Depression and low mood
Depression is not just sadness that goes on a little too long, and it does not lift through willpower. It is a state that affects mood, energy, sleep, thinking and relationships with others, and it keeps itself going.
If it already takes a lot of energy to read this page, that is precisely the kind of moment when support makes sense.
What it is
A depressive episode is recognised by how long it lasts and how much it affects daily life, more than by how intense the sadness is. We speak of depression when, for several weeks and almost every day, mood stays low or interest and pleasure have withdrawn from things that used to matter, with clear consequences for everyday life.
Other common features include tiredness that does not ease with rest, sleep problems — waking very early, or on the contrary needing to sleep all the time —, changes in appetite, difficulty concentrating and making decisions, a general slowing down, and a low opinion of oneself that feels like a plain fact rather than a symptom. This is an important point: depression changes the way you see yourself and your future, so that dark thoughts seem lucid rather than part of the illness.
Withdrawal is both a common consequence and a central mechanism. Because nothing brings pleasure any more, you gradually stop doing things; because you no longer do them, the opportunities to feel anything disappear, which reinforces the state. Depression is not something you get through by waiting for motivation to return, because motivation is exactly what is missing.
The forms vary. An episode may follow an identifiable event — a bereavement, a separation, a job loss — or arise with no apparent trigger, which makes it neither less real nor less legitimate. It may happen once or recur. It may also show itself mainly through irritability, physical pain or increased drinking, particularly when expressing distress has never felt allowed.
Signs that lead people to seek help
These are frequently described when depression sets in.
Low mood almost every day for several weeks
Loss of pleasure and interest in things that used to matter
Constant tiredness, out of proportion to the effort made
Disturbed sleep: waking very early, broken nights, or needing to sleep all the time
Difficulty concentrating or remembering, or being unable to make even the smallest decision
A sense of guilt or worthlessness that seems self-evident
Gradual withdrawal: no longer answering, cancelling plans, no longer going out
Dark thoughts, or the thought that others would be better off without you
If you are having suicidal thoughts, do not wait for an appointment: 3114, France’s national suicide prevention line, is free and available 24 hours a day, and in an immediate emergency you can call 15 or 112. Several of these signs can also have a medical cause, so it is worth seeing your GP as well.
How I work with depression
The work usually begins with things that are concrete and modest. When energy is lacking, there is no point aiming high: instead, we identify what is still possible and gradually reintroduce activities that suit how you are at the moment. This is not an exhortation to try harder; it is a recognised lever — action comes before motivation returns, not the other way round.
Alongside this, we work on the thoughts that come with depression: the idea of being a burden, of having failed, that nothing will change. The aim is not to contradict them with encouraging slogans, which ring hollow and are, but to examine them as hypotheses and test them against the facts. This is slow at first, then becomes more accessible.
Depending on what emerges, we also take time to look at what led here: a loss, an accumulation of difficulties, an older story, a life situation that has become unbearable. Understanding is not enough to feel better, but feeling better without understanding leaves you at risk of ending up in the same place again.
I pay close attention to the risk of suicide, and I raise it directly when the question arises. Talking about it does not create danger, contrary to a widespread belief: on the contrary, it is what makes it possible to assess the situation and put the right things in place.
I am also happy to work alongside your GP or a psychiatrist. When an episode is severe, combining psychological therapy with a medical opinion is what is recommended. I do not prescribe, but I encourage you to see a doctor and can help you prepare for that appointment.
How long it takes
Sessions are usually weekly at first. Regular, closely spaced sessions matter particularly with depression, where spacing them out can let withdrawal take over again.
The length of therapy is not decided in advance: it depends on how long the episode has lasted, how intense it is and what surrounds it. When episodes recur, part of the work involves identifying what triggers them, which takes more time. We review this together, regularly.
When things do start to shift, the first changes are not always in mood: sleep, energy or the ability to do things may change before you feel better. That is useful to know, so as not to conclude too quickly that nothing is moving.
Fees and reimbursementFrequently asked questions
How do I know whether it is depression or just a difficult patch?
The difference lies in how long it lasts, how intense it is and, above all, how much it affects daily life. A difficult patch leaves moments of respite and does not stop you functioning; depression is there almost every day and gets in the way of work, relationships and sleep. That said, this question does not need to be settled before you book: it is precisely one of the things the first sessions help to clarify.
Will I have to take antidepressants?
No, and that decision is not made by a psychologist, since I do not prescribe. For mild to moderate episodes, psychological therapy on its own is a recognised option. For more severe episodes, a combination of medication and psychotherapy is generally what is recommended. The decision rests with your GP or a psychiatrist, depending on your situation.
I have no energy for anything. How can I keep up with therapy?
That is an understandable concern, and lack of energy is part of what we work on, not something you have to overcome first. The work adapts to how you are at the moment: nothing requires you to arrive in good shape or to have prepared anything. Coming and talking is more than enough to begin.
What should I do if I feel really bad between sessions?
The practice does not offer an on-call service and cannot respond to emergencies. At such moments, 3114 is free and available 24 hours a day, answered by trained professionals, and 15 or 112 can be called in case of immediate danger. We then talk about it in session. We can also plan in advance what you will do if such a moment arises.
Other areas of support
Book an appointment
An initial fifteen-minute phone call, with no commitment, lets us see whether my approach matches what you are looking for. If it does not, I will refer you to a colleague.