Taking the First Step: What to Expect in Your First Online Therapy Session for Depression

You've done the hardest part already—you've recognized that you need help and you've taken the brave step of scheduling your first online therapy session for depression. Now, as the appointment approaches, you might be feeling a mixture of hope and anxiety. What will it be like? What will the therapist ask? What if you can't find the right words to explain how you're feeling? What if you cry? What if you don't cry and the therapist thinks you're not really struggling?

These concerns are completely normal. Starting therapy is a courageous act, and feeling nervous about it shows how much this matters to you. The truth is, that first session is designed to be gentle, welcoming, and entirely focused on making you feel comfortable and understood. Your therapist has guided countless people through this exact moment, and they know how to create a space where you can simply be yourself—wherever you are in your depression journey.

Let's walk through what that first session will likely look like, step by step, so you can approach it with confidence rather than worry. By the end of this guide, you'll know exactly what to expect, how to prepare, and why that first conversation might be the beginning of everything changing for the better.

Before You Begin: Creating Your Comfort Zone

One of the beautiful aspects of online therapy is that you get to control your environment completely. Unlike walking into an unfamiliar therapist's office, you can create the perfect setting for your first conversation.

Setting Up Your Space

Choose somewhere in your home where you feel safe and comfortable. This might be your bedroom, a corner of your living room, or even your kitchen table if that's where you feel most at ease. The specific location matters less than how it makes you feel—you want somewhere you can speak freely without worrying about being overheard, and where you feel psychologically safe.

Make sure you have good lighting so your therapist can see you clearly, but don't stress about perfection. Natural light from a window works wonderfully, but a simple lamp will do just fine. Your therapist is there to support you, not judge your interior design or technical setup.

Have tissues within easy reach. It's completely normal to cry during therapy, especially when discussing depression, and having tissues nearby means you don't have to interrupt the flow of conversation to find them. Many people find comfort in having a soft blanket available too—something that makes them feel cocooned and safe.

Gather Your Comfort Items

Consider having a cup of tea, coffee, or water nearby. Staying hydrated is important, and having something warm to sip can be soothing when discussing difficult topics. If you have a particular mug that brings you comfort, use that one. Small details like this can help you feel more grounded during the session.

You might also want to have a notebook and pen handy, though don't feel pressured to take extensive notes. Some people find it helpful to jot down thoughts or questions that come up during the session, while others prefer to simply be present in the conversation. Do whatever feels natural for you.

Technical Preparation

About fifteen minutes before your session, test your internet connection and make sure your device is charged or plugged in. Most online therapy platforms are user-friendly and work well with basic technology, but it's worth checking that your camera and microphone are working properly.

If you're using headphones for privacy, test those too. However, don't worry if technical issues arise during the session—your therapist has experience troubleshooting these problems and can usually help you resolve them quickly, or you can always switch to a phone call if needed.

Managing Household Considerations

If you live with others, let them know you'll need privacy for your appointment time. This might mean asking flatmates to use headphones, requesting that children play quietly in another room, or simply hanging a "do not disturb" sign on your door.

If complete privacy isn't possible, don't let that prevent you from having your session. You can use headphones to keep your therapist's voice private, and speak quietly if needed. Your therapist will understand and work with whatever situation you have.

The Moment of Connection: Logging In and First Impressions

As your appointment time approaches, you might notice your heart beating a bit faster. This is completely normal—you're about to share vulnerable feelings with someone new, and that takes courage. Take a few deep breaths and remind yourself that you're doing something incredibly brave and important for your wellbeing.

Joining the Session

Most online therapy platforms make joining sessions simple—usually just clicking a link in an email or opening an app on your phone. You'll typically join a virtual waiting room first, where you might see a message that your therapist will be with you shortly. Take this moment to settle into your space and remind yourself that you're safe.

When your therapist joins the session, they'll likely begin with a warm greeting and introduction. Something like: "Hello, I'm Dr. Smith. It's lovely to meet you. How are you feeling today?" Their tone will be gentle and welcoming—they understand that this might feel overwhelming for you.

First Impressions and Settling In

Your therapist will probably spend the first few minutes helping you feel comfortable. They might ask how the technology is working for you, whether you can see and hear them clearly, and if you need to adjust anything before you begin talking.

Don't be surprised if they seem genuinely pleased to meet you. Good therapists chose their profession because they truly enjoy helping people, and they often feel honoured when someone trusts them with their struggles. Your therapist wants this to go well and is rooting for your success from the very beginning.

You might notice that your therapist's manner is professional but warm, competent but approachable. They're trained to create an atmosphere where you can be completely honest without fear of judgment. If they seem calmer and more confident than you feel, that's perfect—they're holding the space for both of you while you find your footing.

The Opening Conversation: Getting Started

The beginning of your first session will likely involve some gentle questions designed to help your therapist understand your situation and what brought you to seek help. These aren't tests or interrogations—they're compassionate inquiries from someone who genuinely wants to understand your experience.

The Gentle Beginning

Your therapist might start with something like: "What would be most helpful for you today?" or "What's been going on that led you to reach out for support?" These open-ended questions allow you to share whatever feels most pressing or important to you right now.

There's no right or wrong way to answer these questions. You might have a clear story about how your depression developed, or you might just know that you're struggling and need help. Both responses are perfectly valid. You might say something like:

• "I've been feeling really down for months and I can't seem to shake it"

• "My friends suggested I try therapy because I've been struggling to enjoy things I used to love"

• "I know I have depression, but I'm not sure how to make it better"

• "Everything just feels really heavy and difficult lately"

Permission to Be Imperfect

If you find yourself struggling to articulate exactly how you're feeling, don't worry. Depression often makes it difficult to find words for your experience, and your therapist understands this completely. They might help by asking gentle follow-up questions or offering possible words to describe what you're experiencing.

It's completely okay to say things like:

• "I'm not sure how to explain it"

• "It's hard to put into words"

• "I know this might sound strange, but..."

• "I feel silly saying this, but..."

Your therapist has heard it all before, and nothing you share will shock or surprise them. They're trained to help people explore difficult emotions and experiences, and they know that finding language for depression can be challenging.

The Relief of Being Heard

Many people find that simply beginning to talk about their depression brings some relief. There's something powerful about having another person listen to your experience with complete attention and understanding. Don't be surprised if you feel emotional during this part of the session—that's completely normal and actually a good sign that you're beginning to process feelings you might have been holding inside.

Sharing Your Story: What Your Therapist Might Ask

As the session progresses, your therapist will likely ask questions designed to help them understand your depression and how it's affecting your life. These questions aren't meant to pry or make you uncomfortable—they're gathering information that will help them provide the most effective support possible.

Understanding Your Experience

Your therapist might ask about when you first noticed feeling depressed, what symptoms you're experiencing, and how depression is affecting different areas of your life. These questions help them understand the scope and severity of your depression.

You might be asked about:

• How long you've been feeling this way

• Whether there were any specific triggers or events that seemed to start or worsen your depression

• What symptoms you're experiencing (sadness, fatigue, difficulty concentrating, sleep problems, etc.)

• How depression is affecting your work, relationships, or daily activities

• Whether you've experienced depression before or if this is your first episode

Your Support System and Resources

Understanding what support and resources you currently have helps your therapist know what additional support might be most helpful. They might ask about family, friends, work colleagues, or others who are aware of your struggles and supportive.

They might also ask about any previous therapy experience, current medications, your relationship with your GP, and other healthcare providers. This information helps them coordinate care and avoid duplicating efforts.

Your Goals and Hopes

Even in a first session, your therapist will likely ask about what you hope to gain from therapy. This doesn't need to be a detailed treatment plan—it might be as simple as "I want to feel better" or "I want to understand why this is happening to me."

These goals can evolve and change as therapy progresses, but having some sense of what you're hoping for helps your therapist tailor their approach to your specific needs and preferences.

Addressing the Emotional Reality: It's Okay to Feel

One of the most important things to understand about your first therapy session is that it's completely normal—and actually helpful—to experience strong emotions during the conversation.

If You Feel Sad or Tearful

Depression often involves a lot of sadness, and talking about your struggles might bring those feelings to the surface. If you find yourself crying during the session, know that this is completely normal and nothing to be embarrassed about.

Your therapist has seen tears countless times and understands that crying is often part of the healing process. They won't be uncomfortable with your emotions, and they won't rush you to stop crying or "feel better." Instead, they'll likely acknowledge your feelings with compassion and give you the space you need to experience them.

Have those tissues nearby, take your time, and remember that crying in therapy is often a sign that you're accessing feelings that need attention and care.

If You Feel Numb or Disconnected

Sometimes depression manifests as emotional numbness rather than obvious sadness. If you find yourself feeling disconnected or struggling to access emotions during the session, that's also completely normal and valuable information for your therapist.

Numbness is a common depression symptom, and your therapist will understand if you say things like "I know I should feel sad about this, but I just feel empty" or "I can't seem to feel anything at all." This emotional disconnection is part of what therapy can help address over time.

If You Feel Anxious or Overwhelmed

Starting therapy can feel overwhelming, especially when depression has already made you feel vulnerable and raw. If you find yourself feeling anxious during the session, let your therapist know. They can help you use breathing exercises, grounding techniques, or simply slow down the conversation to a more comfortable pace.

Remember that you're in control of how much you share and how quickly you share it. You don't need to tell your whole story in the first session if that feels like too much.

Permission to Take Breaks

If you need a moment to collect yourself, ask for water, or simply pause the conversation, that's perfectly fine. Your therapist will understand and support whatever you need to feel comfortable and safe during the session.

What Your Therapist Is Really Thinking

It might help to understand what's going through your therapist's mind during that first session. Spoiler alert: they're not judging you, analysing you, or thinking you're broken. Here's what they're actually focusing on:

Professional Compassion

Your therapist is likely feeling genuine compassion for what you're going through. They've chosen a profession dedicated to helping people navigate difficult times, and they understand that seeking therapy takes courage and strength.

They're probably thinking things like: "This person is really brave for reaching out," "I'm honoured that they trust me with this," and "I want to help them feel better." Your struggles don't make you a burden—they make you someone deserving of support and care.

Clinical Assessment

While listening to your story with empathy, your therapist is also conducting a clinical assessment—gathering information about your symptoms, support system, and needs. This isn't cold or calculating; it's professional expertise being applied with care to understand how to help you most effectively.

They're considering questions like: What type of depression are you experiencing? What therapeutic approaches might be most helpful? Are there any immediate safety concerns? What strengths and resources do you have that can support your recovery?

Treatment Planning

Even during the first session, your therapist is beginning to think about how they can best support your healing. They might be considering therapeutic techniques that could help, resources they could share, or homework assignments that might be beneficial.

This planning comes from a place of hope and professional optimism. Your therapist has likely seen many people with similar struggles find their way to better mental health, and they believe the same is possible for you.

Practical Aspects: What Happens Next

Toward the end of your first session, your therapist will likely discuss practical next steps and what ongoing therapy might look like.

Scheduling and Frequency

You'll probably discuss how often to meet and when your next session will be. Many people start with weekly sessions, though the frequency can be adjusted based on your needs, schedule, and preferences.

Your therapist might recommend meeting weekly initially to build momentum and provide consistent support during the early stages of addressing your depression. As you progress, you might space sessions further apart.

Therapeutic Approach

Your therapist might explain what type of therapy they think would be most helpful for your specific situation. For depression, this often includes approaches like Cognitive Behavioural Therapy (CBT), Interpersonal Therapy, or other evidence-based treatments.

They'll explain their approach in understandable terms and help you understand what to expect in future sessions. Don't worry if you don't remember all the details—there's no test, and these concepts will become clearer as you experience them.

Between-Session Support

Many online therapy platforms offer resources you can access between sessions—articles, exercises, mood tracking tools, or ways to message your therapist with questions. Your therapist might introduce some of these resources or suggest simple activities you could try before your next meeting.

Homework and Exercises

Don't be surprised if your therapist suggests simple activities or exercises to try between sessions. These might include mood monitoring, practicing breathing exercises, or engaging in specific activities that could help your depression.

These suggestions aren't tests or requirements—they're invitations to engage with your healing process outside of sessions. If you try them and they help, great. If you don't get to them or they don't work for you, that's also valuable information to discuss next time.

The Most Important Truth: You're Not Alone Anymore

As your first session comes to an end, the most important thing to remember is that you're no longer facing depression alone. You now have a professional ally who understands your condition, believes in your capacity to recover, and is committed to supporting you through the process.

The Beginning of Hope

That first session is often where hope begins to return. Not because everything suddenly feels better, but because you've taken concrete action toward healing and connected with someone whose job it is to help you feel better.

Many people leave their first therapy session feeling a mixture of emotions—perhaps some relief at having shared their story, maybe some anxiety about the work ahead, and often a small but significant sense of hope that things can improve.

Building Momentum

The most difficult step in any journey is the first one, and you've now taken that step. Each subsequent session builds on the foundation of trust and understanding established in this first meeting.

Recovery from depression is rarely linear, and there will likely be ups and downs ahead. But you now have professional support to help you navigate those challenges and celebrate your progress along the way.

If You're Still Hesitating: Permission to Take the Leap

If you're reading this but still haven't scheduled your first session, know that your hesitation is completely understandable. Depression often makes everything feel more difficult and overwhelming, including seeking help.

You Don't Need to Wait Until You're "Bad Enough"

Many people delay seeking therapy because they wonder if their depression is severe enough to warrant professional help. The truth is, you don't need to wait until you're in crisis to deserve support. If depression is affecting your daily life, your relationships, or your overall wellbeing, you deserve help.

You Don't Need to Have Everything Figured Out

You don't need to understand your depression completely or have clear goals before starting therapy. Part of the therapeutic process is gaining understanding and clarity about your experience. It's okay to start with simply knowing that you're struggling and want to feel better.

The Courage You Already Have

Reading this article shows that you're already considering taking this important step. That consideration itself takes courage. You have the strength needed to start therapy—even if that strength feels fragile or small right now.

A Gentle Reminder

Depression wants you to believe that you're hopeless, that nothing will help, and that you're not worth the effort. But depression lies. The fact that you're researching therapy shows that part of you knows recovery is possible, even if that knowledge feels buried under layers of sadness and despair.

Trust that small voice of hope. It's telling you the truth.

Your First Session: A Beginning, Not a Test

As you prepare for your first online therapy session, remember that it's not a test you need to pass or a performance you need to perfect. It's simply a conversation between you and someone trained to help people navigate the challenges you're facing.

You don't need to be articulate, composed, or insightful. You just need to be yourself—wherever you are in your depression journey, however you're feeling on that particular day. Your therapist has the training and experience to meet you exactly where you are and help you move forward from there.

The Session Will End, But Your Support Continues

After that first fifty-minute conversation, you'll close your laptop or end the video call and return to your regular environment. But you'll return with something you didn't have before—a scheduled time to talk with someone who understands depression and believes in your ability to recover.

That next appointment on your calendar represents continuity of support, professional expertise applied to your specific situation, and a commitment to your wellbeing that extends beyond just that first conversation.

The Path Ahead

Your first therapy session is the beginning of a path that leads away from the isolation and hopelessness of depression and toward connection, understanding, and recovery. It's not a magic cure or instant solution, but it's a beginning—and beginnings are powerful things.

Every person who has recovered from depression started exactly where you are now: recognizing they needed help and having the courage to reach out for it. Your first session is your way of saying "I matter enough to get help" and "I believe things can get better."

Both of those statements are absolutely true.

The Invitation to Begin

Your first online therapy session for depression is waiting for you to schedule it. Behind that video call is a trained professional who has dedicated their career to helping people exactly like you find their way out of depression and back to a life that feels worth living.

You deserve support. You deserve to feel better. You deserve to have someone in your corner who understands what you're going through and knows how to help.

That first session will be gentle, compassionate, and entirely focused on understanding your experience and beginning to chart a path toward recovery. You don't need to be perfect or have all the answers. You just need to show up as yourself and trust that healing is possible.

Make that appointment. Set up your comfortable space. Have your tissues and tea ready. And remember that by taking this first step, you're already proving that depression hasn't won—that the part of you that believes in recovery and healing is stronger than the part that wants to give up.

Your brighter path begins with a single click to join that first session. Everything else—the understanding, the tools, the support, the hope—will follow from there.