practical and small-scale — depression does not respond to grand plans.
Therapy sits happily alongside antidepressants if you take them; that is a conversation for you and your GP, and I will support whichever way it goes. We track your mood with a short weekly measure, which matters here more than elsewhere: depression is unreliable at noticing its own improvement, and the numbers often see it before you do.
Sessions run online across the UK and worldwide, or in person at Sanctuary Therapy Centre in Prestwich and Hebden Bridge. If getting out of the house is part of what is hard, online removes one obstacle from the start.
Common questions
I have no energy for therapy. Is it worth starting? That is depression describing itself, and it is exactly why the early sessions are small and concrete. We start with what is possible this week, not with what you would manage if you were well.
Do I have to come off my antidepressants? No. Therapy and medication work well together and NICE recommends both. Any change to medication is between you and your GP.
Is this postnatal depression? Low mood after a birth is common and treatable, and it is not a verdict on you as a parent. We would look at it properly, and if you need your health visitor, GP or a specialist perinatal service involved, I will say so.
What if I am having thoughts of not being here? Please tell me — it is more common than people think, and I will not be shocked. Therapy is not a crisis service, though: if you are in immediate danger call 999 or go to A&E, and you can ring Samaritans free on 116 123 at any hour, or NHS 111 for the mental health option.
Is it depression or is it burnout? They overlap and the treatment overlaps too, but they are not identical — burnout lifts with genuine rest and a changed workload, depression usually does not. Part of the assessment is telling them apart, because it changes where we put the effort.
How long does depression take to lift? It varies more than people would like. Many notice something within four to six weeks of starting behavioural activation, and a full course of 12–20 sessions is typical. A first episode with a clear trigger often moves faster than a long-standing low mood that has been present for years. What predicts a good outcome best is not severity but whether the between-session work happens — which is exactly why we keep it small enough to be possible on a bad week.
Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.
Ready to take the first step?
Send an enquiry and Gisela will be in touch within one working day.