What depression is
Depression is a medical illness that affects how you feel, think and handle daily life. It is different from ordinary sadness after a disappointment, which passes in days. In depression, low mood or loss of interest lasts most of the day, nearly every day, for at least two weeks, and makes it hard to work, study or look after yourself and your family.
Depression is common in every age group and social background in India, but many people do not seek help because of stigma or because they believe they should manage alone. It is not a sign of weakness, and it can be treated.
Signs and symptoms
Symptoms vary between people. Many Indians first notice body symptoms such as tiredness, aches and poor sleep, and may see a doctor for these before recognising low mood. Two weeks or more of several of these symptoms is a reason to seek help.
- Persistent sadness, emptiness or hopelessness
- Loss of interest or pleasure in things you used to enjoy
- Tiredness and low energy, even after rest
- Sleeping too little or too much, and changes in appetite or weight
- Poor concentration and difficulty making decisions
- Feeling worthless or guilty, and thoughts of death or suicide
Depression: causes and risk factors
Depression usually results from a combination of factors rather than one cause. These include family history, changes in brain chemistry, stressful life events such as loss of a loved one, job or financial problems, relationship difficulties, loneliness, and long-term illness such as diabetes, heart disease, cancer or chronic pain.
Women may develop depression during pregnancy or after childbirth, called perinatal or postnatal depression, and around menopause. Alcohol and drug use, some medicines, and an underactive thyroid can also cause or worsen depression. In older adults it is often mistaken for normal ageing.
How depression is diagnosed
A doctor makes the diagnosis by talking with you about your mood, thoughts, sleep, appetite and daily functioning, often using a short questionnaire. There is no blood test for depression itself. However, the doctor may order tests such as thyroid function, haemoglobin, vitamin B12 and blood sugar to check for physical conditions that can cause similar symptoms.
It is important to be honest about any thoughts of self-harm or suicide. Doctors ask about this directly to keep you safe, not to judge you, and asking does not put the idea in someone's mind. Family members can also share what they have noticed, which helps the doctor understand the full picture.
Treatment options for depression
Mild depression often improves with talking therapy, such as cognitive behavioural therapy, along with regular activity, sleep and social support. Moderate to severe depression usually needs a combination of therapy and antidepressant medicine, which is given only on a doctor's prescription.
Antidepressants take a few weeks to start working, and side effects in the first weeks often settle. They are not habit-forming, but they must not be stopped suddenly; your doctor will reduce them slowly when the time is right. Pregnant or breastfeeding women, young people and older adults need specially chosen treatment and closer follow-up.
Self-care and support
Self-care does not replace treatment, but it helps recovery and can prevent relapse. If someone you know seems depressed, listen without judging, encourage them to see a doctor, offer to go with them, and stay in regular touch. Small daily steps like these can make a real difference.
- Keep a simple daily routine with regular meals and sleep
- Do some physical activity every day, even a short walk
- Stay connected with family and friends; do not isolate yourself
- Set small, achievable goals each day
- Avoid alcohol and drugs, which worsen mood
- Take medicines exactly as prescribed and attend follow-ups
When to see a doctor for depression
See a doctor if low mood or loss of interest lasts more than two weeks or affects daily life. If you have thoughts of suicide or self-harm, seek help immediately from a doctor, a hospital emergency department or a mental health helpline, such as the government's Tele-MANAS service on 14416, and tell someone you trust. A doctor or pharmacist can guide you to safe, effective treatment.
Medicines doctors commonly use
Only your doctor can decide which medicine, dose and combination is right for you.
- SSRIs such as sertraline, fluoxetine or escitalopramCommonly used antidepressants that improve mood over several weeks.Only on a doctor's prescription; do not stop suddenly.
- SNRIs such as venlafaxine or duloxetineAntidepressants also useful when depression comes with pain.Only on a doctor's prescription; BP may need checking.
- MirtazapineAn antidepressant that can also help sleep and appetite.Only on a doctor's prescription; may cause drowsiness and weight gain.
- Tricyclic antidepressants such as amitriptylineOlder antidepressants used in selected cases.Only on a doctor's prescription; can be dangerous in overdose and in heart disease.
See a doctor urgently if
- Get help urgently if you or someone else has thoughts of suicide, a plan or has made an attempt.
- See a doctor urgently if the person hears voices, has strange beliefs or is very confused.
- See a doctor urgently if a new mother has severe low mood or thoughts of harming herself or her baby.
- See a doctor soon if the person stops eating, drinking or caring for themselves.
- See a doctor soon if mood worsens or new agitation starts after beginning an antidepressant.
Tests that may help
This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.