Depression

Depression is not a character flaw and it is not something you can decide your way out of. It is a medical condition with a real effect on sleep, appetite, concentration, and the ability to feel pleasure, and it responds to treatment.

What it looks like varies more than most people expect. Some people cannot get out of bed. Others go to work every day, hit their deadlines, and feel nothing at all. Some people are not sad so much as flat, irritable, or exhausted in a way that sleep does not fix. In adolescents it often shows up as irritability and withdrawal rather than visible sadness, which is one reason it gets missed.

What treatment actually involves

The first appointment is a full evaluation of about 60 minutes. That means your history, what has been happening recently, what you have already tried, and what you want to be different. It also means ruling out physical contributors, because thyroid problems, anaemia, sleep disorders, and the side effects of other medication can all produce something that looks exactly like depression and does not respond to an antidepressant.

From there, treatment is built around what fits you. That might be medication, psychotherapy, or both. If medication is part of the plan, you will know what it is for, how long it takes to work, what side effects to watch for, and when we will review it.

If you are having thoughts of suicide

Thoughts of death or of not wanting to be here are a symptom, and they are more common in depression than most people realise. They are treatable and they are safe to say out loud in an appointment.

If you are in immediate danger, do not wait for an appointment. Call or text 988 to reach the Suicide & Crisis Lifeline, call 911, or go to your nearest emergency room. This practice does not provide emergency services.