Cognitive Behavioural Therapy

Sarah Webb - BABCP accredited

Crawley, Horsham and surrounding areas

07929 587036    

What is depression ?

Depression  is a serious illness linked to changes in brain chemistry and electrical activity which can cause a person to have continuous feelings of sadness and despair lasting for weeks or months. Many factors can cause the onset of depression, including genetic characteristics, stress, grief, serious or long-standing illness, giving birth and drug abuse. There is a higher risk of depression occurring if any of these factors occur at the same time.

What are the symptoms of depression ?

Some of the symptoms that we may experience when depressed are:

  • Feelings of sadness, hopelessness and pessimism about the future
  • Rumination
  • Change in appetite and weight – eating far less or more than usual
  • No interest or enjoyment in usual activities
  • Lack of interest or avoidance of social contact
  • Lack of concentration and poor short-term memory
  • Neglecting to take care of ourselves or our living environment
  • Lack of energy and motivation
  • Difficulty in making decisions
  • Unexplained aches and pains
  • Changes in sleep pattern – sleeping far more or far less
  • Difficulty in getting out of bed
  • Thoughts of self-harm or death

Treatments for depression

The NHS advice is that you should visit your GP if you think that you are depressed. The GP will assess the severity of your depression and may prescribe antidepressant medication, a talking therapy such as CBT, a self-help course or a combination of these treatments.

For more NHS information on the treatments for depression, click here.

How can CBT help with depression ?

Depression and its symptoms change the way a person thinks and behaves which tends to make the symptoms worse and keep the depression going - a vicious circle develops which stop the person getting better.

I work with my clients to help them recognise their changed thinking and behaviour patterns and understand the circular nature of depression and its symptoms. Together we share in the development of time-limited goals and strategies which help the client return to normal health and build resilience to the situations or events that caused their depression.


When we are depressed we tend to ruminate. This means we get stuck in a circular process of negative thinking, going over and over the causes and consequences of our depression trying to find solutions. Unfortunately, there is extremely consistent medical evidence that rumination just doesn’t work, and in fact usually makes the depressed person feel worse.

There are a number of steps that you can take to help yourself stop ruminating:

  • Keep busy – try to keep your mind occupied with an absorbing activity
  • Increase your physical activity – go for walk, or a bike ride, or go to the gym
  • Become self-aware of when you start to ruminate - tell yourself that rumination won’t make you feel better and won’t solve your problems. The medical evidence is that rumination doesn’t work and will make you feel worse.
  • Recognise that your thoughts are negatively biased and that this is one of the symptoms of depression – become sceptical about how valid your negative thoughts are at this point in time.

Social withdrawal

Depression often leads people to withdraw from social contact with family and close friends. This social isolation can lead to an increase in the symptoms of depression such as loneliness, sadness and despair.

Although it may be the last thing you feel like doing, I always advise my clients to try hard to maintain their social contact with the people around them. There is very strong evidence that social contact is good for your health and well-being, it maintains your social support network and it helps reduce those feeling of loneliness, sadness and despair which maintain the depression.

Tackling inactivity by setting goals

When we are depressed we often feel that we cannot be bothered with day-to-day tasks and we withdraw from leisure activities that we used to enjoy. This reduction in activity nearly always makes the symptoms of depression worsen, consequently the depressed person becomes even more inactive and so a vicious circle develops.

I work with my clients to set realistic goals that will help them gradually return to normal activity. To begin with these goals might be getting out of bed and dressed by certain time of the day, doing a household chore or going for a 15 minute walk. The goals will become more challenging as the symptoms of the depression start to reduce and the client begins to return to normal health. I recommend that my clients keep a diary of their goals and activities so that they can see their progress and be encouraged by it. This helps to create a virtuous circle: activity – symptoms reduce – more activity - symptoms reduce further, and so on.