Low mood and depression
Persistent low mood needsa proper assessment.
Low mood can be part of depression. It can also occur with poor sleep, physical illness, medicines, stress or another mental-health problem. A safe assessment looks at how severe the symptoms are, how long they have lasted, how they affect daily life and whether there is any immediate risk.
When does low mood become depression?
Low mood is common. It can follow loss, illness, conflict or work pressure. Depression is more than a bad day. Clinicians ask how long symptoms have lasted and how severe they are. They also ask how much symptoms affect sleep, appetite, focus, work, relationships and daily tasks. NICE recommends assessing symptoms and their effect on functioning rather than relying on one symptom alone. [1]
Depression can cause persistent sadness, loss of interest, low energy, hopelessness, guilt and poor concentration. Sleep and appetite may change. Some people feel irritable rather than clearly sad. The clinician also checks whether medicines, alcohol, drugs, physical illness or another mental-health problem may be adding to the symptoms.
A screening form can support the conversation. It does not replace a clinical assessment. The aim is to understand the pattern, risk and treatment choices. A score on its own is not a diagnosis.
What should a medical assessment cover?
NICE advises clinicians to look beyond mood symptoms. This includes previous mental-health problems, past treatment, physical health, medicines, alcohol or drug use, sleep, activity, stressful events, work, debt, loneliness, relationships and support. [1] This wider view matters because several problems can cause similar symptoms. They can also make recovery harder.
A GP or other appropriate clinician may decide that physical assessment or blood tests are useful when the history suggests another contributor, such as anaemia or thyroid disease. Broad private panels are not automatically needed. The test should answer a defined question and have a clear next step if the result is normal or abnormal.
Tell the clinician about all prescribed medicines, over-the-counter products and supplements. Do not stop antidepressants or other prescribed medicines suddenly because mood changes; withdrawal and relapse can both be harmful, so medication changes need a safe plan.
What treatments may be discussed?
Treatment depends on how severe the depression is, what has helped before, personal preference and risk. NICE options include guided self-help, talking treatments and antidepressant medicines when they are appropriate. More severe or complex depression may need specialist mental-health care. [1]
Sleep, regular meals, physical activity, social contact and reducing harmful alcohol or drug use can support recovery. They should be framed as supportive measures, not as proof that depression is caused by lifestyle or can be treated by willpower.
If symptoms are linked to another condition, medicine or major social problem, the plan may also need to address that contributor. A useful treatment plan states who is responsible for follow-up and when the response will be reviewed.
How can sleep, stress and physical health affect mood?
Poor sleep can worsen concentration, irritability and coping, while depression and anxiety can themselves disturb sleep. The relationship can run in both directions. Persistent sleep problems may need their own assessment rather than being treated as only a symptom of depression.
Pain, menopause, long-term illness, disability, medication side effects and other physical concerns can affect mood and function. Recognising those links can improve the plan without implying that one hidden physical cause explains all depression.
Stressful events and social circumstances matter too. NICE specifically recommends asking about trauma, employment, debt, loneliness, living conditions and relationships because treatment works best when the real pressures around the person are visible. [1]
What should you record before an appointment?
A short note is enough. Record when the low mood began, whether it is present most days, what has changed in sleep or appetite, and which activities have become harder. Note previous episodes, previous treatments and what helped or caused problems.
Bring a current medicine and supplement list. Bring recent blood tests or clinic letters if they matter to the problem. Use the full report rather than one highlighted number. This helps the clinician see what has already been checked.
Also write down what you want help with now. One person may want to understand whether they are depressed; another may need treatment review, help with sleep or a route into talking therapy. A clear question makes the consultation more useful.
- Duration and pattern of low mood or loss of interest.
- Sleep, appetite, energy, concentration and daily function.
- Any thoughts of self-harm, suicide or feeling unable to stay safe.
- Current medicines, supplements, alcohol and recreational drugs.
- Previous mental-health treatment and response.
- Important physical symptoms or recent medical diagnoses.
When should low mood be reviewed rather than watched?
Seek medical review when low mood persists, keeps returning, affects work or relationships, or makes ordinary tasks difficult. Earlier review is sensible if symptoms are severe, there is marked anxiety, agitation, significant weight change, heavy alcohol or drug use, or a physical problem may be contributing.
If treatment has already started, contact the responsible clinician if symptoms worsen, side effects are difficult, or new suicidal thoughts appear. NICE advises monitoring mood, agitation, hopelessness and suicidal thinking, especially around treatment changes and periods of increased stress. [1]
A private consultation can support a planned review. It should not delay NHS or specialist mental-health care when that is the safer route.
What patients say about the consultation experience.
Patient reviews can describe the consultation experience. They do not establish that depression has a physical cause or prove that any particular treatment will work.
Individual reviews reflect personal experiences and do not predict diagnosis, treatment response or outcome.
“patient, understanding and kind”
Google reviewer
“warm and compassionate bedside manner”
Google reviewer
“takes incredible care to get to know her patients”
Google reviewer
Common questions
How long does low mood have to last before I seek help?
You do not need to wait for a fixed deadline if symptoms are severe or affecting daily life. If low mood persists, keeps returning or is making work, relationships, sleep or self-care difficult, arrange a clinical review. Seek urgent help immediately if you may harm yourself or cannot stay safe.
Can physical illness cause symptoms that feel like depression?
Yes. Physical illness, pain, medicines, sleep problems and other conditions can affect mood and energy. A clinician uses the history and examination to decide whether targeted physical assessment or tests are needed. This does not mean that every case of depression has a hidden physical cause.
Do I need blood tests for depression?
Not everyone does. Blood tests may be useful when the history suggests a physical contributor, such as anaemia or thyroid disease, or when another condition or medicine needs monitoring. The test should answer a clinical question rather than being ordered as a broad panel without a clear purpose.
Can exercise or diet treat depression on their own?
Physical activity, regular meals, sleep and social contact can support mental and physical health, but they are not substitutes for appropriate depression treatment when treatment is needed. NICE treatment options include psychological therapies and, for some people, antidepressant medicines or specialist care.
Should I stop antidepressants if I feel worse?
Do not stop an antidepressant suddenly without advice from the clinician responsible for it. Worsening mood, agitation or suicidal thoughts need prompt review, particularly after starting or changing treatment. If there is immediate danger or you cannot stay safe, use urgent mental-health or emergency services.
Where should I go if I am having suicidal thoughts?
If you or someone else is in immediate danger, call 999 or go to A&E. If you need urgent mental-health help but it is not an emergency, use NHS 111 and select the mental-health option where available. A routine private appointment is not the urgent route.
Medical sources and further reading
- NICE NG222: Depression in adults, treatment and management. Assessment, treatment and risk-management recommendations. Accessed 28 September 2026.
- NHS: Where to get urgent help for mental health. Current NHS urgent and emergency mental-health routes. Accessed 28 September 2026.
- NHS: Low mood, sadness and depression. Patient information on low mood and depression. Accessed 28 September 2026.
Start with safety, then build the plan around the whole picture.
Depression is treatable, but the right route depends on severity, risk, previous treatment, physical health and what matters to you.