Mental Health disorders
DEPRESSION - When life starts feeling heavier than it used to.
By Rupali Sharma
Clinical Psycholgist
Depression is more than feeling sad. It can affect the way you experience yourself, other people, everyday activities, and the future. Sometimes it looks like sadness. Sometimes it looks like exhaustion, irritability, withdrawal, numbness, or simply losing interest in things that once mattered.
What is depression?
Depression can involve persistent changes in mood, interest, energy, and everyday functioning. Common experiences include low mood, losing pleasure or interest in activities, reduced energy, difficulty concentrating, changes in sleep or appetite, feelings of guilt or worthlessness, and a pessimistic view of the future.
It doesn't look exactly the same for everyone. In some people, anxiety, distress, agitation, irritability, or withdrawal may be more noticeable than sadness itself.
What might it look like?
MOOD
Feeling low, empty, hopeless, unusually irritable or emotionally overwhelmed.
INTEREST
Things that once felt meaningful or enjoyable may begin to feel flat or exhausting.
ENERGY
You may feel tired even after relatively little effort, with less motivation or activity. The ICD-10 description specifically identifies reduced energy and increased fatigability among the central depressive symptoms.
THOUGHTS
Concentration may become harder. You may become much more self-critical or experience guilt, worthlessness or pessimism about the future.
BODY
Sleep and appetite may change. Some people experience significant physical slowing or agitation.
CONNECTION
You may withdraw from people, struggle to communicate, or feel increasingly disconnected from those around you.
In more severe depression, thoughts of self-harm or suicide can occur and require immediate professional attention.
It's not always obvious.
Depression doesn't always look like someone crying or visibly struggling. A person may continue going to work, attending college, caring for their family, and appearing “fine” while internally feeling exhausted, disconnected, or unable to experience much pleasure. This is one reason depression can be difficult to recognise from the outside and sometimes even from within. Clinical severity isn't determined simply by whether someone can continue performing everyday roles; the ICD-10 specifically cautions that social and work functioning should not be treated as an essential measure of severity because individual and social circumstances can affect this relationship.
So when is it more than “just a bad phase”?
Feeling sad, tired, unmotivated or overwhelmed from time to time is part of being human. A depressive episode involves a particular combination, severity and persistence of symptoms. In the ICD-10 framework provided here, a depressive episode generally requires symptoms to persist for around two weeks, although clinical judgement is important, particularly when symptoms are unusually severe or rapidly developing. The classification describes mild, moderate and severe depressive episodes based on the number, type and severity of symptoms, rather than simply whether someone is “functioning” or not.
You might want to pause and check in.
For the past couple of weeks:
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Have I been feeling persistently low or emotionally heavy?
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Have I lost interest in things I normally enjoy?
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Am I more tired than usual?
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Have my sleep or appetite changed?
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Is it harder to concentrate or make decisions?
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Have I become much more self-critical?
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Am I feeling increasingly hopeless about the future?
Have I been withdrawing from people or things that matter to me?
You don't need to tick every box to deserve support.
This is important.
Sometimes the question isn't
“What's wrong with me?”
It's “What has been happening to me?”
Depression can emerge in the context of many different experiences.
Loss.
Relationship difficulties.
Long-term stress.
Trauma.
Loneliness.
Major life changes.
Unresolved emotional experiences.
And sometimes, there isn't an obvious reason at all.
Rather than searching for a single cause, therapy can help you understand the wider picture, what you're experiencing now, the patterns that may be keeping you stuck, and what might help things begin to change.
How can therapy help?
It can be a place to slow down.
To understand what you're experiencing.
To notice patterns you may have been surviving rather than choosing.
To explore difficult emotions without having to immediately fix them.
And, gradually, to develop different ways of responding to yourself, your relationships and your life.
UNDERSTAND
PROCESS
MOVE FORWARD
Make sense of your emotions, thoughts and patterns.
Create space for experiences that may have been difficult to acknowledge or work through.
Develop more sustainable ways of coping, relating and making choices.
Sometimes therapy isn't the only support you need.
For some people, psychological therapy may be appropriate on its own. For others particularly when symptoms are severe or significantly affecting everyday life it may be helpful to involve a psychiatrist or physician as part of care. The professionals also recommend seeking professional help and note that depression may warrant assessment by a mental-health professional, while also pointing out that physical or medical conditions can sometimes produce similar symptoms.
If you're experiencing thoughts of suicide or self-harm, please seek immediate professional or emergency support rather than trying to manage this alone. The ICD-10 material specifically identifies suicidal/self-harm thoughts as clinically important depressive symptoms and notes increased danger in particularly severe depression.
You don't have to arrive with everything figured out.
At Ataraxia, therapy is a space to understand, not judge what you're experiencing. We work collaboratively, paying attention not only to symptoms, but also to the emotional, relational and personal context in which they exist.
Sometimes that means understanding patterns that have developed over time.
Sometimes it means making space for emotions that have been pushed aside.
And sometimes it means simply having somewhere to put down the weight you've been carrying.
Don't wait until it gets worse.
You don't need a diagnosis.
You don't need the perfect words.
You don't even need to know whether therapy is what you need yet.
You can start with a conversation.
Note: This information is intended for psychoeducation and is not a substitute for clinical assessment or diagnosis. The symptoms described can occur in different mental-health and medical contexts. A qualified mental-health professional can help you understand your individual circumstances.
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