Feelings and thoughts
Little pleasure, guilt, low self-esteem, hopelessness and difficulty concentrating or making decisions. Thoughts of death can occur and deserve attention.
Mental health
Depression: symptoms, help and recovery
Gloomy, empty or no longer having fun? Read how depression is recognised, what help is available and what you can do today.
You do not have to determine for yourself whether you have depression. This page helps you organize symptoms and find appropriate help. You will find specific in-depth pages for treatment options and special forms.
Zorgfuik provides general information and does not make a diagnosis. Discuss personal symptoms, treatment and medication with a qualified healthcare provider.
Sources checked for . General information for adults; no self-test or personal treatment advice.
Depression symptoms: what can you notice?
Depression is more than just a few gloomy days. A sad or empty mood and/or clearly less interest and pleasure persists and affects daily life. Not everyone cries a lot: numbness, irritability or especially physical symptoms can also be noticeable.
Sleep and body
Poor or excessive sleep, changed appetite, fatigue and sluggishness or restlessness. Pain can be a factor, but should not be attributed to depression without assessment.
Functioning
Showering, cooking, working, studying or keeping in touch requires more effort. Sometimes it still works, even though there is nothing left at home.
When assessing a depressive episode, factors such as whether symptoms persist for at least two weeks, are present almost daily and have clear consequences. Severe symptoms or safety concerns are reasons to seek help sooner.
How is depression diagnosed?
The GP discusses symptoms, duration, circumstances and what is less successful. Sleep, physical health, medications, alcohol or drugs and previous episodes also count. A questionnaire supports the conversation; a score alone does not establish a diagnosis.
There is no blood test or scan that independently detects depression. However, research into another cause may be necessary if there are indications for this. Also talk about fear, trauma, grief or long-term stress. Such problems can coexist with depression.
An important question concerns previous periods with noticeably little sleep, a lot of energy or disinhibition. These can indicate bipolarity and change the treatment. Pregnancy, recent childbirth and psychotic experiences also deserve special attention.
The severity is not only derived from the number of symptoms. How much do you suffer from it, how safe are you and what support is there? You don't have to wait until you completely drop out to be taken seriously.
Which form or pattern may be relevant?
Compare types
One-off, recurring, long-term or with special characteristics: what do those terms mean?
View the overview →Long-term symptoms
About dysthymia, persistent depression, CBASP and a new look at previous treatment.
Read more →Winter depression
A recurring seasonal pattern, light therapy and practical tips for dark months.
Read more →Around childbirth
Pregnancy, postpartum period, treatment, medication and help for parent and baby.
Read more →Bipolar depression
Why periods of high energy and little sleep are important for the choice of treatment.
Read more →Psychotic features
Delusions or voices in depression require rapid specialist assessment.
Read more →Where do you start looking for help?
Usually make an appointment with your GP first. You can write down in advance what you notice, since when and what no longer works. If necessary, ask someone along. You don't have to have a convincing story or self-chosen diagnosis ready.
The GP or mental health practice assistant can provide guidance and assess together with you which care is appropriate. A psychologist or psychotherapist provides targeted psychological treatment. For complex or severe symptoms, a psychiatrist or specialized team may be necessary.
During a waiting period, ask who will continue to follow you. A referral is not the same as an agreement about bridging. Discuss when you will return and what to do if things deteriorate.
Thuisarts: help with depression. More about referral, treatment and who does what.
What helps with depression?
Guidance and activities
Explanation, feasible structure and regular contact can be part of the plan. Activities are tailored to what is now possible, not to an ideal daily schedule.
Psychotherapy
For example CBT, behavioural activation or IPT. You work specifically on patterns that maintain symptoms. The choice also depends on preference, previous experiences and expertise of the clinician.
Medication where appropriate
Antidepressants can help, but are not the first or only step for everyone. For more severe depression, a combination with psychotherapy is more often discussed.
Discuss in advance what change you want to notice, which disadvantages are important to you and when you will evaluate. If it does not help enough, the plan should be reconsidered. That is not the same as you not trying hard enough.
Dutch guideline: treatment sequence. Detailed explanation is available the treatment page, inclusive antidepressant groups and phase out.
What can you do yourself today?
Choose one small step: eat something, get dressed, go outside or ask someone to come over. You don't have to feel like it or feel pleasure right away. Make the step smaller if it is too big.
Regularity, appropriate exercise and contact can support, but do not replace necessary care. Don't use alcohol or drugs to alter mood or sleep. Take new or increasing symptoms seriously.
On the page with home exercises There are concrete examples of daily structure, activities, thoughts and calm breathing, including boundaries. You don't have to do them all.
How can you support someone with depression?
Listen without immediately demanding a solution. Ask what is difficult and offer concrete help: cooking together, making an appointment or going for a walk. “Let me know if there's anything I can do” can require a lot of initiative from someone who finds that difficult.
Avoid pressure to be positive or comparisons with people who would have it worse. At the same time, as a loved one, you can set boundaries and seek your own support. You don't have to bear treatment and safety alone.
Ask calmly about thoughts of death if you are concerned and seek professional help if you feel unsafe. Don't promise to keep dangerous plans secret.
Monitor recovery and discuss relapse
Recovery doesn't always happen in a straight line. In addition to mood, also look at sleep, initiative, contact and functioning. A better day is valuable, but not automatically a reason to stop treatment.
If depression recurs, a plan with early signals, support and contact agreements helps. Discuss residual symptoms and any medication changes. When tapering is appropriate, you make a plan together.
Questions for your clinician: what do we want to improve, how do we measure that, when do we look again and what is the next step if too little changes?
When to call for help immediately?
Contact your GP or out-of-hours GP service immediately if you have a mental health crisis, psychotic symptoms, serious self-neglect or plans to harm yourself. In case of rapid deterioration, do not wait for a scheduled appointment.
Frequently asked questions
How do I know if I have depression?
Persistent sadness or loss of pleasure can be an indication, especially if your daily life is suffering. A GP assesses duration, other symptoms, circumstances and safety. An online questionnaire does not make a diagnosis.
Should I wait two weeks before asking for help?
No. Two weeks plays a role in the assessment of a depressive episode, but in case of severe symptoms, rapid deterioration or safety concerns, you seek help sooner.
Can depression also cause physical symptoms?
Yes. Changes in sleep and appetite, fatigue, pain or restlessness may occur. Have new physical symptoms assessed; don't automatically attribute them to depression.
Can you be depressed and still keep working?
Yes. What works on the outside does not say everything about the effort or recovery it takes. Also explain what is no longer possible at home, in relationships or in self-care.
What helps with depression?
Guidance, feasible activities, psychotherapy and sometimes medication can be part of treatment. Seriousness, history and preference together determine which approach is suitable.
What do I do during a waiting list for treatment?
Ask the referrer who will monitor you while you wait and when you will be reviewed and who you will call if your condition worsens. A referral does not replace a clear interim care plan.
Where can I get immediate help?
In the event of a mental health crisis, call your GP or out-of-hours GP service and in case of immediate danger to your life, call 112. If you have thoughts of suicide, you can call 0800-0113 free of charge day and night or chat via 113.nl.
Sources