Depression therapy in San Francisco & online across California.
We help adults understand what's underneath their depression, so healing doesn't depend on just pushing through.
Is Depression Affecting Your Daily Life?
Maybe getting through the day takes more effort than it used to, and you can't quite explain why. Maybe things that used to matter to you feel flat, or you're going through the motions of a life that used to feel like yours. If you're tired in a way sleep doesn't fix, or quietly wondering what's wrong with you, you're not lazy and you're not alone.
How Depression Can Show Up
Depression rarely looks like textbook sadness. More often, it shows up as:
Low energy or fatigue — feeling drained even after rest
Loss of interest — things you used to enjoy just don't pull you in anymore
Difficulty concentrating — trouble focusing, deciding, or finishing things
Changes in sleep or appetite — sleeping too much, too little, or eating differently than usual
Feelings of worthlessness or guilt — a harsh inner voice that won't let up
Withdrawal — pulling away from people, even ones you care about
A sense of numbness or heaviness — going through the motions without really feeling present
What We Work With
Persistent low mood and major depressive episodes
Depression tied to burnout or chronic stress
Depression following a major life transition
Postpartum depression
Depression that shows up as irritability, fatigue, or physical symptoms rather than sadness
High achievers and founders whose depression hides behind productivity
Immigrants and first-generation individuals holding two cultures at once
South Asian adults navigating family expectations and cultural stigma around depression
How We Approach Depression
Most depression therapy stops at Cognitive Behavioral Therapy (CBT) — a structured approach to noticing and reframing negative thought patterns. CBT has its place, but it can stay at the surface: it teaches you to think differently about your depression without necessarily addressing why it's there in the first place.
At Spiral Up Therapy, we work with approaches that go deeper — and pair them with practical tools you can use right away.
Psychodynamic & Attachment-Informed Therapy
This is where we start: understanding your story, including your childhood experiences and your relationship with your parents or caregivers. Depression often has roots in old, unmet needs or beliefs about your own worth formed long before you could name them. We help you trace where those beliefs came from and how they still show up today — so the goal isn't just to feel better, but to understand why you feel this way at all.
Cognitive Behavioral Therapy (CBT)
Once a pattern is named, CBT gives us concrete tools to work with it — noticing the automatic, self-critical thoughts that keep low mood in place, and building a more accurate, less punishing perspective in their place.
Acceptance and Commitment Therapy (ACT)
ACT helps you make room for difficult feelings instead of fighting or numbing them, and reconnect with your own values so you can take small, meaningful steps forward even while you're still healing.
Self-Compassion Practice
Depression often runs on self-criticism. Part of this work is learning to be an adult to yourself — steady and caring enough to meet your own struggle with compassion instead of judgment.
Your therapist draws from these based on what you actually need — there's no one-size-fits-all protocol here. Most people notice some relief within the first few months; we recommend ongoing support to keep exploring what's underneath.
Meet the Team
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Manali Deolalkar
Licensed Therapist
Individual Therapy - 250$/session
Couples Therapy - 290$/session
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Melanie Lei
Licensed Therapist
Individual Therapy - 200$/session
Couples Therapy - 250$/session
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Meghna Das
Licensed Therapist
Individual Therapy - 150$/session
Couples Therapy - 175$/session
What Sets Us Apart
Culturally Sensitive Therapy
South Asian Therapy
Immigrant Therapy
Inclusive Therapy
Frequently Asked Questions
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It depends on you. CBT is a strong starting point for managing negative thought patterns; ACT helps you reconnect with meaning and motivation; psychodynamic and attachment-informed work helps when depression is rooted in longer-standing patterns.
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Most clients start weekly and see meaningful shifts within a few months, though this varies by person. We check in on progress and adjust together.
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Yes — online anywhere in California, plus in-person sessions in San Francisco.
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We're out-of-network. Most clients pay directly and use a superbill for reimbursement — ask us about this during your consultation.
You Belong Here 🌟
Whether you’re the first in your family to seek therapy, or you’ve been on this journey for a while, we’re here to walk alongside you. Think of us as a mix of thought partners, compassionate guides, and cheerleaders—here to help you rewrite the story you want to live. Your culture, your struggles, and your dreams all matter—and we’re honored to hold space for them.