Individual therapy

Depression Therapy

Therapy for depression: the gray filter over everything, the enormous effort of seeming fine, the version of you that's quietly gone missing. Depression tells you this is simply who you are now. Depression is a condition with an opinion — and its opinion is not the truth about you.

50-55 minute sessions Structured and warm 100% online · TX · ME · MT · NH
Is this you?

You're doing everything. You're feeling nothing.

From the outside, the machine still runs: the job gets done, the texts get answered eventually, the "I'm fine" lands convincingly. What nobody sees is the cost per unit — how much it takes to do things that used to be free, and how little comes back. If this sounds familiar:

  • Things you genuinely loved — the hobby, the people, the food, the music — have gone flat, like someone turned the flavor off
  • Ordinary tasks cost triple: showering, replying, cooking, deciding — everything runs through wet cement
  • You're withdrawing in ways you can explain away: too busy, too tired, next week for sure
  • There's a narrator in your head now, and it's mean — cataloguing your failures with a confidence it never earned
  • Sleep and appetite have gone strange in one direction or the other, and mornings are the hardest part of the day
  • Part of you keeps saying you have no right to feel this way — good job, good people, no tragedy — as if depression checks credentials
Understanding the loop

Depression shrinks your life, then feeds on the shrinkage

Depression's cruelest mechanism is that its symptoms are also its fuel. Low energy makes you put things down; a smaller life produces less pleasure, mastery, and connection; less of those drops the mood further — and the narrator calls the whole thing proof. The loop runs in predictable stages.

The depression loop A cycle of five stages connected by arrows in a circle: low mood and energy, withdrawal and putting things down, life narrowing with fewer sources of pleasure and connection, mood dropping further, and the inner narrator declaring this is just who I am, feeding back around. The center is labeled: a loop, not a life sentence. A loop, not a life sentence and around again, unless it's interrupted Low mood & energy everything costs triple Withdrawal putting things and people down Life narrows less pleasure, mastery, connection Mood drops further less coming in, less to run on The narrator "this is just who I am now"

The loop can be entered anywhere — which means it can be interrupted anywhere. Small, chosen re-entries into your own life; a narrator cross-examined instead of believed. That's the work, and it's very doable.

Who I work with

Depression doesn't have one face

It can look like collapse, and it can look like a promotion earned while feeling nothing. Yours is the version we work from.

High-functioning depression

Performing fine at full price — the depression nobody would believe if you told them.

After loss or transition

Divorce, a death, a move, a diagnosis, an empty nest — when the sadness stopped moving.

Neurodivergent adults

Depression alongside ADHD or autism — and sorting it from burnout, because they differ.

The irritable version

Depression that shows up as a short fuse and numbness rather than tears — common, and commonly missed.

The long-haulers

Low-grade for years, "just my personality" — and people who've tried therapy before without it sticking.

What we work on

Four fronts, worked in sequence

No pep talks, no gratitude-journal prescriptions, no "have you tried exercise" as a treatment plan. Structured work, sized to the energy you actually have.

Re-entry, not motivation

Depression waits for motivation that never comes; treatment doesn't. We reverse the order — small, specific, chosen re-entries into your own life, sized to a bad day, because in depression action produces motivation, not the other way around.

Cross-examining the narrator

The mean inner voice presents opinion as verdict: worthless, burden, always, never. We put its claims on the record and test them like the shoddy evidence they are — not with forced positivity, but with accuracy. Accuracy is consistently kinder than the narrator.

What the depression is answering

Sometimes depression is weather; often it's also a message — grief unfinished, a life drifted off its values, a relationship or job quietly draining the account. We treat the symptoms and read the message, so the fix isn't just cosmetic.

Staying well

Depression recurs when nobody maps its approach route. We chart your early-warning signature — the specific first dominoes — and build a response plan, so a bad week gets caught before it becomes a bad season.

How treatment works

A clear, structured plan, built in sequence

This is structured work drawing on cognitive-behavioral and acceptance-based approaches (ACT), with a behavioral re-entry engine at its core and depth work where the depression has roots. By session three you'll know your plan, its phases, and roughly how long the work takes. Sessions are 50-55 minutes. Therapy works with or without medication; if you use or are considering it, I'll coordinate with your prescriber — I don't prescribe.

One distinction I take seriously: in neurodivergent adults, depression and neurodivergent burnout get mistaken for each other constantly, and the treatments point in opposite directions — depression's plan says gently do more; burnout's says deliberately do less. Prescribing activation to someone in burnout deepens the hole. We differentiate before we treat, and when both are present, we sequence them.

When depression has hollowed out follow-through, executive function support runs alongside — and if the low mood is tangled up with how you see yourself, self-worth work is part of the same body of practice.

How online therapy works →

1

Assessment

Your version: symptoms, history, what it's costing, and what it might be answering.

2

Re-entry

Small, chosen returns to your own life — the loop's most reliable interruption point.

3

The deeper work

The narrator, the roots, and the patterns that set the stage.

4

Staying well

Your early-warning signature and a concrete plan for the next hard season.

Format

All sessions online via secure, HIPAA-compliant video. You must be physically located in Texas, Maine, Montana, or New Hampshire at the time of session. Depression makes leaving the house one of the most expensive tasks there is — online therapy means getting help doesn't require the energy the depression took.

Investment

Sagebrush Counseling is private pay, and superbills are available for out-of-network reimbursement. Visit the services page for current rates and details.

A note on safety

This practice provides ongoing therapy, not crisis care. If you're in crisis or having thoughts of suicide, call or text 988 (the Suicide & Crisis Lifeline, 24/7), or call 911 in an emergency. For everything else, I'm here. Meet your therapist →

Common questions

About depression therapy

Quick answers. The full FAQ page has the rest.

Yes — depression doesn't check credentials before moving in. It's a condition, not a referendum on whether your circumstances justify it, and "no reason" depression is one of its most common forms. The guilt about not having earned your suffering is itself a classic symptom, and it's one of the first things worth putting down.
Worth sorting carefully, especially for neurodivergent adults, because the treatments point in opposite directions. Rough signposts: depression flattens pleasure across the board and often comes with the attacking inner voice; burnout tracks with demand load, features sensory overwhelm and skill loss, and responds to genuine rest and accommodation. Both can be true at once, and assessment sorts the sequence. The neurodivergent burnout page covers that side in depth.
Not necessarily — therapy is an effective treatment for depression on its own, and it's also effective alongside medication; for some people the combination works best. I don't prescribe, I don't push either direction, and if medication is part of your picture I'll coordinate with your prescriber. The decision stays yours, made with good information instead of pressure.
Fair question, and worth answering specifically rather than defensively. Common reasons a previous round didn't hold: it was all talk and no structure, it treated symptoms without touching what the depression was answering, or it ended without a staying-well plan. Tell me what the last round looked like and where it stalled — that history is some of the most useful assessment data you can bring.
That's not a disqualifier — it's the presenting problem, and the work is built for it. Early sessions ask very little: show up (camera optional on hard days), tell the truth, and take steps sized to a bad day, not a good one. Depression treatment that requires you to already be functioning is badly designed. This isn't that.
Then please reach for support now: call or text 988 to reach the Suicide & Crisis Lifeline, available 24/7, or call 911 if you're in immediate danger. This practice provides ongoing weekly therapy rather than crisis services — but passing thoughts that life feels like too much are also common in depression and absolutely something we can talk about in our work together. You won't shock me, and you won't be handled like a liability.

The gray filter is a symptom. It isn't the truth.

The consultation is free and short. We'll talk by phone (I'll call you at the time you schedule) and see if we're a fit. No pressure, no commitment.

Free 15-min consultation