Counselling for Depression: Can it Actually Help? [And How]

If you or someone you know may be in danger of self harm or suicide, please get help. Call 911 for emergencies or contact the Canada Suicide Prevention Service hotline at 1-833-456-4566 (24/7) or text 45645 (4pm to 12am ET).

It’s normal to experience sadness, or to retreat into some solitude when going through something particularly upsetting or difficult. It’s actually healthy to allow ourselves to feel negative emotions, instead of burying or ignoring them.  

However, sometimes unhappiness or negative thinking patterns, fatigue, or emotional retreat can become commonplace. It can affect relationships, jobs and other aspects of daily life. Depression feels different from the ebbs and flow of everyday life. It is the most common mood disorder, affecting approximately one-in-eight Canadians and neary 5% of all adults worldwide. If this is how you’re feeling, you’re not alone and it can be a great idea to seek help from a trained and licensed counsellor for depression.

Can counselling for depression actually help?

If you’ve been feeling unlike yourself, sad or hopeless, keep in mind these might feel intense, but are normal human feelings – it’s our way of responding to difficult challenges, but sometimes we need some help to overcome them. Considering counselling already shows signs of strength. It can be a long and difficult road to reach that realization and decision to ask for help, and is something to be proud of already. 

According to Margaret Hux, Registered Psychotherapist, “Depression is the last stage in a process where you may not have been able to resolve something really difficult and your body and mind have been shutting down. It’s important to know that as you start to get some energy back, start to feel a bit more clear, you may have anger or anxiety increase.” 

After starting to work with a therapist, it can be a normal phase of your progress to feel new, intense feelings. When those deep issues start to unroot, it can bring about a new series of challenges to overcome. However, Margaret says this can be an indicator things are going in the right direction and there are ways to address those phases along the way.

She adds, “I celebrate when a very depressed client starts to show anger or even anxiety. We use somatic methods to release the anger and anxiety as it arises but also acknowledge and start to look for what needs to be changed, what might this depression be telling them needs to be different in their life. We are looking for a new, better and more positive normal.” 

Understanding depression

It’s important to remember that, since depression is so complex, it will not be the same for everyone. The factors contributing to someone’s mood and the development of depression can vary and intersect. Therefore not everyone will experience depression in the same way, nor react to it in the same way. 

Typically, a “depressive episode” is one where symptoms last nearly all day, every day, for two weeks or more. Those symptoms could include:

• Feeling of unhappiness, or apathy (lack of interest or motivation), or hopelessness
• Anger or irritability
• Lethargy or lack of energy 
• Decision fatigue, difficulty concentrating, memory lapses
• Pain, including back or joint pain or headaches
• Sleep irregularity, either oversleeping or difficulty sleeping
• Feelings of worthlessness, rumination
• Reccuring thoughts of death or suicide

If you have thoughts of suicide and death, explore these thoughts with someone, even if you are not ready for a therapist. Call 911 for emergencies or contact the Canada Suicide Prevention Service hotline at 1-833-456-4566 (24/7) or text 45645 (4pm to 12am ET).

These symptoms can involve isolation and a lack of connection. Pushing yourself to seek counselling and establish a connection with a counsellor can have a very positive effect, even if it's the last thing you want to do

Depression can be expressed physically or emotionally, or a combination of both. One symptom might give way to another over time. For example, sleeplessness could increase body pain. The factors associated with depression (inactivity, substance use) can also increase the chances of physical health issues like cardiovascular disease, cancer or poor respiratory health. Our minds and bodies are very closely connected and taking care of your mental health is an important part of an overall healthy lifestyle.

Risk factors and causes of depression can range from circumstantial (something negative occurred, like sudden loss), it can be genetic or biological, related to social challenges like work pressures or relationship changes, or it can be determined by environmental factors such as exposure to trauma or stress. 

Prolonged stress, including ongoing cognitive distortions (i.e., negative thinking patterns) can affect the neural pathways in the brain. We have neurotransmitters in our brain, which are basically our information carriers. When we’re stressed, they're stressed, and they don’t fire those chemical connections the same way. Those chemical information messengers also help regulate mood and emotion, so if they break down it can, logically, affect how our brain operates over time. It can make it more difficult to shift to a positive outlook. These negative thoughts can also hardwired into our regular thinking pathways, making negative thoughts seem like facts and difficult to overcome.

The good news is, the brain is malleable and can be changed positively with practice and guidance, like through medication or with various therapeutic techniques.

The Role of Counselling in Treating Depression

Working with a counsellor can help support positive changes to thinking patterns and overall outlook on life. There are a variety of approaches and techniques, exercises and methods that have proven to positively impact symptoms of depression. 

Margaret Hux adds, “A therapist can help you to understand that this pattern is not permanent. You can be supported in helping to explore whether the negative thoughts are really the way things are or just the depressive tendency of mind.  It can be very important to start making some small changes and a therapist can help you find and move towards making small steps toward solving your problems. Coming out of depression requires some work but it can be done and there is help.”

It’s important to work with someone who is trained and licensed to provide counselling therapy. They will be trained in evidence-based approaches and have the necessary interpersonal and treatment skills to help those experiencing the complex symptoms of depression. In particular, there are counsellors who are specifically trained in trauma counselling, which can be additionally important as trauma can be highly volatile and sensitive, and triggering or retraumatizing someone can deeply negatively affect their ability to address their depression. 

Evidence-based means those techniques and methods are based on scientific study and peer-reviewed research – it’s proven to be effective and is based on the most current and best-available research. Some counselling techniques that have been shown to help alleviate symptoms of depression include:

• Cognitive-Behavioral Therapy (CBT) is one of the most researched therapeutic techniques. This means there is a lot of funding behind it, and ample training available to professionals. Therefore it’s very common, so keep in mind, like any other technique, it may not be the best option for everyone. CBT is about identifying and challenging negative thinking patterns and understanding how thinking, emotions and behaviours are interconnected, then working to address those with self-awareness and new problem-solving skills.‍

• Interpersonal Therapy (IPT) focuses on conflicts or issues in relationships, and this can be related to the onset or ongoing symptoms of depression. Similar to CBT, IPT is about recognizing the emotions that arise from interpersonal interactions and relationships and, eventually, how to manage or process emotions differently. 
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• Mindfulness-based Cognitive Therapy (MBCT) has been shown to be effective in preventing relapse from depression. Mindfulness therapy in general is about being aware of, and accepting the present moment without judgement. MCBT can be particularly helpful in identifying early signals and triggers that lead to negative patterns, and addressing them before they arise fully.

These kinds of therapies focus on identifying and challenging negative patterns, improving coping skills and addressing the interpersonal issues that may contribute to depression. They can be used in combination with other therapies, like somatic therapy that focuses on our body’s reactions and responses to stress, or wellness-based approaches like meditation.

Effectiveness of Counselling in Managing Depression

It’s important to remember that only some kinds of counselling professionals can perform assessments to give a medical diagnosis for mental illness like depression (psychiatrists, psychologists and some medically certified social workers). Other types of professionals may be trained to recognize signs and symptoms (and may refer for diagnosis), or to apply techniques to support someone through an existing diagnosis, but they cannot provide the diagnosis themselves.

Effectiveness of any one or combination of therapies can vary, and it might take some time to find the mix of approaches that works for you. These are serious interventions, so seeking professional help from a qualified and licensed professional is important to ensure they have the background, training and education. 

Mental health research is robust, but it is continually evolving (and will evolve more) as social acceptance, government funding and accessibility improves.

Current research on counselling for depression show effectiveness in:

• Reduction in Symptoms: Counselling approaches and therapeutic techniques have shown to reduce the symptoms of depression, sometimes drastically. This can mean experiencing improved mood, decreased feelings of hopelessness, improved sleep or focus, improved communications skills, or general increase in overall wellbeing.

• Prevention of Relapse: As mentioned, MBCT has been shown to be particularly effective in preventing relapse. The skills and tools counselling can be effective as new coping mechanisms to help identify, address or alleviate negative patterns before they become persistent again.

• Long-Term Benefits: Because these therapeutic techniques, like the ones listed above, focus a lot on new coping mechanisms and tools for managing stressors and mood, counselling for depression can contribute to long-term improvements in mental health and a positive future outlook for overall mental wellbeing.

Since depression and other mood disorders are closely connected with or determined by brain chemistry, there may be cases where a combination of medication (like antidepressants) is an effective treatment approach. This has shown to be effective in more moderate or severe cases of depression, and less effective in mild cases. As well, there can be side effects to medication so the outcomes can vary person-to-person. Importantly, only medical doctors, including psychiatrists, are able to prescribe medication to help with mental illness.

Given these nuances and complexities with depression and counselling, it’s advisable to seek the help of a professional with a specialization in depression. But, it’s not easy to find the motivation and energy to seek that help, particularly for someone struggling with the symptoms of depression. 

This is where online platforms like First Session can help. On your own time, you can browse therapists in your area, filter by specialization or other factors like demographics, and watch intro videos to get a sense of them before reaching out. This can increase your likelihood of finding a good counsellor fit.

Substance Use and Depression

Studies have shown a strong connection between substance use and abuse, and mental illness, including mood disorders like depression. This is not necessarily a cause-and-effect relationship. There is evidence of a “comorbidity” (correlation, or presence at the same time) of substance abuse or addiction and mental illness. These issues may also share many of the same underlying risk factors: social challenges, family history, genetics, environmental or circumstantial stressors. 

Counselling may help with co-existing challenges like drug or alcohol abuse and depression. Counselling may help address that root cause and therefore help alleviate reliance on substances and symptoms of depression.

‍Sasha Lizárraga, Registered Social Worker and Psychotherapist explains, “Substances to numb and dissociate, disconnection from their body and the world, etc. they may be able to change their lifestyle through willpower for a little while but if the root isn’t looked at the problem will always come back.”

Guide on how to seek counselling for depression

Seeking counselling for depression can be very similar to seeking help for challenges like anxiety, family or relationship conflict, grief, etc. Approaching your search with an open mind and some patience can help. Some people who come to counselling for depression may have a referral from a medical professional or be directed there by someone else involved in their overall wellbeing. 

But, if you’re seeking this help on your own, there are a few things to keep in mind and some tips to help make the process a little bit easier:

1. There is nothing to be ashamed of. Stigma is still very strong when it comes to mental illness and seeking mental health support, despite positive trends to social acceptance in recent years. Letting go of that shame and allowing yourself to ask for help can be a huge first step for many. 

2. Consider your budget. Depending on the type of counsellor, costs for one-hour counselling sessions can range from $65 to $300 and up. There are some provincially and federally funded options for low- or no-cost counselling, but availability can be limited. You may have workplace benefits for counselling; if you’re working and have healthcare coverage, check your booklet or call your provider. Your employer won’t know, and they can help direct you to the right type of professional. 

3. Finding a good therapist fit can make a big difference. The client-relationship fit has been shown to be the number one predictor of success in counselling. This can be especially important for those experiencing symptoms of depression. Finding someone who is compassionate, patient and even someone who has the demeanour or tone of voice that brings you comfort can help. This kind of connection can help build trust, and through that trust, you can hopefully start to envision opening up about your struggles.

When looking for a counsellor on First Session, you can filter by location and review each therapist’s profile to learn if they offer in-person or online sessions. Be sure to look for the locations the professional is able to operate. Many therapists are licensed to operate in more than one province, particularly if they offer online therapy; however, this might impact your workplace coverage. It’s always a good idea to check first and consider a free counselling consultation, if available, to ask some questions about how and where that professional can work with you.

Lifestyle Changes in Conjunction with Counselling

Once again, keep in mind that everyone experiences periods of feeling low, sad, unmotivated or unhappy. Even if you adopt really great coping skills and new strategies to alleviate symptoms of depression, you might experience expected bouts of sadness from time to time. 

This is where lifestyle choices outside of counselling can benefit your overall mental health outlook and improve your chances of cycling through negative emotions in a manageable way. 

Margaret Hux explains the connection, “When your body is depleted of energy, it makes it so much harder to heal from depression and some of the initial steps that are important are finding ways to nourish and rest, and move the body.  Sometimes the most important starting point is helping the client to deeply relax and particularly to improve sleep, since a depressed mind is a stressed mind. So that these types of changes don’t seem insurmountable, it's important to find small steps toward improvement, to be supported in following through on some steps and to celebrate each improvement.”

Practices such as walking outside, stretching, breathing techniques, journaling and meditation can be part of your counselling practice, or your everyday toolkit to help manage stress and negative emotions. Consider healthy eating habits, drink water and add in habits to help you relax, whatever that looks like for you. Even five minutes of mindfulness exercises can help alleviate sharp and immediate symptoms associated with depression.

Concluding thoughts on counselling for depression

Counselling can be an important part of your overall health and wellness plan. If you’re feeling some of the symptoms of depression most of the day, every day, for weeks, it’s likely time to consider talking to someone. You can start with your family doctor. They may even be able to help refer you to a mental health professional so you don’t have to begin that search on your own. 

Try talking to those you trust. If you’re unsure, online resources like First Session can help you build your own knowledge base, which can help you feel confident in taking the next steps in your mental health care.

When it comes to counselling for depression:

1. Depression can feel different for everyone. The symptoms and factors associated with depression can vary and intersect, and it can be personal. Someone else may be coping with similar challenges without expressing the same symptoms, but that is not relevant to your experience nor should it prevent you from asking for help.

2. Counselling techniques can vary. There are a number of evidence-based therapeutic techniques that have shown positive outcomes for helping to alleviate symptoms of depression. Some common techniques include cognitive behaviour therapy (CBT), interpersonal therapy (IPT) or mindfulness-based cognitive therapy (MBCT). Each of these focus on addressing negative thought patterns, how they relate to emotions or behaviours or interpersonal relationships, and improving coping skills. 

3. Counselling can help with depression. Studies have shown counselling can help alleviate symptoms of depression (improve mood, replenish energy, calm nerves and improve focus), prevent relapse with new coping skills and strategies, and offer long term mental health benefits.

4. Lifestyle choices are important. There is evidence of a connection between substance use and depression and they can share some of the same underlying factors for becoming an issue. Counselling may help address more than one issue by tackling the root cause of the distress that leads to undesirable lifestyle choices that negatively impact your wellbeing.

Ready to start your search? Look for a therapist on First Session. You can filter by location, specialization, modality or therapy type and browse videos to get to know the therapist before you reach out.