This page explains what depression is, how it can show up in daily life, and what care involves. It is a general guide, not an assessment, and it cannot tell you what is happening in your own case.
If parts of it sound familiar, that is a reason to have the conversation with a clinician. It is not a reason to sit with it alone for another six months.
What Depression Actually Is
Depression is a medical condition that affects mood, energy, sleep, appetite, concentration, and the way a person sees themselves. It is among the most common reasons people see a psychiatrist.
It is not the same as sadness
Sadness usually has a subject, and it moves. Depression tends to sit underneath everything, including the things a person used to enjoy.
It is not a failure of character
People who are hardworking, capable and well loved develop it. So do people whose lives look, from the outside, entirely fine.
It usually has more than one cause
Biology
Biology plays a part, and it is part of why the condition responds to treatment.
What is happening in a life
Loss, strain at work, money, illness, a difficult relationship, a move away from family.
Long-standing patterns
People who learned early that their needs came last, or that mistakes were dangerous, often carry that forward in ways that make low mood harder to shift.
In India, depression often speaks through the body first
Many people see two or three physicians, and several rounds of tests, before anyone asks about mood. That is not a failing on anyone's part.
It is simply how the condition tends to present here, in the language of weakness, gas and tension rather than sadness.
Depression is not a lack of gratitude. Recognising what is good in your life and being unable to feel it are two different things, and the second one is treatable.
What It Can Feel Like Day To Day
Textbook lists tend to miss the texture of it. This is closer to how people describe it in the consulting room.
Mornings are the worst part.
You wake earlier than you want to, often before it is light, with a weight already sitting on your chest. The day has not started and you are already behind it. Things sometimes ease a little by evening.
Everything costs more than it should.
Replying to a message. Making a phone call. Getting into the shower. Each one is a small negotiation now, and the small things stack up faster than you can clear them.
The volume has gone down.
Food tastes like less. Music that used to move you passes through. You go to the thing you were looking forward to and feel oddly absent inside it. This flatness is often more distressing than the sadness.
The inner commentary turns hostile.
Every old mistake becomes available again, at three in the morning, in detail. You are not just low. You are also, apparently, the reason for it, which is exactly the kind of conclusion depression is good at manufacturing.
You start pulling away.
Calls go unanswered. Plans get postponed. It takes less effort to be alone, and being alone makes the whole thing louder. People read the withdrawal as coldness, which adds guilt on top.
The body is carrying it.
Appetite has changed in one direction or the other. Sleep is broken, or there is far too much of it and none of it restful. You feel physically heavy, and slower than you used to be.
None of these on its own means very much. It is the pattern, and how long it has been running, that matters.
Common Signs
These are the changes clinicians ask about. Most people notice some of them, not all.
- Low, empty or irritable mood present most of the day, most days
- Loss of interest or pleasure in things that usually matter to you
- Fatigue that rest does not seem to repair
- Waking very early and being unable to get back to sleep, or sleeping far more than usual
- Appetite change, with weight moving up or down without intending it
- Difficulty concentrating, reading, following a conversation or making ordinary decisions
- Feeling slowed down, or restless and unable to settle
- Guilt, self-blame, or a persistent sense of being a burden
- Hopelessness about whether things can change
- Irritability and a short fuse, which is often how it shows in men and in adolescents
- Reduced interest in sex or physical closeness
- Unexplained aches, gastric symptoms or headaches that investigations do not account for
- Thoughts that life is not worth living, or thoughts of harming yourself
The last item on that list is common in depression and it is treatable. It is a reason to speak to someone soon, not a reason to feel ashamed.
When It Is Time To Talk To Someone
The most useful question is not how bad it feels. It is how much of your life it is taking up.
It is worth an assessment when:
- The change has been there most days for two weeks or longer
- Work or study has slipped, and you are covering for it
- You are withdrawing from people you would normally want to see
- Basic self-care, eating, bathing, sleep, has become hard to keep up
- People close to you have started saying you seem different
- The things that used to help you get through no longer work
- You are using alcohol, cannabis or sleep medication to manage the feeling
You do not need to be certain before you book. Working out whether something needs treatment is part of what the appointment is for.
A psychiatric consultation does not commit anyone to medication. It commits you to a conversation, an assessment, and an explanation of what is going on. What happens after that is decided with you.
How Treatment Works
Depression is treatable. What treatment looks like depends on how severe it is, how long it has been running, and what fits your life.
Some presentations should not be left to settle on their own. Persistent low mood together with early-morning waking, a marked change in appetite, or thoughts of harming yourself deserves prompt professional attention rather than a wait-and-see approach.
Therapy
Talking therapy has good evidence in depression, and for mild to moderate presentations it is often the first thing to try.
Cognitive behavioural therapy
Works on the loop between thoughts, mood and behaviour, and on the particular thinking styles that keep low mood in place.
Behavioural activation
More practical than it sounds. It rebuilds activity in small graded steps, because waiting to feel motivated before acting tends to keep people stuck.
Schema Therapy
Goes further back, and suits people whose low mood sits on long-standing patterns formed early in life. It addresses the roots rather than the current episode alone.
Medication, when it is indicated
Antidepressants are considered in moderate to severe depression, where therapy alone has not been enough, or where symptoms are making it impossible to engage with therapy at all.
What they are not
They are not sedatives and they are not habit-forming in the way many people fear.
How long they take
Generally a few weeks to show a clear effect, which is worth knowing before you start.
Side effects
Discussed openly before a prescription is written, not discovered afterwards. Dose is reviewed. If a medicine is not suiting you, that is information, and the plan changes.
Stopping
Planned rather than abrupt, and a conversation rather than a discharge.
Combined care
For moderate to severe depression, medication and therapy together tend to work better than either alone. Medication can lift energy and concentration enough that therapy becomes possible.
The physical checks that come first
Thyroid problems, anaemia, vitamin deficiencies, sleep apnoea, chronic pain and heavy alcohol use can all produce something that looks like depression. A proper assessment considers them rather than assuming.
One clinician, one plan
At Weave, care is led by Dr. Niharika Reddy, consultant psychiatrist. Assessment, the plan and the reviews sit with one clinician, so you are not repeating your history to a new person each time.
Decisions are reviewed with you at intervals rather than set once. If something is not working, that is discussed and changed.
What A First Appointment At Weave Looks Like
The first session is 50 minutes. That length is deliberate, because a rushed history is a poor foundation for anything that follows.
What happens in it:
- A structured history. What has been happening, when it started, what was going on around that time, and how it has moved since.
- The wider picture. Sleep, appetite, energy, concentration, alcohol and substance use, medical history, medication, and what has helped before.
- Family and context. What the household, the work and the relationships around you look like, because those shape both the problem and the plan.
- An explanation. In plain language, what seems to be happening and why, with room for your questions.
- A plan you understand. What is being suggested, what the alternatives are, and what the next review will look at.
Fees
Listed openly on the services page, so you can see them before you book. Follow-up appointments are shorter than the first. If finances are tight, talk to us.
Where care happens
In person at Runwal Forests Clinic, Kanjurmarg West, Mumbai, and by video across India for people who cannot travel or prefer to start from home.
Booking
The simplest route is WhatsApp. You can ask a question first without committing to an appointment, and a reply comes within one working day.
If low mood is what brought you here, our mood and bipolar assessment page sets out what the appointment covers.
Free Guides You Can Read First
The Weave Family Library is free, needs no sign-up, and is written in plain language for people rather than for clinicians. Four of the books deal with low mood.
- When the low mood stays, for the person going through it
- Loving someone through low mood, for partners
- Your sibling and low mood, for brothers and sisters
- When someone you love has low mood, for anyone doing the caring
These links open the English editions. Each book is also available in Hindi, Hinglish, Marathi and Kannada, five languages in all, and every edition can be downloaded as a PDF.
If there are thoughts of self-harm or suicide, this needs attention today
Not next month, and not once things have settled down. These thoughts are common in depression, they are treatable, and there is no shame in picking up a phone.
- Immediate danger: call 112
- Tele-MANAS: 14416 or 1800-891-4416 (Government of India, 24 hours)
- Vandrevala Foundation: 9999 666 555 (24 hours)
- AASRA: 022 2754 6669 (24 hours)
- iCall: 9152987821 (Mon-Sat, 10am-8pm; hours may vary)
If it is someone you love rather than you, the same numbers are for you too. Ask directly. Asking about suicide does not put the idea into anyone's head.
Questions People Ask
Should I see a psychiatrist or a psychologist for low mood?
Both can help, and they do different work. A psychiatrist is a medical doctor who can assess the whole picture, including physical causes and medication when it is indicated. A psychologist or psychotherapist provides talking therapy, which is arranged as part of the same plan.
Will I be put on medication?
No, a consultation does not commit you to medication. The first appointment is an assessment, and its purpose is to understand what is happening. Medication is one option among several, discussed when it is clinically indicated and decided with you.
How long does treatment take?
That varies from person to person, and no honest timeline can be promised. Talking therapy is usually a course of sessions, reviewed as it goes. Medication generally takes some weeks to show a clear change, and is often continued after recovery to reduce relapse.
Can low mood be treated online?
In many cases, yes. Assessment for mood problems rests on a careful history and an unhurried conversation, which a video consultation supports well. Some situations need an in-person appointment or local medical care, and you will be told plainly if that applies.
What does a consultation cost?
Fees are listed openly on the services page, so you can see them before you book. A first session is 50 minutes, which allows time for a full history and an explanation you can follow. If finances are tight, talk to us.
Is low mood the same as depression?
Not quite. Low mood is something everyone experiences and usually lifts as circumstances change. Clinicians look for a change present most of the day, most days, for two weeks or longer, with shifts in sleep, appetite, energy, interest and concentration.