Depression is one of the most common reasons people first come to a psychiatrist — and one of the most treatable. If low mood, exhaustion or loss of interest has settled over the last few weeks, it is worth having it looked at properly rather than waiting for it to lift on its own.
What is depression?
Depression is a persistent low mood that affects how you think, feel, and manage daily life. It impacts energy, relationships, and work, but responds effectively to proper clinical care.
Depression is not the same as sadness, and it is not a question of willpower. Sadness is a response to something and lifts as circumstances change; depression settles in and stays, often without an obvious trigger, and it changes sleep, appetite, concentration and energy alongside mood. People frequently describe it as flatness or numbness rather than unhappiness.
It is also common for depression to show up physically before it is recognised emotionally. Persistent tiredness, disturbed sleep, appetite changes, body aches or difficulty concentrating are often the first things people notice, and many arrive at a psychiatrist only after other causes have been investigated and ruled out.
What causes depression?
Depression rarely has a single cause. It usually develops when several factors overlap, which is why two people with the same diagnosis can have arrived there by very different routes. Understanding which factors are relevant in your case is part of what an assessment is for.
Recognised contributing factors include:
- A family history of depression or other mental health conditions
- Prolonged stress at work, in studies, or within relationships
- Bereavement, separation, or another significant loss
- Physical illness, chronic pain, or long-term medical conditions
- Thyroid problems, vitamin deficiencies and some medications
- Disrupted sleep, shift work, or sustained exhaustion
- Alcohol or substance use, which can both trigger and deepen low mood
- Major life transitions, including childbirth and retirement
Common symptoms
Symptoms vary between people, and you do not need to recognise all of these to benefit from an assessment.
- Ongoing sadness or emptiness
- Loss of interest in activities you used to enjoy
- Low energy or constant tiredness
- Sleep or appetite changes
- Trouble focusing or making decisions
- Feeling worthless or overly guilty
- Social withdrawal
- Thoughts of self-harm
When to seek help
If persistent low mood or sadness lasts longer than two weeks and impacts daily life, consulting a psychiatrist early supports a faster recovery.
How depression is diagnosed
There is no blood test for depression. Diagnosis is clinical: it comes from a structured conversation about what you have been experiencing, for how long, and how it is affecting your daily life, work and relationships.
A first consultation usually lasts around 45 minutes to an hour. Dr. Surana will ask about mood, sleep, appetite, energy, concentration and interest in things you normally enjoy, along with your medical history, any medication you take, and family history. She will also ask directly about thoughts of self-harm — this is a routine and necessary part of any psychiatric assessment, not a sign that anything you have said is alarming.
Blood tests are sometimes requested, not to diagnose depression, but to rule out physical causes that can produce identical symptoms — thyroid dysfunction and vitamin B12 or vitamin D deficiency being the most common. Where the picture suggests something other than depression, such as bipolar disorder or an anxiety disorder, that is discussed openly rather than assumed.
You do not need a referral, a diagnosis, or a clear account of what is wrong to book. Describing what has been happening in your own words is enough to begin.
Treatment options
Treatment is matched to severity, circumstances and preference. For mild to moderate depression, psychological therapy alone is often the appropriate starting point. For moderate to severe depression, or where symptoms have not shifted with therapy, a combination of therapy and medication is generally more effective than either on its own.
Psychological therapy. Structured talking therapies help identify the thought patterns and behaviours that maintain low mood, and build practical strategies for managing them. Cognitive behavioural approaches have the strongest evidence base in depression, and therapy is usually delivered as a course of weekly or fortnightly sessions rather than open-ended.
Medication. Antidepressants are considered when symptoms are moderate to severe, persistent, or not responding to therapy alone. They are not sedatives, they are not addictive in the way sleeping tablets or anxiolytics can be, and they do not change your personality. They typically take two to four weeks to show clear benefit, which is why the first few weeks are reviewed closely. Dr. Surana explains the expected benefits, the common side effects, and how long a course is likely to last before anything is started — and the decision is made jointly.
Lifestyle and routine. Sleep regulation, physical activity, reducing alcohol, and re-establishing daily structure are part of the plan rather than an afterthought. These are discussed as specific, achievable changes suited to your circumstances, not general advice.
Family involvement. Where you want it, family members can be included in appointments. Depression affects households, and relatives often need guidance on how to help without taking over.
What recovery looks like
Recovery from depression is usually gradual rather than sudden. Sleep and energy often improve before mood does, and many people notice they are managing daily tasks more easily some weeks before they would describe themselves as feeling better. This lag is normal and expected.
Most people begin to notice meaningful change within four to six weeks of starting an appropriate treatment plan, though this varies with severity and circumstances. Progress is reviewed at each appointment, and the plan is adjusted if it is not working — an initial approach that does not deliver is common and is not a failure.
Where medication is part of treatment, it is generally continued for a period after symptoms resolve, to reduce the chance of relapse, and is then reduced gradually under supervision rather than stopped abruptly. Stopping early is one of the most common reasons depression returns.
The goal is not simply the absence of symptoms but a return to functioning — work, relationships and interests — with a clear understanding of your own early warning signs and what to do if they reappear.
How Trio Mindspace can help
Dr. Kritika Malik Surana provides a judgment-free space with personalised plans combining therapy, medication management, or both.
Every plan begins with a full assessment rather than an assumption. Dr. Surana will explain what she thinks is happening, set out the options, and agree the approach with you before anything starts. You can read more about her background and approach, or see all conditions treated at the clinic.
Frequently asked questions
Yes. Depression is a medical condition with well-established treatments. Most people improve significantly with a plan that combines therapy, medication where appropriate, and practical changes to sleep and routine. Recovery is usually gradual rather than sudden.
Not necessarily. Some people do well with therapy alone, particularly in milder presentations. Medication is discussed when symptoms are moderate to severe, or when they are not shifting with therapy alone. Dr. Surana explains the reasoning, the expected benefits and the possible side effects before anything is started, and the decision is made together.
Most people notice some improvement within four to six weeks of starting a suitable plan, though this varies. Treatment is usually continued for a period after you feel better, because stopping too early is a common cause of relapse. Your review schedule is set out at the first consultation.
Yes. Consultations at Trio Mindspace are confidential. Information is shared outside the session only with your consent, or in the rare circumstances where there is a serious and immediate risk to safety, which would be discussed with you.
Sadness is usually a response to something identifiable and lifts as circumstances change or time passes. Depression settles in and persists, often for weeks or months, and affects far more than mood — sleep, appetite, energy, concentration and interest in things you normally enjoy all change. Many people describe depression as numbness or flatness rather than sadness. If low mood has lasted more than two weeks and is affecting how you function, it is worth having assessed.
No. You can book an appointment directly. Many people come without a referral and without a diagnosis. You do not need to have worked out what is wrong beforehand — describing what has been happening in your own words is enough to start.
No. Antidepressants do not cause cravings or a compulsion to keep taking them, which is what addiction means clinically. They are not sedatives and they do not produce a high. Stopping them abruptly can cause temporary discontinuation symptoms such as dizziness, sleep disturbance or flu-like feelings, which is why any course is reduced gradually under supervision rather than stopped suddenly. This is a withdrawal effect, not addiction.
No. Effective treatment should return you to feeling like yourself, not alter who you are. If you feel flattened, numbed or otherwise not yourself on a medication, that is a reason to raise it at review — it usually indicates the dose or the choice of medication needs adjusting, and there are alternatives.
Bring any previous prescriptions, reports or discharge summaries you have, and the packaging or a written list of any medication you currently take, including for physical conditions. If it helps, note down when the symptoms started and what has changed since — it is easy to forget details in the room. You are welcome to bring a family member or friend.
It can, particularly if treatment is stopped early. Continuing treatment for a period after you feel better substantially reduces that risk, which is why the plan does not end the moment symptoms lift. Part of treatment is identifying your own early warning signs so that if things do start to slip, you recognise it and can seek help quickly rather than waiting.