Winter, low mood and the December dip: what therapies help

By mid-November the days are short, the evenings are long, and the run-up to Christmas adds money worries, family arrangements and social pressure to the usual routine. Many people notice their mood dipping at this time of year. For most, it lifts once the weather improves or the holiday passes. For some, it does not, and the question becomes whether something more is going on.

This is a reference piece about therapy for low mood in the winter months. It describes what the approaches are, how they are used, and how to find support. It does not promise that any particular treatment will work for any particular person.

Why winter can feel heavier

The shortening of daylight is one of the best-documented influences on mood and energy, and it affects people in different ways. Some feel sluggish and sleepy, eat more and want to withdraw. Others feel restless and anxious. The festive period can add its own load: expectations of cheerfulness, time with relatives who are difficult to be around, and the loneliness some people feel when everyone else seems busy.

It is therefore worth separating two things. A low week, or a few flat weeks around the holidays, is a common human experience. A low mood that lasts most of the day, most days, for a fortnight or more, and that changes sleep, appetite, concentration or the ability to get through ordinary tasks, is worth taking seriously. That threshold is the one a GP will usually use when deciding whether to assess.

Assessment before treatment

The first step is usually a conversation with a GP. They will ask about the pattern of mood, sleep, appetite and energy, whether there have been thoughts of self-harm, whether alcohol or other substances are involved, and whether any physical health conditions might be contributing. Some of these can cause low mood on their own, which is one reason a check-up is useful.

If depression is identified, NICE guidance recommends a stepped approach. Mild difficulties may be helped by self-help materials, guided support or a short course of talking therapy. More persistent or severe depression is usually treated with a more intensive psychological therapy, medication, or both, depending on severity and the person’s preference. A GP can explain the options and the reasoning behind them.

Which therapies are used

Several structured talking therapies have a substantial evidence base for depression, and they are the ones most often offered through NHS services.

Cognitive behavioural therapy (CBT) looks at the links between thoughts, feelings and behaviour, and works on specific patterns such as harsh self-criticism, avoidance or a belief that nothing will improve. It is structured and usually time-limited.

Behavioural activation is a simpler approach, often used in the early stages. It focuses on rebuilding a timetable of small, meaningful activities, which can be practical in the darker months when the urge to do nothing is strong.

Mindfulness-based cognitive therapy (MBCT) is designed mainly to reduce the chance of depression returning after recovery. NICE recommends it for people who have had several episodes, and it is taught in a group format over a set number of weeks. Its use for someone currently in a low phase is more limited, so the fit should be discussed with a practitioner. More on the differences is in mindfulness and MBSR-MBCT .

Other approaches, including interpersonal therapy and some forms of counselling, are also used. The evidence for each differs, and the most useful question to ask is what the service offers and how the choice will be made.

Getting started with NHS talking therapies

In England, NHS Talking Therapies services accept referrals for common mental health difficulties, including depression and anxiety. In many areas people can refer themselves, and some services offer a first contact by phone or online. Waiting times vary by area and by demand, and the winter months can bring longer queues, so it is reasonable to ask what the expected wait is and whether any interim support is available.

The sibling guide on NHS talking therapies sets out the steps in more detail, and what happens at a first appointment explains what the initial session usually involves. Private practitioners can also be found, though it is worth checking their registration and qualifications before committing to a course of sessions. The checking a practitioner page covers what to look for.

Keeping steady over the holidays

Therapy is the main route for many people, but ordinary routines matter too. Keeping wake times roughly steady, getting outside in daylight where possible, eating regular meals and keeping in touch with one or two people all support mood. None of these is a substitute for assessment, and none should be used to dismiss a low mood that persists.

Setting realistic expectations for the season can also help. Not every gathering needs to be attended, and it is acceptable to agree a shorter visit or a quieter plan in advance. Some people find it useful to decide, before the festive period starts, which commitments they will keep and which they will drop.

When to seek help now

If someone feels unable to cope, is not sleeping or eating, or has thoughts of harming themselves, they should contact their GP the same day. Outside surgery hours, NHS 111 can advise on the next step, and in an emergency or if someone is at immediate risk, the advice is to call 999. Friends and family who are worried about someone else can also speak to a GP about how to support them.

Low mood in winter is common, and it is often treatable. The most useful first step is usually the least dramatic one: a conversation with a GP about how long the feeling has lasted and how much it is getting in the way. Getting help now lists the routes in more detail.