Depression can make everything feel impossible. It doesn't have to stay that way.

Why the advice everyone gives you does not work

Get to the gym. Get outside. See your friends. Take up something. The people saying this are not wrong about the ingredients. They are wrong about the order.

That advice assumes motivation comes first: you want to go for a walk, so you go. Depression breaks the wanting. Being told to draw on motivation is being told to settle a bill from an account with nothing in it. The instruction is sound. The funds are the problem.

So it fails, and the failure gets filed. You could not manage a twenty-minute walk. Your brother could. One more item in the case against yourself, and next week you attempt even less. Cause and effect have been inverted, and it costs you something every time. Therapy that reissues the same advice in a professional accent is not worth $150 of anyone's money.

Depression that follows something, and depression that arrives from nowhere

Two people describe the same flatness. One can point at the cause: a death, a diagnosis, a marriage ending, four years in a job that ground them down. The other cannot, and that is often the harder version to carry.

When depression follows a loss or a trauma, the work usually has to include the event and not only the mood. Grief with nowhere to go can settle into something that looks like depression from outside. A memory that keeps intruding is often worked with directly, through trauma-focused work such as EMDR, rather than through mood strategies alone. Grief is not automatically depression, either, and treating ordinary mourning as an illness helps nobody.

When there is no obvious cause, the shame is the loudest part. I have no reason to feel this way, and that sentence becomes its own argument for worthlessness. Causes are usually there and simply undramatic: accumulated stress, broken sleep, a chronic illness, a slow drift from everything that used to matter. Sometimes the picture is more biological than therapy alone reaches. Both can be true in one person, and sorting out which is which takes much of the early work.

Common questions

How do I know whether this is depression or just a rough few months?

We cannot tell you. Counsellors do not diagnose, and that label properly comes from a physician. What we can look at with you is duration and reach. A rough patch usually still holds good days and stays contained. Something that has run for weeks, flattened most areas at once, and changed sleep, appetite and concentration is worth taking to a doctor as well as to a therapist. The free 15 minute consultation is about fit, not assessment.

What does it cost, and will insurance cover it?

Individual sessions are $150 for 60 minutes; couples are $175. We can direct-bill Pacific Blue Cross, CVAP and plans on the TELUS eClaims network when you see Mohamad or Alison. Where yours is not one of them, you get an insurance-ready receipt after every session and claim it back. No provincial health plan in Canada covers counselling in private practice, which leaves extended health benefits through work as the usual route. Coverage is written by designation, so check whether your plan lists Registered Psychotherapist, Registered Clinical Counsellor or Registered Social Worker. A small number of reduced-fee spots are held. Ask specifically whether the Qualifying category of Registered Psychotherapist is included, because the plan's wording is what decides it.

When can I book if I am barely holding the workday together?

Sessions run noon to 9pm Pacific, seven days a week, which lands later than it sounds further east: 3pm to midnight in Ontario, 2pm to 11pm in Winnipeg, 4:30pm to 1:30am in Newfoundland. A seven o'clock appointment in Manitoba is five in the afternoon on the coast. Cancellations need 24 hours' notice, and later cancellations and no-shows are charged in full. Depression makes cancelling likely, so choose a slot you can hold on a bad day rather than a good one.

Who would I be working with?

Mohamad Shabib, MACP, CCC, is a Registered Psychotherapist (Qualifying) with the CRPO in Ontario, trained in CBT for Trauma Levels 1 and 2, DBT, Internal Family Systems Levels 1 and 2, and Advanced EMDR, with a graduate diploma in addiction treatment and prevention. He works with clients in all six provinces, in English or Arabic. Alison Shaji is a Registered Clinical Counsellor with the BCACC, British Columbia only, trained in EMDR, CBT, DBT and inner-child and shadow work, in English, Hindi and Malayalam. Rola Shbib is a Registered Social Worker (Ontario) with a background in crisis intervention, suicide prevention, addictions and an honours degree in thanatology.

I tried therapy before and nothing changed. Why would this be different?

We cannot promise it would be. What is worth doing is being specific about last time: which approach, how many sessions, and what the hour actually consisted of. Someone given supportive talk therapy for depression rooted in an assault, or handed thought records when the harder problem was withdrawal, has not tried the approach that matched the problem. Sometimes the honest answer is that the fit was wrong. Say that in the consultation. No referral is needed.