Depression: what it is, how it presents, and how it's treated

Some days, getting out of bed feels like the hardest thing you'll do. Nothing brings pleasure the way it once did. You feel tired even after sleeping. Your thoughts are heavy, slow, full of doubt about yourself.

If this sounds familiar, you are not "weak" and you do not lack willpower. Depression is a clinical condition — with a neurobiological basis, recognised symptoms, and effective treatments.

And most importantly: it is treatable.

What depression is — and what it is not

First: depression is not sadness. Sadness is a normal human response to loss or difficulty, and it passes. Depression persists.

Depression is also not a "bad mood" that can be fixed with positive thinking or a holiday. It is a disorder that changes the way the brain processes emotions, reward, and energy.

Clinically, we speak of Major Depressive Disorder (MDD) when symptoms:

• Persist for at least two weeks
• Interfere with work, relationships, or daily life
• Are not explained by a physical illness or substance use

How it presents — the symptoms

Depression does not always show. Many people function outwardly while struggling internally. Symptoms can be:

Emotional

• Persistent sadness, emptiness, or numbness
• Loss of interest or pleasure in activities once enjoyed (anhedonia)
• Anxiety, irritability, or a sense of restlessness
• Feelings of worthlessness, guilt, or excessive self-criticism

Cognitive

• Difficulty concentrating, making decisions, or remembering things
• Slow, "foggy" thinking
• Negative automatic thoughts ("I'm worthless", "nothing will ever change")
• In severe cases: thoughts of death or suicide

Physical

• Fatigue and lack of energy, even after rest
• Sleep disturbances — oversleeping or insomnia
• Changes in appetite and weight
• Unexplained physical pain (headaches, muscle aches)
• Slowed movement or speech (in severe episodes)

Types of depression

There is more than one form. The main types:

Major Depressive Disorder (MDD): The "classic" depressive episode — intense, impairing, and time-limited. May occur once or recurrently across a lifetime.

Persistent Depressive Disorder (Dysthymia): Less intense but chronic — lasting at least two years. Often goes unnoticed because the person has "got used to" feeling this way.

Seasonal Affective Disorder (SAD): Typically emerges in autumn/winter and is linked to reduced exposure to natural light.

Perinatal Depression: Occurs during or after pregnancy. Affects around 1 in 5 women — and is not the same as "baby blues".

Causes — why depression develops

Depression has no single cause. It results from an interaction of:

Biological factors: Genetic predisposition, neurotransmitter imbalances (serotonin, norepinephrine, dopamine), hormonal shifts (especially in women), chronic physical illness.

Psychological factors: Traumatic childhood experiences, schemas of low self-worth, negative cognitive patterns (all-or-nothing thinking, self-criticism, difficulty registering positive experiences).

Social factors: Loss (of a person, job, or relationship), social isolation, chronic stress, financial pressure, lack of a supportive environment.

When to seek help

Seek help if you recognise yourself in at least five of the following, for more than two weeks:

• You feel sad, empty, or hopeless almost every day
• You have lost interest in activities you used to enjoy
• You have trouble sleeping, or you sleep excessively
• You feel exhausted even after rest
• You notice significant changes in appetite or weight
• You struggle to concentrate at work or to make everyday decisions
• You feel worthless, guilty, or like a burden to others

Treatment — what works

Depression is one of the most treatable mental health conditions. The main approaches:

Cognitive Behavioural Therapy (CBT)

CBT is the most evidence-based treatment for depression. It focuses on the link between thoughts, feelings, and behaviours: identifying the negative cognitive patterns that maintain depression ("I'm worthless", "things will never change") and replacing them with more balanced perspectives.

It also includes behavioural activation — gradually re-engaging with activities that provide meaning or pleasure, even when you don't feel like it.

Duration: typically 12–20 sessions.

Interpersonal Therapy (IPT)

Focuses on relationships and roles: how loss, role transitions, or conflicts fuel depression. Particularly effective for perinatal depression and grief-related depression.

Medication

Antidepressants (SSRIs, SNRIs) do not "change your personality" — they rebalance brain chemistry so that therapy can take effect. They typically take 3–6 weeks to show results. Always prescribed and monitored by a psychiatrist.

Combined treatment

For moderate-to-severe depression, combining therapy with medication consistently outperforms either alone.

Find a therapist for depression in Greece

The first step is often the hardest — but it is also the most important.

On AyloCare find you can:

• Search for psychologists specialised in depression
• Filter by therapeutic approach (CBT, IPT, Psychodynamic)
• Choose online or in-person sessions (Athens, Thessaloniki, and more)
• See real availability and fees

No referral needed. No need to "justify" why you are looking for help.

This article is for informational purposes only and does not replace professional psychological or medical assessment. If you are experiencing a mental health crisis, call 10306 (Suicide Prevention Line, 24/7).