Depression in Adults

Our approach to treating depression

Many different factors can cause depression, and unravelling the cause takes time, empathy and expertise. We have extensive experience in providing treatment for depression using a range of approaches, from medication to therapy. We also understand the importance of using other evidence-based approaches like psychoeducation (providing education and support for mental health problems) and lifestyle changes (such as nutrition or exercise).

‍We’re here to support you through this difficult time and will help match you with a specialist best suited to your needs. Together, we’ll create a treatment plan that’s tailored to you.
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What is depression?

Depression is a common mental health condition marked by ongoing feelings of sadness, hopelessness, and a loss of interest or enjoyment in daily activities. It can also bring physical symptoms, such as changes in sleep, appetite, and energy levels, impacting your ability to manage day-to-day life. Depression often requires support through therapy, medication, or a combination of both. At London Psychiatry Clinic, we offer tailored treatments to help manage and overcome depression.

What are the symptoms of depression?

• Persistent feelings of sadness, low mood, or tearfulness
• Experiencing irritability, restlessness, or a sense of agitation
• Feelings of worthlessness
• Feeling emotionally numb or empty
• Struggling to connect with others, leading to feelings of isolation
• Losing interest or joy in activities usually found pleasurable
• Frequent frustration or anger, even over minor things
• A sense of detachment or unreality
• Lack of self-confidence or self-esteem
• Hopelessness or a sense of despair
• Constant fatigue or low energy
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What does depression feel like? 

Many people wonder if they’re experiencing depression, especially if they don’t feel consistently sad or down. Depression can show up in various ways that are not always obvious. You, or someone you know, might have lost interest in activities that used to bring joy or feel a lingering sense of flatness, a symptom known as anhedonia. Perhaps there’s been difficulty focusing, making decisions, or a persistent feeling of guilt, hopelessness, or unusually low self-esteem that wasn’t there before. Sometimes, it may just be a vague, uneasy feeling that something isn’t quite right. Any of these feelings can be signs of depression.
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Physical Symptoms of Depression

Many people don’t realise that depression can impact the body as much as the mind. Some of the physical symptoms of depression can include:

Disrupted sleep patterns:

• Difficulty falling asleep or staying asleep
• Excessive sleep or feeling the need to sleep more than usual

Changes in appetite and weight:

• Loss of appetite, leading to unintentional weight loss
• Increased hunger, possibly resulting in weight gain

Persistent fatigue:

• Constant tiredness, with a feeling of heaviness in the arms and legs
• Restlessness or feeling unusually fidgety

Decreased interest in sex or other activities
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Depression often brings a unique combination of symptoms, which can vary over time. Symptoms may even ease for a while, only to return unexpectedly, making it challenging to identify the cause.

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Am I depressed?

If you've been feeling down, hopeless, or just not yourself, it’s natural to wonder if it might be depression. Depression doesn’t always look or feel the same for everyone. Some people lose interest in things they once loved; others notice changes in their sleep, appetite, or energy that they can’t quite explain. You might struggle to concentrate, or feel like even small tasks take extra effort.

Recognising these feelings can be difficult, and you don’t have to face them alone. Speaking with a professional can help you understand what you’re going through and explore ways to feel better. Our compassionate team at London Psychiatry Clinic is here to listen, help you make sense of your experiences, and provide the support and treatment you need to start feeling more like yourself again.

What is the best treatment for depression?

Every person experiences depression uniquely, with individual symptoms and circumstances shaping their experience. Effective treatment should be responsive to your personal nuances and align with your preferences and needs. Our approach focuses on understanding the underlying causes of your symptoms and working towards restoring a balanced, healthy mental and physical state.

We will design a personalised treatment plan for you that may combine any of the following evidence-based approaches:

• Psychoeducation – an approach that helps you better understand your symptoms, the nature of depression, and ways to manage it.
• Psychological therapy or talking therapies – including options like cognitive-behavioural therapy (CBT), psychoanalysis, mindfulness-based therapy and more.
• Lifestyle and Nutritional Support – guidance on diet, exercise, and sleep, which play a crucial role in mental health.
• Medication – including antidepressants and other medications, when appropriate, to manage symptoms effectively.
• Cutting-edge Treatments – ketamine therapy or ketogenic diet therapy are offered as an option for treatment-resistant depression under close medical supervision.

Therapy For Depression‍

At London Psychiatry Clinic, we offer a range of therapy options tailored to meet your unique needs. Whether you’re feeling persistently sad, low on motivation, or overwhelmed by hopelessness, therapy provides a safe and supportive space to explore and work through these feelings. 

Our options include structured approaches like Cognitive Behavioural Therapy (CBT) and other therapies that focus on understanding and processing emotions. Our aim is to equip you with tools to rebuild your confidence and strengthen your well-being. Therapy can not only ease your symptoms but also prepare you to manage life’s challenges more effectively.

If you’re ready to take the first step towards a brighter future, get in touch with our team today to discuss your options and book your initial session.

Cognitive Behavioural Therapy For Depression

Cognitive Behavioural Therapy (CBT) is an effective treatment for depression that helps you understand how thoughts, feelings, and behaviours are connected. In CBT, you’ll learn to identify unhelpful thought patterns and gradually replace them with healthier ways of thinking. This approach offers practical strategies to manage depressive symptoms and build resilience. 

CBT not only supports recovery in the present but also gives you lifelong tools to handle difficult thoughts, reducing the chance of future depressive episodes and supporting long-term emotional health.

Online therapy for depression 

We understand therapy can be daunting for some, which is why we offer online therapy so you can speak to our experts in the comfort of your own home. Our online therapy services also mean that no matter where you are in the world, we can help you.

Therapy for depression and anxiety 

Depression and anxiety often go hand in hand, with each condition making the other feel more intense and difficult to manage. We understand the complex interplay between these conditions and offer tailored therapy designed to address both at the same time. 

Our approach combines techniques from several types of therapy, mindfulness practices, and lifetsyle changes. This blend of methods helps you understand how these conditions interact and teaches practical ways to manage your symptoms. For example, you might learn techniques to reduce anxious thoughts, build routines that improve mood, and practice relaxation exercises to ease tension. With our compassionate support, you can work towards a life free from the weight of depression and anxiety.

Do I need therapy?

If you’re struggling with depression, therapy can be a valuable way to find support and relief. It offers a safe space to explore your feelings, understand what may be contributing to your depression, and learn helpful coping strategies.

At London Psychiatry Clinic, we provide therapy options tailored to your needs, offering compassionate and personalised support. The effectiveness of therapy can vary depending on factors like the severity of your symptoms, how long you’ve had them, and any other challenges you may be facing. Some people feel better after a few sessions, while others may benefit from longer-term support.

A strong, trusting relationship with your therapist is also essential. Research shows that feeling supported and understood by your therapist is a key factor in predicting how well therapy works. That’s why we take care to match you with a specialist who fits your needs, helping you feel comfortable and supported from your first session.

Medication for depression

Antidepressants are often prescribed to help treat depression by balancing certain chemicals in the brain. There are different types of antidepressants, including SSRIs and SNRIs, which are usually the first options. Other types, like mood stabilisers or ketamine therapy, may also be helpful, depending on your needs.

At London Psychiatry Clinic, our clinicians work with you to understand your symptoms and see if medication might be a good option. If medication is recommended, we’ll guide you through each option and support you in finding the right fit for your mental health. It can take time to find the most effective medication and dose, so your psychiatrist will monitor and adjust your treatment as needed.

If you decide to try an antidepressant, we follow UK guidelines, which recommend starting with SSRIs before trying other types. This careful approach helps ensure you receive the safest and most effective treatment. Get in touch today to take the first step toward tailored care and expert guidance.

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What are the different types of depression?

Depression is a complex condition with a variety of forms, each with its unique symptoms and causes. Diagnostic labels can help understand symptoms, but we recognise that each person has their own combination of experiences, life circumstances, and personality. Our approach is to treat you as an individual, creating a treatment plan that meets your specific needs.

Research shows that different types of depression may respond better to particular therapies or medications, which is why we conduct a comprehensive assessment to fully understand your symptoms. Some people have symptoms that don’t fit neatly into any one category, and that’s okay. 

Below are some of the main types of depression:
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Reactive Depression

‍Reactive depression is triggered by a specific event or series of events, such as the loss of a loved one, a breakup, or a major life change. It is a natural response to difficult circumstances, but when the sadness becomes prolonged or overwhelming, professional support can help you process your feelings and regain emotional balance.

Clinical Depression

‍Clinical depression, also known as major depressive disorder, is a more severe and persistent form of depression that affects daily functioning. It can lead to intense feelings of sadness, low energy, and a loss of interest in life. Treatment often involves a combination of therapy and, where appropriate, medication to provide relief and promote recovery.

Atypical Depression

‍Atypical depression presents with symptoms that differ from more traditional forms, such as increased appetite, excessive sleeping, or a heightened sensitivity to rejection. Despite its name, it is a common and treatable form of depression. Therapy and medication tailored to these unique symptoms can help significantly.

Chronic Depression

‍Chronic depression, or dysthymia, is a long-lasting form of depression where symptoms persist for years, often at a lower intensity. While it may not feel as overwhelming as other forms, its ongoing nature can take a toll on emotional well-being. Consistent therapy and support are key to managing and improving symptoms over time.

Postnatal Depression

‍Postnatal depression occurs after childbirth and can affect both mothers and, in some cases, fathers. It goes beyond the “baby blues” and can involve feelings of sadness, anxiety, or disconnection from your baby. Early intervention with therapy, support groups, and sometimes medication can make a profound difference in recovery.

Postnatal depression can be caused by hormonal or biological changes after pregnancy, stress associated with the pregnancy or birth, or stress associated with parenthood. 

Getting help for postnatal depression is important as dealing with depressive symptoms could prevent you from bonding with your child. 

If you are experiencing post natal depression, you are not alone. Our experts are here to help. Get in touch today.

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Depression and psychosis

Depression with psychotic features, or psychotic depression, is a form of depression that is also accompanied by hallucinations or delusions. 

Approximately 20% of people with depression will experience some psychotic symptoms. These symptoms could be related to common depression symptoms, such as hallucinations or delusions related to feelings of guilt, worthlessness, detachment or suicidality. Occasionally, the psychotic symptoms can even be completely unrelated to the depressive symptoms. 

Getting help for depression with psychotic features is crucial, as it can be extremely distressing and increase the risk of suicide.

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What is Treatment-resistant depression (TRD)?

Some of our patients feel apprehensive when they hear the term ‘treatment-resistant depression' because they think it means that their depressive symptoms can't be treated. However, treatment-resistant depression (also known as refractory depression) actually refers to depressive symptoms that don't improve after initial treatment, ie taking one course of antidepressants or trying one type of therapy. 

There is always help available for depression.

Treatment-resistant depression is far more common than people might think, as it can be challenging to choose the best treatment for such a complex illness the first time around. Often, GPs will prescribe a standard serotonin antidepressant (such as citalopram or sertraline) to someone who experiences depression for the first time. Approximately 50% of people with depression will notice an improvement in their symptoms after 6-8 weeks.

Our psychiatrists have successfully treated many patients with treatment-resistant depression, by taking the time to understand the previous history and circumstances leading to these symptoms. It is also important to rule out what hasn't worked so far. Treatment plans are formulated using a wide variety of evidence-based approaches that might involve incorporating therapy or switching to a different type of antidepressant (which works on alternate neurotransmitters and receptors). 

Sometimes we find that depressive symptoms can improve after adjusting the nutritional content of our patients' diets or after implementing an exercise plan or other lifestyle changes. In some cases, long-standing symptoms of depression can be related to previously undiagnosed ADHD, and these symptoms of depression often improve once the ADHD is treated.

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What causes depression?

Depression is complex and usually results from a mix of causes. Genetics, brain chemistry, life experiences, and environmental influences can all play a role. Some people are more vulnerable due to biology, while others may develop symptoms after a difficult experience or prolonged stress. Understanding these factors can help in finding the right support and treatment.

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Biological causes of depression

Imbalances in brain chemicals, such as serotonin, dopamine, and norepinephrine, can affect your mood and emotions. Antidepressants work to correct these imbalances, but different medications target different chemicals. This is why one type of medication may work better for some people than others. For example, medicines like fluoxetine (Prozac) target serotonin and may work best for those with a serotonin imbalance. Although we don’t yet know why these imbalances happen, adjusting these chemicals can help relieve symptoms for many people.

Is depression genetic?

Depression has a genetic component, meaning it can run in families. If someone in your family has experienced depression, your risk of developing it may be higher due to shared genes. However, genetics are just one part of the picture. 

Research suggests that about 40-50% of the risk for depression comes from genetics, while 50% comes from other influences like your environment, experiences, and lifestyle. This means depression is usually caused by a mix of both inherited traits and life circumstances.
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Can inflammation cause depression?

Inflammation, the body’s natural response to stress or illness, has been linked to depression. About 30% of people with depression show higher levels of inflammation, which can cause symptoms like fatigue, brain fog, changes in appetite, and social withdrawal. Chronic stress, common in today’s world, can mimic this response and lead to long-term inflammation, potentially increasing the risk of depression.

Certain health conditions, such as diabetes, heart disease, and autoimmune disorders, can also raise inflammation levels, which helps explain why these conditions are often connected to depression. Lifestyle changes like eating a healthy diet, exercising regularly, and getting good sleep can help lower inflammation and improve both physical and mental health.

It’s important to remember that not all depression involves inflammation, but adopting healthier habits can still support your overall well-being. Always consult a healthcare professional to ensure you get the right care for your specific needs.

Watch this video for more information: Explaining 'The Inflamed Mind: a radical new approach to depression’

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Environmental and social factors

Traumatic events or major life changes can trigger depression. This can include major accidents or illnesses, loss of employment or death of a loved one. 

Some people recover in a matter of weeks from these events, while others may go on to develop depression as a result. This is because the traumatic event or major life change triggers a stress response, which can disrupt biological mechanisms (neurotransmitters, cortisol, inflammatory processes) that control mood and behaviour.

Low levels of continuous stress can also trigger a biological stress response in the same way. As chronic stress seems less severe and is ongoing, people don’t always take it as seriously as a major life event. Examples of this could include burnout from work, a breakup with a partner, issues at home or chronic illness.

Lifestyle interventions for depression

Simple lifestyle changes can have an undeniable effect on your mental health. While it’s great to take proactive steps, it’s important to do so with guidance from a professional, like a dietitian or nutritionist, to ensure you’re making safe and effective choices. There’s a lot of misinformation out there about diets and depression, so having expert support is key.

These lifestyle changes are generally low risk, but it’s always a good idea to work with a healthcare professional to ensure they’re safe and suited to your needs.
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Exercise for depression‍

Exercise is a powerful tool in managing depression, offering both physical and mental health benefits. Regular physical activity helps to release endorphins, the body’s natural mood elevators, which can reduce feelings of sadness and anxiety. Exercise also improves sleep, boosts energy levels, and enhances self-esteem, all of which can be impacted by depression. 

Whether it’s a gentle walk, yoga, or a more vigorous workout, incorporating movement into your routine can provide a sense of accomplishment and act as a positive coping mechanism. Our specialists encourage holistic approaches like exercise alongside therapy and other treatments to support your overall well-being.

 - You may find this interview helpful: How Exercise Changes Your Brain and Reduces Your Risk of Depression with Dr Rangan Chatterjee and Brendon Stubbs.

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Diet for depression

One of the best-studied diets for improving depressive symptoms is the Mediterranean diet. It focuses on healthy, whole foods like fruits, vegetables, nuts, whole grains, and olive oil. It’s not only shown to help with mood but is also one of the easiest and most enjoyable diets to stick to. This makes it a great starting point for many people.

Recent research suggests the ketogenic diet may help with more severe or treatment-resistant depression. It’s high in healthy fats and very low in carbohydrates, which may influence brain chemistry and energy levels. New research suggests it could be effective in some cases, but evidence is still limited. This diet is more restrictive and harder to maintain, so professionals usually recommend it when other approaches haven’t worked. For more about the ketogenic diet and mental health, visit our KetoMind page.

If you’re thinking about changing your diet, always work with a dietitian or nutritionist. They can ensure your plan is safe, sustainable, and meets your needs. 

Can nutritional interventions improve depression?

Depression has been associated with a host of nutritional deficiencies and imbalances. Some  of these include: 

• Iron, Vitamin D, Vitamin B12 and magnesium deficiency 
• Imbalance in Omega 3 and Omega 6
• Thyroid issues related to diet
• Hormonal imbalances or menopause exacerbated by poor diet (link to women’s health page)
• Imbalanced gut microbiome (ideally link to a blog article on this)

Probiotics and supplements can be helpful, but only after you have undergone the necessary testing to identify deficiencies.

At the London Psychiatry Clinic, our diet and lifestyle specialists are here to help you explore how tailored changes can support your mental health. Get in touch today to start your journey towards a healthier mind and body.

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Meditation and mindfulness for depression

Meditation and mindfulness practices can be powerful tools for managing depression. By fostering greater awareness of the present moment and reducing negative thought patterns, these techniques help to calm the mind and build resilience. Incorporating mindfulness into your routine can enhance emotional well-being and complement other treatments.

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Art therapy for depression

Art therapy provides a creative outlet to explore and express emotions that may feel difficult to put into words. Through drawing, painting, or other artistic mediums, this therapeutic approach helps to reduce stress, improve self-awareness, and foster healing in a safe and supportive environment.

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Should I see a psychiatrist, a psychologist or a therapist for depression?

You can choose if you’d prefer to see a psychiatrist or a psychologist (or therapist), or both. It is not uncommon for people to have support from both of these specialists, since they offer unique treatments and benefits as a result of their specific training. 

• A psychiatrist is a medical doctor who can prescribe medication and other medical treatments for depression, as well as referrals to psychologists if needed.
  
  
• A psychologist or therapist is someone with extensive training in mental health. They use talking therapy approaches such as cognitive-behavioural therapy, but they don’t prescribe medication.
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Get in touch with our team today to discuss your options and book your initial session.