Low-income and African American patients in women's health clinics are at risk for depression and under-treatment of their depression. This study aimed to understand women's health patients' experiences of depressive symptoms and perspectives on the low uptake of psychotherapy. Twenty-three women with depressive symptoms from a women's health clinic completed individual qualitative interviews. Women reported risk of harm in the therapeutic relationship as the primary barrier; physical and mental health symptoms and doubt that psychotherapy will help were also described. Women also reported psychotherapy can be helpful by allowing women to express their feelings, gain insight, and make life changes.