Depression: signs, causes and finding support

What is depression?

Depression is a persistent low mood, or a loss of interest and pleasure in things you used to enjoy, that lasts for at least two weeks and affects how you think, sleep, eat and get through the day. It's different from an ordinary bad week: it doesn't lift when something nice happens, and it often comes with tiredness, guilt and a sense that nothing will change.

If you've only been feeling flat for a few days, read feeling low for no reason first. Many low patches lift with sleep, movement and a bit of connection. The NHS suggests that a low mood lasting more than about two weeks may be depression and is worth talking to a doctor about.

What are the signs of depression?

The most common signs are a low or empty mood and a loss of interest in things, most days, for two weeks or more. Other signs often come with them:

The free low mood self-check uses the PHQ-9, a nine-question checklist used by doctors worldwide, to show how much these signs have affected you over the last two weeks. It's private and takes three minutes. It isn't a diagnosis, but a score of 10 or more is a good reason to talk to someone.

Can you be depressed and still look fine?

Yes, and many people are. You can go to work, laugh at family dinners and post on Instagram while feeling hollow inside. People sometimes call this smiling depression or high-functioning depression. These aren't formal diagnoses, but they describe something real: the effort of looking fine is exhausting, and it can stop you asking for help because "I don't look depressed."

A related pattern is a low, grey mood that's present most days for years, mild enough that you keep functioning. Doctors call this persistent depressive disorder (once called dysthymia). People often think it's just their personality. If "I've always been a bit like this" sounds familiar, it's worth raising with a professional.

How common is depression in India?

Very common, and mostly unspoken. The World Health Organization's 2017 global estimates put the number of people in India living with depression at about 56 million, or 4.5% of the population. India's National Mental Health Survey 2015–16, run by NIMHANS across 12 states, found that around 1 in 20 adults had experienced depression, and that for every mental health condition apart from epilepsy, more than 60% of people who needed care weren't getting it.

In India, depression often shows up first in the body: tiredness, aches, headaches or stomach trouble that keep sending people to doctors for tests. Stigma ("log kya kahenge"), exam and job pressure, and family expectations make it harder to say "I'm not okay" out loud. Naming it is often the hardest step.

What causes depression?

There's rarely a single cause. Depression usually comes from a mix of things that add up:

• Life events: loss, a breakup, job trouble, money worries, moving away from family.
• Long-running stress: caregiving, a difficult workplace, conflict at home. See signs of burnout if work is the main weight.
• Health and body: long-term illness, thyroid problems, hormonal changes around pregnancy and childbirth, some medicines, alcohol.
• Sleep: poor sleep and depression feed each other.
• Family history and temperament: some people are more vulnerable, which is nobody's fault.
• Loneliness: being cut off from people who know you. Read feeling lonely.

What helps with depression day to day?

Small, regular actions help, even when they feel pointless at first. They don't replace professional help, but they support it, and they're backed by good research.

1. Plan small activities on purpose. Depression tells you to wait until you feel like it. Behavioural activation turns that around: schedule one small, meaningful thing each day and do it anyway. Ekers and colleagues' 2014 meta-analysis of 26 trials found this approach reduced depressive symptoms.
2. Move, a little. A 2023 overview of 97 systematic reviews (about 128,000 people) by Singh and colleagues found physical activity of every kind, including walking and yoga, improved depression symptoms. Ten minutes outside is a real start.
3. Protect your sleep. A 2021 meta-analysis of 65 trials found that improving sleep led to less depression, anxiety and rumination. Begin with a fixed wake-up time; the sleep guide has the rest.
4. Stay in touch with one person. Tell someone you trust how you've really been. One honest message counts.
5. Go easy on alcohol. It may numb things for an evening, but tends to make mood and sleep worse.

When should I see a professional?

See a doctor, psychiatrist or clinical psychologist if your low mood has lasted more than two weeks, if it's affecting work, study or relationships, or if self-help isn't making a difference. Professionals can offer psychological support such as CBT, and a psychiatrist can discuss whether medicine would help. If you don't know where to begin, Tele-MANAS (14416 or 1-800-891-4416) is free, confidential, runs 24×7 in many Indian languages, and can point you to services near you. The need help now page lists more options.

How Mentis fits in

Mentis is a daily wellness app, not a substitute for professional care. It can sit alongside that care: a two-minute check-in with Mimi each day shows your mood as weather, and after a few days Mimi points out patterns, such as short nights showing up as rainy mornings. That record can make it easier to explain to a doctor how the last few weeks have really been. See how mood tracking works, or read this in Hindi: depression ke lakshan.