You did the hard part. You reached out, booked sessions and kept showing up. But weeks or months in, you still feel heavy, flat or hopeless, and you're starting to wonder what the point is. If you feel like therapy is not helping your depression, you're not failing, and you're not out of options. If you typed "therapy not helping depression" into a search bar to get here, you're in the right place. This guide looks at why progress can feel slow, how to tell if therapy is working, questions to ask your therapist and what you can try next.
This post is general information, not a diagnosis or a treatment plan.
Why progress can feel slow
Depression has a way of colouring everything, including how you see your own progress. It can make small improvements hard to notice and setbacks feel huge. A few other things can also slow things down:
Depression drains energy. It can be hard to practise skills between sessions when getting through the day takes everything you have.
Life keeps happening. Stress at work, money worries, health problems or relationship strain can pile on while you're working on your mood.
Some patterns run deep. If your low mood is tied to long-standing beliefs, trauma or grief, it may take time to untangle.
Change isn't a straight line. Many people have good weeks and bad weeks before things steady.
None of this means therapy can't help. But it's worth checking in on whether the current approach is the right one.
How to tell if therapy is working
It can help to look for small shifts, not only big ones. Ask yourself:
Do I understand my depression better than I did before?
Am I noticing unhelpful thoughts or patterns a little sooner?
Have I done anything I was avoiding?
Do hard days pass a bit faster, even if they still come?
Do I feel safe and understood in sessions?
Do I have clear goals, and do I know what we're working on?
If the answer to most of these is no, it's a good time to talk openly with your therapist. Knowing how to tell if therapy is working gives you something concrete to bring to that conversation.
When therapy is not working, talk about it
It can feel awkward to say "I don't think this is helping." Many people worry about hurting their therapist's feelings. But good therapists want this feedback. It's part of the work, and it often leads to helpful changes.
Questions you might ask:
What are we working toward, and how will we know we're getting there?
Can we revisit my goals?
Is there a different approach we could try?
Would more structure, or less, help me?
Are there skills I could practise between sessions?
What do you notice about how I've been doing?
If therapy isn't helping my depression, I can say so. That sentence alone can open up a new direction.
When fit is the issue
Sometimes the problem isn't therapy itself, but the match. The relationship with your therapist is one of the most important parts of counselling. If you don't feel comfortable, heard or understood, it's hard to make progress.
Signs fit might be the issue include:
you hold back important things
you feel judged or misunderstood
their style doesn't suit you, for example too directive or not structured enough
you'd feel more comfortable with someone of a different gender, background or age
Switching therapists is common and okay. It's not a failure, and it doesn't mean the time you've spent was wasted. You can browse our team to see the range of backgrounds and approaches our therapists bring, and our admin team can help you find a new match.
What switching therapists looks like
If you decide to try someone new, it doesn't have to mean starting from scratch. You can bring what you've already learned about yourself, what helped and what didn't. That information can help a new therapist get to know you faster.
It can help to:
think about what you'd like to be different this time
note any approaches you'd like to try, or avoid
share your goals early in the first session
give the new relationship a few sessions to settle
If you're switching within our clinic, our admin team can help you find someone whose style and approach fit what you're looking for.
When therapy makes me anxious
Some people notice that therapy makes them anxious. You might dread sessions, feel exposed or leave feeling worse. Some discomfort can be part of healthy change, especially when you're talking about painful things. But ongoing distress is worth raising.
Tell your therapist how sessions feel. They can slow down, focus more on coping skills or change how sessions are structured so you feel safer.
Other approaches to try
There are many ways to work with low mood. If one approach hasn't fit, another might. Depending on your needs, your therapist might suggest:
CBT, which focuses on how thoughts, feelings and actions connect
Behavioural activation, which helps you rebuild routines and activities that lift mood
ACT, which helps you live by your values while making room for hard feelings
Psychodynamic therapy, which explores deeper patterns and past experiences
EMDR, which can help when depression is linked to trauma
IFS, which works with the different "parts" of you, including the part that feels hopeless
If rumination is a big part of your low mood, our post on how to stop ruminating shares some practical starting points.
Medication and medical care
For some people, therapy works best alongside medication. Whether medication is right for you is a decision to make with a prescriber.
Our nurse practitioners can assess and diagnose concerns such as depression and anxiety, and prescribe medication when needed. If you'd like to explore this, ask our admin team about it in your free consultation.
What about depression without therapy?
Some people wonder whether they should stop therapy altogether and try to manage on their own. Habits like regular movement, sleep routines, time outdoors and connection with others can support your mood.
But managing depression without therapy can be hard, especially if it's moderate or severe, or has lasted a long time. If therapy hasn't helped yet, it often makes sense to change the approach or the therapist before giving up on support entirely.
When things are getting worse
Sometimes depression deepens even while you're in therapy. Let your therapist know right away if you notice:
thoughts that life isn't worth living, or thoughts of suicide
feeling unable to get through basic daily tasks
using alcohol or other substances more to cope
pulling away from almost everyone
These are signs you need more support now, not later. Telling your therapist is not a failure. It helps them respond in the right way.
In person or online
We offer sessions in person in Waterloo, Kitchener, Cambridge and Ottawa, and online anywhere in Ontario. Online sessions use a secure, encrypted video platform.
Cost and billing
Here's what to know about cost:
Individual sessions with our therapists range from $130 to $200, depending on the clinician.
Depending on your plan, insurance may cover some or all of the cost. Coverage varies, so it's worth checking your plan.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers, including for sessions with a Registered Psychotherapist (Qualifying). Desjardins is the exception: through TELUS eClaims, we can direct bill Desjardins for sessions with an RSW, RP or psychologist, but not for an RP (Qualifying).
Your first step
Book a free 15-minute consultation with our admin team. Let them know what you've tried, what hasn't felt right and what you'd like to be different. They'll help you find a therapist and approach that fit.
If you're in crisis: call 911 if you're in immediate danger. If you're having thoughts of suicide, call or text 9-8-8 any time, day or night. You can find more options on our crisis lines page.
Feeling stuck isn't the end of the road. It's often the start of finding what works for you.