Main
- Depression — a mood disorder: low mood and loss of interest persist for weeks, interfering with work, study and communication.
- Causes combine: heredity, chronic stress, thyroid and heart disease, use of certain substances.
- Symptoms affect mood, thinking, body and behaviour: sadness, loss of energy, sleep and appetite disturbances, feelings of guilt.
- Urgent — call an ambulance for thoughts of harming oneself or others and statements about the meaninglessness of life.
- Care is provided by a psychiatrist, psychotherapist and psychologist; the examination begins with a conversation and an assessment of the condition.
What is depression
Depression is a mood disorder in which low mood, loss of interest and loss of energy persist for a long time. A doctor recognises this condition and distinguishes it from ordinary tiredness or a bad mood.
What happens in the body
In depression, the workings of the brain, which is responsible for emotions, sleep, appetite and overall tone, change. A person stops taking pleasure in what used to bring joy and loses interest in usual activities. Even simple everyday tasks require noticeable effort, and rest does not restore former strength. The mood remains low for a long time, and everyday worries begin to seem an unbearable burden. Sleep and appetite change: some sleep too much, others hardly sleep at all, and this further exhausts the body. Gradually work, study and relationships with loved ones suffer, because it becomes difficult to concentrate and make decisions. If this condition persists for weeks, one should not wait for it to pass on its own — it is better to discuss it with a doctor.
What causes it to develop
- Hereditary predisposition: close relatives have a higher risk, but by itself it does not mean that the condition will necessarily develop.
- Chronic stress and severe life events: the loss of a loved one, divorce or prolonged difficulties drain strength and trigger low mood.
- Certain diseases and their effect on the body: thyroid disease, heart disease and other conditions change how one feels and one's mood.
- Taking certain substances and medicines: some remedies and psychoactive substances can cause low mood as a side effect.
- Changes in the workings of the brain: the metabolism of substances responsible for emotions, sleep and reactions to stress is disrupted.
- A combination of factors: there is no single cause, so it is important to assess the circumstances as a whole rather than look for one guilty factor.
Who faces this more often
Anyone can face depression, regardless of age, sex or wealth, but some people are at higher risk. It occurs more often in those who have been through severe events: the loss of a loved one, divorce, job loss or prolonged difficulties. Women seek help more often than men, although this may reflect a difference in willingness to talk about one's condition. A separate group consists of people with chronic diseases, because constant discomfort and limitations affect mood. One's environment also matters: a lack of support from loved ones, loneliness and a tense atmosphere at home or at work increase vulnerability. In adolescents and older people the condition often goes unnoticed, since it is taken for features of age. If a loved one is low and withdrawn for a long time, it is worth gently offering help and not leaving them alone with this condition.
What symptoms can occur?
Manifestations of depression affect mood, thinking, body and behaviour, and they are noticed both by the person themselves and by their loved ones. The duration and severity of these signs are assessed by a doctor, so it is important to understand which changes require attention.
How it is noticed at the very beginning
Persistent low mood and sadness for most of the day become the first noticeable change, which a person often explains away as fatigue. Gradually, interest in former activities and the joy from them are lost, and what used to bring pleasure no longer resonates. A decline in strength and rapid fatigability increase even with small exertions, and usual tasks require noticeable effort. Sleep and appetite disturbances manifest in different ways: a person either cannot fall asleep or sleeps too much, and food loses its taste. Difficulties with concentration and decisions interfere with working, reading and maintaining a conversation, which is why irritation with oneself grows. Feelings of guilt and hopelessness quietly intensify, and loved ones notice that the person avoids communication and falls silent. If such changes persist for most of the day and do not pass, it is worth discussing them with a psychiatrist or psychotherapist, rather than waiting for the condition to pass on its own.
Signs that occur most often
- Persistent low mood and sadness: a bad mood persists for most of the day and does not depend on external events, so rest and entertainment do not relieve it.
- Loss of interest in former activities: favourite activities and meetings stop bringing joy, and the person gives them up, although previously they gave strength.
- Decline in strength and rapid fatigability: even a small exertion takes a lot of energy, and recovery takes longer than usual and does not bring cheerfulness.
- Sleep and appetite disturbances: falling asleep is difficult or sleep is too long, and food loses its taste, which gradually affects weight and well-being.
- Difficulties with concentration and decisions: it is hard to focus on work, reading and conversation, and a simple choice causes confusion and postponement.
- Feelings of guilt and hopelessness: a person blames themselves without reason and sees no way out, so such experiences are worth discussing with a doctor, rather than leaving them unattended.
When to seek help urgently
Examinations and tests
Examinations for depression are needed not to confirm the diagnosis, but to rule out other causes of feeling unwell. The doctor first talks to the person and assesses their condition, and only then decides which additional tests make sense.
How the examination begins
The examination begins with a conversation and an assessment of mental state at an appointment with a doctor. The doctor asks about mood, sleep, appetite, interests and how long ago the changes appeared. He observes speech, facial expressions, the pace of answers and the person's overall composure. The medical history is clarified separately: whether there have been similar conditions before and how they progressed. The doctor asks about past and current physical illnesses, since they can produce a similar picture. Questionnaires for assessing the severity of symptoms help to see the dynamics and compare the condition on different days. Blood tests are needed to rule out other causes of feeling unwell, for example disorders in the functioning of internal organs. If a person comes with ready-made discharge summaries and results, this noticeably shortens the path to a clear picture.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries: take medical documents from other institutions so that the doctor sees the overall picture and does not prescribe anything unnecessary.
- Previous tests: the results of earlier examinations show what has already been checked and help avoid repeating the same thing.
- Notes about the condition: short notes about mood, sleep and appetite give the doctor facts that are difficult to recall at the appointment.
- List of complaints: write down in advance what is troubling you and how long ago, so that nothing is forgotten or missed.
- Questions for the doctor: prepare what you want to clarify, and write down the answers so that you can return to them later.
Which doctor should I see?
Several specialists provide help with depression, and the choice depends on the severity of the condition and the person's readiness to talk. Below — who manages this condition, what the help consists of, and what remains on the patient's side.
Which specialist manages this condition
Depression is managed by a psychiatrist, as well as by a psychotherapist and a psychologist, and there is a difference in their tasks. A psychiatrist assesses the condition as a whole and determines whether medication support is needed. A psychotherapist works with a person's thoughts, reactions and relationships in regular sessions. A psychologist helps to make sense of experiences and to establish everyday supports without prescribing anything. If there is no specialised doctor nearby, you can start with a psychologist or with an appointment with a GP at your place of residence. The GP will listen, assess your general condition and suggest who to turn to next. Delaying seeking help usually increases isolation and prevents a person from returning to ordinary activities. Choose a specialist with whom you feel comfortable talking, and do not postpone the first visit because of doubts.
What the treatment consists of
- Selection of therapy by the doctor: the specialist assesses the condition and determines which help will suit you specifically, because there is no universal approach here.
- Psychotherapy: regular sessions with a specialist help to make sense of thoughts and reactions, as well as to master ways of coping with difficult states.
- Monitoring and adjustment of the treatment plan: the condition changes over time, so the doctor periodically reviews the chosen approaches and changes them if necessary.
- Support of loved ones and daily routine: regular sleep, feasible activity and the involvement of family create a support without which any help is more difficult.
What depends on the patient themselves
The regularity of follow-up with a specialist largely determines how the help with depression unfolds. Missed appointments and pauses in the conversation with the specialist usually return a person to their previous state. The doctor sees changes only at appointments, so an honest account of sleep, appetite and mood makes the help more precise. Notes about your condition between sessions help to notice what exactly affects how you feel. Openness in conversation matters no less: the specialist cannot take hidden difficulties into account. Keeping to agreements with the doctor and psychologist maintains the continuity of help. If the plan does not suit you or something prevents you from following it, say so at the appointment, and do not abandon what you have started in silence.
What helps prevent an exacerbation?
It is impossible to prevent an exacerbation of depression completely, but a person can noticeably reduce its likelihood. A stable daily routine, maintaining connections with loved ones and timely visits to a doctor help keep the condition under observation.
What is changed in habits
Regular sleep sets the foundation of stability in depression, and a shift in falling asleep by even a couple of hours noticeably increases vulnerability to an exacerbation. Physical activity works more gently if it is manageable and repeated almost every day, rather than from time to time. Maintaining social connections protects against growing isolation, when a person stops answering calls and avoids meetings. Limiting alcohol is important because drink disrupts sleep and intensifies low mood as early as the next day. Relatives often notice changes earlier than the person himself: he leaves the house less often, loses interest in former activities, puts things off. If such signs last longer than usual, this is a reason not to wait, but to discuss them with a specialist. It is useful to agree in advance with a loved one on a simple signal by which he will help notice a deterioration in time.
What should be kept under control
- Regularity of sleep: a constant time of getting up and going to bed supports the internal rhythm and serves as an early sign of a disruption.
- Level of activity: manageable daily exercise helps keep mood more even, and its sharp decline often comes ahead of a deterioration.
- Circle of communication: live contacts with loved ones should be monitored, since their reduction often becomes the first noticeable signal.
- Alcohol consumption: drink disrupts sleep and intensifies low mood, so its amount is important to keep under observation.
- One's own observations: short notes about mood and strength help the doctor see the whole picture, and not only the day of the visit.
How often to see a doctor
Regular visits to a doctor are needed even when the state of health seems quite good. An exacerbation of depression often develops gradually, and an outside view notices changes earlier than the person himself. At an appointment the specialist assesses sleep, activity and general condition, and also compares them with what was at the previous meeting. If a person skips visits because "everything has settled down", early signs remain unnoticed and the condition manages to worsen. At the first signs of deterioration it is better not to put off seeking help and to come earlier than the appointed time. The frequency of meetings is determined by the doctor, and it may change depending on the state of health and circumstances. An agreement about the next visit should be kept in a calendar, and not in memory, so as not to miss it unnoticed.
What is worth remembering
Depression is a condition that rarely goes away on its own and almost never yields to willpower. That is why it is important to understand exactly what you notice in yourself or a loved one and where to go with it.
Key takeaways
Depression differs from ordinary tiredness in that a person loses interest in what once brought joy and does not recover after rest. Those around them often mistake this for laziness or a bad character, although behind the outward indifference lies a condition that requires a doctor's involvement. The longer a person explains their state away as tiredness or being overworked, the harder it later becomes to work out where the reaction to circumstances ends and the illness begins. Putting off a conversation with a specialist is the last thing you should do, because here time does not work in the person's favour. If a loved one has withdrawn, stopped keeping in touch or talks about the pointlessness of what is happening, do not leave them alone with it. What becomes a support in coping is not willpower but a calm and consistent plan that has room both for a doctor and for everyday habits. Depression is not a weakness and not a choice, but a condition that can be overcome if you do not delay seeking help.
