Severe depression: what to know

Severe depression is more than a short period of sadness. A person may lose interest or pleasure, feel persistently hopeless or guilty, struggle to concentrate, and find ordinary tasks overwhelming. Sleep may become difficult or excessive, with daytime sleepiness and fatigue adding to the burden. Feeling anxious or irritable can occur alongside low mood. Appetite, self-care, work, relationships, and decision-making may change. A diagnosis considers the pattern, duration, impact, medical history, medicines, and possible bipolar symptoms; one symptom alone cannot establish the cause.

Arrange an appointment with a mental health professional or primary-care clinician promptly. Tell them clearly how mood, sleep, concentration, appetite, and functioning have changed, and mention any thoughts of self-harm or feeling unable to stay safe. Treatment may combine talking therapy, medicine, practical support, and regular review. Choose one trusted person who can stay connected, help with food or appointments, and reduce access to anything you might use to hurt yourself. Keep routines small and achievable while waiting for care.

Get emergency help now if you are thinking about suicide, have made a plan, have taken an overdose, hear or see things others do not, are severely agitated or confused, or cannot care for basic needs. Do not stay alone in that situation; tell someone nearby and contact local emergency services or go to the nearest emergency department. Urgent assessment is also appropriate when symptoms suddenly worsen, sleep drops sharply with unusually high energy, or judgement becomes unsafe.

Ask which treatments fit your symptoms, how safety will be monitored, what side effects to watch for, how insomnia may be addressed, and when the next review should happen.