Is it depression or just low mood? Signs, and what helps

Some days you wake up heavy. Chai tastes of nothing. Work feels like pushing a stone uphill, and people around you say, 'Just think positive.' If this has been going on for weeks, it may not be a mood that will pass on its own. It may be depression, which is a health condition and not a character flaw.

This article explains what depression is, how it differs from ordinary sadness, what helps, and when to reach out. It cannot tell you whether you have depression. Only a qualified professional, such as a psychiatrist or clinical psychologist, can do that after speaking with you.

What depression is

The World Health Organization describes depression as a common mental disorder marked by a low mood or loss of pleasure or interest in activities for long periods. It can affect relationships, study and work. The WHO estimates that about 5% of adults worldwide (5.2% in 2023) live with depression.

Depression is different from ordinary mood swings. Everyone feels sad, nervous or flat at times. These feelings usually pass, often when the situation changes. Depression is more severe and lasts longer, and it gets in the way of sleep, eating, work and daily life (NIMH).

What it can feel like

Commonly used criteria, described by the WHO, NIMH and the American Psychiatric Association, look for a low mood or a loss of interest or pleasure, present most of the day, nearly every day, for at least two weeks (the APA says more than two weeks). Other signs usually come along with it:

• Feeling worthless, or guilty about things that are not your fault
• Trouble concentrating, remembering or making small decisions
• Sleeping too little or too much, or changes in appetite or weight
• Low energy, or feeling slowed down
• Hopelessness about the future
• Pulling away from friends, family and things you used to enjoy

Depression does not always look like crying. NIMH notes that it can also show up as irritability, restlessness, unexplained aches and pains, or digestive problems. The NHS adds that you are unlikely to have every symptom. People often describe mostly the body: 'I am just tired' or 'my head hurts all the time.'

Depression versus sadness

Sadness is a natural response to a loss, a failure or a hard week. It tends to come and go, and you can still enjoy some things. The NHS says low mood may lift after a short time, so a brief dip is not necessarily depression.

With depression, the heaviness stays. Good news does not reach you. You may lose interest in things that used to matter, and everyday tasks feel too big. A clear change in how you manage work, relationships or hobbies is one of the signals professionals look for (APA). Grief and depression can overlap, but they are not the same thing, and a professional can help you tell them apart.

Why it happens

There is rarely one cause. Depression can follow a stressful time, a loss, long-term illness, loneliness, money worries or overwork. It can also appear when life looks fine from outside. Doctors check for physical causes too, because some medical problems can look like depression (APA). So if you are feeling this way, a check-up is a sensible first step.

A cycle that keeps it going

Low mood makes us do less. We cancel plans, skip walks and stop doing small things that used to feel good. With fewer rewarding moments in the day, mood drops further. This is why waiting to 'feel like it' often does not work.

What helps

Talking therapies

The WHO lists psychological treatment as the first-line approach to depression. The therapies with good evidence include behavioural activation, cognitive behavioural therapy (CBT), interpersonal therapy and problem-solving therapy. CBT works on unhelpful thoughts and habits. Interpersonal therapy focuses on relationships and life events (NIMH). Behavioural activation links what you do to how you feel, and builds in small, practical changes (NHS).

There is Indian evidence too. In a randomised trial in Goa published in The Lancet in 2017, 495 adults with moderately severe to severe depression got usual care, with or without the Healthy Activity Program, a brief psychological treatment delivered by trained lay counsellors. At three months, 64% of those who received the program (147 of 230 assessed) had a depression score below 10 on a standard questionnaire (PHQ-9), compared with 39% (91 of 236) with usual care alone.

Looking at painful thoughts

Depression often brings harsh thoughts: 'I am useless', 'nothing will change.' CBT teaches you to notice such thoughts and test them against the evidence, instead of accepting them as fact. Many people find that writing a thought down makes it easier to question.

Medicine

Antidepressant medicines exist, and a psychiatrist or doctor can decide whether they suit you. The WHO says they are not needed for mild depression but can be combined with talking therapy for moderate and severe depression. The NHS says they are not addictive, that side effects vary between types, and that symptoms should start to improve within about four weeks. The APA notes that full benefit may not be seen for two to three months. Any decision to start, change or stop a medicine should be made with your prescriber, never alone.

Looking after the basics

The WHO suggests staying connected with people, keeping regular eating and sleeping routines, and being active, even if it is only a short walk. Alcohol and drugs can make depression worse. These steps support treatment. They do not replace it when depression is moderate or severe.

Myths and the Indian context

• Myth: 'It is just weakness or lack of willpower.' Depression is a health condition. Telling yourself to try harder does not treat it.
• Myth: 'You have a good job and a family, so you cannot be depressed.' Depression can affect anyone, including people who seem to have everything (APA).
• Myth: 'Therapy is only for people who are very ill.' The WHO lists psychological treatment as the first treatment for depression, and the NHS describes talking therapies for depression generally, not only for the most severe cases.
• Myth: 'Taking medicine means you will be dependent forever.' The NHS says antidepressants are not addictive, though stopping suddenly can cause withdrawal symptoms, so any change should be planned with your doctor.

Many Indian adults carry the weight of family expectations, long work hours, job insecurity, caring for elders, or life far from home after a move to a new city. When we feel 'log kya kahenge', it is easy to hide how we feel. In a small study of 50 people treated for depression at a tertiary hospital in India (Int J Soc Psychiatry, 2022), 70% reported having concealed their mental health problem. A 2021 review in the Asian Journal of Psychiatry notes that stigma delays help-seeking in low- and middle-income countries.

Reaching out is a sign of care for yourself and your family, not a failure. Tele MANAS (14416) is free and open day and night. If you live in India, our article on therapy in India explains how to find a professional.