Pergola
For the flat days, and the heavy ones

Therapy for Depression

Depression doesn't always look like the textbook version. Sometimes it's the obvious kind — trouble getting out of bed, crying that comes out of nowhere, a persistent sense that something is wrong. Sometimes it's subtler: things that used to matter have gone gray, you're doing fine from the outside, and you can't remember the last time you felt genuinely interested in anything.

The therapists below work across the whole range of it — from major depressive episodes to low-grade dysthymia to the specific kind of depression that shows up after a loss, a move, a medical diagnosis, or a long season of pushing through. Some draw from CBT to help you notice and interrupt the thinking patterns depression tends to hand you. Some work more relationally — tracking what the depression is protecting you from, or what unspoken grief is underneath it.

Good depression therapy isn't about cheerleading. It's about having someone who can sit with the weight of it, alongside you, until it starts to feel less unbearable and more workable.

2 therapists offering depression therapy
Marcus Alvarez, LCSW, therapist in Los Angeles
Marcus Alvarez, LCSW
Silver Lake, Los Angeles

Therapy for men, couples, and the complicated middle

CouplesDepressionLife Transitions
Accepting new clients$250/session
Hannah Weiss, LMFT, therapist in Los Angeles
Hannah Weiss, LMFT
Santa Monica

Postpartum, grief, and the seasons of motherhood

PostpartumGriefDepression
Accepting new clients$230/session

Common questions

How do I know if what I'm feeling is depression or just a rough patch?+
There's no bright line, and you don't need a diagnosis to start therapy. A useful rule of thumb: if low mood, low energy, or loss of interest have been showing up most days for more than two weeks, and if they're getting in the way of how you want to live, it's worth talking to someone. Many people wait until it gets a lot worse before reaching out — most of them, in hindsight, wish they'd come sooner.
What's the difference between therapy and medication for depression?+
They work in different ways and often work well together. Therapy helps you understand and change the patterns depression thrives in — the rumination, the withdrawal, the way self-criticism keeps you stuck. Medication (prescribed by a psychiatrist or primary care doctor) can lift the floor enough to make the therapy work possible. For mild-to-moderate depression, therapy alone is often enough. For severe depression, the combination tends to work best.
What kinds of therapy are most effective for depression?+
The most-studied approaches are CBT and interpersonal therapy, and both have strong evidence for depression. But the therapist's fit with you matters at least as much as the modality — research consistently shows the relationship itself is one of the biggest predictors of whether therapy works. The clinicians on Pergola tend to blend approaches rather than stick to one.
How long until therapy starts helping?+
Most people notice small shifts in the first 4–6 sessions. Real, durable change for depression usually takes several months of weekly work — longer for depression tangled up with trauma, grief, or chronic life stress. Your therapist will check in regularly on whether the work is moving things.
I'm not sure I have the energy for therapy right now. What do I do?+
That's one of the hardest parts of depression — the thing that might help is also the thing that feels the most impossible. A few things that help: start with a short first message (one or two sentences), pick video sessions so you don't have to go anywhere, and tell your therapist in the first session how hard it was to get there. A good therapist will take it from there.

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