Depression therapy in London
Depression is not one thing.
The word covers everything from a persistent low mood and reduced pleasure to severe episodes of total withdrawal, an inability to function, and thoughts of suicide. What runs through all of it is a kind of disconnection. From pleasure, from other people, from any sense of future possibility, and from yourself.
And it does not respond to effort or encouragement, which is one of the loneliest things about it. Being told to pull yourself together, or to go for a walk, or to count your blessings, tends to confirm to a depressed person that nobody has understood.
This practice offers private depression therapy in central London at Harley Street, in south London at Bermondsey, and online, with Dr Philippe Jacquet, a UKCP-registered integrative psychotherapist and Jungian analyst with twenty-five years of clinical experience.
The causes interact rather than queue up neatly: genetic vulnerability, neurobiology, life events and losses, early attachment patterns, sustained stress, and the particular psychological structures that make some people more susceptible than others. Perfectionism. Self-criticism. A harsh internal relationship with oneself that never lets up.
Which is why treatment has to be built around the particular presentation rather than applied as a protocol.
When depression does not look like sadness
The most frequently missed form is the one that arrives in someone who is, by every external measure, doing well. Their entire life-force has gone into work, while their personal life has quietly emptied out. They perform, sometimes brilliantly, and feel genuinely low underneath. It is usually the last thing anyone around them would guess.
What is missing in that picture is not pleasure. They often have a great deal of that. What is missing is happiness, which comes through other people, and which an emptied-out personal life can no longer supply. So the work is not simply lifting the mood. It is rebuilding the connections the depression has starved.
I have written about this pattern at length in The Desert of Isolation and the Garden of Solitude, which is the fuller account of what is usually called high-functioning depression.
Depression in men often does not announce itself
Men arrive at this practice late, and usually not saying the word depression.
What they describe instead is a short fuse. Sleep that has gone. A tolerance for their own family that has thinned out. Working later because home has become difficult, and then drinking at the end of it because the working has become difficult too. Someone who is low but still turning up, still earning, still functioning, does not match the picture most people carry of depression, including the man himself.
The cost of that delay is years. By the time the word is used, the withdrawal has usually rearranged a marriage and a career around itself.
Scepticism about therapy is not a problem here. A great deal of my clinical work, and my doctoral research, has been with men who came in reluctantly and under some pressure from somebody else. Starting unconvinced is ordinary. Therapy for men sets out how that work usually begins.
When it is being managed with drink
Alcohol is the most common thing a depression is being self-treated with, and the most reliable way of keeping it going.
The logic is immediate and completely understandable. It lifts the mood for an hour or two, it loosens the self-criticism, and it makes an evening alone survivable. The next morning it has lowered the baseline a little further, so a slightly larger dose is needed to reach the same place. Over months the two conditions become one condition, and treating either in isolation tends to fail.
Addiction is one of this practice’s four core specialisms, which means the drinking does not have to be sent somewhere else before the depression can be looked at. They can be worked with as the single thing they have become.
Depression or burnout
The two are close enough that people use the words interchangeably, and separating them changes what the work is. Burnout is attached to a situation and loosens when the demand does. Depression travels with you, and a depression managed as burnout gets treated with rest, which does not reach it.
That distinction matters early rather than later. Burnout or depression: how to tell the difference sets out the tests I use, and burnout covers the other condition in its own right.
What the therapy involves
I work integratively, which means attending both to what has triggered or is maintaining the current episode and to the deeper structures underneath it that created the vulnerability in the first place.
Jungian-informed work is particularly useful where the depression has a meaning dimension: where it is carrying a message about a life that has drifted away from what the person actually values, or where it has arrived alongside a significant transition or a loss of identity. Not every depression is like that. Some are, and treating them as a malfunction to be corrected misses what they are saying.
Where there is a clear trauma component, EMDR can be part of the work. Where words feel inadequate, or where the depression involves a real dissociation from feeling, art therapy often reaches material that talking does not. The approach follows the presentation rather than the other way round.
Medication
I do not prescribe. Where your GP or psychiatrist has recommended medication, I work alongside that rather than against it.
For moderate to severe depression, the evidence suggests that medication and psychotherapy together are more effective than either alone. For milder presentations that is less clear-cut. The first consultation will clarify what is likely to be appropriate for you, and I will say so honestly if I think you should be speaking to a doctor as well as to me.
If things are worse than that
If you are having thoughts of ending your life, please do not wait for a therapy appointment.
Samaritans answer at any hour, free, on 116 123. If you feel at immediate risk, go to A&E or call 999. Your GP can also arrange urgent support, and NHS 111 will direct you if you are unsure where to start.
None of that is a lesser option than therapy. It is the right first step, and the work we might do together can begin once you are safe.
Common questions
Where in London do you see people for depression?
In central London at Harley Street, and in south London at Bermondsey, with online sessions for anyone who cannot travel or who prefers to work from home. Depression in particular can make getting across London feel impossible, and starting online and moving to the room later is a perfectly reasonable way to begin.
Can you have depression without feeling sad?
Yes, and it is common. Many people describe flatness rather than sadness: nothing is enjoyable, nothing matters much, and the day is got through rather than lived. Others notice it first in the body, as exhaustion or disturbed sleep, or in irritability rather than low mood.
Is it depression or burnout?
They overlap and often arrive together, but they are not the same. Burnout is tied to a particular situation and usually lifts when the demand does. Depression travels with you: the flatness is still there on holiday, on sabbatical, after the job has changed. If rest has not touched it, it is worth taking seriously as depression.
Do I need medication, or will therapy be enough?
It depends on severity. For moderate to severe depression the evidence suggests medication and psychotherapy together work better than either alone. I do not prescribe, but I work alongside your GP or psychiatrist where medication has been recommended. The first consultation clarifies what is appropriate for you.
I am drinking more than I used to. Should I deal with that first?
Not necessarily first, but it does have to be part of the work rather than left outside it. Alcohol lifts mood for an hour or two and lowers it for the next day, so sustained drinking keeps a depression in place even while it appears to be helping. Addiction is one of this practice's core specialisms, so the two can be treated together rather than sent to separate people.
Men in my family do not do this. Does therapy work for that?
It does, and a good deal of my clinical work and doctoral research has been with men who arrived reluctantly. Depression in men more often shows up as irritability, withdrawal, overwork or drinking than as visible sadness, which is one reason it goes unnamed for years. Being sceptical about therapy is not an obstacle to it working.
How long does therapy for depression take?
It depends on whether we are working with an episode or with something longer-standing. A depression triggered by an identifiable event often shifts more quickly than one rooted in patterns established early. I would rather give you an honest view after the first consultation than a number now.
What does it cost?
Fees range from £85 to £250 a session depending on whether you see an associate, a senior associate or Dr Jacquet, and whether the session is online or in person. The [fees and terms](/fees-and-terms/) page sets this out in full, including the global insurers we work with.