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At Counselling Twickenham for depression, I am often asked questions about how counselling works. Some people are not always sure whether they are suffering from grief, depression or profound sadness. My clients ask me: what is depression? What are the causes of depression? And how do I identify the symptoms?

Depression is a continuous state of mind which locks people into downward spiral of low moods, hopelessness and despair. It is a normal response to life crises, trauma and grief. If your GP has diagnosed you with depression, you me offered medication such as SSRIs. However, I believe this is not a permanent solution to you problems.

I offer counselling for depression to help people understand their experience and heal the emotions which are the source of the depression. I look at depression as lying at the core of human experience, and therefore treat you as a person, not just as a set of general clinical symptoms.

We do this in partnership, by developing a deeper sense of understanding self-awareness. For example, by improving your ability to identify the underlying feelings, thoughts and emotions which cause it, as well as how depression takes root in relationships. This way you are more likely to gain insight and transform the nature of your experience. This is why we will focus on healing and finding self-acceptance, as a way of living a more fulfilling and meaningful life.

What are the causes of depression?

Counselling theories, including Freud (1917) focus on depression as a kind of defence-mechanism, or mental disorder. I find, however, that if we look at the human dimension, depression is a means of self-protection which relies on “shutting down” your sensory experience  in order to escape or avoid pain (D, Seigel, 1989). Freud (1916) believed depression may be due to childhood experiences of loss and grief, or a sense abandonment by an emotionally absent parent.

Freud also realised that childhood experiences of neglect or emotional detachment can lead to depression in later life. He believed that as adults we may find it difficult to form intimate relationships, fearing loss and abandonment. Freud also distinguished between actual loss (e.g. death of a parent) and symbolic losses experienced in adulthood (e.g. divorce, loss of a job).

He claimed, both kinds of loss can produce a depressive reaction. This is because the individual re-experiences traumatic childhood memories, like when they experienced loss of affection approval or love of a parent.

I believe your state of mind can be improved through compassion and empathy in therapy; as well as using mindfulness to change your frame of mind. You may find you are more predisposed to depression in response to life crisis or traumatic events. Depression is also both genetic and learned. Whether you are predisposed to depression or not, there is a benefit in addressing the issues by talking it through in counselling for depression.

What counselling can I offer for depression?

At counselling Twickenham, Whitton I offer counselling for depression with a human touch. The clinical diagnostic manual for mental disorders (DSM IV) states that the symptoms of depression are: five of the following symptoms have been present during the same 2-week period and represent a change from previous functioning;

  1. a depressed mood most of the day
  2. diminished interest or pleasure in all, or almost all, activities all day
  3. significant weight loss or weight gain, a decrease or increase in appetite
  4. sleeping problems or insomnia most days
  5. psychomotor agitation or retardation e.g. restlessness or lethargy
  6. fatigue or loss of energy most days
  7. feelings of worthlessness or excessive guilt (which may be delusional)
  8. diminished ability to think or concentrate, or indecisiveness
  9. recurrent thoughts of death and recurrent suicidal ideation, or suicide attempt

Childhood Development: 

I believe that most people experience depression at some point, as a normal pattern of grief after the loss of a loved one. Although extended grief may lead to a disproportionate sense of distress in some cases. In my experience, depression is usually developed in childhood as a learned response to poor patterns of attachment between parents and children e.g. as a result of fear, abuse or neglect (M. Klein, 1932).

Klein believed that we internalised our parents during childhood development and that failures by the parents to adequately care for their child, led to painful and traumatic memories. These memories could be remembered or reenacted in adulthood – after a loss in later life or a failure to form intimate and commit to long-term attachments. But I have noticed depression can also be developed after prolonged emotional pain or adult trauma.

Bodily Effects:

During depression you may lose motivation and find it hard to summon the energy for the most basic tasks: such as getting out bed, preparing food, washing or getting dressed. This often includes periods of intense fatigue and restlessness, due to hormone imbalance: This leads to cycles of illness, pain and tension in the neck, back, muscles. You may also suffer from nausea, joint-pain and headaches. You may be prone to sudden fits of tearfulness, mood-swings and anger without an identifiable trigger.

Alan Schore (1991) believed children who are not emotionally attuned to by their parents, find it difficult to self-regulate. They are less aware of their own sensations and emotional states, because they are not validated or mirrored back to them by parents. This is often why your ability to feel confident or self-care waxes and wanes in times of emotional crisis.

Depressive Thoughts:

You may have negative thoughts and beliefs like “I’m no good,” “I am worthless” “whatever I do is never good enough” “no one cares about me”. People with depression can feel intense shame or guilt. You persistently worry about seemingly inconsequential matters and frequently overthink things. In some cases, your concentration may be diminished, while feelings of hopelessness and suicidal thoughts are common.

Beck (1967) believed that people suffering from depression appraised themselves and the world in negative schemas. He described how people formed negative thoughts about the Self, world and their future. Beck claimed that depressed individuals tend to create core beliefs, focussed on helpless and worthlessness.

They interpret events in the world in an unrealistically negative and defeatist way, believing that the world is persecutory or an obstacle to their happiness which cannot be overcome. This leads to a grim view of the future, which they see as totally hopeless because their inadequacy and worthlessness will prevent them being able to improve their lives.

Depressive Feelings:

At times, you may experience low moods and feelings of overwhelming sadness or grief. You may also find yourself expressing negative emotions in moments of tearfulness, anxiety or anger. After a prolonged depression, you might lose your confidence and experience feelings of emptiness. Finally, you begin to withdraw from close relationships with friends, family and work colleagues. Patruska Clarkson (1998) believed that withdrawal is often a way of coping with intense emotions in childhood. As an adult you might seek the support of a loved one, but find it harder to self-regulate emotions in a crisis. In these situations, you can become confused, lost and suffer from anger directed inward.


When you experience depression it interferes with your ability to communicate or express emotion. Sometimes you may feel too numb to experience appropriate emotions and intimacy in relationships. You may find it difficult to receive reassurance or comfort from others. And additionally, you feel unworthy, while being insincere towards you. Finally, you may become so overwhelmed you go through cycles of lethargy, irritability and anger. This makes mutually shared expressions of love difficult to bear.

You often feel isolated and withdrawn, or completely desperate and dependant on others. This is accompanied by feelings of neediness. You may have elements of passive-aggressive behaviour that disrupt relationships and lead to sabotaging behaviours. You may feel unable to participate in social activities, and unable to work due to stress.

At Twickenham  Counselling I encourage you to gain insight into negative patterns of thought, avoidance or self-limiting behaviours. I build a relationship of trust, compassion and empathy with you, so that you can learn to move towards a positive pattern of attachment. You will learn strategies which bring about personal change, through a collaborative process of therapeutic healing and compassion..

Please call me Twickenham Counselling for depression to receive further information and guidance on depression, grief and suicidal thinking.