Question 1

What is depression?

Accepted Answer

Major depressive disorder (MDD) is characterised by at least two weeks of persistent low mood and/or loss of interest or pleasure (anhedonia), accompanied by at least four additional symptoms from: weight or appetite change, sleep disturbance, psychomotor agitation or retardation, fatigue, feelings of worthlessness or excessive guilt, poor concentration, and recurrent thoughts of death or suicidal ideation. Depression exists on a spectrum of severity (mild, moderate, severe) and may occur as a single episode or recurrently. It is highly comorbid with anxiety disorders, chronic physical illness, substance use, and chronic pain.

Question 2

What do people commonly experience with depression?

Accepted Answer

People describe a persistent heaviness — emotional flatness where nothing feels enjoyable, pleasurable, or meaningful. Energy is profoundly reduced; tasks that were once automatic require enormous effort. Sleep changes — either excessive or very disrupted. Self-critical thoughts become dominant and self-compassion inaccessible. Many feel shame about their depression and conceal it from others. Some describe physical pain — aching, heaviness, constriction in the chest — as the primary experience rather than sadness.

Question 3

What lifestyle changes can help with depression?

Accepted Answer

Aerobic exercise 3–5 times per week has the strongest lifestyle evidence for depression. Sleep regularity supports mood stabilisation. Social connection counters the withdrawal that deepens depression. Sunlight exposure (morning, minimum 30 minutes) supports circadian rhythm and serotonin modulation. Reducing alcohol is important — it deepens and prolongs depression. Behavioural activation — scheduling even small meaningful activities — breaks the inertia of depression.

Question 4

What integrative approaches support depression?

Accepted Answer

Evidence-based treatments include antidepressant pharmacotherapy (SSRIs first-line, SNRIs, tricyclics, mirtazapine), and psychological therapies — CBT, IPT, and behavioural activation — with comparable efficacy at moderate severity. Combination therapy is superior for moderate-severe depression. NICE guidelines recommend both approaches and suggest choice based on patient preference, severity, and prior treatment history. Electroconvulsive therapy (ECT) for severe, treatment-resistant, or psychotic depression. Exercise has consistent evidence for mild-moderate depression comparable to antidepressants. Aerobic exercise at least 3 times per week significantly reduces depressive symptoms.

Question 5

When should I seek professional support for depression?

Accepted Answer

Seek doctor or mental health assessment when symptoms persist for two weeks or more and impair daily functioning. Urgent assessment if suicidal ideation is present. Antidepressants and/or psychological therapy should be offered for moderate-severe depression. Digital wellbeing programmes and guided self-help are appropriate for mild presentations.

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