What we are talking about
Depression typically involves depressed mood and/or a marked loss of interest and pleasure in activities over a prolonged period. It is often accompanied by changes in sleep and appetite, fatigue, difficulty concentrating and feelings of guilt or worthlessness.
Presentations differ widely — from mild and prolonged states to severe episodes — and appropriate intervention depends on that characterisation.
How it can show up
- · Depressed, empty or irritable mood for most of the day.
- · Loss of interest or pleasure in usual activities.
- · Persistent fatigue and slowing down.
- · Changes in sleep and appetite.
- · Difficulty concentrating, remembering and deciding.
- · Feelings of guilt, worthlessness or hopelessness.
- · Social withdrawal and reduced activity.
When it may make sense to seek support
When these signs persist for weeks, when they compromise usual functioning, or when thoughts of death or self-harm appear. In the latter case, support should be sought urgently.
How assessment is carried out
Through clinical interview, characterisation of the current and previous episodes, assessment of functional impact, risk and protective factors and — when indicated — validated psychometric instruments. Coordination with general practice or psychiatry is also considered.
What intervention may involve
- · Gradual, planned reactivation of meaningful activities.
- · Work on self-critical and hopeless thought patterns.
- · Regulation of sleep, routine and personal demands.
- · Understanding relational and contextual factors involved.
- · Relapse prevention.
- · Coordination with medical care when indicated.
What to expect from a first session
The first session is mainly about understanding the current situation: what brought you here, for how long, and how it is interfering with daily life. It is also a space to gather relevant history and context, clarify needs and expectations, and make an initial assessment of whether psychotherapy is a suitable response.
Next steps are defined together at the end. If psychotherapy is not the most appropriate answer, that is said clearly and alternatives are suggested.