Health condition · Clinically reviewed
Depression, the guide that answers what to do next.
Not a bad mood to be pushed through. Depression is a treatable medical condition — and modern UK care is more effective than most people expect. Here is how to recognise it, what actually helps, and how to reach urgent support.
Why trust this guide
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Clinically reviewed
Written by our editorial team and reviewed by a registered UK clinician before publication.
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Sourced from guidance
Checked against NICE, Royal College of Psychiatrists and peer-reviewed sources you can see at the end.
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Current for 2026
Reflects current UK guidance on stepped care, therapy choice, medication and rapid-acting options.
Key facts
Depression at a glance.
The essentials, in plain English — what it is, how common it is, how it is diagnosed and how it is treated in the UK today.
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What it is
Persistent low mood, loss of interest and pleasure, and physical symptoms that affect daily life — lasting at least two weeks.
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How common
Around 1 in 6 UK adults each week. Very often coexists with anxiety.
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Severity
Categorised as mild, moderate or severe by symptom count and impact — guiding which treatments are offered.
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Diagnosis
Clinical, using validated tools like PHQ-9. No blood test is needed unless another cause is suspected.
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First-line treatment
Guided self-help or CBT for mild; CBT and/or an SSRI for moderate; combination plus specialist input for severe.
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Recovery
Most people improve significantly with treatment. Relapse is common — continuing treatment for months after recovery reduces the risk.
Why this guide matters
A common condition, and a treatable one.
Depression is one of the most researched conditions in medicine — and the treatments work. The three points below shape everything else on this page.
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You are not weak
Depression is a diagnosable, treatable condition — not a personality flaw or a failure of will.
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Therapy and medication both work
For moderate–severe depression, using both together outperforms either alone.
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Help is available now
NHS Talking Therapies accept self-referral in most areas. See the red-flags section for crisis lines.
How the diagnosis is made
From first conversation to a clear plan.
The steps a UK GP will normally follow, in order — so you know what to expect and why.
Phase 1 · Recognising
Confirming symptoms and their impact
Phase 2 · Confirming
Ruling out physical causes and checking safety
Phase 3 · Managing
Stepped-care plan and review
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Recognising
Two-week rule
Low mood or loss of interest most of the day, most days, for at least two weeks — along with other symptoms.
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Recognising
Impact on life
Sleep, appetite, energy, work and relationships being affected — separating a low patch from depression.
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Recognising
PHQ-9 questionnaire
A validated 9-item score that grades severity and tracks response to treatment.
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Confirming
Ruling out physical causes
Thyroid problems, anaemia, low vitamin D or medication side effects can mimic depression — a physical check confirms.
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Confirming
Suicide-risk assessment
A safe, direct conversation about thoughts of self-harm — it does not make things worse.
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Managing
A stepped-care plan
Self-help and guided CBT for mild; formal CBT or an SSRI for moderate; combination and specialist input for severe.
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Managing
Review at 2–6 weeks
Medication takes weeks to work. PHQ-9 rescored to check progress and adjust the plan.
Typical timeline: 2–6 weeks from first appointment to a settled plan.
Symptoms
What depression actually feels like.
Depression rarely looks like one thing. Any combination of the following, most days for two weeks or more, is worth talking to your GP about.
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Persistent low mood
Feeling down, hopeless or empty most days for two weeks or more.
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Loss of interest
Things that used to be enjoyable feel flat — one of the most reliable signs.
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Sleep changes
Broken sleep, waking early with racing thoughts, or sleeping much more than usual.
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Appetite & weight change
Loss of appetite and weight loss — or eating more and gaining. Either counts.
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Fatigue
Persistent tiredness that rest does not fix — and difficulty starting the simplest tasks.
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Poor concentration
Trouble making decisions, remembering things, or holding attention long enough to read.
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Physical symptoms
Aches, headaches, gut symptoms — depression often presents through the body.
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Thoughts of self-harm
Any thoughts of harming yourself or ending your life — reach out today. Numbers are in the red-flags section.
Treatment
How depression is treated in the UK.
Stepped care — matched to severity. Most people start with talking therapy or an SSRI; more intensive options exist when they are needed.
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Guided self-help
CBT-based workbooks or apps with a therapist supporting you by phone or online — first-line for mild depression.
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One-to-one CBT
12–20 sessions of face-to-face CBT is the gold-standard psychological treatment for moderate depression.
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Behavioural activation
A structured therapy focused on doing more of what matters to you — highly effective on its own.
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SSRIs
Sertraline is first-line. Take 4–6 weeks to work; continue for at least 6–12 months after recovery to reduce relapse.
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SNRIs & mirtazapine
Second-line options — mirtazapine is often used when sleep or appetite is very affected.
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Exercise
Structured exercise (30 minutes, three times a week) has measurable antidepressant effect for mild–moderate depression.
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Combination therapy
For moderate–severe depression, therapy plus medication together outperforms either alone.
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Specialist options
For treatment-resistant depression: augmentation strategies, ketamine/esketamine and ECT in specialist care.
What this guide is based on
The sources behind every statement on this page.
UK national guidance and specialist society information, current at the time of last review.
Key references
Guidelines and standards we relied on.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If you are struggling, please reach out — you do not have to wait for a crisis.
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NICE. Depression in adults: treatment and management (NG222).
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NICE. Depression in adults with a chronic physical health problem (CG91).
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Royal College of Psychiatrists. Patient information on depression.
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Mind. Understanding depression.
Red flags
When to reach out today.
Depression can shift from slow to urgent. These are the situations where support should not wait — and the numbers to call.
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Thoughts of self-harm
Any thoughts of hurting yourself — please reach out. Contact numbers are at the bottom of this list.
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Suicidal thoughts or planning
Especially with intent or a plan — urgent help is available. See the numbers below.
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Psychotic symptoms
Hearing voices, unusual beliefs, or losing touch with reality — urgent psychiatric review.
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Postnatal depression
New mothers — effective, breastfeeding-safe treatment is available. Do not wait.
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Depression with mania
Periods of high energy, racing thoughts, or reduced need for sleep — suggests bipolar and changes treatment.
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Self-neglect
Not eating, drinking or looking after basic care — deserves urgent review.
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Using alcohol or drugs to cope
Common, but risky — support exists.
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New depression in later life
Especially with cognitive change — rule out other causes, and treat both.
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You are in crisis right now
Samaritans 116 123 (24/7, free). NHS 111 (mental health option). Text SHOUT to 85258. In an emergency, call 999 or attend A&E.
Living with it
A recoverable condition, with recurrences to plan for.
Four things that make the biggest difference day to day — small steps, sleep, medication continuity and regular reviews.
A quiet reminder
Progress rarely feels like progress at first.
The score often improves before the feeling does. Keep going, and check in with someone who can see the change from outside.
- 01 Small steps
Do a little, then a little more
Behavioural activation — doing valued things even when you do not feel like it — is one of the most effective treatments.
- 02 Sleep
Protect your sleep
Regular hours matter. Napping and lying in worsen depression; morning light exposure helps.
- 03 Medication
Continue past recovery
Stopping the moment you feel better raises relapse risk. Most people continue for 6–12 months.
- 04 Reviews
Track your score
PHQ-9 every few weeks catches slow decline and confirms progress.
Frequently asked
Everything we get asked about depression.
Quick answers on diagnosis, therapy, medication, side effects and where to get help.
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How do I know if it is depression?
Persistent low mood or loss of interest for two weeks or more, with several other symptoms (sleep, appetite, energy, concentration), affecting daily life. The PHQ-9 questionnaire helps grade severity.
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Do I need blood tests?
Usually a basic set — to rule out thyroid problems, anaemia and low vitamin D, all of which can mimic depression.
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Therapy or medication first?
For mild-to-moderate depression, therapy (CBT or guided self-help) is often first-line. For moderate-severe or by preference, medication is added. Combination therapy often works best.
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Which antidepressant is first-choice?
Sertraline is the usual first-line SSRI — well tolerated and evidence-based. Other SSRIs, SNRIs or mirtazapine are chosen if there is a specific reason.
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How long do antidepressants take to work?
4–6 weeks for the full effect. Some improvement in sleep and appetite often appears sooner. Sometimes symptoms briefly worsen in the first week — discuss with your GP.
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Are antidepressants addictive?
No — they do not cause craving or dose escalation. Stopping suddenly can cause discontinuation symptoms, which is why doses are tapered gradually.
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How long should I stay on them?
After you feel well, at least 6–12 months. Longer for anyone with recurrent depression — your GP will advise.
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Can I refer myself for therapy?
In most parts of the UK, yes — NHS Talking Therapies (previously IAPT) accepts self-referrals online or by phone.
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What if nothing has worked?
Treatment-resistant depression has specialist options — augmentation strategies, ketamine/esketamine and ECT — all delivered in secondary care. It is worth pursuing.
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When should I go to A&E?
If you are having thoughts of self-harm or suicide, or you cannot keep yourself safe. Call 999 or attend your local A&E.