What I treat
Therapy for depression
Being depressed is not the same as being sad. It is that the engine which makes things feel worth the effort has switched off. And that engine gets restarted from the outside, not from the inside.
What it looks like from the inside
People who arrive depressed do not usually say they are sad. They say they feel flat, that they do not care about anything, that they have to force themselves to do things that used to come naturally, or that they do not understand why they feel like this “when nothing is even wrong”.
- Nothing appeals to you, not even what you used to enjoy
- Tiredness that sleep does not fix
- You stop seeing people and stop picking up the phone
- Starting things you used to do without thinking becomes hard
- You talk to yourself in a way you would never talk to anyone else
- Changes in sleep, appetite or concentration
Why it sustains itself
Depression has a very elegant trap: it convinces you to wait until you feel like it before doing things. And the wanting does not come back while you sit still, because wanting is a consequence of activity, not a prerequisite for it.
So you stop going out, stop moving, stop doing what gave you meaning. Every withdrawal makes perfect sense in the short term and sinks the ground a little further in the long term. After a few months life has been emptied of the things that produced mood, and by then there are objective reasons to feel bad.
The problem stops being what happened to you and becomes how small your world has got.
How I work with it
We start by giving activity back, not by analysing the past. It is called behavioural activation and it is among the best-documented things we have: small, concrete, achievable steps, chosen for what they mean to you rather than for what you “should” do. Genuinely small — the size of what you can manage on a bad Tuesday.
In parallel we work on the inner voice. Not with positive thinking, which does not work, but by learning to look at the thought instead of looking out from inside it. The difference between “I am useless” and “I am having the thought that I am useless” sounds trivial and it changes what you can do next.
And we look around. A sunken mood is almost always held up by a context: a grief that never closed, a job that is emptying you out, a relationship in which you have been giving way for years. Adjusting that usually moves more than any technique.
Therapy, medication, or both
I am a psychologist, not a physician: I do not prescribe or withdraw medication. If you are taking antidepressants, psychotherapy neither replaces them nor gets in their way, and I work in coordination with whoever treats you. If I think a medical assessment would help you, I will say so. More detail in the FAQ.
Starting is the hardest part
I know, which is why the first step is a short call and not a form. Tell me where life has got smaller and we will see where to start.
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I reply personally. Sessions in Spanish and English, 100% online.