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Core Symptoms (PHQ-9)
- Persistent low mood most of the day, nearly every day
- Loss of interest or pleasure (anhedonia) — the key symptom
- Significant weight loss or gain, or appetite change
- Insomnia or hypersomnia
- Psychomotor agitation or slowing (observable by others)
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Reduced concentration or decision-making ability
- Recurrent thoughts of death or suicidal ideation
- Diagnosis requires ≥5 symptoms for ≥2 weeks, including low mood or anhedonia
Types of Depression
| Type | Features | Specific Treatment |
|---|---|---|
| Major depressive disorder | Classic features above | CBT, SSRI/SNRI |
| Persistent depressive disorder (dysthymia) | Chronic low-grade depression >2 years | CBT, combined drug + therapy |
| Bipolar depression | Depressive episodes alternating with hypomania/mania | Mood stabiliser (lithium, quetiapine) — NOT SSRI alone |
| Seasonal affective disorder (SAD) | Winter onset; hypersomnia; carbohydrate craving | Light therapy first line; SSRIs if severe |
| Postnatal depression | Within 12 months of childbirth | CBT, SSRI; specific postnatal support |
| Psychotic depression | Hallucinations or delusions alongside depression | Antipsychotic + antidepressant |
CBT First for Mild-ModerateCBT is as effective as antidepressants for mild-to-moderate depression and has better long-term relapse prevention. Self-refer to NHS Talking Therapies online — no GP referral needed.
Do antidepressants change your personality?
No. They treat the neurochemical imbalance that underlies depression. Most people describe feeling 'more like themselves' when treated effectively. Some feel emotionally blunted initially — discuss this with your prescriber.
How long do antidepressants take to work?
Initial effects (improved sleep, energy) appear in 1–2 weeks. Full antidepressant effect typically takes 4–8 weeks. Do not stop if there's no immediate improvement — give at least 6–8 weeks before concluding a drug is ineffective.
When should antidepressants be stopped?
Continue for at least 6–12 months after feeling well (for a first episode). For recurrent depression, long-term therapy is often recommended. Always taper gradually — never stop abruptly.
Is exercise really effective for depression?
Yes. Multiple meta-analyses show exercise is as effective as antidepressants for mild-to-moderate depression. 150 minutes of moderate aerobic exercise per week is the target; even 30 minutes 3× weekly helps.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.