Depression can affect people differently. Common experiences may include:

• Persistent sadness, emptiness, or low mood
• Losing interest or pleasure in activities
• Feeling tired or lacking energy
• Difficulty getting started with everyday tasks
• Withdrawing from friends, family, or social activities
• Changes in sleep
• Changes in appetite or weight
• Difficulty concentrating or making decisions
• Feeling slowed down or unusually restless
• Increased irritability
• Feeling worthless, inadequate, or excessively guilty
• Becoming increasingly critical of oneself
• Feeling hopeless about the future
• Reduced motivation
• Difficulties functioning at work, university, or home
• Thoughts about death, dying, or suicide

A person does not need to experience every symptom for depression to be clinically significant.

It is also important to consider the severity, duration, context, and impact of these experiences. Feeling low following a difficult event does not automatically mean that someone has a depressive disorder.

Assessment helps us understand what the person is experiencing rather than assuming that every period of sadness represents depression.

At People Psychological Solutions, our clinical psychologists work with individuals experiencing depression, persistent low mood, loss of motivation, and related emotional difficulties.

Our first step is to develop an understanding of what has been happening and how it is affecting the person’s life.

Depending on the individual’s circumstances, this may involve:

• Understanding current mood and emotional experiences
• Exploring changes in motivation, pleasure, and everyday activities
• Understanding sleep, appetite, energy, and concentration
• Exploring thoughts about oneself, other people, and the future
• Understanding current stresses, losses, relationships, and life circumstances
• Assessing the impact on work, studies, relationships, and everyday functioning
• Exploring previous periods of depression and previous treatment
• Using standardised psychological measures where clinically appropriate
• Assessing current coping and psychological safety
• Considering other psychological or medical conditions that may contribute to the person’s difficulties
• Developing an individualised psychological formulation and treatment plan

A diagnosis can sometimes be useful, but psychological assessment also asks a broader question:

What has contributed to this person’s depression, and what is keeping it going?

Two people experiencing similar depressive symptoms may have very different circumstances and psychological processes maintaining them. Understanding these differences allows treatment to be individualised.

Depression is treatable.

Several psychological therapies have demonstrated effectiveness for depression. Major clinical guidelines recommend interventions including Cognitive Behavioural Therapy (CBT), Behavioural Activation, and Interpersonal Psychotherapy (IPT), with treatment selection influenced by factors such as severity, clinical needs, previous treatment, and the person’s preferences.

At People Psychological Solutions, treatment is therefore not based upon a single standard programme for everyone experiencing depression.

Depending on the individual’s difficulties, therapy may involve:

• Understanding patterns that contribute to or maintain low mood
• Gradually rebuilding meaningful and rewarding activities
• Reducing patterns of withdrawal and avoidance
• Addressing persistent negative patterns of thinking
• Developing more balanced ways of responding to self-critical thoughts
• Improving problem-solving and coping
• Addressing interpersonal difficulties contributing to depression
• Processing significant losses or life changes
• Developing healthier routines
• Reconnecting with relationships, responsibilities, and activities that matter
• Identifying early warning signs of deterioration
• Developing strategies for maintaining progress and reducing the likelihood of relapse

Treatment goals are developed collaboratively between the client and psychologist.

Behavioural Activation: Breaking the Cycle of Depression

One particularly important component of depression treatment involves understanding the relationship between mood and behaviour.

When someone feels depressed, withdrawing from activities can be understandable. They may stop exercising, seeing friends, engaging in hobbies, completing responsibilities, or doing things that previously provided a sense of achievement.

In the short term, withdrawal can reduce effort and discomfort. Over time, however, the person may experience fewer opportunities for pleasure, accomplishment, connection, and meaning. This can contribute to further deterioration in mood.

Behavioural Activation aims to help people gradually reconnect with activities that are important or meaningful rather than waiting until motivation returns before taking action. It is an established psychological treatment for depression.

This does not mean simply telling someone to “keep busy.”

Activities are selected purposefully according to the person’s individual patterns, circumstances, values, and treatment goals.

Medication can also form part of treatment for depression.

Whether antidepressant medication is appropriate depends on factors including symptom severity, previous treatment, clinical circumstances, and individual preferences. Psychological treatment and medication can also be used together when appropriate.

Clinical psychologists do not prescribe medication.

Where medical assessment or medication may be beneficial, we may recommend consultation with a psychiatrist or another appropriately qualified medical practitioner.

Our psychologists can continue providing psychological treatment alongside medical care where appropriate.

Depression frequently occurs alongside other psychological difficulties, including:

• Anxiety
• Trauma-related difficulties
• OCD
• ADHD
• Autism
• Substance-use difficulties
• Relationship difficulties
• Sleep problems

Sometimes symptoms that initially appear to represent depression may also occur within another psychological or medical condition.

For this reason, our psychologists consider the person’s broader clinical picture rather than treating individual symptoms in isolation.

Where multiple difficulties are present, treatment priorities can be determined collaboratively according to the person’s needs.

Some people experiencing depression may have thoughts about death, not wanting to be alive, or suicide.

These experiences can vary considerably in severity and require careful assessment.

Our psychologists routinely consider psychological safety as part of clinical care and can work collaboratively with clients to determine appropriate support and safety planning.

However, an outpatient psychology appointment is not an emergency service. If you or someone else is in immediate danger or requires urgent medical attention, please contact local emergency services or attend the nearest emergency department.