Most people have flat, fed-up days, and they pass. Depression is different: the NHS describes feeling persistently sad or low for weeks or months.
How severe it is depends on how much it gets in the way of work, relationships and looking after yourself.
Grief after a bereavement is natural and often eases with time; if it doesn’t, or low mood spreads to everything, see your GP.
The NHS suggests seeing a GP if symptoms of depression last most of the day, every day, for more than two weeks.
A GP or psychiatrist can assess whether it is depression, but you don’t need that to start therapy.
How depression shows up day to day
It rarely looks the way it does in films. Some describe it less as sadness and more as having nothing left.
A friend’s message waits a week for a reply, and a whole Saturday goes by on the sofa without any rest in it. Many people recognise some of these:
- Low mood for most of the day, or a flat, numb feeling
- Losing interest in things you used to enjoy, from music to sport
- Tiredness that sleep doesn’t fix, or waking at four or five in the morning and lying there
- Moving or speaking more slowly, changes in appetite, aches with no clear cause
- Guilt, harsh thoughts about yourself, feeling hopeless
- A short fuse with those closest to you
- Finding even small decisions hard, such as what to cook
Some keep going – deadlines met, children looked after – and fall apart only once the door closes. It looks fine, so they decide it can’t be depression.
For others it shows up less as sadness than as a shorter temper, drinking more than usual or ever-longer hours at work.
I didn't really believe in psychology before and thought that I needed to cope on my own
What can sit behind low mood
Sometimes there is a clear trigger. The NHS mentions life events such as bereavement or losing a job, and a family history of depression makes it more likely.
Low mood can also follow a break-up, years of burnout, caring for someone who is ill, or a move to another country.
Or there is no obvious reason: nothing bad has happened, yet getting out of bed is hard. You don’t need to know why to ask for help.
Anxiety often comes with it, and the NHS lists it among the symptoms of depression. If anxiety is what troubles you most, see also anxiety therapy.
How I work with depression
My approach is integrative, so there is no fixed manual to get through.
We often start from how the last week went: how you slept, what got put off, which part of the day was hardest.
Over time we look at what may be keeping the low mood in place. For some people it is standards they never quite meet, or feelings pushed aside for years.
For others it is relationships that take more than they give, or a life that has quietly lost what used to matter.
The point is to see what the heaviness is made of, not to argue you out of it.