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 looked at properly.
What is depression?
Depression is a persistent low mood that affects how you think, feel, and manage daily life. It is not the same as sadness and it is not a question of willpower. Sadness lifts as circumstances change; depression settles in and stays, often without an obvious trigger, changing sleep, appetite, concentration and energy alongside mood. Many people describe it as flatness rather than unhappiness.
It often shows up physically first — tiredness, disturbed sleep or difficulty concentrating — and many people reach a psychiatrist only after other causes have been ruled out.
What causes depression?
Depression rarely has a single cause. It usually develops when several factors overlap, and working out which apply to you 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
- 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. A first consultation lasts around 45 minutes to an hour, covering mood, sleep, appetite, energy and concentration, plus your medical history and any medication you take. Dr Kritika Surana will also ask directly about thoughts of self-harm — a routine part of any psychiatric assessment.
Blood tests are sometimes requested, not to diagnose depression but to rule out physical causes with identical symptoms — most often thyroid dysfunction or vitamin B12 and vitamin D deficiency. You do not need a referral or a diagnosis to book; describing what has been happening in your own words is enough.
Treatment options
Treatment is matched to severity, circumstances and preference. For mild to moderate depression, therapy alone is often the right starting point; where symptoms are more severe or have not shifted with therapy, a combination works better than either alone.
Psychological therapy. Structured talking therapies 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, delivered as a course of weekly or fortnightly sessions.
Medication. Antidepressants are considered when symptoms are moderate to severe, persistent, or not responding to therapy alone. They are not sedatives, not addictive, and do not change your personality. They typically take two to four weeks to show clear benefit, so the first few weeks are reviewed closely. Dr Kritika Surana explains the expected benefits and common side effects before anything is started.
Lifestyle and routine. Sleep regulation, physical activity, reducing alcohol and re-establishing daily structure are part of the plan, discussed as specific achievable changes rather than general advice.
Family involvement. Where you want it, family members can be included in appointments and given guidance on how to help without taking over.
What recovery looks like
Recovery is gradual rather than sudden. Sleep and energy often improve before mood does, and this lag is normal. Most people notice meaningful change within four to six weeks of starting an appropriate plan, and progress is reviewed at each appointment.
Where medication is part of treatment, it continues for a period after symptoms resolve, then is reduced gradually under supervision — 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, with a clear understanding of your own early warning signs.
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 Kritika 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 Kritika 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.