Care begins with understanding what has changed in your life, how long it has been happening, how much it is affecting you, and what may be contributing to it.
What is depression?
Depression is more than having a bad day or feeling sad after a difficult event. Depressive disorders can produce a persistent change in mood or a marked loss of interest or pleasure, together with changes in sleep, appetite, energy, concentration, self-worth or hope for the future. Symptoms can interfere with work, study, relationships and routine self-care.
Depression is influenced by a combination of biological, psychological and social factors. It can occur during or after stressful life events, but it can also develop without an obvious single trigger. Physical illnesses, medicines and substance use can also contribute to depressive symptoms or produce similar experiences.
Depression is not the same as ordinary sadness
Everyone experiences sadness, disappointment or grief. These are part of normal life. Depression becomes a clinical concern when symptoms are persistent, form a characteristic pattern, cause significant distress or impairment, or are accompanied by warning signs such as hopelessness or thoughts of self-harm.
Common symptoms
- Persistent sadness, emptiness or low mood
- Loss of interest or pleasure in activities that usually matter to you
- Low energy, fatigue or feeling slowed down
- Difficulty concentrating, remembering or making decisions
- Changes in sleep — too little, too much or waking earlier than usual
- Changes in appetite or weight
- Feelings of guilt, worthlessness or hopelessness
- Withdrawal from people, reduced functioning or difficulty meeting responsibilities
- Reduced sexual desire or changes in sexual functioning
- Thoughts about death, self-harm or suicide
How is depression assessed?
A diagnosis is clinical. During a consultation, a psychiatrist may ask about the onset and pattern of symptoms, sleep, appetite, energy, concentration, functioning, previous episodes, family history, medicines, alcohol or other substances, and major physical or psychological stressors.
Screening questionnaires can help measure symptom severity, but they do not replace a full assessment. Depending on the history, a clinician may also consider physical health conditions or medicines that can mimic or worsen depressive symptoms.
What can treatment involve?
Treatment is individualised. Depending on the severity and clinical context, it may include evidence-based psychological therapies, medication, behavioural and lifestyle measures, or a combination of approaches. Treatment choices should take account of your preferences, other medical conditions, current medicines and previous responses to treatment.
Psychological therapy
Structured therapies such as cognitive behavioural therapy and interpersonal therapy can help people understand and change patterns that maintain depression, strengthen coping and improve relationships or routines. Therapy may be offered in person or through appropriate online formats.
Medication
Antidepressant medication can be appropriate for some people, particularly when symptoms are moderate or severe, persistent, recurrent or causing substantial impairment. The choice of medication is individual, and benefits and possible adverse effects should be discussed rather than starting or stopping treatment without clinical guidance.
When symptoms are severe or do not improve enough
Some people need more intensive or combined treatment. If depression is severe, recurrent, associated with major functional decline, or not responding adequately to initial treatment, a psychiatrist may discuss additional options and closer follow-up. The treatment plan can be adjusted as your response becomes clearer.
Recovery is often gradual
Improvement may not happen all at once. Sleep, appetite, concentration, energy and motivation can change at different rates. Keeping follow-up appointments, taking medicines as prescribed when they are part of your plan, and discussing side effects or lack of improvement early can make treatment safer and more effective.
When should you seek urgent help?
Do not wait for a routine appointment if you are having thoughts or plans of suicide or self-harm, feel unable to keep yourself safe, are unable to meet basic needs, or develop severe confusion, agitation or rapidly worsening symptoms. In an emergency, seek immediate help from the nearest emergency medical service or hospital.
Questions worth bringing to a consultation
- When did the change in mood or interest begin?
- How has it affected sleep, appetite, concentration, work, study or relationships?
- Have you had similar episodes before?
- What medicines, supplements, alcohol or other substances are you using?
- Have you noticed changes in sexual desire or sexual functioning?
- Have you had thoughts that life is not worth living or thoughts of harming yourself?
Frequently asked questions
How long does depression need to last before it matters?
There is no reason to wait for symptoms to become severe before asking for help. A depressive episode is generally characterised by symptoms that are present most of the day, nearly every day, for at least two weeks, but people with fewer or shorter-lasting symptoms can still benefit from assessment when distress or impairment is significant.
Can depression happen without a major life event?
Yes. Depression can arise from a combination of biological, psychological and social factors, and there may not be one clear cause.
Can depression affect sex life?
Yes. Depression itself may reduce desire, pleasure or sexual functioning. Some medicines can also contribute, so sexual concerns should be part of an open treatment discussion rather than something you have to manage silently.
Does a diagnosis mean I will need lifelong medication?
Not necessarily. Treatment duration varies by the type and course of depression, previous episodes, response to treatment, relapse risk and individual circumstances. Decisions about continuing or changing medication should be made with the treating clinician.