Depression is a mental health condition in which persistent low mood, or loss of interest and enjoyment, lasts weeks or months and interferes with everyday life. The NHS calls it more than unhappiness, and not something a person can snap out of.
Key points
- Depression is low mood or loss of interest lasting weeks or months and disrupting daily life.
- In England, 3.8% of adults met the criteria for a depressive episode in 2023/4.
- NICE splits depression into less severe and more severe, at a PHQ-9 score of 16.
- For less severe depression, NICE says not to offer antidepressants routinely as first treatment.
- The low serotonin account is not supported in that simple form, though antidepressants still help many people.
Symptoms
- Continuous low mood, hopelessness, low self-esteem, guilt, tearfulness or irritability; no motivation or enjoyment.
- Low energy, moving or speaking more slowly than usual, disturbed sleep, appetite or weight changes.
- Avoiding friends, doing fewer activities, difficulties at home, at work or in the family.
- Thoughts of self-harm or suicide.
Causes and risk factors
- Past depression, other health conditions, relationship difficulties, past trauma, living conditions, debt, unemployment and loneliness.
- Bereavement, relationship breakdown and job loss as triggers; family history, childbirth and long-term physical illness as risks.
- The "chemical imbalance" account does not hold up in that simple form, though antidepressants are still effective for many people.
Treatment
- Less severe: guided self-help, group CBT, individual CBT, group exercise, mindfulness, an SSRI, counselling - least intrusive first, without routinely offering antidepressants.
- More severe: individual CBT combined with an antidepressant, individual CBT, antidepressant medication, interpersonal psychotherapy.
- Antidepressants are typically continued for at least six months after symptoms settle, then reduced in stages rather than stopped suddenly.
When to speak to a professional
- Low mood or loss of interest has lasted more than two weeks, or is affecting work, studies or relationships.
- NICE says depression services should have several ways in, including self-referral to NHS Talking Therapies.
- Do not wait if you are having thoughts of suicide or self-harm.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.