Mental Health Foundation, England

https://www.mentalhealth.org.uk/a-to-z/d/depression

*Last updated: 18 February 2022

We all have times when we feel down, but depression is about more than feeling sad or fed up for a few days. Depression causes a low mood that lasts a long time and affects your daily life.

Mild depression can make you feel low and as though everything is harder to do. Severe depression can lead to feeling hopeless and, in some cases, suicidal.

If you’re depressed, you’re not alone. In any given week in England, three in every 100 people will experience depression. Even more – eight in every 100 – will experience mixed depression and anxiety.

Remember that help and support is available, and recovery is possible even if you’ve felt depressed for a long time. Different treatments work for different people, so talk to your GP about alternatives if something isn’t working for you.

What are the symptoms of depression?

Depression affects people in different ways. It can affect your mind, body and behaviour.

You might feel:

• sad, upset or tearful
• guilty or worthless
• restless or irritable
• empty and numb
• lacking in self-confidence and self-esteem
• unable to enjoy things that usually bring you pleasure
• helpless or hopeless
• anxious or worried
• suicidal or want to hurt yourself.

Physical symptoms can include:

• tiredness and lack of energy
• moving or speaking more slowly
• sleep problems: finding it hard to get to sleep or waking up very early
• changes in your weight or appetite
• constipation
• no sex drive and/or sexual problems
• unexplained aches and pains.

You might behave differently. You may:

• avoid other people, even your close friends
• find it hard to function at work, college or school
• find it difficult to make decisions or think clearly
• be unable to concentrate or remember things.

Some people experience psychosis during a severe episode of depression. This means you may see or hear things that aren’t there or believe things that aren’t true.

Different types of depression

Your doctor may diagnose you with depression and say that it’s mild, moderate or severe depending on your symptoms and how severe they are. Or you may be diagnosed with a specific type of depression, such as:

• dysthymia – mild depression that lasts for several years
• seasonal affective disorder (SAD) – depression that comes and goes in a seasonal pattern
• postnatal depression – depression that many parents experience after having a baby. Some people experience antenatal depression during pregnancy.

What causes depression?

Depression is a complex condition. There are different factors that can lead to it, including genetics, physical health problems, difficult childhood experiences and stressful life events such as unemployment, the end of a relationship, or being bullied or assaulted.

You may find that a combination of factors led to your depression, or there might not be an obvious cause.

Getting support

The first step to getting support is to speak to your GP. Many people wait a long time before seeing their GP, but the sooner you go, the sooner you can start to recover. If you’ve felt depressed for a long time, you may feel like it’ll always be part of your life – but try to stay open to the possibility of change. There are many different types of help available now.

Common treatment for depression involves a combination of self-help, talking therapies and medication. The right treatment for you will depend on the type of depression you have and how severe it is.

Self-help resources

Your GP may offer you self-help resources. These are often available quite quickly and may be enough to help you feel better without trying other options. They include self-help books, online cognitive behavioural therapy (CBT) or group exercise classes – there is evidence that exercise can help depression.

The NHS website has more information about self-help, including links to books, apps and online forums.

Talking therapies

Talking therapies involve speaking in confidence to a trained professional about your feelings and worries. There are many different talking therapies that are recommended for depression, including cognitive behavioural therapy (CBT), interpersonal therapy, psychotherapy and counselling. Your GP can advise you about which one you may find most helpful.

You can refer yourself for therapy if you live in England.

NHS waiting lists for talking therapy can be long, so ask your GP what you can do to help yourself while you wait. You can also find a private therapist if you can afford it – see our page on talking therapies for more information.

Medication

Another option is to take antidepressants. You can take them on their own or while having talking therapy.

There are several different types of antidepressants, so talk to your GP about which one might suit you best. If one doesn’t work, you may be prescribed another. You usually need to take them for one or two weeks before you start to feel the benefit.

Read more about antidepressants on the NHS website.

Ways you can look after yourself

If you’re depressed, there are steps you can take to lift your mood and help your recovery. These steps can help if you’ve been depressed in the past and want to stay well.

• Talk about how you’re feeling. Talking to someone you trust, or finding peer support, can help you feel better and less alone.
• Eat well. A healthy diet can lift your mood and maintain your mental health.
• Stay physically active. Exercise may feel like the last thing you want to do, but it can ease the symptoms of depression. Research suggests it may be as effective as antidepressants in helping you feel better.
• Spend time in nature. Research shows that being in nature can make us feel happier, feel our lives are more worthwhile, and reduce our levels of depression.
• Avoid cigarettes and alcohol. They may feel like they’re helping at first, but they make things worse in the long run.
• Consider mindfulness, a technique you can learn to be fully engaged in the present. Studies show it can help reduce the symptoms of depression.
• Try talking therapy to stay well. NICE guidelines recommend CBT or mindfulness-based cognitive therapy if you’ve been depressed in the past.