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Integrative mental health
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Mood

Depression

Also called Major depressive disorder, Clinical depression, Low mood

A persistent low mood and/or loss of interest or pleasure that affects how you feel, think, sleep and function.

Symptoms used to diagnose

The ruleAt least 5 of the 9 symptoms below, most of the day, nearly every day, for 2 weeks or more — and at least one must be a core symptom.

Core symptoms

  • Depressed mood (sad, empty, hopeless; irritable in young people)
  • Markedly less interest or pleasure in almost all activities

Other symptoms

  • Significant weight or appetite change
  • Sleeping much less or much more
  • Visibly slowed down or restless
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive guilt
  • Trouble thinking, concentrating or deciding
  • Recurrent thoughts of death or suicide

How diagnosis works

  • At least 5 of 9 symptoms nearly every day, including low mood or loss of interest/pleasure.
  • Other symptoms: sleep or appetite change, tiredness, slowed or restless movement, worthlessness or guilt, poor concentration, thoughts of death or suicide.
  • Causes real distress or difficulty functioning, and isn't better explained by substances, a medical condition or bipolar disorder.

A diagnosis is made by a qualified clinician after a full assessment — this summary is to help you understand it, not to self-diagnose.

Commonly used medications

Sertraline →Escitalopram →Citalopram →Fluoxetine →Venlafaxine →Duloxetine →Mirtazapine →Bupropion →Trazodone →Aripiprazole →Quetiapine →Lithium →

Therapies & support

  • CBT
  • Behavioural activation
  • Interpersonal therapy
  • Exercise programmes
  • Counselling

Good to know

  • NICE (2022) suggests guided self-help, group CBT or exercise first for less severe depression.

Sources

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    The Maudsley Deprescribing Guidelines

    Horowitz & Taylor, Wiley-Blackwell, 2024