For people who keep functioning, but feel flat, heavy, self-critical, or shut down inside
Depression is not always “staying in bed”. Many people I see are still working and coping outwardly, but internally feel numb, exhausted, hopeless, or trapped in self-criticism.
I offer depression therapy in Central London (W1 / W1W) and online, working with adults whose low mood is maintained by shutdown, avoidance, loss of connection, and internal pressure.
My work integrates evidence-based approaches including ISTDP, DIT, CBT, and psychodynamic therapy, focusing on what maintains the problem now, and what shifts it.
When depression isn’t just sadness
Depression can look like:
- emotional numbness, disconnection, “going through the motions”
- loss of motivation and meaning
- low energy, poor sleep, appetite changes
- harsh self-criticism and shame
- withdrawal from people and activities
- irritability rather than tears
The depression cycle (how it keeps going)
- Stress, loss, disappointment, conflict, or chronic pressure
- Feelings rise (sadness, anger, grief)
- Strategy: shutdown/withdrawal or self-attack
- Reduced activity and connection
- Less reward/meaning → mood lowers further
- Self-criticism increases → cycle strengthens
How ISTDP understands depression
From an ISTDP perspective, depression can be linked to blocked feelings (often grief or anger) and strategies that turn emotion inward:
- self-attack instead of self-protection
- shutdown instead of feeling
Therapy helps build capacity to experience emotion safely, reduce self-attack, and restore vitality and agency.
How therapy helps with depression
We work to:
- identify the maintaining cycle (shutdown, withdrawal, self-criticism)
- reduce internal pressure and self-attack
- reconnect with emotion safely (without overwhelm)
- rebuild activity, structure, and meaning
- work with relational patterns that maintain low mood
What sessions usually look like
Early sessions:
- clarify symptoms and what maintains them
- map emotional/relational patterns
Ongoing work:
- work directly with blocked emotion and self-attack
- rebuild connection and momentum
Related ways I work
- DIT – when mood is strongly linked to relationship patterns
- ISTDP – for shutdown/self-attack and emotional conflict
- CBT – for behavioural activation and rumination loops
You may also find these pages helpful:
Frequently asked questions
What if I’m functioning but feel empty?
That’s very common. Therapy focuses on the pattern, not appearances.
Will therapy force me to talk about the past?
Only where relevant. We focus on what maintains things now.
Do you offer W1W sessions?
Yes, W1W and online.
Do you work with insurance?
Yes, see Fees & Insurance.
Next steps
If low mood is limiting your life, therapy can help you shift the cycle.
