Understanding depression: much more than sadness
Depression is one of the most frequent and, at the same time, most misunderstood mental health disorders. The word "depression" is often used colloquially to refer to a bad day or a passing moment of sadness. But clinical depression is very different: it is a disorder that profoundly affects the way we feel, think and act, and that can become disabling if it does not receive appropriate treatment.
According to the World Health Organization (WHO), depression affects more than 280 million people worldwide and is the leading cause of disability globally. In Spain, the prevalence of depression has risen significantly in recent years, and many people seek an online depression psychologist who can attend to them without having to leave home — a step that, precisely because of depression, can be extraordinarily difficult.
I am Xènia Capel Salcedo, a licensed health psychologist registered with the COPC under number 14982. I offer online depression therapy by video call with an evidence-based approach that integrates cognitive behavioral therapy, behavioral activation and EMDR when depression is linked to traumatic experiences.
Symptoms of depression
Depression manifests itself through a set of symptoms that affect the emotional, cognitive, physical and behavioral domains. To make a diagnosis, several of these symptoms must be present for at least two weeks:
• Persistent depressed mood: Deep sadness, sense of emptiness, hopelessness or irritability for most of the day, almost every day.
• Loss of interest or pleasure: Activities once enjoyed no longer bring satisfaction. Nothing motivates, nothing excites.
• Sleep changes: Insomnia (inability to sleep) or hypersomnia (sleeping excessively) without feeling rested.
• Appetite and weight changes: Loss of appetite with involuntary weight loss, or increased hunger with weight gain.
• Permanent fatigue: Intense tiredness that does not improve with rest. Even the simplest tasks require enormous effort.
• Concentration difficulties: Trouble thinking clearly, making decisions or remembering things.
• Feelings of guilt or worthlessness: Excessive self-criticism, the feeling of being a burden to others, thoughts of being worthless.
• Psychomotor agitation or slowing: Physical restlessness or, on the contrary, much slower movement and speech than usual.
• Thoughts of death: Recurring thoughts about death, suicidal ideation or wishes to disappear. If you have suicidal thoughts, contact the suicide prevention helpline immediately (in Spain: 024).
Types of depression
Online depression treatment must be tailored to the specific type of depression each person presents:
Major Depression
This is the most severe and intense form. Symptoms are severe and significantly affect daily functioning. A major depressive episode can last weeks or months without treatment. Some people experience a single episode in their lifetime; others suffer recurrent depression with multiple episodes.
Dysthymia (Persistent Depressive Disorder)
Dysthymia is a milder but much longer-lasting form of depression. Symptoms are less intense than in major depression, but they last for at least two years almost continuously. Many people with dysthymia feel they "have always been this way" and do not recognize that what they are experiencing is treatable. Online therapy is especially useful for dysthymia, as it allows for regular and sustained support without commuting barriers.
Seasonal Depression
Seasonal affective disorder is a type of depression that appears cyclically, generally in autumn and winter, when natural daylight hours decrease. Symptoms include excessive drowsiness, increased appetite (especially for carbohydrates), weight gain and social isolation. Online therapy makes it possible to start treatment preventively before the darker months arrive.
Postpartum Depression
Postpartum depression affects between 10% and 15% of women after childbirth. It goes far beyond the "baby blues" and may include intense anxiety, feelings of disconnection from the baby, fear of not being a good mother and, in serious cases, thoughts of self-harm or harming the baby. Online therapy is a vital resource for mothers with postpartum depression, as it allows them to receive treatment without having to leave home or be separated from the baby.
How does online therapy help with depression?
Online depression therapy uses the same techniques and protocols as in-person therapy, with effectiveness widely supported by scientific research. The main therapeutic tools I apply are:
Cognitive Behavioral Therapy (CBT)
CBT is the first-line treatment for depression. It is based on identifying and modifying negative thought patterns (such as "I'm worthless", "things will never get better" or "I'm a burden") that fuel and maintain depression. By video call, we can work with thought records, behavioral experiments and cognitive restructuring techniques with the same effectiveness as in an in-person consultation.
Behavioral Activation
Behavioral activation is one of the most powerful techniques against depression. When a person is depressed, they tend to reduce their activities: they stop going out, exercising, seeing friends, doing the things they used to enjoy. This creates a vicious cycle where less activity generates more depression. Behavioral activation breaks this cycle by gradually rescheduling pleasant and meaningful activities. Online therapy is ideal for this approach, since the tasks are carried out in the person's real context.
EMDR for trauma-linked depression
Many depressions originate from unresolved traumatic experiences: losses, abuse, abandonment, situations of violence or emotional neglect. When depression is rooted in trauma, EMDR therapy allows these memories to be processed and the associated emotional charge to be released. The EMDR protocol has been successfully adapted to the online format.
Why is the online format especially suitable for depression?
Depression is probably the disorder for which online therapy offers the most practical advantages:
• No need to leave home: One of the great obstacles for people with depression is the difficulty getting out of bed, showering, dressing and traveling. Online therapy completely eliminates this barrier, making treatment accessible even on the most difficult days.
• Fewer cancellations: Treatment dropout rates are lower in the online format for people with depression, precisely because the effort required to connect is much less than going to a clinic.
• Access from rural areas: Many people who live in rural areas do not have access to specialized psychologists near home. The online depression psychologist solves this problem immediately.
• Privacy: The stigma that still surrounds depression makes some people avoid seeking help for fear of "what others will say". Online therapy eliminates the risk of running into someone you know in the waiting room.
• Constant support: Between sessions, you can communicate with me by message if you have a particularly difficult moment, maintaining a therapeutic bond that gives you a sense of safety.
Therapy and medication: which is the best option?
One of the most frequent questions concerns the role of antidepressant medication. The answer depends on severity:
• Mild depression: Psychological therapy alone is the recommended treatment.
• Moderate depression: Therapy alone may be sufficient, but combining it with medication can speed up improvement.
• Severe depression: The combination of therapy and antidepressant medication is generally the most effective option.
As a psychologist, my role is to guide you on whether a psychiatric assessment could be beneficial and to coordinate with your psychiatrist or general practitioner to offer you comprehensive treatment. Medication alone, without therapy, may relieve symptoms but does not resolve the underlying causes of depression.
Warning signs: when to seek help?
Seek professional help if:
• You feel sad, empty or hopeless most of the day for more than two weeks.
• You have lost interest in activities you used to enjoy.
• Your work, relationships or daily life are being significantly affected.
• You have thoughts of death or self-harm.
• You turn to alcohol or other substances to feel better.
• You feel that you are a burden to your loved ones or that you are worthless.
Relapse prevention
One of the most important aspects of online depression treatment is the prevention of future relapses. Depression tends to be recurrent: a person who has had one depressive episode is at higher risk of having another. For this reason, once therapeutic goals are achieved, we work on a prevention plan that includes:
• Identifying early warning signs: Learning to recognize the first symptoms before they become a full episode.
• Maintaining protective habits: Regular physical exercise, sleep hygiene, balanced nutrition and social connection.
• Personalized action plan: A set of concrete strategies to apply when the first signs appear.
• Follow-up sessions: Spaced visits to monitor mood and reinforce the tools learned.
Start your recovery today
If you think you may be suffering from depression, the first step is to ask for help. I know that when you are in a depressive state, even making a phone call can feel like an immense effort. That is why I have made the contact process as easy as possible: you can write me a simple WhatsApp message and I will take care of the rest.
I offer a free first informational consultation where we will talk about your situation and decide together on the best path. Online depression therapy allows you to start your recovery today, from home, without barriers. You don't have to do it alone.