%20(1).png?width=200&height=80&name=Trillium%20Counselling%20Logo%20(999%20x%20398%20px)%20(1).png "Trillium Counselling Logo (999 x 398 px) (1)")
Depression Counselling
Break the cycle of low mood and exhaustion, and find your energy again
Depression counselling is talk-based support with a registered therapist to help lift low mood and work toward the version of yourself you want to be. At Trillium Counselling, you can meet in person in Kitchener-Waterloo or online across Ontario.
What is depression?
Depression is a common mood condition, and it's more than feeling sad. Your mood may feel low, empty or irritable, or you may lose interest in things you used to enjoy, and it starts to affect your sleep, energy, focus and how you get through the day (CAMH). It may be depression when these symptoms last most of the day, most days, for more than two weeks and get in the way of work, school or relationships (CAMH).
You're not alone in this. About 1 in 13 Canadians aged 15 and older had a major depressive episode in 2022, up from about 1 in 21 in 2012 (Statistics Canada). Depression comes in a few forms, including major depressive disorder, persistent depressive disorder (a low mood that lasts a long time) and seasonal affective disorder. If your depression came after having a baby, our perinatal and postpartum counselling service is made for that. If work exhaustion is the bigger part of your story, our burnout guide may be a better place to start.
Depression often grows out of stress or hard experiences. Our article on how trauma, anxiety and depression are connected explains the link. If you're curious how depression shows up on screen, see depression in movies and TV.
What are the signs of depression?
Depression looks different for everyone, and you don't need every sign below. These six are common ones, and they usually show up together for more than two weeks. Some people keep working, parenting and showing up while feeling empty inside. That's sometimes called high-functioning depression. It's a description, not a diagnosis a physician or psychologist would give, and it's still worth taking seriously.
Loss of interest or pleasure
Things that used to feel good, like hobbies, friends, food or exercise, now feel flat or like too much effort.
Tiredness and sleep changes
You feel drained even after rest, or you sleep much less or much more than usual. Everything feels slower.
Changes in appetite
You eat far less or far more than usual, and your weight may shift without you trying.
Hopelessness and guilt
You carry a steady sense of worthlessness, guilt or self-doubt, or a belief that things won't get better.
Trouble concentrating or deciding
Your mind feels foggy. Reading, remembering and making even small decisions take real effort.
Thoughts of death or suicide
If you're thinking about ending your life, please reach out now: call or text 9-8-8 at any hour. You don't have to be sure, or be in danger, to call.
Not sure if what you're feeling counts? Our guide to the signs it is time to book therapy can help you decide. You never have to be in crisis to reach out.
How does therapy help with depression?
Therapy can help by working on the patterns that keep low mood going: pulling back from things you used to do, being hard on yourself, and avoiding whatever feels difficult. For mild to moderate depression, evidence-based psychotherapy is about as effective as antidepressant medication (CAMH). Canadian treatment guidelines prefer psychotherapy as the first step for mild depression when it's easy to access (CANMAT 2023 guidelines).
Early sessions focus on what depression looks like for you, day to day. From there, you and your therapist work on small, doable steps. You might bring back activities that give you energy or meaning, notice the thoughts that pull you down and check whether they're accurate, and build skills for hard moments.
Which types of therapy do we use for depression?
Your therapist will suggest an approach based on what your depression looks like, what you've already tried and what feels realistic right now. Common options at Trillium include:
- Cognitive behavioural therapy (CBT), including behavioural activation, looks at how what you do and think connects to how you feel. CBT usually runs 12 to 16 weekly sessions, and behavioural activation, its activity-focused part, usually 6 to 8 (CAMH).
- Mindfulness-based cognitive therapy (MBCT) helps you notice low-mood spirals early. If you've had depression more than once, it was linked to a lower risk of it coming back over the following year or so (JAMA Psychiatry, 2019).
- Acceptance and commitment therapy (ACT) helps you make room for hard feelings while you keep moving toward what matters to you.
- Dialectical behaviour therapy (DBT) builds skills for handling intense emotions and getting through hard moments. It can help when low mood comes with overwhelming feelings.
- EMDR therapy can be added when low mood is tied to difficult past experiences. Some of our therapists offer it alongside the approaches above.
You don't have to choose. If you're curious about the differences, we've written plainly about CBT versus ACT and CBT versus DBT.
Who provides depression counselling at Trillium?
Most of our team provides individual counselling for Depression, by Registered Social Workers (MSW, RSW) and Registered Psychotherapists (RP). The Ontario College of Social Workers and Social Service Workers and the College of Registered Psychotherapists of Ontario both authorize members to provide psychotherapy (OCSWSSW, 2024).
You don't need a diagnosis to start. A formal diagnosis of depression comes from a physician, psychiatrist, nurse practitioner or psychologist, and our therapists work with what you're going through either way. Our team doesn't include psychologists or psychiatrists, so if you'd like a diagnosis, your family doctor is the usual first step. Unsure who does what? Our explainer on psychotherapists, psychologists and psychiatrists walks through it.
Below are a few of the therapists at Trillium Counselling who support clients with depression, in Kitchener-Waterloo and online across Ontario. Not sure who to request? You don't have to. After a free 20-minute consult with our intake team, we'll suggest a therapist who's experience fits your needs and schedule, including team members not pictured here.
Right Therapist, Right Plan, Real Support
Evidence‑based therapy plus the right counselling match helps you move from coping to thriving—on a schedule that sticks.
How do we match you with the right therapist?
You start with a free 20-minute matching consult with our intake team. It's a friendly conversation about what's been going on and what you'd like to be different. It isn't therapy, and it isn't an assessment. We ask about your preferences, like therapist style, approach, schedule, and in person or online. Then we suggest a therapist from our team whose experience fits, and we confirm next steps and insurance before you book.
If you'd rather not explain everything on the phone, a few sentences is plenty. And if it doesn't feel like the right fit after a few sessions, just say so. Our article on when it is time to change therapists explains how to bring it up.
What happens in your first sessions of depression counselling?
Your first session is a conversation. Your therapist will ask what a typical day looks like now, how your sleep, energy, appetite and motivation have changed, what you've already tried and what you'd like to be different. You can ask how they work, too. Low mood can sometimes include thoughts of not wanting to be here, so your therapist will also ask about safety. That's routine care. It doesn't mean you're in trouble.
.png?width=5000&height=2083&name=Depression%20WHO%20(1).png "Depression WHO (1)")
After that, sessions are usually bi-weekly at first and 50 minutes long. There's often a small step to try between sessions, like planning one activity that gives you a little energy. The amount of sessions is really so unique to each person, their history, their journey and their current goals. As a general observation counselling on average can last around 12 to 16 sessions (CANMAT 2023 guidelines). Your therapist will review progress with you along the way, and you set the pace together.
Can therapy help if you have both anxiety and depression?
Yes, and many people have both. Worry, restlessness and low mood tend to feed each other. That means the same skills, including CBT, mindfulness and acceptance-based work, can help with both at once. For people with chronic or severe depression, or a second condition such as an anxiety disorder, combined psychotherapy and medication works better than either alone (CAMH). It's worth bringing your doctor in too.
Every therapist pictured below lists both anxiety and depression among their areas of experience, so one therapist can help you with both. Our anxiety counselling page explains how we approach the anxiety side.
Is online depression therapy an option?
Yes. Trillium offers depression therapy by secure video to clients anywhere in Ontario, and in person at our Waterloo office. CBT works in several formats, including one-on-one, group and telephone or digital delivery (CANMAT 2023 guidelines). When depression makes leaving the house feel like too much, having sessions from your own space can make it easier to keep showing up. Our online counselling page explains how it works.
Do you need medication, or is therapy enough?
Talk therapy is the first treatment for depression, and medication is usually added when depression is moderate or severe (World Health Organization). For chronic, severe or hard-to-treat depression, combined psychotherapy and medication works better than either alone (CAMH).
Our therapists do not prescribe. If you'd like to explore medication, a family doctor, nurse practitioner or psychiatrist can assess that with you, and we're glad to work alongside them. You can start therapy first and involve your doctor later. Either way, tell your doctor if your mood is getting worse or you have thoughts of harming yourself.
Depression counselling in Waterloo Region and across Ontario
Trillium Counselling offers in-person depression counselling at 55 Erb Street East, Suite 303, in uptown Waterloo, a short drive from Kitchener, Cambridge, Guelph and the surrounding townships. We also see clients anywhere in Ontario online by secure video. Our hours run until 9 p.m. Monday to Thursday and 8 p.m. on Friday, with Saturday mornings available. If time is the sticking point, five ways to fit therapy into a busy life is worth two minutes.
Sessions are typically $175 per 50 minutes depending on the therapist. We offer direct billing to most major insurers where your plan allows. You'll find current fees, hours and insurance details on our hours and rates page. If guilt about taking up a spot is holding you back, we wrote about why guilt is often the first barrier to getting help.
Depression counselling FAQs
+Does therapy work for depression?
Does therapy work for depression?
Yes. For mild to moderate depression, evidence-based psychotherapy is about as effective as antidepressant medication (CAMH). For chronic or severe depression, combining therapy with medication works better than either alone. No approach works for everyone, so your therapist will check in on how you're doing and adjust the plan with you.
+Which type of therapy works for depression?
Which type of therapy works for depression?
Canadian guidelines recommend CBT, interpersonal therapy and behavioural activation as first-line psychological treatments for depression (CANMAT 2023 guidelines). At Trillium, our therapists often use CBT, mindfulness-based cognitive therapy, ACT and DBT, depending on what your depression looks like and what you've already tried. There's no single right choice, and feeling a good fit with your therapist matters too.
+Do I need medication for depression, or can therapy be enough?
Do I need medication for depression, or can therapy be enough?
Many people with mild to moderate depression start with therapy alone, and medication is usually added when depression is moderate or severe (World Health Organization). Our therapists do not prescribe. A family doctor, nurse practitioner or psychiatrist can talk through medication with you, and we can work alongside them. If your mood is getting worse, let your doctor know soon.
+How do I know if it is depression or just a rough patch?
How do I know if it is depression or just a rough patch?
A rough patch often lifts as things change. Depression tends to last most of the day, most days, for more than two weeks, and it gets in the way of work, school or relationships (CAMH). Only a physician, psychiatrist, nurse practitioner or psychologist can diagnose depression, but you don't have to wait for that answer to get support. If you can't tell, a free consult or a visit to your doctor are both good next steps.
+Do I need a diagnosis of depression to start therapy?
Do I need a diagnosis of depression to start therapy?
A formal diagnoses is not a requirement to work with a therapist on the challenging symptoms you are experiencing. You can start therapy based on how you're feeling and what's getting in the way. A formal diagnosis of depression can only come from a physician, psychiatrist, nurse practitioner or psychologist, and our therapists do not diagnose. They work with what you're going through whether or not you ever pursue a diagnosis. If you'd like one, or want to talk about medication, your family doctor is the usual first step.
+How many therapy sessions will I need for depression?
How many therapy sessions will I need for depression?
It varies. For most people, the research points to about 12 to 16 sessions of a first-line psychotherapy (CANMAT 2023 guidelines). Behavioural activation usually takes 6 to 8 weekly sessions, and mindfulness-based cognitive therapy about 8 (CAMH). Some people need fewer. Some, especially with long-standing depression, choose to keep going longer. We can't promise a number, and your therapist will review progress with you regularly.
+Who offers depression counselling in Kitchener-Waterloo?
Who offers depression counselling in Kitchener-Waterloo?
Trillium Counselling offers depression counselling in person at 55 Erb Street East, Suite 303, in Waterloo, and online by secure video across Ontario. Our therapists are Registered Social Workers (RSW) and Registered Psychotherapists (RP), and you can check each of them on a public register. You can book a free 20-minute matching consult online or by calling 226-752-8857, and we'll suggest a therapist who fits.
+Is depression counselling covered by insurance in Ontario?
Is depression counselling covered by insurance in Ontario?
Depression counselling with a Registered Social Worker or Registered Psychotherapist is not covered directly by OHIP, but many extended health plans reimburse it, and Trillium can direct bill most major insurers where your plan allows. Coverage varies, so check your annual amount and whether Social Worker (MSW, RSW) or Psychotherapist (RP) sessions are eligible.
+Can I do depression therapy online in Ontario?
Can I do depression therapy online in Ontario?
Yes. Our therapists offer depression therapy by secure video to clients anywhere in Ontario, and some offer online sessions only. CBT works in individual, group and telephone or digital formats (CANMAT 2023 guidelines). When your energy and motivation are low, online sessions can be easier to keep.
+What should I do if I am having thoughts of suicide?
What should I do if I am having thoughts of suicide?
If you're thinking about ending your life, call or text 9-8-8, Canada's Suicide Crisis Helpline, at any hour, or contact Here 24/7 at 1-844-437-3247 in Waterloo Wellington. If you're in immediate danger, call 9-1-1 or go to your nearest emergency department. Trillium Counselling does not provide crisis services. If you're not in immediate danger, therapy can be a place to talk about these thoughts, and you can tell your therapist in your first session.
+How do I start therapy when I barely have the energy to get out of bed?
How do I start therapy when I barely have the energy to get out of bed?
Start smaller than you think you need to. The free 20-minute consult is a short conversation with our intake team, and you can book it online or by phone without having anything figured out. Online sessions mean no travel, and our hours run until 9 p.m. Monday to Thursday and 8 p.m. on Friday. Your therapist will set the pace with you, often starting with one small, manageable step instead of a big plan.
+Can depression come back after therapy?
Can depression come back after therapy?
It can, especially if you've had more than one episode, which is why planning to stay well matters. Mindfulness-based cognitive therapy, which teaches you to notice low-mood patterns early, was linked to a lower risk of relapse in people with repeated depression (JAMA Psychiatry, 2019). The skills you build in therapy are ones you keep using after sessions end, and you're welcome to come back for a few sessions if your mood starts to slip.
About the reviewer
Katelyn Regier, MSW, RSW, is a Registered Social Worker at Trillium Counselling with a post-graduate certificate in dialectical behaviour therapy (DBT) from Wilfrid Laurier University and additional training or experience with depression, anxiety, suicidal ideation and trauma. Last reviewed September 2026. Katelyn’s work and passion is centred around creating a safe space where you can feel supported and not alone in your healing journey. Everyone’s path to recovery looks different, and it is Katelyn’s goal to walk with you as you discover what this path looks like for you.
Keep reading about depression
Plain-language answers to the questions people ask before they reach out.
How do I know if I need therapy? 12 signs it's time to book
You do not need to be in crisis. The everyday signs people usually notice first, and what to do next.
Trauma and moodTrauma, anxiety and depression: how they're connected
Why difficult experiences can show up later as low mood or worry, and how trauma-focused treatment fits in.
Hidden depressionHigh-functioning depression
When you look fine on the outside but feel empty inside.
BarriersWhy guilt is the first barrier to getting help
Feeling like you should cope alone is common. Here is how to get past it and reach out.
ServiceAnxiety counselling in Kitchener-Waterloo and online
When worry and low mood show up together: how our therapists approach the anxiety side.
ServiceCBT therapy at Trillium
How cognitive behavioural therapy works, what a course looks like and who on our team offers it.
Not sure yet? Let’s talk it through.
If you’d like to ask questions or explore your options first, book a free 20-minute matching consult or give us a call (226-752-8857) . One of our team members will help you find the right therapist and next steps that feel comfortable for you.
If you need help right now
Call or text 9-8-8, Canada’s Suicide Crisis Helpline. It is free, confidential and open 24 hours a day, every day. In Waterloo Wellington, Here 24/7 answers around the clock at 1-844-437-3247. If someone is in immediate physical danger, call 9-1-1.
Trillium Counselling does not provide crisis services. For non-urgent support, book a free consultation or call 226-752-8857.